The Efficacy of Intraoperative Neurophysiological Monitoring Using Transcranial Electrically Stimulated Muscle-evoked Potentials (TcE-MsEPs) for Predicting Postoperative Segmental Upper Extremity Motor Paresis After Cervical Laminoplasty.

PubMed

Fujiwara, Yasushi; Manabe, Hideki; Izumi, Bunichiro; Tanaka, Hiroyuki; Kawai, Kazumi; Tanaka, Nobuhiro

2016-05-01

Prospective study. To investigate the efficacy of transcranial electrically stimulated muscle-evoked potentials (TcE-MsEPs) for predicting postoperative segmental upper extremity palsy following cervical laminoplasty. Postoperative segmental upper extremity palsy, especially in the deltoid and biceps (so-called C5 palsy), is the most common complication following cervical laminoplasty. Some papers have reported that postoperative C5 palsy cannot be predicted by TcE-MsEPs, although others have reported that it can be predicted. This study included 160 consecutive cases that underwent open-door laminoplasty, and TcE-MsEP monitoring was performed in the biceps brachii, triceps brachii, abductor digiti minimi, tibialis anterior, and abductor hallucis. A >50% decrease in the wave amplitude was defined as an alarm point. According to the monitoring alarm, interventions were performed, which include steroid administration, foraminotomies, etc. Postoperative deltoid and biceps palsy occurred in 5 cases. Among the 155 cases without segmental upper extremity palsy, there were no monitoring alarms. Among the 5 deltoid and biceps palsy cases, 3 had significant wave amplitude decreases in the biceps during surgery, and palsy occurred when the patients awoke from anesthesia (acute type). In the other 2 cases in which the palsy occurred 2 days after the operation (delayed type), there were no significant wave decreases. In all of the cases, the palsy was completely resolved within 6 months. The majority of C5 palsies have been reported to occur several days after surgery, but some of them have been reported to occur immediately after surgery. Our results demonstrated that TcE-MsEPs can predict the acute type, whereas the delayed type cannot be predicted. A >50% wave amplitude decrease in the biceps is useful to predict acute-type segmental upper extremity palsy. Further examination about the interventions for monitoring alarm will be essential for preventing palsy.

Monitoring millimeter wave stray radiation during ECRH operation at ASDEX Upgrade

NASA Astrophysics Data System (ADS)

Schubert, M.; Honecker, F.; Monaco, F.; Schmid-Lorch, D.; Schütz, H.; Stober, J.; Wagner, D.

2012-09-01

Due to imperfection of the single path absorption, ECRH at ASDEX Upgrade (AUG) is always accompanied by stray radiation in the vacuum vessel. New ECRH scenarios with O2 and X3 heating schemes extend the operational space, but they have also the potential to increase the level of stray radiation. There are hazards for invessel components. Damage on electric cables has already been encountered. It is therefore necessary to monitor and control the ECRH with respect to the stray radiation level. At AUG a system of Sniffer antennas equipped with microwave detection diodes is installed. The system is part of the ECRH interlock circuit. We notice, however, that during plasma operation the variations of the Sniffer antenna signal are very large. In laboratory measurements we see variations of up to 20 dB in the directional sensitivity and we conclude that an interference pattern is formed inside the copper sphere of the antenna. When ECRH is in plasma operation at AUG, the plasma is acting as a phase and mode mixer for the millimeter waves and thus the interference pattern inside the sphere changes with the characteristic time of the plasma dynamics. In order to overcome the difficulty of a calibrated measurement of the average stray radiation level, we installed bolometer and pyroelectric detectors, which intrinsically average over interference structures due to their large active area. The bolometer provides a robust calibration but with moderate temporal resolution. The pyroelectric detector provides high sensitivity and a good temporal resolution, but it raises issues of possible signal drifts in long pulses.

Ecrh on Asdex Upgrade - System Extension, New Modes of Operation, Plasma Physics Results

NASA Astrophysics Data System (ADS)

Stober, J.; Wagner, D.; Giannone, L.; Leuterer, F.; Marascheck, M.; Mlynek, A.; Monaco, F.; Münich, M.; Poli, E.; Reich, M.; Schmid-Lorch, D.; Schütz, H.; Schweinzer, J.; Treutterer, W.; Zohm, H.; Meier, A.; Scherer, Th.; Flamm, J.; Thumm, M.; Höhnle, H.; Kasparek, W.; Stroth, U.; Chirkov, A. V.; Denisov, G. G.; Litvak, A.; Malygin, S. A.; Myasnikov, V. E.; Nichiporenko, V. O.; Popov, L. G.; Soluyanova, E. A.; Tai, E. M.

2011-02-01

The ECRH system at ASDEX Upgrade is currently extended from 1.6 MW to 5 MW. The extension so far consists of 2-frequency units, which use single diamond-disk vacuum-windows to transmit power at the natural resonances of these disks (105 & 140 GHz). For the last unit of this extension two additional intermediate non-resonant frequencies are foreseen, requiring new window concepts. For the torus a polarisation-independent double-disk window has been developed. For the gyrotron a grooved diamond disk is actually favoured, for which the grooved surfaces act as anti-reflective coating. Since ASDEX Upgrade operates with completely W-covered plasma facing components, central ECRH is often applied to suppresses W-accumulation in the plasma center. In order to extend the operational range for central ECRH, X3- and O2-heating schemes were developed. Both are characterized by incomplete single-path absorption. For X3 heating, the X2 resonance at the pedestal on the high field side is used as a 'beam-dump', for the O2 scheme a specific reflector tile on the inner heat shield enforces a second path through the plasma center. The geometry for NTM control had to be modified to allow simultaneous central heating. In real-time the ECRH position can be determined either by ray-tracing based on real-time equilibria and density profiles or from ECE for modulated ECRH power. Fast real-time ECE also allows to determine the NTM position. Further major physics applications of the system are summarized.

Estimation of Electron Bernstein Emission in the TJ-II Stellarator

NASA Astrophysics Data System (ADS)

García-Rega\\ Na, J. M.; Cappa, A.; Castejón, F.; Tereshchenko, M.

2009-05-01

In order to study experimentally the viability of first harmonic EBW heating in the TJ-II stellarator by means of the O-X-B tecnique [1], an EBE diagnostic was recently installed [2]. In the present work a theoretical estimation of the EBW radiation in the TJ-II plasmas have been carried out making use of the ray tracing code TRUBA [3]. The line of sight of the EBE diagnostic may be modified using an internal movable mirror and therefore, for comparison with the experimental results, the theoretical O-X-B emission window has been determined. Experimental density and temperature profiles obtained in NBI discharges are considered in the simulations.References:[1] F. Castejon et al, Nucl. Fusion 48, 075011 (2008).[2] J. Caughman et al, Proc. 15th Joint Workshop on ECE and ECRH, Yosemite, USA (2008).[3] M. A. Tereshchenko et. al, Proc. 30th EPS Conference on Contr. Fusion and Plasma Phys., 27A, P-1.18 (2003).

Study of energetic particle physics with advanced ECEI system on the HL-2A tokamak

NASA Astrophysics Data System (ADS)

Shi, Zhongbing; Jiang, Min; Yu, Liming; Chen, Wei; Shi, Peiwan; Zhong, Wulyu; Yang, Zengchen; Zhang, Boyu; Ji, Xiaoquan; Li, Yonggao; Zhou, Yan; Song, Shaodong; Huang, Mei; Song, Xianming; Li, Jiaxuan; Yuan, Baoshan; Fu, Bingzhong; Liu, Zetian; Ding, Xuantong; Xu, Yuhong; Yang, Qingwei; Duan, Xuru

2017-07-01

Understanding the physics of energetic particles (EP) is crucial for the burning plasmas in next generation fusion devices such as ITER. In this work, three types of internal kink modes (a saturated internal kink mode (SK), a resonant internal kink mode (RK), and a double e-fishbone) excited by energetic particles in the low density discharges during ECRH/ECCD heating have been studied by the newly developed 24(poloidal) × 16(radial) = 384 channel ECEI system on the HL-2A tokamak. The SK and RK rotate in the electron diamagnetic direction poloidally and are destabilized by the energetic trapped electrons. The SK is destabilized in the case of qmin > 1, while the RK is destabilized in the case of qmin < 1. The double e-fishbone, which has two m/n = 1/1 modes propagating in the opposite directions poloidally, has been observed during plasma current ramp-up with counter-ECCD. Strong thermal transfer and mode coupling between the two m/n = 1/1 modes have been studied.

Effect of Esophageal Cancer Surgeon Volume on Management and Mortality From Emergency Upper Gastrointestinal Conditions: Population-based Cohort Study.

PubMed

Markar, Sheraz R; Mackenzie, Hugh; Askari, Alan; Faiz, Omar; Hanna, George B

2017-11-01

To study the influence of esophageal cancer surgeon volume upon mortality from upper gastrointestinal emergencies. Volume-outcome relationships led to the centralization of esophageal cancer surgery. Hospital Episode Statistics data were used to identify patients admitted to hospitals within England (1997-2012). The influence of esophageal high-volume (HV) cancer surgeon status (≥5 resections per year) upon 30-day and 90-day mortality from esophageal perforation (EP), paraesophageal hernia causing obstruction or gangrene (PEH) and perforated peptic ulcer (PPU) was analyzed, independent of HV esophageal cancer center status and patient and disease-specific confounding factors. A total of 3707, 12,411, and 57,164 patients with EP, PEH, and PPU, respectively, were included. The observed 90-day mortality was 36.5%, 11.5%, and 29.0% for EP, PEH, and PPU, respectively.Management by HV cancer surgeon was independently associated with significant reductions in 30-day and 90-day mortality from EP (odds ratio, OR 0.51, 95% confidence interval, CI, 0.40-0.66), PEH (OR=0.70, 95% CI 0.53-0.91), and PPU (OR=0.85, 95% CI 0.7-0.95). Subset analysis of those patients receiving primary surgery as treatment showed no change in mortality when performed by HV cancer surgeons.However HV cancer surgeons performed surgery as primary treatment more commonly for EP (OR=2.38, 95% CI 1.87-3.04) and PEH (OR=2.12, 95% CI 1.79-2.51). Furthermore surgery was independently associated with reduced mortality for all 3 conditions. The complex elective workload of HV esophageal cancer surgeons appears to lower the threshold for surgical intervention in specific upper gastrointestinal emergencies such as EP and PEH, which in turn reduces mortality.

ECRH Studies on Tokamak Plasmas.

DTIC Science & Technology

1980-10-10

r.I*cru.Dtrtibution uUnliited 300 Unicorn Pork Drive Woburn, Massachusetts 04801 ECRH STUDIES ON TOKAMAK PLASMAS JAYCOR Project No. 6183 Final Report...up techniques now in use or being suggested, include growing the plasma from a small minor radius or applying a negative voltage spike immediately

The anode power supply for the ECRH system on the J-TEXT tokamak

NASA Astrophysics Data System (ADS)

Donghui, XIA; Fangtai, CUI; Changhai, LIU; Zhenxiong, YU; Yikun, JIN; Zhijiang, WANG; J-TEXT, Team1

2018-01-01

The electron cyclotron resonance heating (ECRH) system with a 60 GHz/200 kW/0.5 s gyrotron donated by the Culham Science Center is being developed on the J-TEXT tokamak for plasma heating, current drive and MHD studies. Simultaneously, an anode power supply (APS) has been rebuilt and tested for the output power control of the gyrotron, of which the input voltage is derived from an 80 kV negative cathode power supply. The control strategy by controlling the grid voltage of the tetrode TH5186 is applied to obtain an accurate anode climbing voltage, of which the output voltage can be obtained from 0-30 kV with respect to the cathode power supply. The characteristics of the APS, including control, protection, modulation, and output waveform, were tested with a 100 kV/60 A negative cathode power supply, a dummy load and the ECRH control system. The results indicate that the APS can meet the requirements of the ECRH system on J-TEXT.

Feasibility of AN Ecrh System for Jet:. Plant Layout, Auxiliaries and Services

NASA Astrophysics Data System (ADS)

Lennholm, M.; Bouquey, F.; Braune, H.; Farthing, J.; Garavaglia, S.; Giruzzi, G.; Granucci, G.; Jennison, M.; Parkin, A.

2011-02-01

A study conducted over the last year to asses the desirability and feasibility of installing an ECRH system on the JET tokamak has concluded that such a system is indeed both desirable and feasible. Details of physics studies, launcher and transmission line design, and power supplies are presented elsewhere in these proceedings. This paper concentrates on the logistical implications of installing this system at JET. The paper addresses issues such as port allocation and plant location. The study has concluded that a new building will be needed to house the ECRH plant. Building layout proposals are presented together with considerations regarding the required auxiliary equipment.

Feasibility study of ECRH in NSTX-U startup plasma

NASA Astrophysics Data System (ADS)

Lopez, N. A.; Poli, F.; Taylor, G.; Harvey, R.; Petrov, Yu.

2016-10-01

A key mission goal of the National Spherical Torus eXperiment Upgrade (NSTX-U) is the demonstration of fully non-inductive startup and operation. In part to accomplish this, a 1MW, 28 GHz ECRH system is presently being developed for implementation on NSTX-U in 2018. Like most spherical tokamaks, NSTX-U operates in the overdense regime (fpe>fce) , which limits traditional ECRH to the early startup phase. An extensive modelling effort of the propagation and absorption of EC waves in the evolving plasma is thus required to define the most effective window of operation, and to optimize the launcher geometry for maximal heating and for current drive during this window. In fact, the ECRH system will play an important role in preparing a target plasma for subsequent injection of IC waves and NBI. Here we assess the feasibility of O1-mode ECRH in NSTX-U startup plasma at full field of 1T through time-dependent simulations performed with the transport solver TRANSP. Linear ray-tracing calculations conducted by GENRAY are coupled into the TRANSP framework, allowing the plasma equilibrium and the temperature profiles to evolve self-consistently in response to the injected microwave power. Furthermore, we investigate additional possibilities of heating and current drive made available through coupling the injected O-mode power to the electrostatic EBW via the slow X-mode as an intermediary.

Understanding Wave-mean Flow Feedbacks and Tropospheric Annular Variability

NASA Astrophysics Data System (ADS)

Lorenz, D. J.

2016-12-01

The structure of internal tropospheric variability is important for determining the impact of the stratosphere on the troposphere. This study aims to better understand the fundamental dynamical mechanisms that control the feedbacks between the eddies and the mean flow, which in turn select the tropospheric annular mode. Recent work using Rossby Wave Chromatography suggests that "barotropic processes", which directly impact the meridional propagation of wave activity (specifically the reflectivity of the poleward flank of the mid-latitude jet), are more important for the positive feedback between the annular mode and the eddies than "baroclinic processes", which involve changes in the generation of wave activity by baroclinic instability. In this study, experiments with a fully nonlinear quasi-geostrophic model are discussed which provide independent confirmation of the importance of barotropic versus baroclinic processes. The experiments take advantage of the steady-state balance at upper-levels between the meridional gradient in diabatic heating and the second derivative of the upper-level EP flux divergence. Simulations with standard Newtonian heating are compared to simulations with constant-in-time heating taken from the climatology of the standard run and it is found that the forced annular mode response to changes in surface friction is very similar. Moreover, as expected from the annular mode response, the eddy momentum fluxes are also very similar. This is despite the fact that the upper-level EP flux divergence is very different between the two simulations (upper-level EP flux divergence must remain constant in the constant heating simulation while in the standard simulation there is no such constraint). The upper-level balances are maintained by a large change in the baroclinic wave source (i.e. vertical EP flux), which is accompanied by little momentum flux change. Therefore the eddy momentum fluxes appear to be relatively insensitive to the wave activity source. A more detailed comparison suggests a helpful rule-of-thumb relating the amplitude of the baroclinic wave source to the upper-level vorticity flux forced by this wave source.

Pilot study on quantitative assessment of muscle imbalance: differences of muscle synergies, equilibrium-point trajectories, and endpoint stiffness in normal and pathological upper-limb movements.

PubMed

Oku, Takanori; Uno, Kanna; Nishi, Tomoki; Kageyama, Masayuki; Phatiwuttipat, Pipatthana; Koba, Keitaro; Yamashita, Yuto; Murakami, Kenta; Uemura, Mitsunori; Hirai, Hiroaki; Miyazaki, Fumio; Naritomi, Hiroaki

2014-01-01

This paper proposes a novel method for assessment of muscle imbalance based on muscle synergy hypothesis and equilibrium point (EP) hypothesis of motor control. We explain in detail the method for extracting muscle synergies under the concept of agonist-antagonist (AA) muscle pairs and for estimating EP trajectories and endpoint stiffness of human upper limbs in a horizontal plane using an electromyogram. The results of applying this method to the reaching movement of one normal subject and one hemiplegic subject suggest that (1) muscle synergies (the balance among coactivation of AA muscle pairs), particularly the synergies that contributes to the angular directional kinematics of EP and the limb stiffness, are quite different between the normal subject and the hemiplegic subject; (2) the concomitant EP trajectory is also different between the normal and hemiplegic subjects, corresponding to the difference of muscle synergies; and (3) the endpoint (hand) stiffness ellipse of the hemiplegic subject becomes more elongated and orientation of the major axis rotates clockwise more than that of the normal subject. The level of motor impairment would be expected to be assessed from a comparison of these differences of muscle synergies, EP trajectories, and endpoint stiffness among normal and pathological subjects using the method.

A near infra-red video system as a protective diagnostic for electron cyclotron resonance heating operation in the Wendelstein 7-X stellarator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Preynas, M.; Laqua, H. P.; Marsen, S.

The Wendelstein 7-X stellarator is a large nuclear fusion device based at Max-Planck-Institut für Plasmaphysik in Greifswald in Germany. The main plasma heating system for steady state operation in W7-X is electron cyclotron resonance heating (ECRH). During operation, part of plama facing components will be directly heated by the non-absorbed power of 1 MW rf beams of ECRH. In order to avoid damages of such components made of graphite tiles during the first operational phase, a near infra-red video system has been developed as a protective diagnostic for safe and secure ECRH operation. Both the mechanical design housing the cameramore » and the optical system are very flexible and respect the requirements of steady state operation. The full system including data acquisition and control system has been successfully tested in the vacuum vessel, including on-line visualization and data storage of the four cameras equipping the ECRH equatorial launchers of W7-X.« less

Experimental investigation of the ECRH stray radiation during the start-up phase in Wendelstein 7-X

NASA Astrophysics Data System (ADS)

Moseev, Dmitry; Laqua, Heinrich; Marsen, Stefan; Stange, Torsten; Braune, Harald; Erckmann, Volker; Gellert, Florian; Oosterbeek, Johann Wilhelm; Wenzel, Uwe

2017-07-01

Electron cyclotron resonance heating (ECRH) is the main heating mechanism in the Wendelstein 7-X stellarator (W7-X). W7-X is equipped with five absolutely calibrated sniffer probes that are installed in each of the five modules of the device. The sniffer probes monitor energy flux of unabsorbed ECRH radiation in the device and interlocks are fed with the sniffer probe signals. The stray radiation level in the device changes significantly during the start-up phase: plasma is a strong microwave absorber and during its formation the stray radiation level in sniffer probes reduces by more than 95%. In this paper, we discuss the influence of neutral gas pressure and gyrotron power on plasma breakdown processes.

Electron cyclotron thruster new modeling results preparation for initial experiments

NASA Technical Reports Server (NTRS)

Hooper, E. Bickford

1993-01-01

The following topics are discussed: a whistler-based electron cyclotron resonance heating (ECRH) thruster; cross-field coupling in the helicon approximation; wave propagation; wave structure; plasma density; wave absorption; the electron distribution function; isothermal and adiabatic plasma flow; ECRH thruster modeling; a PIC code model; electron temperature; electron energy; and initial experimental tests. The discussion is presented in vugraph form.

ECRH launching scenario in FFHR-d1

NASA Astrophysics Data System (ADS)

Yanagihara, Kota; Kubo, Shin; Shimozuma, Takashi; Yoshimura, Yasuo; Igami, Hiroe; Takahashi, Hiromi; Tsujimura, Tohru; Makino, Ryohhei

2016-10-01

ECRH is promising as a principal heating system in a prototype helical reactor FFHR-d1 where the heating power of 80 MW is required to bring the plasma parameter to break even condition. To generate the plasma and bring it to ignition condition in FFHR-d1, it is effective to heat the under/over-dense plasma with normal ECRH or Electron Bernstein Wave (EBW). Normal ECRH is well established but heating via EBW need sophisticated injection control. EBW can be excited via the O(ordinary)-X(extraordinary)-B(EBW) mode conversion process by launching the ordinary wave from the low field side to plasma cut-off layer with optimum injection angle, and the range of injection angle to get high OXB mode conversion rate is called OXB mode conversion window. Since the window position can change as the plasma parameter, it is necessary to optimize the injection angle so as to aim the window in response to the plasma parameters. Candidates of antenna positions are determined by optimum injection points on the plasma facing wall calculated by the injection angle. Given such picked up area, detailed analysis using ray-tracing calculations and engineering antenna design will be performed.

Collective Thomson scattering of a high power electron cyclotron resonance heating beam in LHD (invited).

PubMed

Kubo, S; Nishiura, M; Tanaka, K; Shimozuma, T; Yoshimura, Y; Igami, H; Takahash, H; Mutoh, T; Tamura, N; Tatematsu, Y; Saito, T; Notake, T; Korsholm, S B; Meo, F; Nielsen, S K; Salewski, M; Stejner, M

2010-10-01

Collective Thomson scattering (CTS) system has been constructed at LHD making use of the high power electron cyclotron resonance heating (ECRH) system in Large Helical Device (LHD). The necessary features for CTS, high power probing beams and receiving beams, both with well defined Gaussian profile and with the fine controllability, are endowed in the ECRH system. The 32 channel radiometer with sharp notch filter at the front end is attached to the ECRH system transmission line as a CTS receiver. The validation of the CTS signal is performed by scanning the scattering volume. A new method to separate the CTS signal from background electron cyclotron emission is developed and applied to derive the bulk and high energy ion components for several combinations of neutral beam heated plasmas.

Overview of recent and current research on the TCV tokamak

NASA Astrophysics Data System (ADS)

S. Codathe TCV Team

2013-10-01

Through a diverse research programme, the Tokamak à Configuration Variable (TCV) addresses physics issues and develops tools for ITER and for the longer term goals of nuclear fusion, relying especially on its extreme plasma shaping and electron cyclotron resonance heating (ECRH) launching flexibility and preparing for an ECRH and NBI power upgrade. Localized edge heating was unexpectedly found to decrease the period and relative energy loss of edge localized modes (ELMs). Successful ELM pacing has been demonstrated by following individual ELM detection with an ECRH power cut before turning the power back up to trigger the next ELM, the duration of the cut determining the ELM period. Negative triangularity was also seen to reduce the ELM energy release. H-mode studies have focused on the L-H threshold dependence on the main ion species and on the divertor leg length. Both L- and H-modes have been explored in the snowflake configuration with emphasis on edge measurements, revealing that the heat flux to the strike points on the secondary separatrix increases as the X-points approach each other, well before they coalesce. In L-mode, a systematic scan of the auxiliary power deposition profile, with no effect on confinement, has ruled it out as the cause of confinement degradation. An ECRH power absorption observer based on transmitted stray radiation was validated for eventual polarization control. A new profile control methodology was introduced, relying on real-time modelling to supplement diagnostic information; the RAPTOR current transport code in particular has been employed for joint control of the internal inductance and central temperature. An internal inductance controller using the ohmic transformer has also been demonstrated. Fundamental investigations of neoclassical tearing mode (NTM) seed island formation by sawtooth crashes and of NTM destabilization in the absence of a sawtooth trigger were carried out. Both stabilizing and destabilizing agents (electron cyclotron current drive on or inside the q = 1 surface, respectively) were used to pace sawtooth oscillations, permitting precise control of their period. Locking of the sawtooth period to a pre-defined ECRH modulation period was also demonstrated. Sawtooth control has permitted nearly failsafe NTM prevention when combined with backup NTM stabilization by ECRH.

Research on long pulse ECRH system of EAST in support of ITER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Xiaojie, E-mail: xjiew@ipp.ac.cn; Liu, Fukun; Shan, Jiafang

2015-12-10

Experimental Advanced Superconducting Tokamak (EAST), as a fully superconducting tokamak in China, aims to achieve high performance plasma under steady-state operation. To fulfill the physical objectives of EAST, a program of 4-MW long pulse electron cyclotron resonance heating and current drive (EC H&CD) system, which would offer greater flexibility for plasma shape and plasma stabilization has been launched on EAST since 2011. The system, composed of 4 gyrotrons with nominal 1MW output power and 1000s pulse length each, is designed with the feature of steerable power handling capabilities at 140 GHz, using second harmonic of the extraordinary mode(X2). The missions ofmore » the ECRH system are to provide plasma heating, current drive, plasma profile tailoring and control of magneto-hydrodynamic (MHD) instabilities. Presently, the first two 140-GHz 1-MW gyrotrons, provided by GYCOM and CPI, respectively, have been tested at long pulse operation. The tubes, the associated power supplies, cooling system, cryogenic plant, 2 transmission lines and an equatorial launcher are now installed at EAST. The power generated from each tube will be transmitted by an evacuated corrugated waveguide transmission line and injected into plasma from the low field side (radial port) through a front steering equatorial launcher. Considering the diverse applications of the EC system, the beam’s launch angles can be continuously varied with the optimized scanning range of over 30° in poloidal direction and ±25° in toroidal, as well as the polarization could be adjusted during the discharge by the orientations of a pair of polarizers in the transmission line to maintain the highest absorption for different operational scenarios. The commissioning of the first 2MW ECRH plant for EAST is under way. The design, R&D activities and recent progress of the long pulse 140-GHz ECRH system are presented in this paper. As the technological requirements for EAST ECRH have many similarities with ITER devices, the installation and experience of EAST ECRH system may provide valuable data for the ITER.« less

[European Community Respiratory Health Survey in Adults (ECRHS)].

PubMed

Heinrich, J; Richter, K; Frye, C; Meyer, I; Wölke, G; Wjst, M; Nowak, D; Magnussen, H; Wichmann, H E

2002-05-01

The European Community Respiratory Health Survey (ECRHS) was the first study to assess the geographical variation in asthma, allergy, and allergic sensitization in adults using the same instruments and definitions. The database of the ECRHS includes information from approximately 140 000 individuals aged 20 - 44 years from 22 countries. The aim of this review is to summarize the results of the ECRHS and to present the specific contribution of the German centers in Hamburg and Erfurt. The prevalence ranged from 2.0 - 11.9 % for asthma, 9.5 - 40.9 % for allergic rhinitis, 4.0 - 32.0 % for wheeze, 3.4 - 27.9 % for bronchial hyperreactivity, and 16.2 - 44.5 % for allergic sensitisation against common aeroallergens. Although the prevalence of these atopic disorders were found to be consistently higher for the Hamburg center compared to the Erfurt center, strong regional differences in the prevalences were also found within several other European countries. Overall Europe, the lowest prevalences were seen in the Eastern and Middle European countries with the center Erfurt, followed by the Mediterranean region. The highest prevalences were reported for all English speaking centers. Strong geographic variation was reported for medication for asthma. Asthma seems to be undertreated in several countries. Environmental exposures and in particular indoor factors, and exposures at the workplace are playing a major role for asthma in adulthood. Furthermore, protective effects on atopy were found for exposures to pets (dogs) and a large number of siblings in early childhood. In conclusion, the ECRHS has shown that the prevalence of asthma varies widely. The fact that the geographical pattern is consistent with the distribution of atopy and bronchial responsiveness supports the conclusion that the geographical variations in the prevalence of asthma are true and likely due to environmental factors.

Regarding the optimization of O1-mode ECRH and the feasibility of EBW startup on NSTX-U

NASA Astrophysics Data System (ADS)

Lopez, N. A.; Poli, F. M.

2018-06-01

Recently published scenarios for fully non-inductive startup and operation on the National Spherical Torus eXperiment Upgrade (NSTX-U) (Menard et al 2012 Nucl. Fusion 52 083015) show Electron Cyclotron Resonance Heating (ECRH) as an important component in preparing a target plasma for efficient High Harmonic Fast Wave and Neutral Beam heating. The modeling of the propagation and absorption of EC waves in the evolving plasma is required to define the most effective window of operation, and to optimize the launcher geometry for maximal heating and current drive during this window. Here, we extend a previous optimization of O1-mode ECRH on NSTX-U to account for the full time-dependent performance of the ECRH using simulations performed with TRANSP. We find that the evolution of the density profile has a prominent role in the optimization by defining the time window of operation, which in certain cases may be a more important metric to compare launcher performance than the average power absorption. This feature cannot be captured by analysis on static profiles, and should be accounted for when optimizing ECRH on any device that operates near the cutoff density. Additionally, the utility of the electron Bernstein wave (EBW) in driving current and generating closed flux surfaces in the early startup phase has been demonstrated on a number of devices. Using standalone GENRAY simulations, we find that efficient EBW current drive is possible on NSTX-U if the injection angle is shifted below the midplane and aimed towards the top half of the vacuum vessel. However, collisional damping of the EBW is projected to be significant, in some cases accounting for up to 97% of the absorbed EBW power.

Regarding the optimization of O1-mode ECRH and the feasibility of EBW startup on NSTX-U

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lopez, Nicolas; Poli, Francesca M.

Recently published scenarios for fully non-inductive startup and operation on the National Spherical Torus eXperiment Upgrade (NSTX-U) [Menard J et al 2012 Nucl. Fusion 52 083015] show Electron Cyclotron Resonance Heating (ECRH) as an important component in preparing a target plasma for efficient High Harmonic Fast Wave and Neutral Beam heating. The modelling of the propagation and absorption of EC waves in the evolving plasma is required to define the most effective window of operation, and to optimize the launcher geometry for maximal heating and current drive during this window. Here in this paper, we extend a previous optimization ofmore » O1-mode ECRH on NSTX-U to account for the full time-dependent performance of the ECRH using simulations performed with TRANSP. We find that the evolution of the density profile has a prominent role in the optimization by defining the time window of operation, which in certain cases may be a more important metric to compare launcher performance than the average power absorption. This feature cannot be captured by analysis on static profiles, and should be accounted for when optimizing ECRH on any device that operates near the cutoff density. Additionally, the utility of the electron Bernstein wave (EBW) in driving current and generating closed flux surfaces in the early startup phase has been demonstrated on a number of devices. Using standalone GENRAY simulations, we find that efficient EBW current drive is possible on NSTX-U if the injection angle is shifted below the midplane and aimed towards the top half of the vacuum vessel. However, collisional damping of the EBW is projected to be significant, in some cases accounting for up to 97\\% of the absorbed EBW power.« less

Regarding the optimization of O1-mode ECRH and the feasibility of EBW startup on NSTX-U

DOE PAGES

Lopez, Nicolas; Poli, Francesca M.

2018-03-29

Recently published scenarios for fully non-inductive startup and operation on the National Spherical Torus eXperiment Upgrade (NSTX-U) [Menard J et al 2012 Nucl. Fusion 52 083015] show Electron Cyclotron Resonance Heating (ECRH) as an important component in preparing a target plasma for efficient High Harmonic Fast Wave and Neutral Beam heating. The modelling of the propagation and absorption of EC waves in the evolving plasma is required to define the most effective window of operation, and to optimize the launcher geometry for maximal heating and current drive during this window. Here in this paper, we extend a previous optimization ofmore » O1-mode ECRH on NSTX-U to account for the full time-dependent performance of the ECRH using simulations performed with TRANSP. We find that the evolution of the density profile has a prominent role in the optimization by defining the time window of operation, which in certain cases may be a more important metric to compare launcher performance than the average power absorption. This feature cannot be captured by analysis on static profiles, and should be accounted for when optimizing ECRH on any device that operates near the cutoff density. Additionally, the utility of the electron Bernstein wave (EBW) in driving current and generating closed flux surfaces in the early startup phase has been demonstrated on a number of devices. Using standalone GENRAY simulations, we find that efficient EBW current drive is possible on NSTX-U if the injection angle is shifted below the midplane and aimed towards the top half of the vacuum vessel. However, collisional damping of the EBW is projected to be significant, in some cases accounting for up to 97\\% of the absorbed EBW power.« less

Inequalities between Kappa and Kappa-Like Statistics for "k x k" Tables

ERIC Educational Resources Information Center

Warrens, Matthijs J.

2010-01-01

The paper presents inequalities between four descriptive statistics that can be expressed in the form [P-E(P)]/[1-E(P)], where P is the observed proportion of agreement of a "kappa x kappa" table with identical categories, and E(P) is a function of the marginal probabilities. Scott's "pi" is an upper bound of Goodman and Kruskal's "lambda" and a…

Design and application of a new control system for tokamak ECRH power supply

NASA Astrophysics Data System (ADS)

Hao, Xu; Zhang, Jian; Huang, Yiyun

2016-03-01

The biggest challenge of designing and building tokamak electron cyclotron resonance heating (ECRH) pulse step modulation (PSM) power supply is satisfying its required output voltage rising time to be less than 100 µs while suppressing the voltage overshoot to be no more than 1%. To fulfill the two requirements, a new control strategy with startup time in microsecond range is proposed in this paper, and a new control system to realize the control strategy is introduced. The control system was built and tested on 60 kV/50 A ECRH power supply. The experimental results indicate that the control system can restrain the overshoot effectively, increase response speed, and obviously improve the dynamic characteristics of the PSM power supply system. Thus, the proposed control system helps the PSM power supply to meet the design specifications.

Design of the high voltage isolation transmission module with low delay for ECRH system on J-TEXT

NASA Astrophysics Data System (ADS)

Haiyan, MA; Donghui, XIA; Zhijiang, WANG; Fangtai, CUI; Zhenxiong, YU; Yikun, JIN; Changhai, LIU

2018-02-01

As a flexible auxiliary heating method, the electron cyclotron resonance heating (ECRH) has been widely used in many tokamaks and also will be applied for the J-TEXT tokamak. To meet requirements of protection and fault analysis for the ECRH system on J-TEXT, signals of gyrotrons such as the cathode voltage and current, the anode voltage and current, etc should be transmitted to the control and data acquisition system. Considering the high voltage environment of gyrotrons, isolation transmission module based on FPGA and optical fiber communication has been designed and tested. The test results indicate that the designed module has strong anti-noise ability, low error rate and high transmission speed. The delay of the module is no more than 5 μs which can fulfill the requirements.

Novel mono-static arrangement of the ASDEX Upgrade high field side reflectometers compatible with electron cyclotron resonance heating stray radiation.

PubMed

Silva, A; Varela, P; Meneses, L; Manso, M

2012-10-01

The ASDEX Upgrade frequency modulated continuous wave broadband reflectometer system uses a mono-static antenna configuration with in-vessel hog-horns and 3 dB directional couplers. The operation of the new electron cyclotron resonance heating (ECRH) launcher and the start of collective Thomson scattering experiments caused several events where the fragile dummy loads inside the high field side directional couplers were damaged, due to excessive power resulting from the ECRH stray fields. In this paper, we present a non-conventional application of the existing three-port directional coupler that hardens the system to the ECRH stray fields and at the same time generates the necessary reference signal. Electromagnetic simulations and laboratory tests were performed to validate the proposed solution and are compared with the in-vessel calibration tests.

Extension of operational regime in high-temperature plasmas and effect of ECRH on ion thermal transport in the LHD

NASA Astrophysics Data System (ADS)

Takahashi, H.; Nagaoka, K.; Murakami, S.; Osakabe, M.; Nakano, H.; Ida, K.; Tsujimura, T. I.; Kubo, S.; Kobayashi, T.; Tanaka, K.; Seki, R.; Takeiri, Y.; Yokoyama, M.; Maeta, S.; Nakata, M.; Yoshinuma, M.; Yamada, I.; Yasuhara, R.; Ido, T.; Shimizu, A.; Tsuchiya, H.; Tokuzawa, T.; Goto, M.; Oishi, T.; Morita, S.; Suzuki, C.; Emoto, M.; Tsumori, K.; Ikeda, K.; Kisaki, M.; Shimozuma, T.; Yoshimura, Y.; Igami, H.; Makino, R.; Seki, T.; Kasahara, H.; Saito, K.; Kamio, S.; Nagasaki, K.; Mutoh, T.; Kaneko, O.; Morisaki, T.; the LHD Experiment Group

2017-08-01

A simultaneous high ion temperature (T i) and high electron temperature (T e) regime was successfully extended due to an optimized heating scenario in the LHD. Such high-temperature plasmas were realized by the simultaneous formation of an electron internal transport barrier (ITB) and an ion ITB by the combination of high power NBI and ECRH. Although the ion thermal confinement was degraded in the plasma core with an increase of T e/T i by the on-axis ECRH, it was found that the ion thermal confinement was improved at the plasma edge. The normalized ion thermal diffusivity {χ\\text{i}}/T\\text{i}1.5 at the plasma edge was reduced by 70%. The improvement of the ion thermal confinement at the edge led to an increase in T i in the entire plasma region, even though the core transport was degraded.

Bolometer Results in the Long-Microwave-Heated WEGA Stellarator

NASA Astrophysics Data System (ADS)

Zhang, D.; Otte, M.; Giannone, L.

2006-01-01

A 12 channel bolometer camera based on a gold foil absorber has been installed on the WEGA stellarator to measure the radiation power losses of the plasma. The measured total radiation power is typically less than 30% of the ECRH input power. However, this radiated power fraction depends on the ECRH input power, the magnetic configuration and the field strength as well as the working gas. For separatrix-bounded configurations, core-peaked radiation intensity profiles are usually detected, while in a limiter-configuration they are flatter, broader and more asymmetric. In addition, significant radiation originating from the SOL region is measured for all the cases studied. The SOL radiation changes with changing the plasma-wave interaction region, indicating a strong correlation between radiation and power deposition. Under the WEGA-plasma conditions (Te<10 eV), it is considered that the radiation profile reflects the plasma pressure associated with the power deposition distribution of the ECRH.

First results from protective ECRH diagnostics for Wendelstein 7-X

NASA Astrophysics Data System (ADS)

Marsen, S.; Corre, Y.; Laqua, H. P.; Moncada, V.; Moseev, D.; Niemann, H.; Preynas, M.; Stange, T.; The W7-X Team

2017-08-01

Wendelstein 7-X (W7-X) is a steady state capable optimised stellarator. The main heating system is electron cyclotron resonance heating (ECRH) operating at 140 GHz providing up to 9 MW microwave power. The power is launched into the machine by front steerable quasi-optical launchers in X- or O-mode. While in X-mode the first pass absorption is 99%, it is only 40... 70% in O-mode. O2-mode heating is forseen for high density operation above the X2 cutoff density of 1.2\\centerdot {{10}20} m-3. A set of diagnostics has been developed to protect the machine from non absorbed ECRH power which can easily damage in vessel components. The non absorbed power hitting the inner wall is measured by waveguides embedded in the first wall (ECA diagnostic). In order to prevent the inner wall from overheating or arcing, a near-infra red sensitive video diagnostic with a dynamic range of 450...1200 °C was integrated in the ECRH launchers. Thermal calculations for the carbon tiles predict a temperature increase above the detection threshold for scenarios of plasma start-up failure or poor absorption on a time scale of 50 ms. However, the temperature increase measured by an IR camera in experiments with failed break down, i.e. no ECRH absorption for up to 50 ms, was only Δ T≈ 70{{~}\\circ} C. In discharges with ≈ 5% transmission the measured temperature increase was comparable. The stray radiation level inside the machine is measured by so called sniffer probes resembling microwave diode detectors which were designed to collect all radiation approaching the probing surface independent of incident angle and polarization. Five sniffer probes are installed at different toroidal positions. They were integrated in the ECRH interlock system. During the first operational phase of W7-X this was the only available plasma interlock system. The signal quality proofed to be high enough for a reliable termination in case of poor absorption. After a breakdown phase of 10 ms, the sniffer probe signals dropped by more than an order of magnitude. Especially in the very first days of operation, most discharges died by a radiative collapse due to impurity influx. In this case the heating power was reliably switched off due to the increased level of stray radiation. Moreover, ECRH bolometers with a slower response time in the launcher ports and an empty diagnostic port were used to estimate the stray radiation level in the ports. In the launcher ports it could be shown that the stray radiation could lead to an overheating of the bellows in long discharges. Possible counter measures are discussed.

Small-Scale Tropopause Dynamics and TOMS Total Ozone

NASA Technical Reports Server (NTRS)

Stanford, John L.

2002-01-01

This project used Earth Probe Total Ozone Mapping Spectrometer (EP TOMS) along-track ozone retrievals, in conjunction with ancillary meteorological fields and modeling studies, for high resolution investigations of upper troposphere and lower stratosphere dynamics. Specifically, high resolution along-track (Level 2) EP TOMS data were used to investigate the beautiful fine-scale structure in constituent and meteorological fields prominent in the evolution of highly non-linear baroclinic storm systems. Comparison was made with high resolution meteorological models. The analyses provide internal consistency checks and validation of the EP TOMS data which are vital for monitoring ozone depletion in both polar and midlatitude regions.

Stratospheric cooling and downward planetary-wave propagation in the lowermost stratosphere during the 2010-11 winter

NASA Astrophysics Data System (ADS)

Nishii, K.; Nakamura, H.; Orsolini, Y. J.

2012-04-01

Dynamical cooling in the polar stratosphere is induced by weakening of E-P flux convergence (i.e. anomalous divergence) in the stratosphere. As the E-P flux convergence is mainly contributed to by upward planetary-wave (PW) propagation from the troposphere, the intensity of its propagation is well correlated with the E-P flux convergence and the polar stratospheric temperature. Recent studies (Orsolini et al. 2009, QJRMS; Nishii et al. 2010, GRL) pointed out that a tropospheric blocking high over the western Pacific, whose anomalous circulation is projected strongly onto the Western Pacific (WP) teleconnection pattern, tends to weaken the upward PW propagation and thus lower the polar stratospheric temperature. In this study, we present a possibility that downward PW propagation in the lowermost stratosphere can also cause the E-P flux divergence in the polar stratosphere and thereby the stratospheric cooling. On the basis of prominent downward events of the 100-hPa E-P flux averaged over the mid- to high-latitudes in the northern hemisphere, we performed a lag composite analysis for each of the terms of the transformed Eulerian mean (TEM) equation. In the composite time evolution, downward E-P flux in the lowermost stratosphere and the E-P flux divergence aloft are evident around the reference date, followed by persistent cooling of the polar stratosphere for more than two weeks. About one week before the reference date, enhanced upward E-P flux and its convergence lead to the deceleration of upper-stratospheric zonal winds and thus the weakening of their vertical shear , which may result in the formation of a turning surface for upward-propagating PWs. Our results are overall consistent with Harnik (2009, JGR), who showed that a short pulse of upward-propagating PWs forms a turning surface in the upper stratosphere, where the PWs that subsequently propagate upward can be reflected back. By taking above results into consideration, we analyzed the prolonged cold 2010-11 winter. We found that while three cooling events in December and January were accompanied by tropospheric WP pattern events, cooling in February and March was led by downward-propagating PW events.

Longterm follow-up in European respiratory health studies – patterns and implications

PubMed Central

2014-01-01

Background Selection bias is a systematic error in epidemiologic studies that may seriously distort true measures of associations between exposure and disease. Observational studies are highly susceptible to selection bias, and researchers should therefore always examine to what extent selection bias may be present in their material and what characterizes the bias in their material. In the present study we examined long-term participation and consequences of loss to follow-up in the studies Respiratory Health in Northern Europe (RHINE), Italian centers of European Community Respiratory Health Survey (I-ECRHS), and the Italian Study on Asthma in Young Adults (ISAYA). Methods Logistic regression identified predictors for follow-up participation. Baseline prevalence of 9 respiratory symptoms (asthma attack, asthma medication, combined variable with asthma attack and/or asthma medication, wheeze, rhinitis, wheeze with dyspnea, wheeze without cold, waking with chest tightness, waking with dyspnea) and 9 exposure-outcome associations (predictors sex, age and smoking; outcomes wheeze, asthma and rhinitis) were compared between all baseline participants and long-term participants. Bias was measured as ratios of relative frequencies and ratios of odds ratios (ROR). Results Follow-up response rates after 10 years were 75% in RHINE, 64% in I-ECRHS and 53% in ISAYA. After 20 years of follow-up, response was 53% in RHINE and 49% in I-ECRHS. Female sex predicted long-term participation (in RHINE OR (95% CI) 1.30(1.22, 1.38); in I-ECRHS 1.29 (1.11, 1.50); and in ISAYA 1.42 (1.25, 1.61)), as did increasing age. Baseline prevalence of respiratory symptoms were lower among long-term participants (relative deviations compared to total baseline population 0-15% (RHINE), 0-48% (I-ECRHS), 3-20% (ISAYA)), except rhinitis which had a slightly higher prevalence. Most exposure-outcome associations did not differ between long-term participants and all baseline participants, except lower OR for rhinitis among ISAYA long-term participating smokers (relative deviation 17% (smokers) and 44% (10–20 pack years)). Conclusions We found comparable patterns of long-term participation and loss to follow-up in RHINE, I-ECRHS and ISAYA. Baseline prevalence estimates for long-term participants were slightly lower than for the total baseline population, while exposure-outcome associations were mainly unchanged by loss to follow-up. PMID:24739530

THE BENEFITS OF WETLANDS: THE UPPER HALFWAY CREEK PROJECT

EPA Science Inventory

Researchers from the U.S. EPA are working in collaboration with U.S. Geological Survey and the U.S. Fish and Wildlife Services on this project. Upper Halfway Creek marsh is a constructed wetland managed by the U.S. Fish and Wildlife Service. This project will assist the U.S. EP...

The structure and component characteristics of partial nitrification biofilms under autotrophic and heterotrophic conditions.

PubMed

Xu, Hanli; Wang, Cunbao; Liang, Zhiwei; He, Liyi; Wu, Weixiang

2015-04-01

The differences in the structure and component characteristics of partial nitrification biofilms between autotrophic and heterotrophic conditions were investigated in this work. Three-dimensional excitation-emission matrix fluorescence spectroscopy (EEM), fluorescence staining, and confocal laser scanning microscopy (CLSM) were used to determine differences in the architecture and extracellular polymeric substance (EPS) distribution of the autotrophic and heterotrophic biofilms. Partial nitrification was successfully achieved, and the results demonstrated that an appropriate amount of organic carbon (chemical oxygen demand (COD)/N = 2.6) is advantageous for obtaining better partial nitrification. The final ammoniation and nitrosation rates achieved were 97 and 99 %, respectively. Proteins (PN) and polysaccharides (PS) were dominant in the tightly bound EPS (TB-EPS) of autotrophic and heterotrophic biofilms, with PN/PS ratios of 0.96 and 0.69, respectively. Proteins, lipids, α-D-glucopyranose polysaccharides, and nucleic acids were mostly present within the layers of biofilms, but they were distributed in the upper-middle portion of the autotrophic biofilm and increased with depth from the upper layer in the heterotrophic biofilms.

The W7-X ECRH Plant: Recent Achievements

NASA Astrophysics Data System (ADS)

Erckmann, V.; Brand, P.; Braune, H.; Dammertz, G.; Gantenbein, G.; Kasparek, W.; Laqua, H. P.; Michel, G.; Schmid, M.; Thumm, M.; Weissgerber, M.

2007-09-01

The 10 MW, 140 GHz, CW ECRH-plant for W7-X is in an advanced state of commissioning and the installation was used to investigate advanced applications for extended heating- and current drive scenarios. The operation of the TED gyrotrons was recently extended to a 2nd frequency of 103.6 GHz at reduced output power and first results are presented. An improved collector sweep system for the W7-X gyrotrons with enhanced power capability and smooth power distribution was developed, results are reported.

The neoclassical ``Electron Root'' feature in the Wendelstein-7-AS stellarator

NASA Astrophysics Data System (ADS)

Maaßberg, H.; Beidler, C. D.; Gasparino, U.; Romé, M.; Dyabilin, K. S.; Marushchenko, N. B.; Murakami, S.

2000-01-01

The neoclassical prediction of the "electron root," i.e., a strongly positive radial electric field, Er (being the solution of the ambipolarity condition of the particle fluxes), is analyzed for low-density discharges in Wendelstein-7-AS [G. Grieger, W. Lotz, P. Merkel, et al., Phys. Fluids B 4, 2081 (1992)]. In these electron cyclotron resonance heated (ECRH) discharges with highly localized central power deposition, peaked Te profiles [with Te(0) up to 6 keV and with Ti≪Te] and strongly positive Er in the central region are measured. It is shown that this "electron root" feature at W7-AS is driven by ripple-trapped suprathermal electrons generated by the ECRH. The fraction of ripple-trapped particles in the ECRH launching plane, which can be varied at W7-AS, is found to be the most important. After switching off the heating the "electron root" feature disappears nearly immediately, i.e., two different time scales for the electron temperature decay in the central region are observed. Monte Carlo simulations in five-dimensional phase space are presented, clearly indicating that the additional "convective" electron fluxes driven by the ECRH are of the same order as the ambipolar neoclassical prediction for the "ion root" at much lower Er. For the predicted "electron root," the ion fluxes calculated based on the traditional neoclassical ordering are much too small; shortcomings of the usual approach are indentified and a new ordering scheme is proposed.

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis

PubMed Central

Campbell, Rosalind; Augustine, Titus; Hurst, Helen; Pararajasingam, Ravi; van Dellen, David; Armstrong, Sheilagh; Bartley, Carol; Birtles, Linda; Summers, Angela

2015-01-01

♦ Introduction: Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis in which gastrointestinal (GI) symptoms reduce appetite and dietary intake. Adequate nutrition is important, especially if surgery is required. Although the incidence of EPS is low, the present report is able to detail preoperative nutrition status and treatment in a large cohort of patients from a national EPS referral center. ♦ Methods: Of 51 patients admitted to this EPS specialist center hospital for their first peritonectomy in the study period, 50 had a preoperative dietetic assessment, and 49 underwent upper-arm anthropometry. ♦ Results: Mean body mass index (BMI) was 20.6 kg/m2. Mean weight loss was 14% of body weight in the preceding 6 months, with 35 of 50 patients losing more than 10%. On anthropometry, 25 of 49 patients were below the 5th percentile for mid-arm circumference (MAC), 17 of 49 were below for triceps skinfold thickness (TSF), and 21 of 49 were below for mid-arm muscle circumference (MAMC). Mean handgrip strength (HGS) was 60% of normal, with 43 of 49 patients being below 85% of normal. Appetite was poor in 21 of 50 patients, and 37 of 50 had upper and 40 of 50 had lower GI symptoms. By subjective global assessment, 27 of 51 patients were graded as severely malnourished, and 5 of 51, as well-nourished. Mean serum albumin was 28 g/L and did not correlate with BMI, MAC, TSF, MAMC, or HGS. In most patients, C-reactive protein was elevated (mean: 111 mg/L). Preoperative parenteral nutrition was given to 46 of 51 patients for a mean of 21 days. ♦ Discussion: Our findings demonstrate the poor nutrition status of patients admitted for EPS surgical intervention. Anthropometrics reveal depleted fat and lean body mass in EPS patients, which might be a result of anorexia and inflammation, and the reason that albumin was not an accurate marker of nutrition. Poor nutrition status is likely to negatively affect outcome in this patient group. ♦ Conclusions: Early recognition of GI symptoms may herald a diagnosis of EPS. Optimization of preoperative nutrition status with intensive nutrition support is needed. PMID:24584612

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis.

PubMed

Campbell, Rosalind; Augustine, Titus; Hurst, Helen; Pararajasingam, Ravi; van Dellen, David; Armstrong, Sheilagh; Bartley, Carol; Birtles, Linda; Summers, Angela

2015-01-01

♦ Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis in which gastrointestinal (GI) symptoms reduce appetite and dietary intake. Adequate nutrition is important, especially if surgery is required. Although the incidence of EPS is low, the present report is able to detail preoperative nutrition status and treatment in a large cohort of patients from a national EPS referral center. ♦ Of 51 patients admitted to this EPS specialist center hospital for their first peritonectomy in the study period, 50 had a preoperative dietetic assessment, and 49 underwent upper-arm anthropometry. ♦ Mean body mass index (BMI) was 20.6 kg/m(2). Mean weight loss was 14% of body weight in the preceding 6 months, with 35 of 50 patients losing more than 10%. On anthropometry, 25 of 49 patients were below the 5th percentile for mid-arm circumference (MAC), 17 of 49 were below for triceps skinfold thickness (TSF), and 21 of 49 were below for mid-arm muscle circumference (MAMC). Mean handgrip strength (HGS) was 60% of normal, with 43 of 49 patients being below 85% of normal. Appetite was poor in 21 of 50 patients, and 37 of 50 had upper and 40 of 50 had lower GI symptoms. By subjective global assessment, 27 of 51 patients were graded as severely malnourished, and 5 of 51, as well-nourished. Mean serum albumin was 28 g/L and did not correlate with BMI, MAC, TSF, MAMC, or HGS. In most patients, C-reactive protein was elevated (mean: 111 mg/L). Preoperative parenteral nutrition was given to 46 of 51 patients for a mean of 21 days. ♦ Our findings demonstrate the poor nutrition status of patients admitted for EPS surgical intervention. Anthropometrics reveal depleted fat and lean body mass in EPS patients, which might be a result of anorexia and inflammation, and the reason that albumin was not an accurate marker of nutrition. Poor nutrition status is likely to negatively affect outcome in this patient group. ♦ Early recognition of GI symptoms may herald a diagnosis of EPS. Optimization of preoperative nutrition status with intensive nutrition support is needed. Copyright © 2015 International Society for Peritoneal Dialysis.

Study of plasma start-up initiated by second harmonic electron cyclotron resonance heating on WEGA experiment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Preynas, M.; Laqua, H. P.; Otte, M.

Although both 1st harmonic ordinary mode (O1) and 2nd harmonic extra-ordinary mode (X2) have been successfully used to initiate pre-ionization and breakdown in many devices, a complete theoretical model is still missing to explain the success of this method. Moreover, some experimental observations are not completely understood, such as what occurs during the delay time between the turn-on of ECRH power and first signals of density or light measurements. Since during this free period the ECRH power has to be absorbed by in-vessel components, it is of prime importance to know what governs this delay time. Recently, dedicated start-up experimentsmore » have been performed on WEGA, using a 28 GHz ECRH system in X2-mode. This machine has the interesting capability to be run also as a tokamak allowing comparative experiments between stellarator (ι/2π > 0) and tokamak (ι/2π = 0) configurations. Different scans in heating power, neutral gas pressure, and rotational transform (ι) show clearly that the start-up is a two step process. A first step following the turn-on of the ECRH power during which no measurable electron density (or just above the noise level in some cases), ECE and radiated power is detected. Its duration depends strongly on the level of injected power. The second step corresponds to the gas ionization and plasma expansion phase, with a velocity of density build-up and filling-up of the vessel volume depending mainly on pressure, gas and rotational transform. Moreover, an interesting scenario of ECRH pre-ionization without loop voltage in tokamak configuration by applying a small optimal vertical field is relevant for start-up assistance on future experiments like ITER. The results from this experimental parametric study are useful for the modeling of the start-up assisted by the second harmonic electron cyclotron resonance heating. The aim of this work is to establish predictive scenarios for both ITER and W7-X operation.« less

Rf-assisted current startup in FED

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borowski, S.K.; Peng, Y.K.M.; Kammash, T.

1981-01-01

Auxiliary rf heating of electrons before and during the current rise phase in FED is examined as a means of reducing both the initiation loop voltage and resistive flux expenditure during startup. Prior to current initiation, 1 to 2 MW of electron cyclotron resonance heating (ECRH) power at approximately 90 GHz is used to create a small volume of high conductivity plasma near the upper hybrid resonance (UHR) region. This plasma conditioning permits a small radius (a/sub o/ approximately 0.2-0.4 m) current channel to be established with a relatively low initial loop voltage (<25 V). During the subsequent plasma expansionmore » and current ramp phase, additional rf power is introduced to reduce volt-second consumption due to plasma resistance. The physics models used for analyzing the UHR heating and current rise phases are also discussed.« less

[The synaptic proteins of the temporal associative area in the neocortex (field Ep) of cats with normal and decreased cognitive capacities].

PubMed

Zakharova (Orlova), E I; Mukhin, E I

1994-01-01

Fractions of light and heavy synaptosomes were prepared from associative temporal area of cat brain, which were previously tested behaviorally for ability to solve the generalization, gnostic and abstraction tasks. The synaptic membrane subfractions and synaptoplasma fractions were isolated and the content of the total protein and of the demasked protein sulfhydryl groups (SH groups) was investigated spectrophotometrically. The maximal content of the demasked SH groups was revealed in the upper subfractions (mainly the membranes of cholinergic synapses) and minimal content--in the lower subfractions (mainly noncholinergic synapses). Significantly smaller total protein content in the upper and middle subfractions of light synaptosomes was found, and more demasked SH groups in the membrane-bound proteins of the upper and middle subfractions of light and heavy synaptosomes was found in the cortex area of the "clever" then "silly" cats. Suggestion concerning characteristic for brains of "clever" cats relatively low total quantity of synapses in the area Ep of the cortex and significantly higher proportion of cholinergic ones is discussed.

Precipitation forecasts for rainfall runoff predictions. A case study in poorly gauged Ribb and Gumara catchments, upper Blue Nile, Ethiopia

NASA Astrophysics Data System (ADS)

Seyoum, Mesgana; van Andel, Schalk Jan; Xuan, Yunqing; Amare, Kibreab

Flow forecasting in poorly gauged, flood-prone Ribb and Gumara sub-catchments of the Blue Nile was studied with the aim of testing the performance of Quantitative Precipitation Forecasts (QPFs). Four types of QPFs namely MM5 forecasts with a spatial resolution of 2 km; the Maximum, Mean and Minimum members (MaxEPS, MeanEPS and MinEPS where EPS stands for Ensemble Prediction System) of the fixed, low resolution (2.5 by 2.5 degrees) National Oceanic and Atmospheric Administration Global Forecast System (NOAA GFS) ensemble forecasts were used. Both the MM5 and the EPS were not calibrated (bias correction, downscaling (for EPS), etc.). In addition, zero forecasts assuming no rainfall in the coming days, and monthly average forecasts assuming average monthly rainfall in the coming days, were used. These rainfall forecasts were then used to drive the Hydrologic Engineering Center’s-Hydrologic Modeling System, HEC-HMS, hydrologic model for flow predictions. The results show that flow predictions using MaxEPS and MM5 precipitation forecasts over-predicted the peak flow for most of the seven events analyzed, whereas under-predicted peak flow was found using zero- and monthly average rainfall. The comparison of observed and predicted flow hydrographs shows that MM5, MaxEPS and MeanEPS precipitation forecasts were able to capture the rainfall signal that caused peak flows. Flow predictions based on MaxEPS and MeanEPS gave results that were quantitatively close to the observed flow for most events, whereas flow predictions based on MM5 resulted in large overestimations for some events. In follow-up research for this particular case study, calibration of the MM5 model will be performed. The overall analysis shows that freely available atmospheric forecasting products can provide additional information on upcoming rainfall and peak flow events in areas where only base-line forecasts such as no-rainfall or climatology are available.

Extension of the ECRH operational space with O2 and X3 heating schemes to control tungsten accumulation in ASDEX Upgrade

NASA Astrophysics Data System (ADS)

Höhnle, H.; Stober, J.; Herrmann, A.; Kasparek, W.; Leuterer, F.; Monaco, F.; Neu, R.; Schmid-Lorch, D.; Schütz, H.; Schweinzer, J.; Stroth, U.; Wagner, D.; Vorbrugg, S.; Wolfrum, E.; ASDEX Upgrade Team

2011-08-01

ASDEX Upgrade has been operated with tungsten-coated plasma-facing components for several years. H-mode operation with good confinement has been demonstrated. Nevertheless, purely neutral beam injection-heated H-modes with reduced gas puff, moderate heating power or/and increased triangularity tend to accumulate tungsten, followed by a radiative collapse. Under these conditions, central electron heating with electron cyclotron resonance heating (ECRH), usually in X2 polarization, changes the impurity transport in the plasma centre, reducing the central tungsten concentration and, in many cases, stabilizing the plasma. In order to extend the applicability of central ECRH to a wider range of magnetic field and plasma current additional ECRH schemes with reduced single-pass absorption have been implemented: X3 heating allows us to reduce the magnetic field by 30%, such that the first H-modes with an ITER-like value of the safety factor of q95 = 3 could be run in the tungsten-coated device. O2 heating increases the cutoff density by a factor of 2 allowing higher currents and triangularities to be addressed. For both schemes, scenarios have been developed to cope with the associated reduced absorption. In the case of central X3 heating, the X2 resonance lies close to the pedestal top at the high-field side of the plasma, serving as a beam dump. For O2, holographic mirrors have been developed which guarantee a second pass through the plasma centre. The beam position on these reflectors is controlled by fast thermocouples. Stray-radiation protection has been implemented using sniffer probes.

Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction.

PubMed

Svanes, Øistein; Bertelsen, Randi J; Lygre, Stein H L; Carsin, Anne E; Antó, Josep M; Forsberg, Bertil; García-García, José M; Gullón, José A; Heinrich, Joachim; Holm, Mathias; Kogevinas, Manolis; Urrutia, Isabel; Leynaert, Bénédicte; Moratalla, Jesús M; Le Moual, Nicole; Lytras, Theodore; Norbäck, Dan; Nowak, Dennis; Olivieri, Mario; Pin, Isabelle; Probst-Hensch, Nicole; Schlünssen, Vivi; Sigsgaard, Torben; Skorge, Trude D; Villani, Simona; Jarvis, Debbie; Zock, Jan P; Svanes, Cecilie

2018-05-01

Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described. This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction. The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders. As compared with women not engaged in cleaning (ΔFEV 1  = -18.5 ml/yr), FEV 1 declined more rapidly in women responsible for cleaning at home (-22.1; P = 0.01) and occupational cleaners (-22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = -8.8 ml/yr; -13.1, P = 0.02; and -15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV 1 decline (-22.0, P = 0.04; and -22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV 1 /FVC decline or airway obstruction. Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.

Employment status and use of respiratory protection among metalworkers, solderers and welders

PubMed Central

Mirabelli, Maria C; Zock, Jan‐Paul; Plana, Estel; Benke, Geza; Kromhout, Hans; Norbäck, Dan; Olivieri, Mario; Radon, Katja; Villani, Simona; Kogevinas, Manolis

2007-01-01

Objectives Reported associations of self‐employment with occupational injury and cerebrovascular disease suggest that worker safety and health precautions may vary by occupational status. The authors assessed the extent to which use of respiratory protection and ventilation equipment is associated with self‐employed versus employee status among adults in an international study. Methods The European Community Respiratory Health Survey II (ECRHS II) is a follow‐up study conducted in a population‐based random sample of adult ECRHS I participants. Men and women enrolled in the ECRHS II completed interviewer‐administered questionnaires to provide information about their occupational status and job history during the 9‐year ECRHS follow‐up period. Respondents in selected occupational groups completed supplemental questionnaires about their jobs and use of respiratory protection and ventilation equipment on‐the‐job. The authors assessed self‐reported use of respiratory and ventilation equipment among 72 self‐employed and 371 employed adults in metalworking, soldering and welding occupations. Results Local exhaust ventilation (fixed extraction: OR 0.37, 95% CI 0.17 to 0.80; mobile extraction: OR 0.23, 95% CI 0.09 to 0.60; on‐tool extraction: OR 0.39, 95% CI 0.18 to 0.88) was reported less frequently among self‐employed respondents than among employed respondents. The magnitude of the negative association between self‐employment status and any of the three types of local exhaust ventilation was not attenuated by adjustment for duration of work per day or week or asthma and/or wheezing symptoms. Respiratory protection was not associated with employment status in these data. Conclusions More limited use of local exhaust ventilation among self‐employed workers compared to employees suggests the need to promote occupational safety among self‐employed workers. PMID:17387135

Disruption avoidance by means of electron cyclotron waves

NASA Astrophysics Data System (ADS)

Esposito, B.; Granucci, G.; Maraschek, M.; Nowak, S.; Lazzaro, E.; Giannone, L.; Gude, A.; Igochine, V.; McDermott, R.; Poli, E.; Reich, M.; Sommer, F.; Stober, J.; Suttrop, W.; Treutterer, W.; Zohm, H.; ASDEX Upgrade, the; FTU Teams

2011-12-01

Disruptions are very challenging to ITER operation as they may cause damage to plasma facing components due to direct plasma heating, forces on structural components due to halo and eddy currents and the production of runaway electrons. Electron cyclotron (EC) waves have been demonstrated as a tool for disruption avoidance by a large set of recent experiments performed in ASDEX Upgrade and FTU using various disruption types, plasma operating scenarios and power deposition locations. The technique is based on the stabilization of magnetohydrodynamic (MHD) modes (mainly m/n = 2/1) through the localized injection of EC power on the resonant surface. This paper presents new results obtained in ASDEX Upgrade regarding stable operation above the Greenwald density achieved after avoidance of density limit disruptions by means of ECRH and suitable density feedback control (L-mode ohmic plasmas, Ip = 0.6 MA, Bt = 2.5 T) and NTM-driven disruptions at high-β limit delayed/avoided by means of both co-current drive (co-ECCD) and pure heating (ECRH) with power <=1.7 MW (H-mode NBI-heated plasmas, PNBI ~ 7.5 MW, Ip = 1 MA, Bt = 2.1 T, q95 ~ 3.6). The localized perpendicular injection of ECRH/ECCD onto a resonant surface leads to the delay and/or complete avoidance of disruptions. The experiments indicate the existence of a power threshold for mode stabilization to occur. An analysis of the MHD mode evolution using the generalized Rutherford equation coupled to the frequency and phase evolution equations shows that control of the modes is due to EC heating close to the resonant surface. The ECRH contribution (Δ'H term) is larger than the co-ECCD one in the initial and more important phase when the discharge is 'saved'. Future research and developments of the disruption avoidance technique are also discussed.

Recent Trends in Fusion Gyrotron Development at KIT

NASA Astrophysics Data System (ADS)

Gantenbein, G.; Avramidis, K.; Franck, J.; Illy, S.; Ioannidis, Z. C.; Jin, J.; Jelonnek, J.; Kalaria, P.; Pagonakis, I. Gr.; Ruess, S.; Rzesnicki, T.; Thumm, M.; Wu, C.

2017-10-01

ECRH&CD is one of the favorite heating system for magnetically confined nuclear fusion plasmas. KIT is strongly involved in the development of high power gyrotrons for use in ECRH systems for nuclear fusion. KIT is upgrading the sub-components of the existing 2 MW, 170 GHz coaxial-cavity short-pulse gyrotron to support long-pulse operation up to 1 s, all components will be equipped with a specific active cooling system. Two important developments for future high power, highly efficient gyrotrons will be discussed: design of gyrotrons with high operating frequency (˜ 240 GHz) and efficiency enhancement by using advanced collector designs with multi-staged voltage depression.

Core turbulence behavior moving from ion-temperature-gradient regime towards trapped-electron-mode regime in the ASDEX Upgrade tokamak and comparison with gyrokinetic simulation

NASA Astrophysics Data System (ADS)

Happel, T.; Navarro, A. Bañón; Conway, G. D.; Angioni, C.; Bernert, M.; Dunne, M.; Fable, E.; Geiger, B.; Görler, T.; Jenko, F.; McDermott, R. M.; Ryter, F.; Stroth, U.

2015-03-01

Additional electron cyclotron resonance heating (ECRH) is used in an ion-temperature-gradient instability dominated regime to increase R / L Te in order to approach the trapped-electron-mode instability regime. The radial ECRH deposition location determines to a large degree the effect on R / L Te . Accompanying scale-selective turbulence measurements at perpendicular wavenumbers between k⊥ = 4-18 cm-1 (k⊥ρs = 0.7-4.2) show a pronounced increase of large-scale density fluctuations close to the ECRH radial deposition location at mid-radius, along with a reduction in phase velocity of large-scale density fluctuations. Measurements are compared with results from linear and non-linear flux-matched gyrokinetic (GK) simulations with the gyrokinetic code GENE. Linear GK simulations show a reduction of phase velocity, indicating a pronounced change in the character of the dominant instability. Comparing measurement and non-linear GK simulation, as a central result, agreement is obtained in the shape of radial turbulence level profiles. However, the turbulence intensity is increasing with additional heating in the experiment, while gyrokinetic simulations show a decrease.

Effect of ECRH and resonant magnetic fields on formation of magnetic islands in the T-10 tokamak plasma

NASA Astrophysics Data System (ADS)

Shestakov, E. A.; Savrukhin, P. V.

2017-10-01

Experiments in the T-10 tokamak demonstrated possibility of controlling the plasma current during disruption instability using the electron cyclotron resonance heating (ECRH) and the controlled operation of the ohmic current-holding system. Quasistable plasma discharge with repeating sawtooth oscillations can be restored after energy quench using auxiliary ECRH power when PEC / POH > 2-5. The external magnetic field generation system consisted of eight saddle coils that were arranged symmetrically relative to the equatorial plane of the torus outside of the vacuum vessel of the T-10 tokamak to study the possible resonant magnetic field effects on the rotation frequency of magnetic islands. The saddle coils power supply system is based on four thyristor converters with a total power of 300 kW. The power supply control system is based on Siemens S7 controllers. As shown by preliminary experiments, the interaction efficiency of external magnetic fields with plasma depends on the plasma magnetic configuration. Optimal conditions for slowing the rotation of magnetic islands were determined. Additionally, the direction of the error magnetic field in the T-10 tokamak was determined, and the threshold value of the external magnetic field was determined.

Performance and properties of the first plasmas of Wendelstein 7-X

NASA Astrophysics Data System (ADS)

Klinger, T.; Alonso, A.; Bozhenkov, S.; Burhenn, R.; Dinklage, A.; Fuchert, G.; Geiger, J.; Grulke, O.; Langenberg, A.; Hirsch, M.; Kocsis, G.; Knauer, J.; Krämer-Flecken, A.; Laqua, H.; Lazerson, S.; Landreman, M.; Maaßberg, H.; Marsen, S.; Otte, M.; Pablant, N.; Pasch, E.; Rahbarnia, K.; Stange, T.; Szepesi, T.; Thomsen, H.; Traverso, P.; Velasco, J. L.; Wauters, T.; Weir, G.; Windisch, T.; The Wendelstein 7-X Team

2017-01-01

The optimized, superconducting stellarator Wendelstein 7-X went into operation and delivered first measurement data after 15 years of construction and one year commissioning. Errors in the magnet assembly were confirmend to be small. Plasma operation was started with 5 MW electron cyclotron resonance heating (ECRH) power and five inboard limiters. Core plasma values of {{T}\\text{e}}>8 keV, {{T}\\text{i}}>2 keV at line-integrated densities n≈ 3\\centerdot {{10}19}~{{\\text{m}}-2} were achieved, exceeding the original expectations by about a factor of two. Indications for a core-electron-root were found. The energy confinement times are in line with the international stellarator scaling, despite unfavourable wall conditions, i.e. large areas of metal surfaces and particle sources from the limiter close to the plasma volume. Well controlled shorter hydrogen discharges at higher power (4 MW ECRH power for 1 s) and longer discharges at lower power (0.7 MW ECRH power for 6 s) could be routinely established after proper wall conditioning. The fairly large set of diagnostic systems running in the end of the 10 weeks operation campaign provided first insights into expected and unexpected physics of optimized stellarators.

Regional difference in small-scale heterogeneities in the crust and upper mantle in Japan derived by the analysis of high-frequency P-wave

NASA Astrophysics Data System (ADS)

Takemura, S.; Furumura, T.

2010-12-01

In order to understand distribution properties of small-scale heterogeneities in the crust and upper mantle structure, we analyze three-component seismograms recorded by Hi-net in Japan. We examined relative strength of the P-wave in the transverse (T) component and its change as a function of frequency and propagation distances, which is strongly relating to the strength of seismic wave scattering in the lithosphere. We analyzed 53,220 Hi-net record from 310 shallow (h<30km) crustal earthquakes with MJMA =2.0-5.3. The three-component seismograms are firstly applied by band-pass filter with pass band frequency of f=1-2, 2-4, 4-8, 8-16, 16-32 Hz and then the Hilbert transform is used to synthesize envelope of each component. Then, the energy partition (EP) of P wave in the T component relative to total P-wave energy is evaluated around the P wave in 3-sec time window. The estimated EP value is almost constant 0.2 in high-frequencies (8-16 Hz) at shorter distance, while it is 0.07 in low-frequencies (1-2 Hz). We found clearly frequency-change property of EP value. But at larger distance over 150 km, EP values gradually increase with increasing distance. In high-frequencies (8-16, 16-32 Hz), especially EP values asymptotically reach from 0.2 to 0.33, equi-partitioning of P-wave energy into three components. This may because Pn-phase dominates in larger hypocentral distances. In order to examine difference in the EP in each area of Japan which would be relating to the strength of crustal heterogeneities in each area we divided the area of Japan into three regions, fore-arc side of Tohoku, back-arc side of Tohoku and Chugoku-Shikoku area. The difference in EP value in each area is clearly found in the high-frequency (4-8 Hz) band, where larger EP (0.2) was obtained at back-arc side of Tohoku relative to smaller EP (0.1) at fore-arc side of Tohoku and Chugoku-Shikoku. This is consistent with the results of Carcole and Sato (2009) who estimated the strength of crustal heterogeneities based on the multi lapse time-window analysis. In order to clarify the cause of such regional difference of EP, we conduct 3-D FDM simulations using stochastic random media. The model covers a zone 204.8 km by 204.8 km by 64.0 km descretized with 0.1 km in horizontal direction and 0.05 km in vertical direction. The small-scale heterogeneity in the lithosphere is constructed by velocity fluctuation from average velocity. The fluctuation is characterized by von Karman-type ACF with the correlation length a, the rms value e and decay order k. We assume average background velocities of P-wave and S-wave are VP = 5.8 km and VS = 3.36 km, respectively. We employ an explosive point source into the model. The FDM simulations were conducted on the Earth Simulator at JAMSTEC. We conducted a number of FDM simulation using different model parameters of stochastic random media for different e (= 0.03, 0.05, 0.07, 0.09) and fixed a and k (a = 5km, k = 0.5). The simulation results confirm EP value increases linearly with increasing e. We also found that larger EP obtained in the back-arc side of Tohoku can be explained by 4% larger e relative to those of other regions.

Extract of Pelargonium sidoides (EPs 7630) improves phagocytosis, oxidative burst, and intracellular killing of human peripheral blood phagocytes in vitro.

PubMed

Conrad, Andreas; Hansmann, Cathrin; Engels, Inge; Daschner, Franz D; Frank, Uwe

2007-01-01

Clinical data show that EPs 7630, an aqueous ethanolic extract from the roots of Pelargonium sidoides, can be used for the treatment of upper respiratory tract infections (URTI). The biological effects of the preparation have not been fully investigated. The objective of this study was to examine the impact of EPs 7630 on the activity of human peripheral blood phagocytes (PBP). A whole blood-based, flow cytometric assay was used to simultaneously assess phagocytosis and oxidative burst. Calcein-AM stained Candida albicans (DSM 1386) were used as target organisms. Oxidative burst was measured by addition of dihydroethidium (DHE). Target organisms and whole blood were co-incubated and analyzed after 0, 2, 4, 6, 10, and 30 min. Intracellular killing of the target organisms was evaluated by determining the number of surviving yeast cells after co-incubation of C. albicans and human whole blood. EPs 7630 was applied in therapeutically relevant concentrations between 0 and 30 microg/ml. Compared with controls EPs 7630 increased the number of phagocytosing PBP during the observed time points between 2 and 10 min in a concentration-dependent manner, with a maximum enhancement of 56% at 2 min (p=0.002). The application of EPs 7630 also led to a significant increase in the number of burst-active PBP for all time points observed beyond 2 min (p<0.001). The maximum augmentation was 120% after application of 30 microg/ml EPs 7630 at 4 min. Using a microbiological assay, intracellular killing was also enhanced by EPs 7630. This was expressed by a significant reduction in the number of surviving target organisms (p<0.001). The maximum reduction in viable yeast cells (-31%) was observed after co-incubation for 120 min with the highest concentration of EPs 7630 (30 microg/ml). In conclusion, the positive effects of EPs 7630 on phagocytosis, oxidative burst, and intracellular killing of yeast cells as test organisms are important components of the compound's biological activity. Our findings constitute a valuable contribution to understanding the clinical effects of EPs 7630.

A new fossil cercopithecid tibia from Laetoli and its implications for positional behavior and paleoecology.

PubMed

Laird, Myra F; Kozma, Elaine E; Kwekason, Amandus; Harrison, Terry

2018-05-01

Detailed analyses and comparisons of postcranial specimens of Plio-Pleistocene cercopithecids provide an opportunity to examine the recent evolutionary history and locomotor diversity in Old World monkeys. Studies examining the positional behavior and substrate preferences of fossil cercopithecids are also important for reconstructing the paleoenvironments of Plio-Pleistocene hominin sites. Here we describe a new fossil cercopithecid tibia (EP 1100/12) from the Australopithecus afarensis-bearing Upper Laetolil Beds (∼3.7 Ma) of Laetoli in northern Tanzania. The fossil tibia is attributed to cf. Rhinocolobus sp., which is the most common colobine at Laetoli. In addition to qualitative comparisons, the tibial shape of EP 1100/12 was compared to that of 190 extant cercopithecids using three-dimensional landmarks. Discriminant function analyses of the shape data were used to assess taxonomic affinity and shape variation relating to positional behavior. EP 1100/12 clustered with extant colobines, particularly the large-bodied genera Nasalis and Rhinopithecus. Comparisons reveal that EP 1100/12 belongs to a large-bodied monkey that engaged in arboreal pronograde quadrupedalism. These findings add further support to previous inferences that woodland and forest environments dominated the paleoenvironment of the Upper Laetolil Beds, which supported the diverse community of cercopithecids at Laetoli. The inferred paleoecology and the presence of large-bodied arboreally-adapted monkeys at Laetoli show that A. afarensis had access to a range of diverse habitats, including woodlands and forests. This supports the possibility that A. afarensis, with its potential range of positional capabilities, was able to utilize arboreal settings for food acquisition and refuge from predators. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination.

PubMed

Boniface, Keith S; Shokoohi, Hamid; Smith, E Reed; Scantlebury, Kari

2011-06-01

The aim of this study was to examine the capability of ultrasound-naïve paramedics to obtain interpretable Focused Assessment With Sonography for Trauma (FAST) images under the remote direction of emergency physicians (EPs). Paramedics without experience using ultrasound participated in a 20-minute lecture covering orientation to the ultrasound machine and the FAST examination. The paramedics subsequently performed FAST examinations on a model patient, whereas the EP remained in another room, out of visual contact. The EP communicated with the paramedic via radio, viewing video from the ultrasound machine on a monitor and directing the probe movements to obtain the views of the FAST examination. We examined the success rate, time to complete the examinations, and adequacy of images from the paramedics' first FAST examination. Fifty-one paramedics performed their first FAST examinations and were able to successfully complete 100% of the views of the FAST. The median time from probe placement to examination completion was 262 seconds (interquartile range, 206-343 seconds). The median time to complete right upper quadrant (RUQ) versus left upper quadrant (LUQ) views was 39 and 50 seconds, respectively. The time to complete the LUQ scan took significantly longer than the RUQ (P < .01). Paramedics completed cardiac and pelvic view in a median time of 42 and 25 seconds, respectively. The study demonstrated that paramedics with no prior ultrasound experience could obtain FAST images under remote guidance from experienced EPs in less than 5 minutes. Given rapidly evolving data transmission technology, this has applicability in battlefield, remote, and rural prehospital settings. Copyright © 2011 Elsevier Inc. All rights reserved.

Simulating planetary wave propagation to the upper atmosphere during stratospheric warming events at different mountain wave scenarios

NASA Astrophysics Data System (ADS)

Gavrilov, Nikolai M.; Koval, Andrey V.; Pogoreltsev, Alexander I.; Savenkova, Elena N.

2018-04-01

Parameterization schemes of atmospheric normal modes (NMs) and orographic gravity waves (OGWs) have been implemented into the mechanistic Middle and Upper Atmosphere Model (MUAM) simulating atmospheric general circulation. Based on the 12-members ensemble of runs with the MUAM, a composite of the stratospheric warming (SW) has been constructed using the UK Met Office data as the lower boundary conditions. The simulation results show that OGW amplitudes increase at altitudes above 30 km in the Northern Hemisphere after the SW event. At altitudes of about 50 km, OGWs have largest amplitudes over North American and European mountain systems before and during the composite SW, and over Himalayas after the SW. Simulations demonstrate substantial (up to 50-70%) variations of amplitudes of stationary planetary waves (PWs) during and after the SW in the mesosphere-lower thermosphere of the Northern Hemisphere. Westward travelling NMs have amplitude maxima not only in the Northern, but also in the Southern Hemisphere, where these modes have waveguides in the middle and upper atmosphere. Simulated variations of PW and NM amplitudes correspond to changes in the mean zonal wind, EP-fluxes and wave refractive index at different phases of the composite SW events. Inclusion of the parameterization of OGW effects leads to decreases in amplitudes (up to 15%) of almost all SPWs before and after the SW event and their increase (up to 40-60%) after the SW in the stratosphere and mesosphere at middle and high northern latitudes. It is suggested that observed changes in NM amplitudes in the Southern Hemisphere during SW could be caused by divergence of increased southward EP-flux. This EP-flux increases due to OGW drag before SW and extends into the Southern Hemisphere.

Projected decreases in future marine export production: the role of the carbon flux through the upper ocean ecosystem

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laufkotter, Charlotte; Vogt, Meike; Gruber, Nicolas

Here, accurate projections of marine particle export production (EP) are crucial for predicting the response of the marine carbon cycle to climate change, yet models show a wide range in both global EP and their responses to climate change. This is, in part, due to EP being the net result of a series of processes, starting with net primary production (NPP) in the sunlit upper ocean, followed by the formation of particulate organic matter and the subsequent sinking and remineralisation of these particles, with each of these processes responding differently to changes in environmental conditions. Here, we compare future projectionsmore » in EP over the 21st century, generated by four marine ecosystem models under the high emission scenario Representative Concentration Pathways (RCP) 8.5 of the Intergovernmental Panel on Climate Change (IPCC), and determine the processes driving these changes. The models simulate small to modest decreases in global EP between -1 and -12%. Models differ greatly with regard to the drivers causing these changes. Among them, the formation of particles is the most uncertain process with models not agreeing on either magnitude or the direction of change. The removal of the sinking particles by remineralisation is simulated to increase in the low and intermediate latitudes in three models, driven by either warming-induced increases in remineralisation or slower particle sinking, and show insignificant changes in the remaining model. Changes in ecosystem structure, particularly the relative role of diatoms matters as well, as diatoms produce larger and denser particles that sink faster and are partly protected from remineralisation. Also this controlling factor is afflicted with high uncertainties, particularly since the models differ already substantially with regard to both the initial (present-day) distribution of diatoms (between 11–94% in the Southern Ocean) and the diatom contribution to particle formation (0.6–3.8 times higher than their contribution to biomass). As a consequence, changes in diatom concentration are a strong driver for EP changes in some models but of low significance in others. Observational and experimental constraints on ecosystem structure and how the fixed carbon is routed through the ecosystem to produce export production are urgently needed in order to improve current generation ecosystem models and their ability to project future changes.« less

Projected decreases in future marine export production: the role of the carbon flux through the upper ocean ecosystem

DOE PAGES

Laufkotter, Charlotte; Vogt, Meike; Gruber, Nicolas; ...

2016-07-14

Here, accurate projections of marine particle export production (EP) are crucial for predicting the response of the marine carbon cycle to climate change, yet models show a wide range in both global EP and their responses to climate change. This is, in part, due to EP being the net result of a series of processes, starting with net primary production (NPP) in the sunlit upper ocean, followed by the formation of particulate organic matter and the subsequent sinking and remineralisation of these particles, with each of these processes responding differently to changes in environmental conditions. Here, we compare future projectionsmore » in EP over the 21st century, generated by four marine ecosystem models under the high emission scenario Representative Concentration Pathways (RCP) 8.5 of the Intergovernmental Panel on Climate Change (IPCC), and determine the processes driving these changes. The models simulate small to modest decreases in global EP between -1 and -12%. Models differ greatly with regard to the drivers causing these changes. Among them, the formation of particles is the most uncertain process with models not agreeing on either magnitude or the direction of change. The removal of the sinking particles by remineralisation is simulated to increase in the low and intermediate latitudes in three models, driven by either warming-induced increases in remineralisation or slower particle sinking, and show insignificant changes in the remaining model. Changes in ecosystem structure, particularly the relative role of diatoms matters as well, as diatoms produce larger and denser particles that sink faster and are partly protected from remineralisation. Also this controlling factor is afflicted with high uncertainties, particularly since the models differ already substantially with regard to both the initial (present-day) distribution of diatoms (between 11–94% in the Southern Ocean) and the diatom contribution to particle formation (0.6–3.8 times higher than their contribution to biomass). As a consequence, changes in diatom concentration are a strong driver for EP changes in some models but of low significance in others. Observational and experimental constraints on ecosystem structure and how the fixed carbon is routed through the ecosystem to produce export production are urgently needed in order to improve current generation ecosystem models and their ability to project future changes.« less

Performance and properties of the first plasmas of Wendelstein 7-X

DOE PAGES

Klinger, Thomas; Alonso, A.; Bozhenkov, S.; ...

2016-10-18

The optimized, superconducting stellarator Wendelstein 7-X went into operation and delivered first measurement data after 15 years of construction and one year commissioning. Errors in the magnet assembly were confirmend to be small. Plasma operation was started with 5 MW electron cyclotron resonance heating (ECRH) power and five inboard limiters. Core plasma values ofmore » $${{T}_{\\text{e}}}>8$$ keV, $${{T}_{\\text{i}}}>2$$ keV at line-integrated densities $$n\\approx 3\\centerdot {{10}^{19}}~{{\\text{m}}^{-2}}$$ were achieved, exceeding the original expectations by about a factor of two. Indications for a core-electron-root were found. The energy confinement times are in line with the international stellarator scaling, despite unfavourable wall conditions, i.e. large areas of metal surfaces and particle sources from the limiter close to the plasma volume. Well controlled shorter hydrogen discharges at higher power (4 MW ECRH power for 1 s) and longer discharges at lower power (0.7 MW ECRH power for 6 s) could be routinely established after proper wall conditioning. Lastly, the fairly large set of diagnostic systems running in the end of the 10 weeks operation campaign provided first insights into expected and unexpected physics of optimized stellarators.« less

Casualty Risk Assessment Controlled Re-Entry of EPS - Ariane 5ES - ATV Mission

NASA Astrophysics Data System (ADS)

Arnal, M.-H.; Laine, N.; Aussilhou, C.

2012-01-01

To fulfil its mission of compliance check to the French Space Operations Act, CNES has developed ELECTRA© tool in order to estimate casualty risk induced by a space activity (like rocket launch, controlled or un-controlled re-entry on Earth of a space object). This article describes the application of such a tool for the EPS controlled re-entry during the second Ariane 5E/S flight (Johannes Kepler mission has been launched in February 2011). EPS is the Ariane 5E/S upper composite which is de-orbited from a 260 km circular orbit after its main mission (release of the Automated Transfer Vehicle - ATV). After a brief description of the launcher, the ATV-mission and a description of all the failure cases taken into account in the mission design (which leads to "back-up scenarios" into the flight software program), the article will describe the steps which lead to the casualty risk assessment (in case of failure) with ELECTRA©. In particular, the presence on board of two propulsive means of de-orbiting (main engine of EPS, and 4 ACS longitudinal nozzles in case of main engine failure or exhaustion) leads to a low remaining casualty risk.

Occupational allergic diseases in kitchen and health care workers: an underestimated health issue.

PubMed

Bilge, Ugur; Unluoglu, Ilhami; Son, Nazan; Keskin, Ahmet; Korkut, Yasemin; Unalacak, Murat

2013-01-01

This study evaluated the frequencies of allergic symptoms and rate of upper respiratory infections during the past year in the general population, kitchen workers (KW) and health care workers (HCW). The European Community Respiratory Health Survey (ECRHS) was used to inquire retrospectively about asthma and asthma-like symptoms and the number of treatments required for previous upper respiratory tract infections (URTI: acute pharyngitis, acute sinusitis, etc.) during the past year for health care workers, kitchen workers, and members of the general population. Adjusted odds ratios by gender, age, and smoking status were calculated. 579 subjects (186 from the general population, 205 KW, and 188 HCW; 263 females, 316 males) participated in the study. Noninfectious (allergic) rhinitis was significantly higher in the HCW and KW groups than in the general population (P < 0.001). Cumulative asthma was significantly higher only in the HCW group (P < 0.05). In addition, the HCW and KW groups had significantly higher risks of ≥2/year URTI (OR: 1.59, 95% CI: 1.07-2.38 versus OR: 1.57, 95% CI: 1.05-2.38) than the general population. Occupational allergic respiratory diseases are an important and growing health issue. Health care providers should become familiar with workplace environments and environmental causes of occupational rhinitis and asthma.

The Physics Performance Of The Front Steering Launcher For The ITER ECRH Upper Port

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henderson, M.; Chavan, R.; Nikkola, P.

2005-09-26

The capability of any given e.m.-wave plasma heating system to be utilized for physics applications depends strongly on the technical properties of the launching antenna (or launcher). An effective ECH launcher must project a small mm-wave beam spot size far into the plasma and 'steer' the beam across a large fraction of the plasma cross section (along the resonance surface). Thus the choice in the launcher concept and design may either severely limit or enhance the capability of a heating system to be effectively applied for physics applications, such as sawtooth stabilization, control of the Neoclassical Tearing Mode (NTM), Edgemore » Localized Mode (ELM) control, etc. Presently, two antenna concepts are under consideration for the ITER upper port ECH launcher: front steering (FS) and remote steering (RS) launchers. The RS launcher has the technical advantage of easier maintenance access to the steering mirror, which is isolated from the torus vacuum. The FS launcher places the steering mirror near the plasma increasing the technical challenges, but significantly enhancing the focusing and steering capabilities of the launcher, offering a threefold increase in NTM stabilization efficiency over the RS launcher as well as the potential for application to other critical physics issues such as ELM or sawtooth control.« less

Major results from the first plasma campaign of the Wendelstein 7-X stellarator

DOE PAGES

Wolf, R. C.; Ali, A.; Alonso, A.; ...

2017-07-27

Here, after completing the main construction phase of Wendelstein 7-X (W7-X) and successfully commissioning the device, first plasma operation started at the end of 2015. Integral commissioning of plasma start-up and operation using electron cyclotron resonance heating (ECRH) and an extensive set of plasma diagnostics have been completed, allowing initial physics studies during the first operational campaign. Both in helium and hydrogen, plasma breakdown was easily achieved. Gaining experience with plasma vessel conditioning, discharge lengths could be extended gradually. Eventually, discharges lasted up to 6 s, reaching an injected energy of 4 MJ, which is twice the limit originally agreedmore » for the limiter configuration employed during the first operational campaign. At power levels of 4 MW central electron densities reached 3 × 10 19 m –3, central electron temperatures reached values of 7 keV and ion temperatures reached just above 2 keV. Important physics studies during this first operational phase include a first assessment of power balance and energy confinement, ECRH power deposition experiments, 2nd harmonic O-mode ECRH using multi-pass absorption, and current drive experiments using electron cyclotron current drive. As in many plasma discharges the electron temperature exceeds the ion temperature significantly, these plasmas are governed by core electron root confinement showing a strong positive electric field in the plasma centre.« less

Major results from the first plasma campaign of the Wendelstein 7-X stellarator

NASA Astrophysics Data System (ADS)

Wolf, R. C.; Ali, A.; Alonso, A.; Baldzuhn, J.; Beidler, C.; Beurskens, M.; Biedermann, C.; Bosch, H.-S.; Bozhenkov, S.; Brakel, R.; Dinklage, A.; Feng, Y.; Fuchert, G.; Geiger, J.; Grulke, O.; Helander, P.; Hirsch, M.; Höfel, U.; Jakubowski, M.; Knauer, J.; Kocsis, G.; König, R.; Kornejew, P.; Krämer-Flecken, A.; Krychowiak, M.; Landreman, M.; Langenberg, A.; Laqua, H. P.; Lazerson, S.; Maaßberg, H.; Marsen, S.; Marushchenko, M.; Moseev, D.; Niemann, H.; Pablant, N.; Pasch, E.; Rahbarnia, K.; Schlisio, G.; Stange, T.; Pedersen, T. Sunn; Svensson, J.; Szepesi, T.; Trimino Mora, H.; Turkin, Y.; Wauters, T.; Weir, G.; Wenzel, U.; Windisch, T.; Wurden, G.; Zhang, D.; Abramovic, I.; Äkäslompolo, S.; Aleynikov, P.; Aleynikova, K.; Alzbutas, R.; Anda, G.; Andreeva, T.; Ascasibar, E.; Assmann, J.; Baek, S.-G.; Banduch, M.; Barbui, T.; Barlak, M.; Baumann, K.; Behr, W.; Benndorf, A.; Bertuch, O.; Biel, W.; Birus, D.; Blackwell, B.; Blanco, E.; Blatzheim, M.; Bluhm, T.; Böckenhoff, D.; Bolgert, P.; Borchardt, M.; Borsuk, V.; Boscary, J.; Böttger, L.-G.; Brand, H.; Brandt, Ch.; Bräuer, T.; Braune, H.; Brezinsek, S.; Brunner, K.-J.; Brünner, B.; Burhenn, R.; Buttenschön, B.; Bykov, V.; Calvo, I.; Cannas, B.; Cappa, A.; Carls, A.; Carraro, L.; Carvalho, B.; Castejon, F.; Charl, A.; Chernyshev, F.; Cianciosa, M.; Citarella, R.; Ciupiński, Ł.; Claps, G.; Cole, M.; Cole, M. J.; Cordella, F.; Cseh, G.; Czarnecka, A.; Czermak, A.; Czerski, K.; Czerwinski, M.; Czymek, G.; da Molin, A.; da Silva, A.; Dammertz, G.; Danielson, J.; de la Pena, A.; Degenkolbe, S.; Denner, P.; Dhard, D. P.; Dostal, M.; Drevlak, M.; Drewelow, P.; Drews, Ph.; Dudek, A.; Dundulis, G.; Durodie, F.; van Eeten, P.; Effenberg, F.; Ehrke, G.; Endler, M.; Ennis, D.; Erckmann, E.; Esteban, H.; Estrada, T.; Fahrenkamp, N.; Feist, J.-H.; Fellinger, J.; Fernandes, H.; Fietz, W. H.; Figacz, W.; Fontdecaba, J.; Ford, O.; Fornal, T.; Frerichs, H.; Freund, A.; Führer, M.; Funaba, T.; Galkowski, A.; Gantenbein, G.; Gao, Y.; García Regaña, J.; Garcia-Munoz, M.; Gates, D.; Gawlik, G.; Geiger, B.; Giannella, V.; Gierse, N.; Gogoleva, A.; Goncalves, B.; Goriaev, A.; Gradic, D.; Grahl, M.; Green, J.; Grosman, A.; Grote, H.; Gruca, M.; Guerard, C.; Haiduk, L.; Han, X.; Harberts, F.; Harris, J. H.; Hartfuß, H.-J.; Hartmann, D.; Hathiramani, D.; Hein, B.; Heinemann, B.; Heitzenroeder, P.; Henneberg, S.; Hennig, C.; Hernandez Sanchez, J.; Hidalgo, C.; Hölbe, H.; Hollfeld, K. P.; Hölting, A.; Höschen, D.; Houry, M.; Howard, J.; Huang, X.; Huber, M.; Huber, V.; Hunger, H.; Ida, K.; Ilkei, T.; Illy, S.; Israeli, B.; Ivanov, A.; Jablonski, S.; Jagielski, J.; Jelonnek, J.; Jenzsch, H.; Junghans, P.; Kacmarczyk, J.; Kaliatka, T.; Kallmeyer, J.-P.; Kamionka, U.; Karalevicius, R.; Kasahara, H.; Kasparek, W.; Kenmochi, N.; Keunecke, M.; Khilchenko, A.; Kinna, D.; Kleiber, R.; Klinger, T.; Knaup, M.; Kobarg, Th.; Köchl, F.; Kolesnichenko, Y.; Könies, A.; Köppen, M.; Koshurinov, J.; Koslowski, R.; Köster, F.; Koziol, R.; Krämer, M.; Krampitz, R.; Kraszewsk, P.; Krawczyk, N.; Kremeyer, T.; Krings, Th.; Krom, J.; Krzesinski, G.; Ksiazek, I.; Kubkowska, M.; Kühner, G.; Kurki-Suonio, T.; Kwak, S.; Lang, R.; Langish, S.; Laqua, H.; Laube, R.; Lechte, C.; Lennartz, M.; Leonhardt, W.; Lewerentz, L.; Liang, Y.; Linsmeier, Ch.; Liu, S.; Lobsien, J.-F.; Loesser, D.; Loizu Cisquella, J.; Lore, J.; Lorenz, A.; Losert, M.; Lubyako, L.; Lücke, A.; Lumsdaine, A.; Lutsenko, V.; Majano-Brown, J.; Marchuk, O.; Mardenfeld, M.; Marek, P.; Massidda, S.; Masuzaki, S.; Maurer, D.; McCarthy, K.; McNeely, P.; Meier, A.; Mellein, D.; Mendelevitch, B.; Mertens, Ph.; Mikkelsen, D.; Mishchenko, O.; Missal, B.; Mittelstaedt, J.; Mizuuchi, T.; Mollen, A.; Moncada, V.; Mönnich, T.; Morizaki, T.; Munk, R.; Murakami, S.; Musielok, F.; Náfrádi, G.; Nagel, M.; Naujoks, D.; Neilson, H.; Neubauer, O.; Neuner, U.; Ngo, T.; Nocentini, R.; Nührenberg, C.; Nührenberg, J.; Obermayer, S.; Offermanns, G.; Ogawa, K.; Ongena, J.; Oosterbeek, J. W.; Orozco, G.; Otte, M.; Pacios Rodriguez, L.; Pan, W.; Panadero, N.; Panadero Alvarez, N.; Panin, A.; Papenfuß, D.; Paqay, S.; Pavone, A.; Pawelec, E.; Pelka, G.; Peng, X.; Perseo, V.; Peterson, B.; Pieper, A.; Pilopp, D.; Pingel, S.; Pisano, F.; Plaum, B.; Plunk, G.; Povilaitis, M.; Preinhaelter, J.; Proll, J.; Puiatti, M.-E.; Sitjes, A. Puig; Purps, F.; Rack, M.; Récsei, S.; Reiman, A.; Reiter, D.; Remppel, F.; Renard, S.; Riedl, R.; Riemann, J.; Rimkevicius, S.; Riße, K.; Rodatos, A.; Röhlinger, H.; Romé, M.; Rong, P.; Roscher, H.-J.; Roth, B.; Rudischhauser, L.; Rummel, K.; Rummel, T.; Runov, A.; Rust, N.; Ryc, L.; Ryosuke, S.; Sakamoto, R.; Samartsev, A.; Sanchez, M.; Sano, F.; Satake, S.; Satheeswaran, G.; Schacht, J.; Schauer, F.; Scherer, T.; Schlaich, A.; Schlüter, K.-H.; Schmitt, J.; Schmitz, H.; Schmitz, O.; Schmuck, S.; Schneider, M.; Schneider, W.; Scholz, M.; Scholz, P.; Schrittwieser, R.; Schröder, M.; Schröder, T.; Schroeder, R.; Schumacher, H.; Schweer, B.; Shanahan, B.; Shikhovtsev, I. V.; Sibilia, M.; Sinha, P.; Sipliä, S.; Skodzik, J.; Slaby, C.; Smith, H.; Spiess, W.; Spong, D. A.; Spring, A.; Stadler, R.; Standley, B.; Stephey, L.; Stoneking, M.; Stridde, U.; Sulek, Z.; Surko, C.; Suzuki, Y.; Szabó, V.; Szabolics, T.; Szökefalvi-Nagy, Z.; Tamura, N.; Terra, A.; Terry, J.; Thomas, J.; Thomsen, H.; Thumm, M.; von Thun, C. P.; Timmermann, D.; Titus, P.; Toi, K.; Travere, J. M.; Traverso, P.; Tretter, J.; Tsuchiya, H.; Tsujimura, T.; Tulipán, S.; Turnyanskiy, M.; Unterberg, B.; Urban, J.; Urbonavicius, E.; Vakulchyk, I.; Valet, S.; van Millingen, B.; Vela, L.; Velasco, J.-L.; Vergote, M.; Vervier, M.; Vianello, N.; Viebke, H.; Vilbrandt, R.; Vorkörper, A.; Wadle, S.; Wagner, F.; Wang, E.; Wang, N.; Warmer, F.; Wegener, L.; Weggen, J.; Wei, Y.; Wendorf, J.; Werner, A.; Wiegel, B.; Wilde, F.; Winkler, E.; Winters, V.; Wolf, S.; Wolowski, J.; Wright, A.; Xanthopoulos, P.; Yamada, H.; Yamada, I.; Yasuhara, R.; Yokoyama, M.; Zajac, J.; Zarnstorff, M.; Zeitler, A.; Zhang, H.; Zhu, J.; Zilker, M.; Zimbal, A.; Zocco, A.; Zoletnik, S.; Zuin, M.

2017-10-01

After completing the main construction phase of Wendelstein 7-X (W7-X) and successfully commissioning the device, first plasma operation started at the end of 2015. Integral commissioning of plasma start-up and operation using electron cyclotron resonance heating (ECRH) and an extensive set of plasma diagnostics have been completed, allowing initial physics studies during the first operational campaign. Both in helium and hydrogen, plasma breakdown was easily achieved. Gaining experience with plasma vessel conditioning, discharge lengths could be extended gradually. Eventually, discharges lasted up to 6 s, reaching an injected energy of 4 MJ, which is twice the limit originally agreed for the limiter configuration employed during the first operational campaign. At power levels of 4 MW central electron densities reached 3  ×  1019 m-3, central electron temperatures reached values of 7 keV and ion temperatures reached just above 2 keV. Important physics studies during this first operational phase include a first assessment of power balance and energy confinement, ECRH power deposition experiments, 2nd harmonic O-mode ECRH using multi-pass absorption, and current drive experiments using electron cyclotron current drive. As in many plasma discharges the electron temperature exceeds the ion temperature significantly, these plasmas are governed by core electron root confinement showing a strong positive electric field in the plasma centre.

Major results from the first plasma campaign of the Wendelstein 7-X stellarator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolf, R. C.; Ali, A.; Alonso, A.

Here, after completing the main construction phase of Wendelstein 7-X (W7-X) and successfully commissioning the device, first plasma operation started at the end of 2015. Integral commissioning of plasma start-up and operation using electron cyclotron resonance heating (ECRH) and an extensive set of plasma diagnostics have been completed, allowing initial physics studies during the first operational campaign. Both in helium and hydrogen, plasma breakdown was easily achieved. Gaining experience with plasma vessel conditioning, discharge lengths could be extended gradually. Eventually, discharges lasted up to 6 s, reaching an injected energy of 4 MJ, which is twice the limit originally agreedmore » for the limiter configuration employed during the first operational campaign. At power levels of 4 MW central electron densities reached 3 × 10 19 m –3, central electron temperatures reached values of 7 keV and ion temperatures reached just above 2 keV. Important physics studies during this first operational phase include a first assessment of power balance and energy confinement, ECRH power deposition experiments, 2nd harmonic O-mode ECRH using multi-pass absorption, and current drive experiments using electron cyclotron current drive. As in many plasma discharges the electron temperature exceeds the ion temperature significantly, these plasmas are governed by core electron root confinement showing a strong positive electric field in the plasma centre.« less

Impact of laparoscopic sleeve gastrectomy on upper gastrointestinal symptoms.

PubMed

Carabotti, Marilia; Silecchia, Gianfranco; Greco, Francesco; Leonetti, Frida; Piretta, Luca; Rengo, Marco; Rizzello, Mario; Osborn, John; Corazziari, Enrico; Severi, Carola

2013-10-01

Altered gastric anatomy following laparoscopic sleeve gastrectomy (LSG) is likely to induce upper gastrointestinal (GI) symptoms. Published studies, however, have focused mainly on gastroesophageal reflux disease (GERD). This study aims to evaluate LSG's impact on the prevalence of upper GI symptoms and to assess the effects of time from surgery, weight loss, and proton pump inhibitor (PPI) therapy. The validated Rome III Criteria symptom questionnaire for upper GI symptoms, including quality of life items, has been self-administered to 97 patients who underwent LSG. Symptoms were analyzed either separately or altogether to classify patients in GERD or dyspepsia, subdivided in epigastric pain (EPS) and post-prandial distress (PDS) syndromes. Before LSG, 52.7% of the patients were asymptomatic, 27.0% had GERD, and 8.1% had dyspepsia (2.7% EPS, 5.4% PDS). After a median follow-up of 13 months, 91.9% of the patients complained of upper GI symptoms, the most prevalent being PDS (59.4 %). GERD prevalence did not differ before and after LSG. The only symptom strongly related to LSG was dysphagia (OR 4.7, 95% CI 1.3-20.4, p = 0.015), which was present in 19.7% of the patients and mainly associated with PDS rather than GERD. GI symptoms, however, did not have a great impact on quality of life. Time from surgery, weight loss after surgery, as well as concomitant PPI, did not influence the symptoms. After a median follow-up of 13 months, PDS-like dyspepsia, rather than GERD, was the main complaint, both poorly responding to PPI therapy. A longer follow-up will be necessary to evaluate their future persistency.

Extended plate and beam demonstration home

Treesearch

Patricia Gunderson; Vladimir Kochkin; Xiping Wang

2018-01-01

An extended plate and beam (EP&B) design was developed at Home Innovation Research Labs (Upper Marlboro, Maryland) in an effort to provide traditional light-frame wall construction details that are compatible with continuous insulating sheathing. This would encourage wide-spread adoption of high-R walls and promote greater energy efficiency in new houses. The...

IDENTIFICATION OF SPECIES-ENVIRONMENT RELATIONSHIPS IN THE HUDSON-RARITAN ESTUARY AND RELATED SUB-BASINS

EPA Science Inventory

The US EP A's Regional Environmental Monitoring and Assessment Program (REMAP) conducted a study in 1993/94 to assess the effects of sediment contamination in the Hudson- Raritan area (Upper New York, Raritan Bay, Jamaica Bay, western Long Island Sound and the Bight Apex). This s...

Dynamics of the Oceanic Surface Mixed Layer. Proceedings of ’Aha Huliko’a Hawaiian Winter Workshop (4th) Held in Manoa, Hawaii on January 14-16, 1987,

DTIC Science & Technology

1987-01-01

the tropical Pacific Ocean . Contribution in Atmospheric Science No. 20, University of California, Davis. Wyrtki, K., 1981: An estimate of... distribution of net E-P and heating in the tropical Pacific determines the vertical T-S relationship of the upper ocean in the western equatorial Pacific... contributing factor. The effect of such impulsive forcing on the western equatorial Pacific upper ocean can be seen in Fig. 11 from the

RF-assisted current startup in FED

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borowski, S. K.; Peng, Yueng Kay Martin; Kammash, T.

1981-01-01

Auxiliary rf heating of electrons before and during the current rise phase in FED is examined as a means of reducing both the initiation loop voltage and resistive flux expendicture during startup. Prior to current initiation, 1 to 2 MW of electron cyclotron resonance heating (ECRH) power at {approx} 90 GHz is used to create a small volume of high conductivity plasma (T{sub e} {approx_equal} 100-200 eV, n{sub e} {approx_equal} 10{sup 13} cm{sup -3}) near the upper hybrid resonance (UHR) region. This plasma conditioning permits a small radius (a{sub o} {approx_equal} 0.2-0.4 m) current channel to be established with amore » relatively low initial loop voltage (<25 V). During the subsequent plasma expansion and current ramp phase, additional rf power is introduced to reduce volt-second consumption due to plasma resistance. The physics models used for analyzing the UHR heating and current rise phases are also discussed.« less

Constrained binary classification using ensemble learning: an application to cost-efficient targeted PrEP strategies.

PubMed

Zheng, Wenjing; Balzer, Laura; van der Laan, Mark; Petersen, Maya

2018-01-30

Binary classification problems are ubiquitous in health and social sciences. In many cases, one wishes to balance two competing optimality considerations for a binary classifier. For instance, in resource-limited settings, an human immunodeficiency virus prevention program based on offering pre-exposure prophylaxis (PrEP) to select high-risk individuals must balance the sensitivity of the binary classifier in detecting future seroconverters (and hence offering them PrEP regimens) with the total number of PrEP regimens that is financially and logistically feasible for the program. In this article, we consider a general class of constrained binary classification problems wherein the objective function and the constraint are both monotonic with respect to a threshold. These include the minimization of the rate of positive predictions subject to a minimum sensitivity, the maximization of sensitivity subject to a maximum rate of positive predictions, and the Neyman-Pearson paradigm, which minimizes the type II error subject to an upper bound on the type I error. We propose an ensemble approach to these binary classification problems based on the Super Learner methodology. This approach linearly combines a user-supplied library of scoring algorithms, with combination weights and a discriminating threshold chosen to minimize the constrained optimality criterion. We then illustrate the application of the proposed classifier to develop an individualized PrEP targeting strategy in a resource-limited setting, with the goal of minimizing the number of PrEP offerings while achieving a minimum required sensitivity. This proof of concept data analysis uses baseline data from the ongoing Sustainable East Africa Research in Community Health study. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Alternate charging profiles for the onboard nickel cadmium batteries of the Explorer Platform/Extreme Ultraviolet Explorer

NASA Technical Reports Server (NTRS)

Rao, Gopalakrishna M.; Prettyman-Lukoschek, Jill S.

1995-01-01

The Explorer Platform/Extreme Ultraviolet Explorer (EP/EUVE) spacecraft power is provided by the Modular Power Subsystems (MPS) which contains three 50 ampere-hour Nickel Cadmium (NiCd) batteries. The batteries were fabricated by McDonnell Douglas Electronics Systems Company, with the cells fabricated by Gates Aerospace Batteries (GAB), Gainesville, Florida. Shortly following launch, the battery performance characteristics showed similar signatures as the anomalous performance observed on both the Upper Atmosphere Research Satellite (UARS) and the Compton Gamma Ray Observatory (CGRO). This prompted the development and implementation of alternate charging profiles to optimize the spacecraft battery performance. The Flight Operations Team (FOT), under the direction of Goddard Space Flight Center's (GSFC) EP/EUVE Project and Space Power Applications Branch have monitored and managed battery performance through control of the battery Charge to Discharge (C/D) ratio and implementation of a Solar Array (SA) offset. This paper provides a brief overview of the EP/EUVE mission, the MPS, the FOT's battery management for achieving the alternate charging profile, and the observed spacecraft battery performance.

Preparation and thermal properties of mineral-supported polyethylene glycol as form-stable composite phase change materials (CPCMs) used in asphalt pavements.

PubMed

Jin, Jiao; Lin, Feipeng; Liu, Ruohua; Xiao, Ting; Zheng, Jianlong; Qian, Guoping; Liu, Hongfu; Wen, Pihua

2017-12-05

Three kinds of mineral-supported polyethylene glycol (PEG) as form-stable composite phase change materials (CPCMs) were prepared to choose the most suitable CPCMs in asphalt pavements for the problems of asphalt pavements rutting diseases and urban heat islands. The microstructure and chemical structure of CPCMs were characterized by SEM, FT-IR and XRD. Thermal properties of the CPCMs were determined by TG and DSC. The maximum PEG absorption of diatomite (DI), expanded perlite (EP) and expanded vermiculite (EVM) could reach 72%, 67% and 73.6%, respectively. The melting temperatures and latent heat of CPCMs are in the range of 52-55 °C and 100-115 J/g, respectively. The results show that PEG/EP has the best thermal and chemical stability after 100 times of heating-cooling process. Moreover, crystallization fraction results show that PEG/EP has slightly higher latent heats than that of PEG/DI and PEG/EVM. Temperature-adjusting asphalt mixture was prepared by substituting the fine aggregates with PEG/EP CPCMs. The upper surface maximum temperature difference of temperature-adjusting asphalt mixture reaches about 7.0 °C in laboratory, and the surface peak temperature reduces up to 4.3 °C in the field experiment during a typical summer day, indicating a great potential application for regulating pavement temperature field and alleviating the urban heat islands.

Comparisons of planetary wave propagation to the upper atmosphere during stratospheric warming events at different QBO phases

NASA Astrophysics Data System (ADS)

Koval, Andrey V.; Gavrilov, Nikolai M.; Pogoreltsev, Alexander I.; Savenkova, Elena N.

2018-06-01

The dynamical coupling of the lower and upper atmosphere by planetary waves (PWs) is studied. Numerical simulations of planetary wave (PW) amplitudes during composite sudden stratospheric warming (SSW) events in January-February are made using a model of general circulation of the middle and upper atmosphere with initial and boundary conditions typical for the westerly and easterly phases of quasi-biennial oscillation (QBO). The changes in PW amplitudes in the middle atmosphere before, during and after SSW event for the different QBO phases are considered. Near the North Pole, the increase in the mean temperature during SSW reaches 10-30 K at altitudes 30-50 km for four pairs of the model runs with the eQBO and wQBO, which is characteristic for the sudden stratospheric warming event. Amplitudes of stationary PWs in the middle atmosphere of the Northern hemisphere may differ up to 30% during wQBO and eQBO before and during the SSW. After the SSW event SPW amplitudes are substantially larger during wQBO phase. PW refractivity indices and Eliassen-Palm flux vectors are calculated. The largest EP-fluxes in the middle atmosphere correspond to PWs with zonal wavenumber m=1. Simulated changes in PW amplitudes correspond to inhomogeneities of the global circulation, refractivity index and EP-flux produced by the changes in QBO phases. Comparisons of differences in PW characteristics and circulation between the wQBO and eQBO show that PWs could provide effective coupling mechanism and transport dynamical changes from local regions of the lower atmosphere to distant regions of the upper atmosphere of both hemispheres.

North American wintertime temperature anomalies: the role of El Niño diversity and differential teleconnections

NASA Astrophysics Data System (ADS)

Beyene, Mussie T.; Jain, Shaleen

2018-06-01

El Niño-Southern Oscillation (ENSO) teleconnections induced wintertime surface air temperature (SAT) anomalies over North America show inter-event variability, asymmetry, and nonlinearity. This diagnostic study appraises the assumption that ENSO-induced teleconnections are adequately characterized as symmetric shifts in the SAT probability distributions for North American locations. To this end, a new conditional quantile functional estimation approach presented here incorporates: (a) the detailed nature of location and amplitude of SST anomalies—in particular the Eastern Pacific (EP), Central Pacific (CP) ENSO events—based on its two leading principal components, and (b) over the entire range of SATs, characterize the differential sensitivity to ENSO. Statistical significance is assessed using a wild bootstrap approach. Conditional risk at upper and lower quartile SAT conditioned on archetypical ENSO states is derived. There is marked asymmetry in ENSO effects on the likelihood of upper and lower quartile winter SATs for most North American regions. CP El Niño patterns show 20-80% decrease in the likelihood of lower quartile SATs for Canada and US west coast and a 20-40% increase across southeastern US. However, the upper quartile SAT for large swathes of Canada shows no sensitivity to CP El Niño. Similarly, EP El Niño is linked to a 40-80% increase in the probability of upper quartile winter SATs for Canada and northern US and a 20% decrease for southern US and northern Mexico regions; however, little or no change in the risk of lower quartile winter temperatures for southern parts of North America. Localized estimate of ENSO-related risk are also presented.

ELM suppression in helium plasmas with 3D magnetic fields

DOE PAGES

Evans, T. E.; Loarte, A.; Orlov, D. M.; ...

2017-06-21

Experiments in DIII-D, using non-axisymmetric magnetic perturbation fields in high-purity low toroidal rotation, 4He plasmas have resulted in Type-I edge localized mode (ELM) suppression and mitigation. Suppression is obtained in plasmas with zero net input torque near the L–H power threshold using either electron cyclotron resonant heating (ECRH) or balanced co- and counter-I p neutral beam injection (NBI) resulting in conditions equivalent to those expected in ITER's non-active operating phase. In low-power ECRH H-modes, periods with uncontrolled density and impurity radiation excursions are prevented by applying n = 3 non-axisymmetric magnetic perturbation fields. ELM suppression results from a reduction andmore » an outward shift of the electron pressure gradient peak compared to that in the high-power ELMing phase. Here, the change in the electron pressure gradient peak is primarily due to a drop in the pedestal temperature rather than the pedestal density.« less

ELM suppression in helium plasmas with 3D magnetic fields

NASA Astrophysics Data System (ADS)

Evans, T. E.; Loarte, A.; Orlov, D. M.; Grierson, B. A.; Knölker, M. M.; Lyons, B. C.; Cui, L.; Gohil, P.; Groebner, R. J.; Moyer, R. A.; Nazikian, R.; Osborne, T. H.; Unterberg, E. A.

2017-08-01

Experiments in DIII-D, using non-axisymmetric magnetic perturbation fields in high-purity low toroidal rotation, 4He plasmas have resulted in Type-I edge localized mode (ELM) suppression and mitigation. Suppression is obtained in plasmas with zero net input torque near the L-H power threshold using either electron cyclotron resonant heating (ECRH) or balanced co- and counter-I p neutral beam injection (NBI) resulting in conditions equivalent to those expected in ITER’s non-active operating phase. In low-power ECRH H-modes, periods with uncontrolled density and impurity radiation excursions are prevented by applying n  =  3 non-axisymmetric magnetic perturbation fields. ELM suppression results from a reduction and an outward shift of the electron pressure gradient peak compared to that in the high-power ELMing phase. The change in the electron pressure gradient peak is primarily due to a drop in the pedestal temperature rather than the pedestal density.

The ECRH/ECCD system on Tore Supra, a major step towards continuous operation

NASA Astrophysics Data System (ADS)

Lennholm, M.; Agarici, G.; Berger-By, G.; Bosia, P.; Bouquey, F.; Cellier, E.; Clary, J.; Clapit, M.; Darbos, C.; Giruzzi, G.; Jung, M.; Magne, R.; Roux, D.; Segui, J. L.; Traisnel, E.; Zou, X.

2003-11-01

The 118 GHz electron cyclotron heating and current drive (ECRH/ECCD) system under development in Cadarache, France, for use on the Tore Supra tokamak (Pain M. et al 1994 Proc. 18th SOFT (Karlsruhe) pp 481 4: Darbos C. et al 2000 Proc. 21st SOFT (Madrid) pp 605 9), is designed to launch 2.4 MW of power for up to 10 min into the plasma. At present two out of six gyrotrons are installed and available for injection of up to 800 kW. This paper concentrates on the generation and transmission of the ECRH/ECCD power for very long pulse operation. The power is injected into the plasma as Gaussian beams by an antenna which, using actively cooled mirrors inside the Tore Supra vacuum vessel, allows extensive control of both the poloidal and toroidal injection angles. The toroidal field on Tore Supra is normally in the range of 3.8 4 T, which for 118 GHz gives almost central deposition at the fundamental electron cyclotron resonance. A pair of actively cooled corrugated mirrors is installed in each matching optics unit at the output of each gyrotron allowing complete control of the polarization of the wave transmitted to the antenna, with the result that pure O-mode—or pure X-mode—power injection can be achieved for all injection angles. In tokamak experiments, a world record energy of 17.8 MJ has been injected into the plasma. New upgraded gyrotrons specified to produce 400 kW for up to 10 min will be introduced over the next 3 4 years.

PM 2.5 and NO 2 assessment in 21 European study centres of ECRHS II: annual means and seasonal differences

NASA Astrophysics Data System (ADS)

Hazenkamp-von Arx, Marianne E.; Götschi, Thomas; Ackermann-Liebrich, Ursula; Bono, Roberto; Burney, Peter; Cyrys, Josef; Jarvis, Deborah; Lillienberg, Linnea; Luczynska, Christina; Maldonado, Jose A.; Jaén, Angeles; de Marco, Roberto; Mi, Yahong; Modig, Lars; Bayer-Oglesby, Lucy; Payo, Felix; Soon, Argo; Sunyer, Jordi; Villani, Simona; Weyler, Joost; Künzli, Nino

The follow-up of cohorts of adults from more than 20 European centres of the former ECRHS I (1989-1992) investigates long-term effects of exposure to ambient air pollution on respiratory health, in particular asthma and change of pulmonary function. Since PM 2.5 is not routinely monitored in Europe, we measured PM 2.5 concentrations in 21 participating centres to estimate 'background' exposure in these cities. Winter (November-February), summer (May-August) and annual mean (all months) values of PM 2.5 were determined from measuring periods between June 2000 and November 2001. Sampling was conducted for 7 days per month for a year. Annual and winter mean concentrations of PM 2.5 vary substantially being lowest in Iceland and highest in centres in Northern Italy. Annual mean concentrations ranged from 3.7 to 44.9 μg m -3, winter mean concentrations from 4.8 to 69.2 μg m -3, and summer mean concentrations from 3.3 to 23.1 μg m -3. Seasonal variability occurred but did not follow the same pattern across all centres. Therefore, ranking of centres varied from summer to winter. Simultaneously, NO 2 concentrations were measured using passive sampling tubes. Annual mean NO 2 concentrations range from 4.9 to 72.1 μg m -3 with similar seasonal variations across centres and constant ranking of centres between seasons. The correlation between annual NO 2 and PM 2.5 concentrations is fair (Spearman correlation coefficient rs=0.75), but when considered as monthly means the correlation is far less consistent and varies substantially between centres. The range of PM 2.5 mass concentrations obtained in ECRHS II is larger than in other current cohort studies on long-term effects of air pollution. This substantial variation in PM 2.5 exposure will improve statistical power in future multi-level health analyses and to some degree may compensate for the lack of information on within-city variability. Seasonal means may be used to indicate potential differences in the toxicity across the year. Across ECRHS cities annual NO 2 might serve as a surrogate for PM 2.5, especially for past exposure assessment, when PM 2.5 is not available.

Recent progress of RF-dominated experiments on EAST

NASA Astrophysics Data System (ADS)

Liu, F. K.; Zhao, Y. P.; Shan, J. F.; Zhang, X. J.; Ding, B. J.; Wang, X. J.; Wang, M.; Xu, H. D.; Qin, C. M.; Li, M. H.; Gong, X. Z.; Hu, L. Q.; Wan, B. N.; Song, Y. T.; Li, J. G.

2017-10-01

The research of EAST program is mostly focused on the development of high performance steady state scenario with ITER-like poloidal configuration and RF-dominated heating schemes. With the enhanced ITER-relevant auxiliary heating and current drive systems, the plasma profile control by coupling/integration of various combinations has been investigated, including lower hybrid current drive (LHCD), electron cyclotron resonance heating (ECRH) and ion cyclotron resonance heating (ICRH). The 12 MW ICRH system has been installed on EAST. Heating and confinement studies using the Hydrogen Minority Heating scheme have been investigated. One of the importance challenges for EAST is coupling higher power into the core plasma, experiments including changing plasma position, electron density, local gas puffing and antenna phasing scanning were performed to improve ICRF coupling efficiency on EAST. Results show that local gas injection and reducing the k|| can improve the coupling efficiency directly. By means of the 4.6 GHz and 2.45 GHz LHCD systems, H-mode can be obtained and sustained at relatively high density, even up to ne ˜ 4.5 × 1019 m-3, where a current drive effect is still observed. Meanwhile, effect of source frequency (2.45GHz and 4.6GHz) on LHCD characteristic has been studied on EAST, showing that higher frequency improves penetration of the coupled LH (lower hybrid) power into the plasma core and leads to a better effect on plasma characteristics. Studies demonstrate the role of parasitic effects of edge plasma in LHCD and the mitigation by increasing source frequency. Experiments of effect of LH spectrum and plasma density on plasma characteristics are performed, suggesting the possibility of plasma control for high performance. The development of a 4MW ECRH system is in progress for the purpose of plasma heating and MHD control. The built ECRH system with 1MW source power has been successfully put into use on EAST in 2015. H-mode discharges with L-H transition triggered by ECRH injection were obtained and its effects on the electron temperature, particle confinement and the core MHD stabilities were observed. By further exploring and optimizing the RF combination for the sole RF heating and current drive regime, fully non-inductive H-mode discharges with Vloop˜0V has progressed steadily in the 2016 campaign. The overview of the significant progress of RF dominated experiments is presented in this paper.

Can postoperative deltoid weakness after cervical laminoplasty be prevented by using intraoperative neurophysiological monitoring?

PubMed

Ando, Muneharu; Tamaki, Tetsuya; Matsumoto, Takuji; Maio, Kazuhiro; Teraguchi, Masatoshi; Takiguchi, Noboru; Iwahashi, Hiroki; Onishi, Makiko; Nakagawa, Yukihiro; Iwasaki, Hiroshi; Tsutsui, Shunji; Takami, Masanari; Yamada, Hiroshi

2018-04-17

Laminoplasty, frequently performed in patients with cervical myelopathy, is safe and provides relatively good results. However, motor palsy of the upper extremities, which occurs after decompression surgery for cervical myelopathy, often reduces muscle strength of the deltoid muscle, mainly in the C5 myotome. The aim of this study was to investigate prospectively whether postoperative deltoid weakness (DW) can be predicted by performing intraoperative neurophysiological monitoring (IONM) during cervical laminoplasty and to clarify whether it is possible to prevent palsy using IONM. We evaluated the 278 consecutive patients (175 males and 103 females) who underwent French-door cervical laminoplasty for cervical myelopathy under IONM between November 2008 and December 2016 at our hospital. IONM was performed using muscle evoked potential after electrical stimulation to the brain [Br(E)-MsEP] from the deltoid muscle. Seven patients (2.5%) developed DW after surgery (2 with acute and 5 with delayed onset). In all patients, deltoid muscle strength recovered to ≥ 4 on manual muscle testing 3-6 months after surgery. Persistent IONM alerts occurred in 2 patients with acute-onset DW. To predict the acute onset of DW, Br(E)-MsEP alerts in the deltoid muscle had both a sensitivity and specificity of 100%. The PPV of persistent Br(E)-MsEP alerts had both a sensitivity and specificity of 100% for acute-onset DW. There was no change in Br(E)-MsEP in patients with delayed-onset palsy. The incidence of deltoid palsy was relatively low. Persistent Br(E)-MsEP alerts of the deltoid muscle had a 100% sensitivity and specificity for predicting a postoperative acute deficit. IONM was unable to predict delayed-onset DW. In only 1 patient were we able to prevent postoperative DW by performing a foraminotomy.

Association Between Functional Dyspepsia and Severity of Depression.

PubMed

Jamil, Ommara; Sarwar, Shahid; Hussain, Zahid; Fiaz, Raja Omer; Chaudary, Ram Dev

2016-06-01

To determine the association between functional dyspepsia and the severity of depression. Cross-sectional study. Department of Medicine, King Edward Medical University/Mayo Hospital, Lahore, from September 2012 till January 2013. After taking informed written consent, patients with symptoms of dyspepsia fulfilling the Rome III criteria were included in the study. All patients were evaluated for depression, using Hamilton depression rating scale (HDRS). Upper gastrointestinal endoscopy was done. Fischers' exact test and independent t-test were used for determining significance of association. One hundred and one patients with mean age of 35.81 (±14.81) years and male to female ratio of 1.41:1 (54/47) were included. Predominant symptoms were early satiety (72.3%), epigastric pain (65.3%), bloating (49.5%), postprandial fullness (40.6%), and regurgitation (40.6%). Alarm symptoms were positive in 44 (43.6%) patients. Dyspepsia were classified as epigastric pain syndrome (EPS, 69.3%), and postprandial distress syndrome (PDS, 30.7%). Significantly more females had PDS (p=0.04), with positive endoscopic findings in EPS (p=0.03). Positive endoscopic findings noted were esophagitis in 21.8%, and gastritis in 48.5% patients. All patients except one had depression, mild in 22.8%, moderate in 33.7%, severe in 31.7%, and very severe in 10.9% patients. Severe depression was seen in 32 (45.7%) patients with EPS and PDS; whereas very severe depression was in 11 (15.7%) patients of EPS, while 11 (35.4%) patients of PDS had severe depression but the difference was not significant. Functional dyspepsia is associated with depression, while positive endoscopic findings are more likely in patients with EPS. Very severe depression was only seen with epigastric pain syndrome.

ECRH and its effects on neoclassical transport in a stellarator

NASA Astrophysics Data System (ADS)

Seol, Jaechun

The banana center orbit deviates significantly from the magnetic surface due to the symmetry-breaking term in the magnetic field configuration. Energetic electrons can escape the plasma without collision, since the drift speed is proportional to the perpendicular energy of electron and the collision frequency is reduced as the electron energy goes up. A direct loss flux can be generated from energetic electron population in a stellarator. Thus energetic electron populations can substantially modify the neoclassical transport properties in stellarators. A model accounting for this change in transport is developed assuming the presence of electron cyclotron resonance heating (ECRH). The quasilinear diffusion coefficient for second harmonic X-mode ECRH is developed for a bumpy stellarator. Care is taken in accounting for the pitch-angle dependence of the quasilinear diffusion coefficient since application to experiments with narrow resonance zones is of interest. Weakly relativistic effects are considered through the mass effect on the cyclotron frequency. For trapped particles in a three dimensional configuration, collisionless loss zones exist in velocity space. Radio-frequency (rf) waves accelerate trapped electrons into the direct loss zone in bumpy stellarators and produce a direct loss flux. An analytic expression for this loss flux is derived; it is proportional to the rf field strength and the value of the zeroth order distribution function at the minimum speed for collisionless loss. The direct loss flux of electrons is another source of a non-ambipolar particle flux in bumpy stellarators. This additional non-ambipolar flux modifies the ambipolarity equation which generally has multiple roots for the radial electric field. An electron root (large positive Er) is easily obtained if the electrons are in the 1/nu regime and the ions are in the nu regime.

Electron particle transport and turbulence studies in the T-10 tokamak

NASA Astrophysics Data System (ADS)

Vershkov, V. A.; Borisov, M. A.; Subbotin, G. F.; Shelukhin, D. A.; Dnestrovskii, Yu. N.; Danilov, A. V.; Cherkasov, S. V.; Gorbunov, E. P.; Sergeev, D. S.; Grashin, S. A.; Krylov, S. V.; Kuleshin, E. O.; Myalton, T. B.; Skosyrev, Yu. V.; Chistiakov, V. V.

2013-08-01

The goals of this paper are to compare the results of electron particle transport measurements in ohmic (OH) plasmas by means of a small perturbation technique, high-level gas puff and gas switch off, investigate the phenomenon of ‘density pump out’ during electron cyclotron resonance heating (ECRH) and to correlate density behaviour with turbulence. Two approaches for plasma particle transport studies were compared: the low perturbation technique of periodic puff (δn/ne = 0.3%) and strong density variations (δn/ne < 50%), including density ramp-up by gas puff and ramp-down with gas switch off. The model with constant in time diffusion coefficients and pinch velocities could describe the core density perturbations but failed at the edge. In the case of strong puff three stages were distinguished. Degraded energy confinement and, respectively, low turbulence frequencies were observed during density ramp-up and ramp-down, while enhanced confinement and higher turbulence frequencies were typical for the intermediate stage. Density profile variation during this intermediate phase could be described in the framework of the transport model with constant in time coefficients. The application of ECRH at the density ramp-up phase provided the possibility of postponing the ‘density pump out’. The increase in the low-frequency modes in turbulence spectra was observed at the ‘density pump out’ phase during central ECRH. Although the high- and low-frequency bands of turbulence spectra behaved as trapped electron mode and ion temperature gradient, respectively, they both rotated at the same angular velocity as a rigid body together with magnetohydrodynamic mode m/n = 2/1 and [E × B] plasma rotation.

Upgrades and Real Time Ntm Control Application of the Ece Radiometer on Asdex Upgrade

NASA Astrophysics Data System (ADS)

Hicks, N. K.; Suttrop, W.; Behler, K.; Giannone, L.; Manini, A.; Maraschek, M.; Raupp, G.; Reich, M.; Sips, A. C. C.; Stober, J.; Treutterer, W.; ASDEX Upgrade Team; Cirant, S.

2009-04-01

The 60-channel electron cyclotron emission (ECE) radiometer diagnostic on the ASDEX Upgrade tokamak is presently being upgraded to include a 1 MHz sampling rate data acquisition system. This expanded capability allows electron temperature measurements up to 500 kHz (anti-aliasing filter cut-off) with spatial resolution ~1 cm, and will thus provide measurement of plasma phenomena on the MHD timescale, such as neoclassical tearing modes (NTMs). The upgraded and existing systems may be run in parallel for comparison, and some of the first plasma measurements using the two systems together are presented. A particular planned application of the upgraded radiometer is integration into a real-time NTM stabilization loop using targeted deposition of electron cyclotron resonance heating (ECRH). For this loop, it is necessary to determine the locations of the NTM and ECRH deposition using ECE measurements. As the magnetic island of the NTM repeatedly rotates through the ECE line of sight, electron temperature fluctuations at the NTM frequency are observed. The magnetic perturbation caused by the NTM is independently measured using Mirnov coils, and a correlation profile between these magnetic measurements and the ECE data is constructed. The phase difference between ECE oscillations on opposite sides of the island manifests as a zero-crossing of the correlation profile, which determines the NTM location in ECE channel space. To determine the location of ECRH power deposition, the power from a given gyrotron may be modulated at a particular frequency. Correlation analysis of this modulated signal and the ECE data identifies a particular ECE channel associated with the deposition of that gyrotron. Real time equilibrium reconstruction allows the ECE channels to be translated into flux surface and spatial coordinates for use in the feedback loop.

A note on the velocity derivative flatness factor in decaying HIT

NASA Astrophysics Data System (ADS)

Djenidi, L.; Danaila, L.; Antonia, R. A.; Tang, S.

2017-05-01

We develop an analytical expression for the velocity derivative flatness factor, F, in decaying homogenous and isotropic turbulence (HIT) starting with the transport equation of the third-order moment of the velocity increment and assuming self-preservation. This expression, fully consistent with the Navier-Stokes equations, relates F to the product between the second-order pressure derivative (∂2p /∂x2) and second-order moment of the longitudinal velocity derivative ((∂u/∂x ) 2), highlighting the role the pressure plays in the scaling of the fourth-order moment of the longitudinal velocity derivative. It is also shown that F has an upper bound which follows the integral of k*4Ep*(k* ) where Ep and k are the pressure spectrum and the wavenumber, respectively (the symbol * represents the Kolmogorov normalization). Direct numerical simulations of forced HIT suggest that this integral converges toward a constant as the Reynolds number increases.

E. coli Surface Properties Differ between Stream Water and Sediment Environments.

PubMed

Liang, Xiao; Liao, Chunyu; Thompson, Michael L; Soupir, Michelle L; Jarboe, Laura R; Dixon, Philip M

2016-01-01

The importance of E. coli as an indicator organism in fresh water has led to numerous studies focusing on cell properties and transport behavior. However, previous studies have been unable to assess if differences in E. coli cell surface properties and genomic variation are associated with different environmental habitats. In this study, we investigated the variation in characteristics of E. coli obtained from stream water and stream bottom sediments. Cell properties were measured for 77 genomically different E. coli strains (44 strains isolated from sediments and 33 strains isolated from water) under common stream conditions in the Upper Midwestern United States: pH 8.0, ionic strength 10 mM and 22°C. Measured cell properties include hydrophobicity, zeta potential, net charge, total acidity, and extracellular polymeric substance (EPS) composition. Our results indicate that stream sediment E. coli had significantly greater hydrophobicity, greater EPS protein content and EPS sugar content, less negative net charge, and higher point of zero charge than stream water E. coli . A significant positive correlation was observed between hydrophobicity and EPS protein for stream sediment E. coli but not for stream water E. coli . Additionally, E. coli surviving in the same habitat tended to have significantly larger (GTG) 5 genome similarity. After accounting for the intrinsic impact from the genome, environmental habitat was determined to be a factor influencing some cell surface properties, such as hydrophobicity. The diversity of cell properties and its resulting impact on particle interactions should be considered for environmental fate and transport modeling of aquatic indicator organisms such as E. coli .

In situ observation of the growth of biofouling layer in osmotic membrane bioreactors by multiple fluorescence labeling and confocal laser scanning microscopy.

PubMed

Yuan, Bo; Wang, Xinhua; Tang, Chuyang; Li, Xiufen; Yu, Guanghui

2015-05-15

Since the concept of the osmotic membrane bioreactor (OMBR) was introduced in 2008, it has attracted growing interests for its potential applications in wastewater treatment and reclamation; however, the fouling mechanisms of forward osmosis (FO) membrane especially the development of biofouling layer in the OMBR are not yet clear. Here, the fouled FO membranes were obtained from the OMBRs on days 3, 8 and 25 in sequence, and then the structure and growing rule of the biofouling layer formed on the FO membrane samples were in-situ characterized by multiple fluorescence labeling and confocal laser scanning microscopy (CLSM). CLSM images indicated that the variations in abundance and distribution of polysaccharides, proteins and microorganisms in the biofouling layer during the operation of OMBRs were significantly different. Before the 8th day, their biovolume dramatically increased. Subsequently, the biovolumes of β-d-glucopyranose polysaccharides and proteins continued increasing and leveled off after 8 days, respectively, while the biovolumes of α-d-glucopyranose polysaccharides and microorganisms decreased. Extracellular polymeric substances (EPS) played a significant role in the formation and growth of biofouling layer, while the microorganisms were seldom detected on the upper fouling layer after 3 days. Based on the results obtained in this study, the growth of biofouling layer on the FO membrane surface in the OMBR could be divided into three stages. Initially, EPS was firstly deposited on the FO membrane surface, and then microorganisms associated with EPS located in the initial depositing layer to form clusters. After that, the dramatic increase of the clusters of EPS and microorganisms resulted in the quick growth of biofouling layer during the flux decline of the OMBR. However, when the water flux became stable in the OMBR, some microorganisms and EPS would be detached from the FO membrane surface. Copyright © 2015 Elsevier Ltd. All rights reserved.

Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population.

PubMed

Ghoshal, Uday C; Singh, Rajan

2017-02-01

As best estimates on functional gastrointestinal disorders (FGIDs) prevalence are expected from community studies, which are scanty from Asia, we evaluated the prevalence and risk factors of FGIDs in a rural Indian community. House-to-house survey was undertaken by trained interviewers using translated-validated Rome III and hospital anxiety and depression questionnaires. Among 3426 subjects ≥ 18 years old from 3 villages in Uttar Pradesh, 84% participated, of whom 80% were finally analyzed. Of these 2774 subjects (age 38.4 ± 16.5 years, 1573 [56.7%] male), 2654 [95.7%] were vegetarian and 120 [4.3%] non-vegetarian. Socioeconomic classes were upper (16.7%), upper middle (15.1%), lower middle (22%), upper lower (22.2%), and lower (24%) using Prasad's Classification; 603 (21.7%) had FGIDs (413 [14.9%] dyspepsia, 75 [2.7%] irritable bowel syndrome (IBS) and 115 [4.1%] dyspepsia-IBS overlap), by Rome III criteria. In subjects with dyspepsia, 49/528 (9%) had epigastric pain, 141 (27%) postprandial distress syndromes (EPS, PDS) and 338 (64%) EPS-PDS overlap. IBS was more often diarrhea than constipation-predominant subtype. On univariate analysis, chewing tobacco, aerated drink, tea/coffee, disturbed sleep, vegetarianism, and anxiety parameters and presence of dyspepsia predicting occurrence of IBS were associated with FGIDs. On multivariate analysis, chewing tobacco, aerated soft drink, tea/coffee, vegetarianism, anxiety parameters, and presence of dyspepsia predicting IBS were significant. Functional gastrointestinal disorders, particularly dyspepsia-IBS overlap, are common in rural Indian population; the risk factors included chewing tobacco, aerated soft drink, tea/coffee, vegetarian diet, disturbed sleep, anxiety, and dyspepsia predicting occurrence of IBS. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Predictions of H-mode performance in ITER

NASA Astrophysics Data System (ADS)

Budny, Robert

2008-11-01

Time-dependent integrated predictions of performance metrics such as the fusion power PDT, QDT≡ PDT/Pext, and alpha profiles are presented. The PTRANSP [1] code is used, along with GLF23 to predict plasma profiles, NUBEAM for NNBI and alpha heating, TORIC for ICRH, and TORAY for ECRH. Effects of sawteeth mixing, beam steering, beam shine-through, radiation loss, ash accumulation, and toroidal rotation are included. A total heating of Pext=73MW is assumed to achieve H-mode during the density and current ramp-up phase. Various mixes of NNBI, ICRH, and ECRH heating schemes are compared. After steady state conditions are achieved, Pext is stepped down to lower values to explore high QDT. Physics and computation uncertainties lead to ranges in predictions for PDT and QDT. Physics uncertainties include the L->H and H->L threshold powers, pedestal height, impurity and ash transport, and recycling. There are considerably more uncertainties predicting the peak value for QDT than for PDT. [0pt] [1] R.V. Budny, R. Andre, G. Bateman, F. Halpern, C.E. Kessel, A. Kritz, and D. McCune, Nuclear Fusion 48 (2008) 075005.

Advanced electron cyclotron heating and current drive experiments on the stellarator Wendelstein 7-X

NASA Astrophysics Data System (ADS)

Stange, Torsten; Laqua, Heinrich Peter; Beurskens, Marc; Bosch, Hans-Stephan; Bozhenkov, Sergey; Brakel, Rudolf; Braune, Harald; Brunner, Kai Jakob; Cappa, Alvaro; Dinklage, Andreas; Erckmann, Volker; Fuchert, Golo; Gantenbein, Gerd; Gellert, Florian; Grulke, Olaf; Hartmann, Dirk; Hirsch, Matthias; Höfel, Udo; Kasparek, Walter; Knauer, Jens; Langenberg, Andreas; Marsen, Stefan; Marushchenko, Nikolai; Moseev, Dmitry; Pablant, Novomir; Pasch, Ekkehard; Rahbarnia, Kian; Mora, Humberto Trimino; Tsujimura, Toru; Turkin, Yuriy; Wauters, Tom; Wolf, Robert

2017-10-01

During the first operational phase (OP 1.1) of Wendelstein 7-X (W7-X) electron cyclotron resonance heating (ECRH) was the exclusive heating method and provided plasma start-up, wall conditioning, heating and current drive. Six gyrotrons were commissioned for OP1.1 and used in parallel for plasma operation with a power of up to 4.3 MW. During standard X2-heating the spatially localized power deposition with high power density allowed controlling the radial profiles of the electron temperature and the rotational transform. Even though W7-X was not fully equipped with first wall tiles and operated with a graphite limiter instead of a divertor, electron densities of n e > 3·1019 m-3 could be achieved at electron temperatures of several keV and ion temperatures above 2 keV. These plasma parameters allowed the first demonstration of a multipath O2-heating scenario, which is envisaged for safe operation near the X-cutoff-density of 1.2·1020 m-3 after full commissioning of the ECRH system in the next operation phase OP1.2.

140 GHz EC waves propagation and absorption for normal/oblique injection on FTU tokamak

NASA Astrophysics Data System (ADS)

Nowak, S.; Airoldi, A.; Bruschi, A.; Buratti, P.; Cirant, S.; Gandini, F.; Granucci, G.; Lazzaro, E.; Panaccione, L.; Ramponi, G.; Simonetto, A.; Sozzi, C.; Tudisco, O.; Zerbini, M.

1999-09-01

Most of the interest in ECRH experiments is linked to the high localization of EC waves absorption in well known portions of the plasma volume. In order to take full advantage of this capability a reliable code has been developed for beam tracing and absorption calculations. The code is particularly important for oblique (poloidal and toroidal) injection, when the absorbing layer is not simply dependent on the position of the EC resonance only. An experimental estimate of the local heating power density is given by the jump in the time derivative of the local electron pressure at the switching ON of the gyrotron power. The evolution of the temperature profile increase (from ECE polychromator) during the nearly adiabatic phase is also considered for ECRH profile reconstruction. An indirect estimate of optical thickness and of the overall absorption coefficient is given by the measure of the residual e.m. power at the tokamak walls. Beam tracing code predictions of the power deposition profile are compared with experimental estimates. The impact of the finite spatial resolution of the temperature diagnostic on profile reconstruction is also discussed.

Control system of neoclassical tearing modes in real time on HL-2A tokamak.

PubMed

Yan, Longwen; Ji, Xiaoquan; Song, Shaodong; Xia, Fan; Xu, Yuan; Ye, Jiruo; Jiang, Min; Chen, Wenjin; Sun, Tengfei; Liang, Shaoyong; Ling, Fei; Ma, Rui; Huang, Mei; Qu, Hongpeng; Song, Xianming; Yu, Deliang; Shi, Zhongbin; Liu, Yi; Yang, Qingwei; Xu, Min; Duan, Xuru; Liu, Yong

2017-11-01

The stability and performance of tokamak plasmas are routinely limited by various magneto-hydrodynamic instabilities, such as neoclassical tearing modes (NTMs). This paper presents a rather simple method to control the NTMs in real time (RT) on a tokamak, including the control principle of a feedback approach for RT suppression and stabilization for the NTMs. The control system combines Mirnov, electron cyclotron emission, and soft X-ray diagnostics used for determining the NTM positions. A methodology for fast detection of 2/1 or 3/2 NTM positions with 129 × 129 grid reconstruction is elucidated. The forty poloidal angles for steering the electron cyclotron resonance heating (ECRH)/electron cyclotron current drive launcher are used to establish the alignment of antenna mirrors with the center of the NTM and to ensure launcher emission intersecting with the rational surface of a magnetic island. Pilot experiments demonstrate the RT control capability to trace the conventional tearing modes (CTMs) in the HL-2A tokamak. The 2/1 CTMs have been suppressed or stabilized by the ECRH power deposition on site or with the steerable launcher.

Control system of neoclassical tearing modes in real time on HL-2A tokamak

NASA Astrophysics Data System (ADS)

Yan, Longwen; Ji, Xiaoquan; Song, Shaodong; Xia, Fan; Xu, Yuan; Ye, Jiruo; Jiang, Min; Chen, Wenjin; Sun, Tengfei; Liang, Shaoyong; Ling, Fei; Ma, Rui; Huang, Mei; Qu, Hongpeng; Song, Xianming; Yu, Deliang; Shi, Zhongbin; Liu, Yi; Yang, Qingwei; Xu, Min; Duan, Xuru; Liu, Yong

2017-11-01

The stability and performance of tokamak plasmas are routinely limited by various magneto-hydrodynamic instabilities, such as neoclassical tearing modes (NTMs). This paper presents a rather simple method to control the NTMs in real time (RT) on a tokamak, including the control principle of a feedback approach for RT suppression and stabilization for the NTMs. The control system combines Mirnov, electron cyclotron emission, and soft X-ray diagnostics used for determining the NTM positions. A methodology for fast detection of 2/1 or 3/2 NTM positions with 129 × 129 grid reconstruction is elucidated. The forty poloidal angles for steering the electron cyclotron resonance heating (ECRH)/electron cyclotron current drive launcher are used to establish the alignment of antenna mirrors with the center of the NTM and to ensure launcher emission intersecting with the rational surface of a magnetic island. Pilot experiments demonstrate the RT control capability to trace the conventional tearing modes (CTMs) in the HL-2A tokamak. The 2/1 CTMs have been suppressed or stabilized by the ECRH power deposition on site or with the steerable launcher.

Evaluation of the highly sensitive Roche thyroglobulin II assay and establishment of a reference limit for thyroglobulin-negative patient samples.

PubMed

Rotteveel-de Groot, Dorien M; Ross, H Alec; Janssen, Marcel J R; Netea-Maier, Romana T; Oosting, Janine D; Sweep, Fred C G J; van Herwaarden, Antonius E

2016-08-01

Thyroglobulin (Tg) measurements are used to monitor for residual thyroid tissue in patients with differentiated thyroid cancer (DTC) after thyroidectomy and radioiodine ablative therapy. In recent years highly sensitive Tg assays have been developed. In this study the analytical performance of the new Roche Elecsys Tg II assay was evaluated and compared with the well documented Access2 Tg assay (Beckman-Coulter). Analytical performance was examined using various Clinical and Laboratory Standards Institute (CLSI) evaluation protocols. Tg negative patient sera were used to establish an upper reference limit (URL) for the Elecsys Tg II assay. Non-linearity, drift and carry-over according to CLSI EP10 and EP6 in a measuring range of 0.04-500 ng/mL were non-significant. Total precision according to CLSI EP5 was 10% at a Tg concentration of 0.08 ng/mL. A patient serum comparison performed according to a modified CLSI EP9 protocol showed a significant difference of a factor of approximately 1.4, despite using an identical CRM calibrator. The Elecsys Tg II assay measured Tg with a two-fold higher sensitivity than the Access2 assay. Finally, using human sera without Tg, an URL of 0.05 ng/mL was determined. In our hands the highly sensitive Elecsys Tg II assay shows a good analytical performance and a higher sensitivity compared to the Access2 Tg assay. An URL of 0.05 ng/mL for the Elecsys Tg II assay was determined which may improve the clinical utility of the assay for the detection of residual DTC or disease recurrence.

Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health

PubMed Central

Ljubin-Sternak, Sunčanica; Meštrović, Tomislav

2014-01-01

The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health. PMID:25614838

Double fillet lap of laser welding of thin sheet AZ31B Mg alloy

NASA Astrophysics Data System (ADS)

Ishak, Mahadzir; Salleh, M. N. M.

2018-05-01

In this paper, we describe the experimental laser welding of thin sheet AZ31B using double fillet lap joint method. Laser welding is capable of producing high quality weld seams especially for small weld bead on thin sheet product. In this experiment, both edges for upper and lower sheets were subjected to the laser beam from the pulse wave (PW) mode of fiber laser. Welded sample were tested their joint strength by tensile-shear strength method and the fracture loads were studied. Strength for all welded samples were investigated and the effect of laser parameters on the joint strength and appearances were studied. Pulsed energy (EP) from laser process give higher effect on joint strength compared to the welding speed (WS) and angle of irradiation (AOI). Highest joint strength was possessed by sample with high EP with the same value of WS and AOI. The strength was low due to the crack defect at the centre of weld region.

Oral health condition and reasons for tooth extraction among an adult population (20-64 years old).

PubMed

Silva-Junior, Manoelito Ferreira; Sousa, Anne Caroline Correia de; Batista, Marília Jesus; Sousa, Maria da Luz Rosário de

2017-08-01

The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.

Occupational lead exposure aboard a tall ship.

PubMed

Landrigan, P J; Straub, W E

1985-01-01

To evaluate occupational exposures to lead in shipfitters cutting and riveting lead-painted iron plates aboard an iron-hulled sailing vessel, we conducted an environmental and medical survey. Lead exposures in seven personal (breathing zone) air samples ranged from 108 to 500 micrograms/m3 (mean 257 micrograms/m3); all were above the Occupational Safety and Health Administration (OSHA) standard of 50 micrograms/m3. In two short-term air samples obtained while exhaust ventilation was temporarily disconnected, mean lead exposure rose to 547 micrograms/m3. Blood lead levels in ten shipfitters ranged from 25 to 53 micrograms/dl (mean, 37.8 micrograms/dl); levels in three of these workers exceeded the upper normal limit of 40 micrograms/dl. Blood lead levels in shipfitters were significantly higher than in other shipyard workers (mean 10.0 micrograms/dl; p less than 0.001). Smoking shipfitters (mean, 47 micrograms/dl) had significantly higher lead levels than nonsmokers (mean, 32 micrograms/dl; p = 0.03). Lead levels in shipfitters who wore respirators were not lower than in those who wore no protective gear (p = 0.68). Four shipfitters had erythrocyte protoporphyrin (EP) concentrations above the adult upper normal limit of 50 micrograms/dl. A close correlation was found between blood lead and EP levels (r = 0.70). Prevalence of lead-related symptoms was no higher in shipfitters than in other workers. No cases of symptomatic lead poisoning were noted. These data indicate that serious occupational exposure to lead can occur in a relatively small boatyard.

Simultaneous spatiotemporal mapping of in situ pH and bacterial activity within an intact 3D microcolony structure

NASA Astrophysics Data System (ADS)

Hwang, Geelsu; Liu, Yuan; Kim, Dongyeop; Sun, Victor; Aviles-Reyes, Alejandro; Kajfasz, Jessica K.; Lemos, Jose A.; Koo, Hyun

2016-09-01

Biofilms are comprised of bacterial-clusters (microcolonies) enmeshed in an extracellular matrix. Streptococcus mutans can produce exopolysaccharides (EPS)-matrix and assemble microcolonies with acidic microenvironments that can cause tooth-decay despite the surrounding neutral-pH found in oral cavity. How the matrix influences the pH and bacterial activity locally remains unclear. Here, we simultaneously analyzed in situ pH and gene expression within intact biofilms and measured the impact of damage to the surrounding EPS-matrix. The spatiotemporal changes of these properties were characterized at a single-microcolony level following incubation in neutral-pH buffer. The middle and bottom-regions as well as inner-section within the microcolony 3D structure were resistant to neutralization (vs. upper and peripheral-region), forming an acidic core. Concomitantly, we used a green fluorescent protein (GFP) reporter to monitor expression of the pH-responsive atpB (PatpB::gfp) by S. mutans within microcolonies. The atpB expression was induced in the acidic core, but sharply decreased at peripheral/upper microcolony regions, congruent with local pH microenvironment. Enzymatic digestion of the surrounding matrix resulted in nearly complete neutralization of microcolony interior and down-regulation of atpB. Altogether, our data reveal that biofilm matrix facilitates formation of an acidic core within microcolonies which in turn activates S. mutans acid-stress response, mediating both the local environment and bacterial activity in situ.

Molar loss and powder diet leads to memory deficit and modifies the mRNA expression of brain-derived neurotrophic factor in the hippocampus of adult mice.

PubMed

Takeda, Yosuke; Oue, Hiroshi; Okada, Shinsuke; Kawano, Akira; Koretake, Katsunori; Michikawa, Makoto; Akagawa, Yasumasa; Tsuga, Kazuhiro

2016-12-05

It is known that tooth loss is known to be a risk factor for Alzheimer's disease and soft diet feeding induces memory impairment. Recent studies have shown that brain-derived neurotrophic factor (BDNF) is associated with tooth loss or soft diet in young animal model, and that BDNF expression is decreased in patients with Alzheimer's disease. However, single or combined effect of tooth loss and/or soft diet on brain function has not fully understood. Here we examined the effect of molar loss and powder diet on memory ability and the expression of BDNF mRNA in the hippocampus of adult C57BL/6J mice. Twenty eight-weeks-old C57BL/6J mice were divided into intact molar group and extracted molar group. They were randomly divided into the I/S group (Intact upper molar teeth/Solid diet feeding), the E/S group (Extracted upper molar teeth/Solid diet feeding), the I/P group (Intact upper molar teeth/Powder diet feeding), and the E/P group (Extracted upper molar teeth/Powder diet feeding). The observation periods were 4 and 16-week. To analyze the memory ability, the step-through passive avoidance test was conducted. BDNF-related mRNA in the hippocampus was analyzed by real-time polymerase chain reaction (RT-PCR). At 4 weeks later, we performed memory test and isolated brains to analyze. There were no differences in memory function and BDNF mRNA level between these four groups. However, at 16 weeks later, E/S and E/P group showed memory impairment, and decreased level of BDNF mRNA. Whereas, the powder diet had no effect on memory function and BDNF mRNA level even at 16 weeks later. These results suggest that the effect of molar loss and powder diet on memory function and BDNF mRNA levels were different, molar loss may have a greater long-term effect on memory ability than powder diet does.

Predictions of high QDT in ITER H-mode plasmas

NASA Astrophysics Data System (ADS)

Budny, Robert

2009-05-01

Time-dependent integrated predictions of performance metrics such as the fusion power PDT, QDT≡ PDT/Pext, and alpha profiles are presented. The PTRANSP code (see R.V. Budny, R. Andre, G. Bateman, F. Halpern, C.E. Kessel, A. Kritz, and D. McCune, Nuclear Fusion 48 075005, and F. Halpern, A. Kritz, G. Bateman, R.V. Budny, and D. McCune, Phys. Plasmas 15 062505) is used, along with GLF23 to predict plasma profiles, NUBEAM for NNBI and alpha heating, TORIC for ICRH, and TORAY for ECRH. Effects of sawteeth mixing, beam steering, beam shine-through, radiation loss, ash accumulation, and toroidal rotation are included. A total heating of Pext=73MW is assumed to achieve H-mode during the density and current ramp-up phase. Various mixes of NNBI, ICRH, and ECRH heating schemes are compared. After steady state conditions are achieved, Pext is stepped down to lower values to explore high QDT. Physics and computation uncertainties lead to ranges in predictions for PDT and QDT. Physics uncertainties include the L->H and H->L threshold powers, pedestal height, impurity and ash transport, and recycling. There are considerably more uncertainties predicting the peak value for QDT than for PDT.

Disruption mitigation and avoidance at ASDEX Upgrade

NASA Astrophysics Data System (ADS)

Maraschek, M.; Pautasso, G.; Esposito, B.; Granucci, G.; Stober, J.; Treutterer, W.

2009-11-01

Disruptions are a major concern for tokamaks and in particular for ITER. They cause high heat loads during the thermal quench and high mechanical forces during the subsequent current quench. The generation and loss of runaway electrons (highly accelerated electrons carrying large fractions of the plasma current) can produce damage to the vessel structures. Therefore, schemes are implemented in present tokamaks to mitigate or to even avoid them. Mitigation has been proven to be effective through the injection of noble gases causing a reduction of the thermal heat load by radiation and a reduction of the mechanical forces. In addition 25% of the required density for the collisional suppression of runaways in ITER has been reached. For the trigger of the noble gas injection a locked mode detector is routinely used at ASDEX Upgrade. An extension to more complex precursors is planed. A different approach has been used for disruption avoidance by injecting ECRH triggered by the loop voltage increase before the disruption. The avoidance of an ongoing density limit disruption has been achieved when the ECRH is deposited at resonant surfaces where MHD modes, such as the m=2/n=1, occur. Present schemes for the mitigation and eventually avoidance of disruptions will be discussed.

Investigation of the long-lived saturated internal mode and its control on the HL-2A tokamak

NASA Astrophysics Data System (ADS)

Wei, Deng; Yi, Liu; Xian-Qu, Wang; Wei, Chen; Yun-Bo, Dong; Ohdachi, S.; Xiao-Quan, Ji; Yong, Shen; Jian-Yong, Cao; Jun, Zhou; Bei-Bing, Feng; Yong-Gao, Li; Xian-Li, Huang; Jin-Ming, Gao; Xiao-Yu, Han; Mei, Huang; Xiao-Gang, Wang

2014-01-01

HL-2A plasmas heated by neutral beam injection (NBI) regularly exhibit n = 1 long-lived saturated magnetohydrodynamic instabilities. A reduction in the electron density and plasma stored energy and an increase in fast ion losses are usually observed in the presence of such perturbations. The observed long-lived saturated internal mode (LLM) occurs when the safety factor profile has a weak shear in a broad range of the plasma centre with qmin around unity. It is found that the ideal interchange mode can become marginally stable due to the weak magnetic shear reaching a critical value. The LLM, due to its pressure-driven feature, is destabilized by the strong interaction with fast ions in the low-shear region during the NBI. Furthermore, for the first time it is clearly observed that the LLMs can be suppressed by electron cyclotron resonant heating (ECRH), or by supersonic molecular beam injection in HL-2A plasmas. Low-n sidebands observed during the LLM are also suppressed by increasing the ECRH power. The control of LLMs is due to the change in the magnetic shear or in the pressure profile induced by the local heating or fuelling.

Predictors of microbial agents in dust and respiratory health in the Ecrhs.

PubMed

Tischer, Christina; Zock, Jan-Paul; Valkonen, Maria; Doekes, Gert; Guerra, Stefano; Heederik, Dick; Jarvis, Deborah; Norbäck, Dan; Olivieri, Mario; Sunyer, Jordi; Svanes, Cecilie; Täubel, Martin; Thiering, Elisabeth; Verlato, Giuseppe; Hyvärinen, Anne; Heinrich, Joachim

2015-05-02

Dampness and mould exposure have been repeatedly associated with respiratory health. However, less is known about the specific agents provoking or arresting health effects in adult populations. We aimed to assess predictors of microbial agents in mattress dust throughout Europe and to investigate associations between microbial exposures, home characteristics and respiratory health. Seven different fungal and bacterial parameters were assessed in mattress dust from 956 adult ECRHS II participants in addition to interview based home characteristics. Associations between microbial parameters and the asthma score and lung function were examined using mixed negative binomial regression and linear mixed models, respectively. Indoor dampness and pet keeping were significant predictors for higher microbial agent concentrations in mattress dust. Current mould and condensation in the bedroom were significantly associated with lung function decline and current mould at home was positively associated with the asthma score. Higher concentrations of muramic acid were associated with higher mean ratios of the asthma score (aMR 1.37, 95%CI 1.17-1.61). There was no evidence for any association between fungal and bacterial components and lung function. Indoor dampness was associated with microbial levels in mattress dust which in turn was positively associated with asthma symptoms.

HIV Pre-Exposure Prophylaxis Stigma as a Multidimensional Barrier to Uptake Among Women Who Attend Planned Parenthood.

PubMed

Calabrese, Sarah K; Dovidio, John F; Tekeste, Mehrit; Taggart, Tamara; Galvao, Rachel W; Safon, Cara B; Willie, Tiara C; Caldwell, Abigail; Kaplan, Clair; Kershaw, Trace S

2018-05-22

PrEP uptake has lagged among US women. PrEP stigma is a recognized barrier to uptake among MSM but remains largely unexplored among women. This study examined the pervasiveness of PrEP stigma among US women and its implications for uptake. Setting/Methods: In a 2017 online survey of Planned Parenthood patients drawn from the three cities with the highest numbers of new HIV infections in Connecticut, 597 heterosexually-active, HIV-negative, PrEP-inexperienced women reported background characteristics, two dimensions of anticipated PrEP stigma (PrEP-user stereotypes and PrEP disapproval by others), and three indicators of potential PrEP uptake (interest in learning more about PrEP, intention to use PrEP, and comfort discussing PrEP with a provider). Participants commonly perceived PrEP-user stereotypes, with many believing that others would regard them as promiscuous (37%), HIV-positive (32%), bad (14%), or gay (11%) if they used PrEP. Thirty percent would feel ashamed to disclose PrEP use. Many participants expected disapproval by family (36%), sex partners (34%), and friends (25%). In adjusted analyses, perception of PrEP-user stereotypes was uniquely associated with lower comfort discussing PrEP with a provider. Expected PrEP disapproval by others was uniquely associated with less PrEP interest, less intention to use PrEP, and less comfort discussing PrEP with a provider. Exploratory moderation analyses suggested intention to use PrEP was greatest when participants anticipated low levels of both PrEP-user stereotypes and PrEP disapproval by others. Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.

Bulk Lorentz factors of gamma-ray bursts

NASA Astrophysics Data System (ADS)

Ghirlanda, G.; Nappo, F.; Ghisellini, G.; Melandri, A.; Marcarini, G.; Nava, L.; Salafia, O. S.; Campana, S.; Salvaterra, R.

2018-01-01

Knowledge of the bulk Lorentz factor Γ0 of gamma-ray bursts (GRBs) allows us to compute their comoving frame properties shedding light on their physics. Upon collisions with the circumburst matter, the fireball of a GRB starts to decelerate, producing a peak or a break (depending on the circumburst density profile) in the light curve of the afterglow. Considering all bursts with known redshift and with an early coverage of their emission, we find 67 GRBs (including one short event) with a peak in their optical or GeV light curves at a time tp. For another 106 GRBs we set an upper limit tpUL. The measure of tp provides the bulk Lorentz factor Γ0 of the fireball before deceleration. We show that tp is due to the dynamics of the fireball deceleration and not to the passage of a characteristic frequency of the synchrotron spectrum across the optical band. Considering the tp of 66 long GRBs and the 85 most constraining upper limits, we estimate Γ0 or a lower limit Γ0LL. Using censored data analysis methods, we reconstruct the most likely distribution of tp. All tp are larger than the time Tp,γ when the prompt γ-ray emission peaks, and are much larger than the time Tph when the fireball becomes transparent, that is, tp>Tp,γ>Tph. The reconstructed distribution of Γ0 has median value 300 (150) for a uniform (wind) circumburst density profile. In the comoving frame, long GRBs have typical isotropic energy, luminosity, and peak energy ⟨ Eiso ⟩ = 3(8) × 1050 erg, ⟨ Liso ⟩ = 3(15) × 1047 erg s-1, and ⟨ Epeak ⟩ = 1(2) keV in the homogeneous (wind) case. We confirm that the significant correlations between Γ0 and the rest frame isotropic energy (Eiso), luminosity (Liso), and peak energy (Ep) are not due to selection effects. When combined, they lead to the observed Ep-Eiso and Ep-Liso correlations. Finally, assuming a typical opening angle of 5 degrees, we derive the distribution of the jet baryon loading which is centered around a few 10-6M⊙.

77 FR 65935 - Notice of Application for Approval of Discontinuance or Modification of a Railroad Signal System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

... NS Port Road Branch from Perrysburg, MD, Milepost (MP) PD-0.3, to Enola, PA, MP EP-68.2. The discontinuance would include automatic signals: PD 1.9, PD 6.4, PD 9.7, PD 15.7, PD 18.7, PD 23.6, PD 28.8, PD 35.7, EP 35.2, EP 40.0, EP 42.4, EP 47.6, EP 49.5, EP 53.6, EP 54.0, EP 58.3, EP 62.8, EP 67.1. The...

Functional and bioinformatics analysis of an exopolysaccharide-related gene (epsN) from Lactobacillus kefiranofaciens ZW3.

PubMed

Wang, Jingrui; Tang, Wei; Zheng, Yongna; Xing, Zhuqing; Wang, Yanping

2016-09-01

A novel lactic acid bacteria strain Lactobacillus kefiranofaciens ZW3 exhibited the characteristics of high production of exopolysaccharide (EPS). The epsN gene, located in the eps gene cluster of this strain, is associated with EPS biosynthesis. Bioinformatics analysis of this gene was performed. The conserved domain analysis showed that the EpsN protein contained MATE-Wzx-like domains. Then the epsN gene was amplified to construct the recombinant expression vector pMG36e-epsN. The results showed that the EPS yields of the recombinants were significantly improved. By determining the yields of EPS and intracellular polysaccharide, it was considered that epsN gene could play its Wzx flippase role in the EPS biosynthesis. This is the first time to prove the effect of EpsN on L. kefiranofaciens EPS biosynthesis and further prove its functional property.

First description of a metamorphic sole related to ophiolite obduction in the northern Caribbean: Geochemistry and petrology of the Güira de Jauco Amphibolite complex (eastern Cuba) and tectonic implications

NASA Astrophysics Data System (ADS)

Lázaro, C.; Blanco-Quintero, I. F.; Rojas-Agramonte, Y.; Proenza, J. A.; Núñez-Cambra, K.; García-Casco, A.

2013-10-01

The Güira de Jauco Amphibolite Complex underlies the Mayarí-Baracoa Ophiolitic Belt (eastern Cuba) and is composed of highly foliated amphibolite, locally with blocks of sheared serpentinitie that enclose concordant layers of amphibolite. These amphibolites are interpreted as remnants of a sub-ophiolitic metamorphic sole likely formed during late Cretaceous times before the initiation of the collision between the Caribbean and the North American plates. The complex includes common amphibolites (Hbl + Pl ± Ep ± Ttn ± Rt ± Qtz ± Ap), garnet amphibolites (Hbl + Grt + Pl + Ep ± Ttn ± Qtz ± Ap) and clinopyroxene amphibolites (Hbl + Pl + Cpx ± Ep ± Ttn ± Qtz ± Ap). Geochemical data indicates that the protoliths are igneous mafic rocks of basaltic composition that likely formed part of the upper and lower(?)crust of an oceanic lithosphere. Rare Earth element contents suggest a Mid-Ocean Ridge Basalt (MORB) origin. However, the enrichment in Large-Ion Lithophile elements and the depletion in NbTaTi as compared to Normal-MORB, suggests a suprasubduction scenario, either a back-arc or a fore-arc setting. The pressure-temperature estimates of metamorphism indicate that the entire amphibolite body underwent similar peak metamorphic conditions at 650-665 °C and 8.5-8.7 kbar (ca. 30 km depth), corresponding to a relatively high apparent geothermal gradient of 23 °C/km.

Countability of Planck Boxes in Quantum Branching Models

NASA Astrophysics Data System (ADS)

Berezin, Alexander A.

2002-04-01

Two popular paradigms of cosmological quantum branching are Many World (MW) model of parallel universes (Everett, Deutsch) and inflationary quantum foam (IQF) model (Guth, Linde). Taking Planck L,T units as physically smallest, our Big Bang miniverse with size 10E28 cm and duration 10E18 sec has some 10E244 (N) elementary 4D Planck Boxes (PB) in its entire spacetime history. Using combinatorics, N! (about 10E10E247) is upper estimate for number of all possible 4D states, i.e. scale of "eternal return" (ER; Nietzsche, Eliade) for such miniverses. To count all states in full Megaverse (all up and down branches of infinite tree of all MW and/or IQF miniverses) we recall that all countable infinities have same (aleph-naught) cardinality (Cantor). Using Godel-type numbering, count PB in our miniverse by primes. This uses first N primes. Both MW and IQF models presume splitting of miniverses as springing (potentially) from each PB, making each PB infinitely rich, inexhaustible and unique. Next branching level is counted by integers p1Ep2, third level by p1Ep2Ep3 integers, etc, ad infinitum. To count in up and down directions from "our" miniverse, different branching subsets of powers of primes can be used at all levels of tower exponentiation. Thus, all PB in all infinitude of MW and/or IQF branches can be uniquely counted by never repeating integers (tower exponents of primes), offering escape from grim ER scenarios.

EpsA is an essential gene in exopolysaccharide production in Lactobacillus johnsonii FI9785.

PubMed

Dertli, Enes; Mayer, Melinda J; Colquhoun, Ian J; Narbad, Arjan

2016-07-01

Lactobacillus johnsonii FI9785 has an eps gene cluster which is required for the biosynthesis of homopolymeric exopolysaccharides (EPS)-1 and heteropolymeric EPS-2 as a capsular layer. The first gene of the cluster, epsA, is the putative transcriptional regulator. In this study we showed the crucial role of epsA in EPS biosynthesis by demonstrating that deletion of epsA resulted in complete loss of both EPS-1 and EPS-2 on the cell surface. Plasmid complementation of the epsA gene fully restored EPS production, as confirmed by transmission electron microscopy and nuclear magnetic resonance (NMR) analysis. Furthermore, this complementation resulted in a twofold increase in the expression levels of this gene, which almost doubled amounts of EPS production in comparison with the wild-type strain. Analysis of EPS by NMR showed an increased ratio of the heteropolysaccharide to homopolysaccharide in the complemented strain and allowed identification of the acetylated residue in EPS-2 as the (1,4)-linked βGlcp unit, with the acetyl group located at O-6. These findings indicate that epsA is a positive regulator of EPS production and that EPS production can be manipulated by altering its expression. © 2015 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

Production of extracellular polymeric substances (EPS) by Serratia sp.1 using wastewater sludge as raw material and flocculation activity of the EPS produced.

PubMed

Bezawada, J; Hoang, N V; More, T T; Yan, S; Tyagi, N; Tyagi, R D; Surampalli, R Y

2013-10-15

Growth profile and extracellular polymeric substances (EPS) production of Serratia sp.1 was studied in shake flask fermentation for 72 h using wastewater sludge as raw material. Maximum cell concentration of 6.7 × 10(9) cfu/mL was obtained at 48 h fermentation time. EPS dry weight, flocculation activity and dewaterability of different EPS (tightly bound or TB-EPS, loosely bound or LB-EPS and broth-EPS or B-EPS) were also measured. The highest concentration of LB-EPS (2.45 g/L) and TB-EPS (0.99 g/L) were attained at 48 h of fermentation. Maximum flocculation activity and dewaterability (ΔCST) of TB-EPS (76.4%, 14.5s and 76.5%, 15.5s), LB-EPS (67.8%, 8.1s and 64.7%, 7.6s) and broth EPS (61%, 6.1s and 70.4%, 6.8s) were obtained at 36 and 48 h of growth. Higher flocculation activity and dewaterability were achieved with TB-EPS than with the two other EPS. Characterization of TB-EPS and LB-EPS was done in terms of their protein and carbohydrate content. Protein content was much higher in TB-EPS where as carbohydrate content was only slightly higher in TB-EPS than LB-EPS. Morphology of the Serratia strain after fermentation in sludge and TSB was observed under a scanning electron microscope and the cell size was found to be bigger in the sludge medium than the TSB medium. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prostaglandin E2 regulates melanocyte dendrite formation through activation of PKCζ

PubMed Central

Scott, Glynis; Fricke, Alex; Fender, Anne; McClelland, Lindy; Jacobs, Stacey

2007-01-01

Prostaglandins are lipid signaling intermediates released by keratinocytes in response to ultraviolet irradiation (UVR) in the skin. The main prostaglandin released following UVR is PGE2, a ligand for 4 related G-protein coupled receptors (EP1, EP2, EP3 and EP4). Our previous work established that PGE2 stimulates melanocyte dendrite formation through activation of the EP1 and EP3 receptors. The purpose of the present report is to define the signaling intermediates involved in EP1 and EP3-dependent dendrite formation in human melanocytes. We recently showed that activation of the atypical PKCζ isoform stimulates melanocyte dendricity in response to treatment with lysophosphatidylcholine. We therefore examined the potential contribution of PKCζ activation on EP1 and EP3-dependent dendrite formation in melanocytes. Stimulation of the EP1 and EP3 receptors by selective agonists activated PKCζ, and inhibition of PKCζ activation abrogated EP1 and EP3-receptor mediated melanocyte dendricity. Because of the importance of Rho-GTP binding proteins in the regulation of melanocyte dendricity, we also examined the effect of EP1 and EP3 receptor activation on Rac and Rho activity. Neither Rac nor Rho was activated upon treatment with EP1,3-receptor agonists. We show that melanocytes express only the EP3A1 isoform, but not the EP3B receptor isoform, previously associated with Rho activation, consistent with a lack of Rho stimulation by EP3 agonists. Our data suggest that PKCζ activation plays a predominant role in regulation of PGE2-dependent melanocyte dendricity. PMID:17850789

A comparison of sea surface salinity in the equatorial Pacific Ocean during the 1997-1998, 2012-2013, and 2014-2015 ENSO events

NASA Astrophysics Data System (ADS)

Corbett, Caroline M.; Subrahmanyam, Bulusu; Giese, Benjamin S.

2017-11-01

Sea surface salinity (SSS) variability during the 1997-1998 El Niño event and the failed 2012-2013 and 2014-2015 El Niño events is explored using a combination of observations and ocean reanalyses. Previously, studies have mainly focused on the sea surface temperature (SST) and sea surface height (SSH) variability. This analysis utilizes salinity data from Argo and the Simple Ocean Data Assimilation (SODA) reanalysis to examine the SSS variability. Advective processes and evaporation minus precipitation (E-P) variability is understood to influence SSS variability. Using surface wind, surface current, evaporation, and precipitation data, we analyze the causes for the observed SSS variability during each event. Barrier layer thickness and upper level salt content are also examined in connection to subsurface salinity variability. Both advective processes and E-P variability are important during the generation and onset of a successful El Niño, while a lack of one or both of these processes leads to a failed ENSO event.

Demonstration of imaging X-ray Thomson scattering on OMEGA EP.

PubMed

Belancourt, Patrick X; Theobald, Wolfgang; Keiter, Paul A; Collins, Tim J B; Bonino, Mark J; Kozlowski, Pawel M; Regan, Sean P; Drake, R Paul

2016-11-01

Foams are a common material for high-energy-density physics experiments because of low, tunable densities, and being machinable. Simulating these experiments can be difficult because the equation of state is largely unknown for shocked foams. The focus of this experiment was to develop an x-ray scattering platform for measuring the equation of state of shocked foams on OMEGA EP. The foam used in this experiment is resorcinol formaldehyde with an initial density of 0.34 g/cm 3 . One long-pulse (10 ns) beam drives a shock into the foam, while the remaining three UV beams with a 2 ns square pulse irradiate a nickel foil to create the x-ray backlighter. The primary diagnostic for this platform, the imaging x-ray Thomson spectrometer, spectrally resolves the scattered x-ray beam while imaging in one spatial dimension. Ray tracing analysis of the density profile gives a compression of 3 ± 1 with a shock speed of 39 ± 6 km/s. Analysis of the scattered x-ray spectra gives an upper bound temperature of 20 eV.

Home-based pre-exposure prophylaxis (PrEP) services for gay and bisexual men: An opportunity to address barriers to PrEP uptake and persistence

PubMed Central

Rendina, H. Jonathon; Grov, Christian

2017-01-01

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting HIV/STI self-testing from home with PrEP prescription mailing after an initial in-person clinic visit. We examined the associations of demographics, sexual HIV transmission risk, concern about frequent medical checkups associated with PrEP, health care access, and PrEP intentions with preferences for healthcare provider type and HB-PrEP. Concern about frequent medical checkups were associated with preferring a PCP for PrEP-related care, but men who perceived a barrier to bringing up the topic of PrEP with a doctor preferred a specialist clinic or provider more than a PCP. HB-PrEP was more appealing for younger men and those engaged in sexual HIV transmission risk, suggesting HB-PrEP could help reach GBM most vulnerable to HIV and in need of PrEP. HB-PrEP expansion has potential to increase PrEP uptake and persistence among GBM, particularly for men with barriers to clinic-based care and higher intentions to initiate PrEP. Clinical guidelines regarding HB-PrEP are needed to expand its use. PMID:29281688

Prostaglandin E2 modulates dendritic cell function via EP2 and EP4 receptor subtypes.

PubMed

Harizi, Hedi; Grosset, Christophe; Gualde, Norbert

2003-06-01

We have reported previously that PGE(2) inhibits dendritic cells (DC) functions. Because E prostanoid receptor (EPR) subtypes involved in this action are unknown, expression and functions of these receptors were examined in DC. Western blot and flow cytometry analyses showed that all EPRs were coexpressed in DC. In a dose-dependent manner, lipopolysaccharide (LPS) enhanced EP(2)R/EP(4)R but not EP(1)R/EP(3)R expressions. NS-398, a cyclooxygenase (COX)-2-selective inhibitor, suppressed LPS-enhanced EP(2)R/EP(4)R expression, suggesting that COX-2-issued prostaglandin E(2) (PGE(2)) modulates DC function through stimulation of specific EPR subtypes. Using selective agonists, we found that butaprost, an EP(2)R agonist, and PGE(1) alcohol, an EP(2)R and EP(2)R/EP(4)R agonist, inhibited major histocompatibility complex class II expression and enhanced interleukin-10 production from DC. However, no effect was observed with sulprostone and 17-phenyl-omega-trinor-PGE(2), selective agonists for EP(1)R and EP(1)R/EP(3)R, respectively. Treatment of DC with dibutyryl cyclic adenosine monophosphate (cAMP), an analog of cAMP, mimics PGE(2)-induced, inhibitory effects. Taken together, our data demonstrate that EP(2)R/EP(4)R are efficient for mediating PGE(2)-induced modulation of DC functions.

Innovative combination of electrolysis and Fe(II)-activated persulfate oxidation for improving the dewaterability of waste activated sludge.

PubMed

Zhen, Guang-Yin; Lu, Xue-Qin; Li, Yu-You; Zhao, You-Cai

2013-05-01

The feasibility of electrolysis integrated with Fe(II)-activated persulfate (S2O8(2-)) oxidation to improve waste activated sludge (WAS) dewaterability was evaluated. The physicochemical properties (sludge volume (SV), total suspended solids (TSS) and volatile suspended solids (VSS)) and extracellular polymeric substances (EPS), including slime EPS, loosely bound EPS (LB-EPS) and tightly bound EPS (TB-EPS) were characterized to identify their exact roles in sludge dewatering. While dewaterability negatively corresponded to LB-EPS, TB-EPS, protein (PN) and polysaccharide (PS) in LB-EPS and TB-EPS, it was independent of SV, TSS, VSS, slime EPS and PN/PS. Further study through scanning electron microscope (SEM) verified the entrapment of bacterial cells by TB-EPS, protecting them against electrolysis disruption. Comparatively, electrolysis integrated with S2O8(2-)/Fe(II) oxidation was able to effectively disrupt the protective barrier and crack the entrapped cells, releasing the water inside EPS and cells. Therefore, the destruction of both TB-EPS and cells is the fundamental reason for the enhanced dewaterability. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influence of loosely bound extracellular polymeric substances (EPS) on the flocculation, sedimentation and dewaterability of activated sludge.

PubMed

Li, X Y; Yang, S F

2007-03-01

Laboratory experiments on the activated sludge (AS) process were carried out to investigate the influence of microbial extracellular polymeric substances (EPS), including loosely bound EPS (LB-EPS) and tightly bound EPS (TB-EPS), on biomass flocculation, sludge settlement and dewaterability. The heat EPS extraction method was modified to include a mild step and a harsh step for extracting the LB-EPS and TB-EPS, respectively, from the sludge suspension. Six lab-scale AS reactors were used to grow AS with different carbon sources of glucose and sodium acetate, and different sludge retention times (SRTs) of 5, 10 and 20 days. The variation in the bioreactor condition produced sludge with different abundances of EPS and different flocculation and separation characteristics. The sludge that was fed on glucose had more EPS than the sludge that was fed on acetate. For any of the feeding substrates, the sludge had a nearly consistent TB-EPS value regardless of the SRT, and an LB-EPS content that decreased with the SRT. The acetate-fed sludge performed better than the glucose-fed sludge in terms of bioflocculation, sludge sedimentation and compression, and sludge dewaterability. The sludge flocculation and separation improved considerably as the SRT lengthened. The results demonstrate that the LB-EPS had a negative effect on bioflocculation and sludge-water separation. The parameters for the performance of sludge-water separation were much more closely correlated with the amount of LB-EPS than with the amount of TB-EPS. It is argued that although EPS is essential to sludge floc formation, excessive EPS in the form of LB-EPS could weaken cell attachment and the floc structure, resulting in poor bioflocculation, greater cell erosion and retarded sludge-water separation.

Pharmacological characterization of the inhibitory activity of beta h-endorphin (beta h-EP), [Arg9,19,24,28,29]-beta h-EP, [Gln8,Gly31]-beta h-EP-Gly-Gly-NH2, in the neuroeffector junction of the mouse vas deferens.

PubMed

Valenzuela, R; Li, C H; Huidobro-Toro, J P

1991-08-01

The inhibitory opioid activities of beta h-endorphin (beta h-EP), its structurally related peptide analogues [Gln8,Gly31]-beta h-EP-Gly-Gly-NH2 (Gly-Gly-beta h-EP), [Arg9,19,24,28,29]-beta h-EP (Arg-beta h-EP) and methionine enkephalin have been examined in the electrically stimulated mouse vas deferens bioassay. All four peptides behaved as full agonists; methionine enkephalin was the most potent followed by Arg-beta h-EP, beta h-EP and Gly-Gly-beta h-EP. Neither Gly-Gly-beta h-EP nor Arg-beta h-EP antagonized the inhibitory action of beta h-EP or methionine enkephalin. An hour of tissue exposure to 30 nM beta-funaltrexamine followed by thorough washing, displaced to the right, in a parallel fashion, the concentration-response curves of beta h-EP and analogues. Whereas the displacement of the concentration response curves was 8 to 10-fold for beta h-EP and Arg-beta h-EP, it was only about 3-fold for Gly-Gly-beta h-EP and methionine enkephalin. Naltrindole was the most potent antagonist of methionine enkephalin with an apparent pA2 of 9.4; its potency as an antagonist of beta h-EP and related analogues was approximately one-tenth of this with pA2 values approximately 8.5. Norbinaltorphimine also antagonized the action of the opioid peptides with pA2 values close to 7.8.

The Crystal Structure of a Binary Complex of Two Pseudopilins: EpsI And EpsJ From the Type 2 Secretion System of Vibrio Vulnificus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yanez, M.E.; Korotkov, K.V.; Abendroth, J.

2009-05-28

Type II secretion systems (T2SS) translocate virulence factors from the periplasmic space of many pathogenic bacteria into the extracellular environment. The T2SS of Vibrio cholerae and related species is called the extracellular protein secretion (Eps) system that consists of a core of multiple copies of 11 different proteins. The pseudopilins, EpsG, EpsH, EpsI, EpsJ and EpsK, are five T2SS proteins that are thought to assemble into a pseudopilus, which is assumed to interact with the outer membrane pore, and may actively participate in the export of proteins. We report here biochemical evidence that the minor pseudopilins EpsI and EpsJ frommore » Vibrio species interact directly with one another. Moreover, the 2.3 {angstrom} resolution crystal structure of a complex of EspI and EpsJ from Vibrio vulnificus represents the first atomic resolution structure of a complex of two different pseudopilin components from the T2SS. Both EpsI and EpsJ appear to be structural extremes within the family of type 4a pilin structures solved to date, with EpsI having the smallest, and EpsJ the largest, 'variable pilin segment' seen thus far. A high degree of sequence conservation in the EpsI:EpsJ interface indicates that this heterodimer occurs in the T2SS of a large number of bacteria. The arrangement of EpsI and EpsJ in the heterodimer would correspond to a right-handed helical character of proteins assembled into a pseudopilus.« less

Adolescent Human Immunodeficiency Virus Care Providers’ Attitudes Toward the Use of Oral Pre-Exposure Prophylaxis in Youth

PubMed Central

Zimet, Gregory; Lally, Michelle; Kahn, Jessica A.

2016-01-01

Abstract Oral pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention is currently indicated for use in adults in the United States and may soon be indicated for minor adolescents. However, implementation of PrEP use among minors may present unique barriers. We conducted 15 individual, semi-structured interviews among US clinicians caring for HIV-infected and at-risk youth. The theory-driven interview guide assessed demographics, perceived role of oral PrEP in HIV prevention among adolescents, perceived barriers to and facilitating factors for use of PrEP in adolescents, and clinician-reported likelihood of prescribing PrEP. Transcripts were analyzed using framework analysis. Overall, clinicians viewed PrEP as a time-limited intervention that is one part of a comprehensive approach to HIV prevention among adolescents. Perceived barriers to prescribing to minors included concerns about: confidentiality, legality of minors consenting to PrEP without parental involvement, ability of minors to understand the risks/benefits of PrEP, the possible impact of PrEP on bone accrual, off-label use of PrEP medication in minors, and the high costs associated with PrEP use. Clinician-reported facilitating factors for prescribing PrEP to youth included educating communities and other clinicians about PrEP, ensuring adequate financial resources and infrastructure for delivering PrEP, developing formal guidance on effective behavioral interventions that should be delivered with PrEP, and gaining personal experience with prescribing PrEP. Clinicians indicated greater comfort with prescribing PrEP to adults versus minors. For PrEP to become more widely available to youth at risk for HIV infection, barriers that are unique to PrEP use in minors must be addressed. PMID:27410497

“Support Your Client at the Space That They're in”: HIV Pre-Exposure Prophylaxis (PrEP) Prescribers' Perspectives on PrEP-Related Risk Compensation

PubMed Central

Magnus, Manya; Mayer, Kenneth H.; Krakower, Douglas S.; Eldahan, Adam I.; Hawkins, Lauren A. Gaston; Underhill, Kristen; Hansen, Nathan B.; Kershaw, Trace S.; Betancourt, Joseph R.; Dovidio, John F.

2017-01-01

Abstract Despite the demonstrated effectiveness of HIV pre-exposure prophylaxis (PrEP) and evidence that most PrEP users do not engage in risk compensation (i.e., increased risk behavior due to a perceived decrease in HIV susceptibility), some healthcare providers report patient risk compensation to be a deterrent to prescribing PrEP. Overcoming this barrier is essential to supporting PrEP access and uptake among people at risk for HIV. To inform such efforts, this qualitative study explored PrEP-related risk compensation attitudes among providers with firsthand experience prescribing PrEP. US-based PrEP providers (n = 18), most of whom were HIV specialists, were recruited through direct outreach and referral from colleagues and other participants. Individual 90-min semistructured interviews were conducted by phone or in person from September 2014 through February 2015, transcribed, and thematically analyzed. Three attitudinal themes emerged: (1) providers' role is to support patients in making informed decisions, (2) risk behavior while taking PrEP does not fully offset PrEP's protective benefit (i.e., PrEP confers net protection, even with added behavioral risk), and (3) PrEP-related risk compensation is unduly stigmatized within and beyond the healthcare community. Participants were critical of other healthcare providers' negative judgment of patients and reluctance to prescribe PrEP due to anticipated risk compensation. Several providers also acknowledged an evolution in their thinking from initial ambivalence toward greater acceptance of PrEP and PrEP-related behavior change. PrEP providers' insights about risk compensation may help to address unsubstantiated concerns about PrEP-related risk compensation and challenge the acceptability of withholding PrEP on these grounds. PMID:28414261

Prostaglandin receptors EP1-4 as a potential marker for clinical outcome in urothelial bladder cancer.

PubMed

von der Emde, Laura; Goltz, Diane; Latz, Stefan; Müller, Stefan C; Kristiansen, Glen; Ellinger, Jörg; Syring, Isabella

2014-01-01

Prostaglandins, especially prostaglandin E2 (PGE2), and COX-2 play an important role in carcinogenesis of many tumors including bladder cancer (BCA). The PGE2 receptors EP1-4 regulate tumor cell growth, invasion and migration in different tumor entities but EP expression in BCA remains to be determined. In the present study we examined the expression of EP1-4 in non-muscle invasive bladder cancer (NMIBC), muscle invasive bladder cancer (MIBC) and normal urothelial tissue (NU) using immunohistochemistry. Nuclear and cytoplasmic EP1-4 expression was correlated with clinicopathological parameters and survival of BCA patients. EP1, EP2 and EP3 were significantly less expressed in the cytoplasm und nucleus of NMIBC and MIBC than in NU; EP4 cytoplasmic staining in MIBC was significantly higher compared to NU. The cytoplasmic staining was significantly more abundant in MIBC than in NMIBC in all investigated receptors except EP2. The level of EP staining in NMIBC was correlated with staging and grading, especially cytoplasmic EP1. Nuclear staining of EP1 was an independent predictor of BCA recurrence-free survival in NMIBC patients. EP receptors are dysregulated in BCA. The increase of EP1 may be used as prognostic parameter in NMIBC patients and its dysregulation could be targeted by specific EP1 inhibitors.

Prostaglandin receptors EP1-4 as a potential marker for clinical outcome in urothelial bladder cancer

PubMed Central

von der Emde, Laura; Goltz, Diane; Latz, Stefan; Müller, Stefan C; Kristiansen, Glen; Ellinger, Jörg; Syring, Isabella

2014-01-01

Prostaglandins, especially prostaglandin E2 (PGE2), and COX-2 play an important role in carcinogenesis of many tumors including bladder cancer (BCA). The PGE2 receptors EP1-4 regulate tumor cell growth, invasion and migration in different tumor entities but EP expression in BCA remains to be determined. In the present study we examined the expression of EP1-4 in non-muscle invasive bladder cancer (NMIBC), muscle invasive bladder cancer (MIBC) and normal urothelial tissue (NU) using immunohistochemistry. Nuclear and cytoplasmic EP1-4 expression was correlated with clinicopathological parameters and survival of BCA patients. EP1, EP2 and EP3 were significantly less expressed in the cytoplasm und nucleus of NMIBC and MIBC than in NU; EP4 cytoplasmic staining in MIBC was significantly higher compared to NU. The cytoplasmic staining was significantly more abundant in MIBC than in NMIBC in all investigated receptors except EP2. The level of EP staining in NMIBC was correlated with staging and grading, especially cytoplasmic EP1. Nuclear staining of EP1 was an independent predictor of BCA recurrence-free survival in NMIBC patients. EP receptors are dysregulated in BCA. The increase of EP1 may be used as prognostic parameter in NMIBC patients and its dysregulation could be targeted by specific EP1 inhibitors. PMID:25520883

Prevalence of actual uptake and willingness to use pre-exposure prophylaxis to prevent HIV acquisition among men who have sex with men in Hong Kong, China

PubMed Central

Lau, Joseph T. F.; Fang, Yuan; Ip, Mary; Gross, Danielle L.

2018-01-01

Objectives This study was to investigate the prevalence of actual uptake of pre-exposure prophylaxis (PrEP), willingness to use daily oral PrEP under two cost scenarios, and potential issues related to PrEP use among men who have sex with men (MSM) with HIV negative/unknown sero-status in Hong Kong, China. Factors associated with the two measures of willingness were also investigated. Methods 403 eligible MSM completed the anonymous venue-based face-to-face interview/telephone interview. Results Only 1% had ever used PrEP. After being briefed about some facts of PrEP, the prevalence of willingness to use daily oral PrEP was 7.7% if they could purchase PrEP at private hospitals/clinics at HK$8,000 (US$1,032)/month (market rate) and 45.2% if free PrEP was provided by public hospitals/clinics in Hong Kong (free PrEP). After adjusted for significant background variables, significant factors of these two measures of willingness included: (1) number of correct responses to knowledge on PrEP, (2) perceived risk of HIV infection in the next six months, and (3) constructs of the Theory of Planned Behavior: positive and negative attitudes toward PrEP, perceived their significant others would support them take PrEP (perceived subjective norm), perceived number of local MSM who were willing to take PrEP (perceived descriptive norm), and confidence in using PrEP under the two scenarios (perceived behavioral control). Among all participants, 9.7% and 25.1% would start and discontinue using PrEP without consulting doctors; 26.0% would not take PrEP daily if it was provided for free, and 42.4% would not take up HIV testing every 3 months after using PrEP. Conclusion Different strategies should be considered for promoting PrEP at market rate and if free PrEP is made available. Future promotion should increase their knowledge about PrEP, modify their perceptions related to HIV and PrEP, and address some potential issues related to PrEP use. PMID:29432470

Effect of salinity on extracellular polymeric substances of activated sludge from an anoxic-aerobic sequencing batch reactor.

PubMed

Wang, Zichao; Gao, Mengchun; Wang, Zhe; She, Zonglian; Chang, Qingbo; Sun, Changqing; Zhang, Jian; Ren, Yun; Yang, Ning

2013-11-01

The effect of salinity on extracellular polymeric substances (EPS) of activated sludge was investigated in an anoxic-aerobic sequencing batch reactor (SBR). The contents of loosely bound EPS (LB-EPS) and tightly bound EPS (TB-EPS) were positively correlated with the salinity. The polysaccharide (PS) and protein (PN) contents in both LB-EPS and TB-EPS increased with the increase of salinity. With the increase of salinity from 0.5% to 6%, the PN/PS ratios in LB-EPS and TB-EPS decreased from 4.8 to 0.9 and from 2.9 to 1.4, respectively. The four fluorescence peaks in both LB-EPS and TB-EPS identified by three-dimensional excitation-emission matrix fluorescence spectroscopy are attributed to PN-like substances and humic acid-like substances. The Fourier transform infrared spectra of the LB-EPS and TB-EPS appeared to be very similar, but the differences across the spectra were apparent in terms of the relative intensity of some bands with the increase of salinity. The sludge volume index showed a linear correlation with LB-EPS (R(2)=0.9479) and TB-EPS (R(2)=0.9355) at different salinities, respectively. Copyright © 2013 Elsevier Ltd. All rights reserved.

Plasma interface of the EC waves to the LHD peripheral region

NASA Astrophysics Data System (ADS)

Kubo, S.; Igami, H.; Tsujimura, T. I.; Shimozuma, T.; Takahashi, H.; Yoshimura, Y.; Nishiura, M.; Makino, R.; Mutoh, T.

2015-12-01

In order to realize an efficient ECRH and also to reduce stray radiation due to non-absorbed power during ECRH, it is necessary to excite a wave that is absorbed well near the electron cyclotron resonance. In the normal fusion magnetic field confinement machine and in the electron cyclotron frequency range, WKB approximation is valid almost all the way from antenna to the absorption region due to the large scale-length of the plasma density λn and the magnetic shear τs as compared with the local wavelength λ0. In these situation, it is well known that the O/X mode propagates as O/X mode if τs ≫ λ0. Even in these situation, if τs and λn are comparable and |1/λO-1/λX|τs ≪ 1, there still remains the question from where "X" - or "O" - mode become "X" - or "O" mode at the peripheral region. In order to simulate this situation, one dimensional full wave calculation code which solve electromagnetic wave equation under arbitrary magnetic field configuration and arbitrary density profile for a given polarization state are developed and incorporated in the upgraded ray tracing code LHDGauss. It is tried to find the density and shear scale lengths region where the mode mixing effect is not negligible.

Role of poloidal flows on the particle confinement time in a simple toroidal device : an experimental study

NASA Astrophysics Data System (ADS)

Kumar, Umesh; Ganesh, R.; Saxena, Y. C.; Thatipamula, Shekar G.; Sathyanarayana, K.; Raju, Daniel

2017-10-01

In magnetized toroidal devices without rotational transform also known as Simple Magnetized Torus (SMT). The device BETA at the IPR is one such SMT with a major radius of 45 cm, minor radius of 15 cm and a maximum toroidal field of 0.1 Tesla. Understanding confinement in such helical configurations is an important problem both for fundamental plasma physics and for Tokamak edge physics. In a recent series of experiments it was demonstrated experimentally that the mean plasma profiles, fluctuation, flow and turbulence depend crucially on the parallel connection length, which was controlled by external vertical field. In the present work, we report our experimental findings, wherein we measure the particle confinement time for hot cathode discharge and ECRH discharge, with variation in parallel connection length. As ECRH plasma don't have mean electric field and hence the poloidal rotation of plasma is absent. However, in hot cathode discharge, there exist strong poloidal flows due to mean electric field. An experimental comparison of these along with theoretical model with variation in connection length will be presented. We also present experimental measurements of variation of plasma confinement time with mass as well as the ratio of vertical field to toroidal magnetic field.

"Since both of us are using antiretrovirals, we have been supportive to each other": facilitators and barriers of pre-exposure prophylaxis use in heterosexual HIV serodiscordant couples in Kisumu, Kenya.

PubMed

Patel, Rena C; Stanford-Moore, Gaelen; Odoyo, Josephine; Pyra, Maria; Wakhungu, Imeldah; Anand, Keerthana; Bukusi, Elizabeth A; Baeten, Jared M; Brown, Joelle M

2016-01-01

Since 2015, the World Health Organization recommends pre-exposure prophylaxis (PrEP) for all persons at substantial risk for HIV, including HIV-uninfected partners in serodiscordant relationships in resource-limited settings. As PrEP moves from clinical trials to real-world use, understanding facilitators of and barriers to PrEP initiation and adherence is critical to successful PrEP implementation and rollout. We conducted 44 in-depth individual or couple interviews with 63 participants (30 without HIV and 33 with HIV) enrolled in the Partners Demonstration Project in Kisumu, Kenya, between August and September 2014. The semi-structured interviews discussed the following: 1) perceived advantages and disadvantages of antiretroviral therapy (ART)/PrEP; 2) reasons for accepting or declining ART/PrEP and 3) influence of prevention of transmission to partner or infant on ART/PrEP use. Transcripts from the interviews were iteratively analyzed using inductive content analysis. Our study identified three key factors that may facilitate initiation of PrEP in this population. First, participants using PrEP felt reduced stress and increased trust in their HIV serodiscordant relationships. Second, greater community-wide knowledge of PrEP was thought to likely increase PrEP acceptance. Third, greater education and counselling by providers on PrEP use was also considered to likely increase the adoption of PrEP. We also identified three key barriers to initiation of and adherence to PrEP. First, most participants who declined PrEP expressed doubts about the relative additional effectiveness of PrEP in combination with other prevention tools. Second, perceived stigma related to PrEP use was an important barrier to PrEP initiation. Third, many struggled with overcoming perceived side effects or logistical challenges of taking daily PrEP, particularly when they themselves were not ill. Leveraging the facilitators and overcoming barriers to PrEP uptake may enhance the successful rollout of PrEP among HIV serodiscordant couples in Kenya and other areas in sub-Saharan Africa, thereby reducing sexual transmission of HIV. Further research focused on how best to provide counselling on combination HIV prevention tools in the context of PrEP use is a crucial next step to delivering PrEP.

Monitoring multiple sclerosis by multimodal evoked potentials: Numerically versus ordinally scaled scoring systems.

PubMed

Schlaeger, Regina; Hardmeier, Martin; D'Souza, Marcus; Grize, Leticia; Schindler, Christian; Kappos, Ludwig; Fuhr, Peter

2016-03-01

To compare the ability of different evoked potential scores (EPS) to monitor and predict the disease course in multiple sclerosis (MS). Seventy-two patients with MS or clinically isolated syndrome were investigated by visual, motor, and somatosensory EP and expanded disability status scale (EDSS) at baseline (T0) and months 6, 12, 24, 36 (T4). EP results were rated according to ordinal (o), semi-quantitative (sq), and quantitative (q) EPS. Spearman rank correlation and multivariable linear regression were used to investigate the associations between EPS and clinical disability. All EPS correlated with EDSS cross-sectionally (0.72⩽rho⩽0.87, all p<0.001) and longitudinally (0.39⩽rho⩽0.47, all p⩽0.004). EPS(T0) and EDSS(T0) together explained 85-86% of EDSS(T4) variance. A posteriori power calculation showed that the sample sizes needed to detect significant changes over 6 months in q-EPS, sq-EPS and o-EPS with 90% certainty would be 50, 129 and 222, respectively. q-EPS change(T1-T0) correlated with EDSS change(T4-T0) (rho=0.56, p<0.001), while sq-EPS and o-EPS changes(T1-T0) did not. All three EPS allow disease course monitoring in MS. However, the quantitative EPS detects clinically relevant short-term changes with a smaller sample size than semi-quantitative or ordinal EPS. These results underscore the potential of EPS to characterize MS disease evolution. Copyright © 2016. Published by Elsevier Ireland Ltd.

Discriminant Value of Rome III Questionnaire in Dyspeptic Patients

PubMed Central

Abid, Shahab; Siddiqui, Shaheryar; Jafri, Wasim

2011-01-01

Background/Aim: Rome III criteria has modified the description of functional dyspepsia (FD) and divided this into subgroups. However, the discriminative value of Rome III questionnaire-based diagnosis of FD is yet to be determined. Objectives: To evaluate the Rome III questionnaire for the diagnosis of FD and whether it can discriminate between postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) in patients with dyspeptic symptoms. Patients and Methods: Consecutive patients, who were not on proton pump inhibitors (PPI), were asked to participate. Patients who have previously established acid peptic disease or predominantly reflux symptoms or having alarm symptoms such as weight loss and hematemesis were excluded. Rome III questionnaire for FD was used to identify the patients as having FD and divide into its subgroups; PDS or EPS. Gastro-duodenal biopsies, liver function tests and ultrasound were done to establish the diagnosis of FD. Results: Out of 272 patients with upper gastrointestinal (GI) symptoms without alarm features, who were enrolled in the study, a total of 191 (70%) fulfilled the criteria of FD based upon Rome III questionnaire. EPS subgroup was found in 109 (57%), PDS in 17 (9%) patients, overlap between EPS and PDS was present in 56 (29%) patients. Nine (5%) patients remained indeterminate. Diagnosis of FD was established in 136/191 (71%) patients only. Gastritis was present in 116 patients (85%), Duodenitis in 44 (32%) and Helicobacter pylori infection in 70 (51%) patients. Among 55 patients (29%) who had organic diseases, EPS was seen in 35 (64%), PDS in 5 (9%) and overlap in 15 (27%) patients. Underlying organic causes were gastric or duodenal ulcers in 14 patients, Barrett esophagus in five, chronic liver disease in seven, gall stones in five, Giardiasis and celiac disease in three each. Gastric carcinoma, Crohns disease and gastric polyps were seen in one patient each. Conclusion: This study indicates that 30% of patients who fulfilled the Rome III criteria for FD actually had organic disease. Almost one-third of patients with functioanl dyspepsia did not qualify for one of the two subgroups of FD of Rome III. There is also a need to further define the Rome III-based subgroups of FD for research purpose. PMID:21372351

The modern trends in space electromagnetic instrumentation

NASA Astrophysics Data System (ADS)

Korepanov, V.

The future trends of the experimental plasma physical development in outer space demands more and more exact and sophisticated scientific instrumentation. Moreover, the situation is complicated by constant reducing of financial support of scientific research, even in leading countries. This resulted in the development of mini, micro and nanosatellites with low price and short preparation time. Consequently, it provoked the creation of new generation of scientific instruments with reduced weight and power consumption but increased level of metrological parameters. The recent state of the development of electromagnetic (EM) sensors for microsatellites is reported. The set of EM sensors produced at LCISR includes following devices. Flux-gate magnetometers (FGM). The reduction of new of satellite versions FGM weight as well as power consumption was achieved not only due to the use of new electronic components but also because the development of new operation modes. To this the scientific and technological study allowed to decrease FGM noise and now typical figure is about 10 picotesla rms at 1 Hz and the record one is below 1 picotesla. Also because of satellite weight reduction the possibility was studied to use FGM only for satellite attitude control. The magnetic orientation and stabilization system was developed and new FGM for orientation was created. It uses industrial components and special measures are taken to increase its reliability. Search-coil magnetometers (SCM). The super-light version of SCM was created as the result of intensive scientific and technological research. These new SCMs can have about six decades operational frequency band noise with upper limit ~ 1 MHz and noise level of few femtotesla with total weight about 75 grams. Electric probes (EP). The study of operation condition of EP immersed in space plasma allowed to find the possibilities to decrease the EP weight conserving the same noise factor. Two types of EP operating from DC and from 0,1 Hz are created and successfully tested. Wave probe (WP). The WP is another kind of instrument which combines in one sensor three independent sensors: SCM, EP and split Langmuir probe. Such a combination allowed to create a principally new instru ment U wave probe. The developed theory confirms that WP can directly measure vector components in space plasma. All these space sensors are described and their experimentally obtained parameters are presented. This work was partially supported by INTAS grant 2000-465.

Impact of ethyl pyruvate on Adriamycin-induced cardiomyopathy in rats

PubMed Central

Liu, Menglin; Wang, Menglong; Liu, Jianfang; Luo, Zhen; Shi, Lei; Feng, Ying; Li, Li; Xu, Lin; Wan, Jun

2016-01-01

Ethyl pyruvate (EP), a derivative of pyruvic acid, is known to have protective effects against ischemic cardiomyopathy and other disorders. However, little is known about its role in Adriamycin (ADR)-induced cardiomyopathy. The present study was designed to investigate the impact of EP on ADR-induced cardiomyopathy in an animal model. Sixty male Sprague-Dawley (SD) rats were divided into four groups: Normal control, EP, ADR and ADR + EP groups (n=15/group). Rats in the ADR and ADR + EP groups were treated with ADR (2.5 mg/kg/week intraperitoneally) for 6 weeks. From the eighth week, rats in the EP and ADR + EP groups received EP via gastric lavage at a dose of 50 mg/kg/day for 30 days. After completing the EP treatment, cardiac function was assessed by echocardiography and then rats were sacrificed. Hearts were harvested for subsequent analysis. Compared with rats in the normal control and EP groups (without ADR treatment), rats in the ADR and ADR + EP groups showed significant impairments in terms of cardiac function, apoptosis, severe oxidative stress and fibrosis in the heart. However, these impairments were alleviated by EP treatment in the ADR + EP group. Upon EP treatment, cardiac function was significantly improved. The levels of oxidative stress, fibrosis and apoptosis in the myocardial tissues were also significantly reduced. These findings indicated that EP treatment attenuated, at least partially, ADR-induced cardiomyopathy in rats. PMID:27882138

Optimizing content for pre-exposure prophylaxis (PrEP) counseling for men who have sex with men: Perspectives of PrEP users and high-risk PrEP naïve men.

PubMed

Wade Taylor, S; Mayer, Kenneth H; Elsesser, Steven M; Mimiaga, Matthew J; O'Cleirigh, Conall; Safren, Steven A

2014-05-01

Existing trials of antiretroviral (ARV) medication as chemoprophylaxis against HIV reveal that the degree of protection is primarily dependent on product adherence. However, there is a lack of data on targets for behavioral interventions to improve adherence to ARV as prevention. Information from individuals who have used ARV as pre-exposure prophylaxis (PrEP) can inform behavioral intervention development. Thirty-nine HIV-uninfected MSM at high risk for HIV acquisition participated in one of four semi-structured focus groups. Two of the focus groups consisted of MSM who had been prescribed and used PrEP in the context of a clinical trial; the other two consisted of high-risk MSM who had not previously used PrEP. An in-depth, within-case/across-case content analysis resulted in six descriptive themes potentially salient for a PrEP adherence behavioral intervention: (1) motivations to use PrEP, (2) barriers to PrEP use, (3) facilitators to PrEP use, (4) sexual decision-making in the context of PrEP, (5) prospective PrEP education content, and, (6) perceived effective characteristics of PrEP delivery personnel. Addressing these themes in behavioral interventions in the context of prescribing PrEP may result in the optimal "packaging" public health programs that implement PrEP for high-risk MSM.

Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study

PubMed Central

2018-01-01

Background Awareness of pre-exposure prophylaxis (PrEP) for HIV prevention is increasing, but little is known about the functional knowledge of PrEP and its impact on willingness to use PrEP. Objective The objective of this study was to assess the functional knowledge of PrEP among a sample of gay, bisexual, and other men who have sex with men (MSM) participating in a Web-based survey of sexually active MSM. Methods Men at least 18 years old, residing in the United States, and reporting sex with a man in the previous 6 months were recruited through social networking websites. PrEP functional knowledge included the following 4 questions (1) efficacy of consistent PrEP use, (2) inconsistent PrEP use and effectiveness, (3) PrEP and condom use, and (4) effectiveness at reducing sexually transmitted infections (STIs). Ordinal logistic regression was used to identify respondent characteristics associated with PrEP functional knowledge. In a subsample of participants responding to HIV prevention questions, we compared willingness to use PrEP by response to PrEP functional knowledge using logistic regression analysis adjusted for age, race and ethnicity, and education level. Results Among 573 respondents, PrEP knowledge was high regarding adherence (488/573, 85.2%), condom use (532/573, 92.8%), and STIs (480/573, 83.8%), but only 252/573 (44.0%) identified the correct efficacy. Lower functional PrEP knowledge was associated with minority race/ethnicity (P=.005), lower education (P=.01), and not having an HIV test in the past year (P=.02). Higher PrEP knowledge was associated with willingness to use PrEP (P=.009). Younger age was not associated with higher PrEP functional knowledge or willingness to use PrEP. Conclusions PrEP knowledge was generally high in our study, including condom use and consistent use but may be lacking in higher risk MSM. The majority of respondents did not correctly identify PrEP efficacy with consistent use, which could impact motivation to seek out PrEP for HIV prevention. Targeted messaging to increase PrEP knowledge may increase PrEP use. PMID:29362213

Beyond SHARP-- Primary Formaldehyde from Oil and Gas Exploration and Production in the Gulf of Mexico Region

NASA Astrophysics Data System (ADS)

Olaguer, E. P.

2010-12-01

Formaldehyde has been named by the EPA as a hazardous air pollutant that may be carcinogenic and also cause irritation to the eyes, nose, throat and lung. Moreover, it is a powerful radical and ozone precursor. The 2009 Study of Houston Atmospheric Radical Precursors (SHARP) was conceived by the Houston Advanced Research Center (HARC) on behalf of the Texas Environmental Research Consortium (TERC) to examine the relative importance of primary and secondary formaldehyde (HCHO) and nitrous acid (HONO) in ozone formation. SHARP confirmed that primary combustion sources of HCHO, such as flares end engines, may be underestimated (by an order of magnitude or more) in official emission inventories used for the purpose of air quality modeling in highly industrialized areas such as Houston. This presentation provides recently generated modeling and observational evidence that the same may be true in both rural and urban areas with oil and gas exploration and production (E&P) activities, such as the Upper Green River Basin of Wyoming and the Barnett Shale of Texas. Oil and gas E&P is increasing in the Gulf of Mexico region, particularly in the Barnett, Haynesville, Eagle Ford, Cana-Woodford, and Fayetteville shale basins. In the Barnett Shale, E&P activities are moving into urban neighborhoods, and may affect the ability to bring the Dallas-Ft. Worth region into attainment of the federal ozone standard. Data concerning formaldehyde emissions from drill rig and pipeline compressor engines, flares, and glycol or amine reboilers, should be obtained in order to more accurately model air quality in the Gulf of Mexico region.

Characteristics of extracellular polymeric substances from sludge and biofilm in a simultaneous nitrification and denitrification system under high salinity stress.

PubMed

Zhao, Linting; She, Zonglian; Jin, Chunji; Yang, Shiying; Guo, Liang; Zhao, Yangguo; Gao, Mengchun

2016-09-01

The composition and distribution of extracellular polymeric substance (EPS) both from suspended sludge and attached biofilm were investigated in a simultaneous nitrification and denitrification (SND) system with the increase of the salinity from 1.0 to 3.0 %. Fourier-transform infrared (FTIR) spectroscopy and three-dimensional excitation-emission matrix (3D-EEM) fluorescence spectroscopy were used to examine proteins (PN), polysaccharides (PS) and humic substances (HS) present in EPS. High total nitrogen removal (above 83.9 %) via SND was obtained in the salinity range of 1.0-2.5 %. Total EPS in the sludge increased from 150.2 to 200.6 mg/gVSS with the increase of salinity from 1.0 to 3.0 %, whereas the corresponding values in the biofilm achieved the maximum of 288.6 mg/g VSS at 2.0 % salinity. Dominant composition of EPS was detected as HS in both sludge and biofilm, having the percentages of 50.6-68.6 and 41.1-69.9 % in total EPS, respectively. Both PN and PS contents in soluble EPS (S-EPS), loosely bound EPS (LB-EPS) and tightly bound EPS (TB-EPS) of sludge and biofilm increased with the increased salinity. The FTIR spectrum and 3D-EEM fluorescence spectroscopy of S-EPS, LB-EPS and TB-EPS in the sludge and biofilm showed the changes of functional groups and conformations of the compositions in EPS with the increase of salinity. The results demonstrated that the characteristics of EPS varied from sludge to biofilm. The obtained results could provide a better understanding of the salinity effect on the EPS characteristics in a SND system.

Young Transgender Women's Attitudes Toward HIV Pre-exposure Prophylaxis.

PubMed

Wood, Sarah M; Lee, Susan; Barg, Frances K; Castillo, Marne; Dowshen, Nadia

2017-05-01

Our primary aim was to explore themes regarding attitudes toward HIV pre-exposure prophylaxis (PrEP) among young transgender women (YTW), in order to develop a theoretical model of PrEP uptake in this population disproportionally affected by HIV. Qualitative study nested within a mixed-method study characterizing barriers and facilitators to health services for YTW. Participants completed an in-depth interview exploring awareness of and attitudes toward PrEP. Key themes were identified using a grounded theory approach. Participants (n = 25) had a mean age of 21.2 years (standard deviation 2.2, range 17-24) and were predominately multiracial (36%) and of HIV-negative or unknown status (68%). Most participants (64%) reported prior knowledge of PrEP, and 28% reported current use or intent to use PrEP. Three major content themes that emerged were variability of PrEP awareness, barriers and facilitators to PrEP uptake, and emotional benefits of PrEP. Among participants without prior PrEP knowledge, participants reported frustration that PrEP information has not been widely disseminated to YTW, particularly by health care providers. Attitudes toward PrEP were overwhelmingly positive; however, concerns were raised regarding barriers including cost, stigma, and adherence challenges. Both HIV-positive and negative participants discussed emotional and relationship benefits of PrEP, which were felt to extend beyond HIV prevention alone. A high proportion of YTW in this study had prior knowledge of PrEP, and attitudes toward PrEP were positive among participants. Our findings suggest several domains to be further explored in PrEP implementation research, including methods of facilitating PrEP dissemination and emotional motivation for PrEP uptake. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Dietary assimilation of cadmium associated with bacterial exopolymer sediment coatings by the estuarine amphipod Leptocheirus plumulosus: Effects of Cd concentration and salinity

USGS Publications Warehouse

Schlekat, C.E.; Decho, Alan W.; Chandler, G.T.

1999-01-01

Bacterial extracellular substances (also known as exopolysaccharides, or EPS) may serve as vectors for trophic transfer of metals in benthic systems because these ubiquitous sediment coatings can sorb high concentrations of toxic metals, and because many benthic invertebrates assimilate EPS sediment coatings upon ingestion. We conducted 3 sets of experiments to determine the assimilative bioavailability of EPS-associated Cd to the benthic amphipod Leptocheirus plumulosus as a function of Cd concentration and salinity. Bioavailability was measured as L. plumulosus Cd assimilation efficiency (AE) from EPS-coated silica (EPS-Si) and from uncoated silica (NC-Si) using modified pulse-chase methods with the gamma-emitting radioisotope 109Cd. Cd AE was significantly greater from NC-Si than from EPS-Si at 7.5???, but not at 2.5 or 25???. Overall, Cd AE from EPS-Si was between 15.1 and 21.5%. Because EPS-Si sorbed more Cd than NC-Si, EPS coatings magnified the amount of Cd amphipods accumulated at each salinity by up to a factor of 10. Salinity did not directly affect Cd AE from EPS-Si, but because Cd-EPS partitioning increased with decreasing salinity, amphipods accumulated more Cd from EPS at the lowest Cd-EPS incubation salinity (2.5 ???) than at higher salinities (7.5 and 25 ???). Finally, Cd concentration in EPS exhibited an inverse relationship with Cd AE at 2.5 ???, but not at 25 ???. Specifically, Cd AE was 12 times greater at 1 compared with 10 ??g Cd ??g-1 EPS. Together, these results show that estuarine benthos can accumulate Cd from EPS sediment coatings, but that the degree to which this phenomenon occurs is dependent upon seawater salinity and Cd concentration in EPS.

PrEP awareness and decision-making for Latino MSM in San Antonio, Texas

PubMed Central

García, Moctezuma; Harris, Allyssa L.

2017-01-01

Pre-Exposure Prophylaxis (PrEP) has been promoted among high-risk populations as an effective HIV biomedical intervention. However, limited research is available on the significance of culturally informed biomedical interventions for Latino MSM. A total of 159 self-administered Internet surveys were completed by Latino MSM ages 21–30 in San Antonio, Texas. The purpose of this research was to develop an instrument that measured Latino MSM attitudes and beliefs towards PrEP, identify associations between demographic factors and PrEP related factors and to suggest culturally appropriate strategies for the promotion of PrEP among the Latino MSM population. Research findings revealed implications for PrEP at the structural and individual level for Latino MSM. Structural level indicators emphasized the importance for raising PrEP awareness among Latino MSM in regards to PrEP related expenses, ameliorating stigmatization of high-risk populations, enhancing access to PrEP informed medical providers, and address mistrust of the government and medical providers role on addressing health disparities among Latino MSM. Overall, the findings for individual factors emphasize the need for patient-centered interventions for Latino MSM. Latino MSM currently on PrEP require supplemental resources to enhance PrEP adherence. Latino MSM not on PrEP require alternate options for PrEP delivery and/or cognitive behavioral approaches minimizing HIV risk behavior for Latino MSM concerned with PrEP toxicity, which may require non-biomedical interventions. Integration of Latino MSM currently on PrEP as peer educators provides a valuable resource for developing culturally informed PrEP interventions for Latino MSM. Peer educators are able to share their experiential knowledge of PrEP contextualized through cultural norms, beliefs, and values. PMID:28953905

EpCAM and the biology of hepatic stem/progenitor cells

PubMed Central

Theise, Neil D.; Schmelzer, Eva; Boulter, Luke; Gires, Olivier; van Grunsven, Leo A.

2014-01-01

Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein, which is frequently and highly expressed on carcinomas, tumor-initiating cells, selected tissue progenitors, and embryonic and adult stem cells. During liver development, EpCAM demonstrates a dynamic expression, since it can be detected in fetal liver, including cells of the parenchyma, whereas mature hepatocytes are devoid of EpCAM. Liver regeneration is associated with a population of EpCAM-positive cells within ductular reactions, which gradually lose the expression of EpCAM along with maturation into hepatocytes. EpCAM can be switched on and off through a wide panel of strategies to fine-tune EpCAM-dependent functional and differentiative traits. EpCAM-associated functions relate to cell–cell adhesion, proliferation, maintenance of a pluripotent state, regulation of differentiation, migration, and invasion. These functions can be conferred by the full-length protein and/or EpCAM-derived fragments, which are generated upon regulated intramembrane proteolysis. Control by EpCAM therefore not only depends on the presence of full-length EpCAM at cellular membranes but also on varying rates of the formation of EpCAM-derived fragments that have their own regulatory properties and on changes in the association of EpCAM with interaction partners. Thus spatiotemporal localization of EpCAM in immature liver progenitors, transit-amplifying cells, and mature liver cells will decisively impact the regulation of EpCAM functions and might be one of the triggers that contributes to the adaptive processes in stem/progenitor cell lineages. This review will summarize EpCAM-related molecular events and how they relate to hepatobiliary differentiation and regeneration. PMID:25477371

Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation: A qualitative study.

PubMed

Bil, Janneke P; van der Veldt, Wendy M; Prins, Maria; Stolte, Ineke G; Davidovich, Udi

2016-09-01

Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM).Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach.Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients' medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support.To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent increases in STIs, condom use should be monitored and PrEP should be integrated into routine STI screening and counseling.

Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation

PubMed Central

Bil, Janneke P.; van der Veldt, Wendy M.; Prins, Maria; Stolte, Ineke G.; Davidovich, Udi

2016-01-01

Abstract Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM). Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach. Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients’ medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support. To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent increases in STIs, condom use should be monitored and PrEP should be integrated into routine STI screening and counseling. PMID:27684827

Demographic Differences in PrEP-Related Stereotypes: Implications for Implementation.

PubMed

Golub, Sarit A; Gamarel, Kristi E; Surace, Anthony

2017-05-01

Qualitative interviews about pre-exposure prophylaxis (PrEP) stereotypes were conducted with a subsample of 160 MSM who participated in a PrEP messaging study. Negative stereotypes about PrEP users were identified by 80 % of participants. Two types of stereotypes were most common: PrEP users are HIV-infected (and lying about it), and PrEP users are promiscuous and resistant to condom use. Participants' identification of these stereotype categories differed significantly by demographic factors (i.e., race/ethnicity, education). Expanding access to PrEP requires recognizing potential differences in the experience or anticipation of PrEP-related stereotypes that might impact willingness to discuss PrEP with providers, friends, or partners.

Evaluating filterability of different types of sludge by statistical analysis: The role of key organic compounds in extracellular polymeric substances.

PubMed

Xiao, Keke; Chen, Yun; Jiang, Xie; Zhou, Yan

2017-03-01

An investigation was conducted for 20 different types of sludge in order to identify the key organic compounds in extracellular polymeric substances (EPS) that are important in assessing variations of sludge filterability. The different types of sludge varied in initial total solids (TS) content, organic composition and pre-treatment methods. For instance, some of the sludges were pre-treated by acid, ultrasonic, thermal, alkaline, or advanced oxidation technique. The Pearson's correlation results showed significant correlations between sludge filterability and zeta potential, pH, dissolved organic carbon, protein and polysaccharide in soluble EPS (SB EPS), loosely bound EPS (LB EPS) and tightly bound EPS (TB EPS). The principal component analysis (PCA) method was used to further explore correlations between variables and similarities among EPS fractions of different types of sludge. Two principal components were extracted: principal component 1 accounted for 59.24% of total EPS variations, while principal component 2 accounted for 25.46% of total EPS variations. Dissolved organic carbon, protein and polysaccharide in LB EPS showed higher eigenvector projection values than the corresponding compounds in SB EPS and TB EPS in principal component 1. Further characterization of fractionized key organic compounds in LB EPS was conducted with size-exclusion chromatography-organic carbon detection-organic nitrogen detection (LC-OCD-OND). A numerical multiple linear regression model was established to describe relationship between organic compounds in LB EPS and sludge filterability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of C/N ratio on extracellular polymeric substances of activated sludge from an anoxic-aerobic sequencing batch reactor treating saline wastewater.

PubMed

Wang, Zichao; Gao, Mengchun; Xin, Yanjun; Ma, Dong; She, Zonglian; Wang, Zhe; Sun, Changqing; Ren, Yun

2014-01-01

The effect of C/N ratio on extracellular polymeric substances (EPS) of activated sludge was investigated in an anoxic-aerobic sequencing batch reactor (SBR) treating saline wastewater. The protein (PN) and protein/polysaccharide (PN/PS) ratio in the loosely bound EPS (LB-EPS) increased with the decrease of C/N ratio, whereas the PS in the LB-EPS decreased. The PS, PN and PN/PS ratio in the tightly bound EPS (TB-EPS) were independent of C/N ratio. Two fluorescence peaks in the LB-EPS and TB-EPS were identified at excitation/emission (Ex/Em) wavelengths of 275-280/335-340 nm and 220-225/330-340 nm by three-dimensional excitation-emission matrix (3D-EEM) fluorescence spectroscopy, respectively. These peaks in LB-EPS and TB-EPS were, respectively, associated with tryptophan protein-like substances and aromatic protein-like substances. The tryptophan protein-like fluorescence peaks in LB-EPS showed blue shift along the Ex axis and red shift along the Em axis with the decrease of C/N ratio. Fourier transform infrared spectra suggested that the variation of C/N ratio had more distinct effect on the functional groups of protein in the LB-EPS than those in the TB-EPS. The sludge volume index value decreased with the increase of LB-EPS, but there was no correlation between SVI and TB-EPS.

PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers

PubMed Central

Zablotska, Iryna; Grulich, Andrew E; Phanuphak, Nittaya; Anand, Tarandeep; Janyam, Surang; Poonkasetwattana, Midnight; Baggaley, Rachel; van Griensven, Frits; Lo, Ying-Ru

2016-01-01

Introduction HIV epidemics in the Asia-Pacific region are concentrated among men who have sex with men (MSM) and other key populations. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention and could be a potential game changer in the region. We discuss the progress towards PrEP implementation in the Asia-Pacific region, including opportunities and barriers. Discussion Awareness about PrEP in the Asia-Pacific is still low and so are its levels of use. A high proportion of MSM who are aware of PrEP are willing to use it. Key PrEP implementation barriers include poor knowledge about PrEP, limited access to PrEP, weak or non-existent HIV prevention programmes for MSM and other key populations, high cost of PrEP, stigma and discrimination against key populations and restrictive laws in some countries. Only several clinical trials, demonstration projects and a few larger-scale implementation studies have been implemented so far in Thailand and Australia. However, novel approaches to PrEP implementation have emerged: researcher-, facility- and community-led models of care, with PrEP services for fee and for free. The WHO consolidated guidelines on HIV testing, treatment and prevention call for an expanded access to PrEP worldwide and have provided guidance on PrEP implementation in the region. Some countries like Australia have released national PrEP guidelines. There are growing community leadership and consultation processes to initiate PrEP implementation in Asia and the Pacific. Conclusions Countries of the Asia-Pacific region will benefit from adding PrEP to their HIV prevention packages, but for many this is a critical step that requires resourcing. Having an impact on the HIV epidemic requires investment. The next years should see the region transitioning from limited PrEP implementation projects to growing access to PrEP and expansion of HIV prevention programmes. PMID:27760688

Enhancing HIV Pre-exposure, Prophylaxis Practices via an Educational Intervention.

PubMed

Newman, Rebecca; Katchi, Tasleem; Karass, Michael; Gennarelli, Melissa; Goutis, Jason; Kifayat, Alina; Solanki, Shantanu; Yandrapalli, Srikanth; Forman, Leanne; Nabors, Christopher

2018-04-20

Pre-exposure prophylaxis (PrEP) for HIV involves using antiretroviral drugs to prevent individuals at high risk from acquiring HIV infection. Most practicing primary care providers believe PrEP to be safe and effective, but less than half have prescribed or referred for PrEP. Attitudes and prescribing patterns among house officers have not been well described previously. Can an educational intervention enhance HIV PrEP practices among internal medicine house officers? This study relied on a pretest/posttest design. All categorical trainees at a medium-sized internal medicine program were offered a baseline survey to assess their knowledge on PrEP. This was followed by a PrEP-focused educational intervention and a postintervention survey. Likert scales captured perceptions regarding safety, effectiveness, barriers, factors that would promote PrEP use, potential side effects, impact on risk-taking behavior, and provider comfort level in assessing behavioral risks and in PrEP prescribing. Data were analyzed using descriptive statistics, Wilcoxon signed rank test, and the Kruskal-Wallis test. Significance was accepted for P < 0.05. Forty-eight (100%) trainees participated in the educational session, 45 (94%) in a preintervention survey, and 36 (75%) in a postintervention survey. Before PrEP training, 22% of respondents were unaware of PrEP, 78% believed PrEP was effective, 66% believed PrEP was safe, 62% had fair or poor awareness of side effects; 18% of residents had referred for or prescribed PrEP, and 31% believed they were likely to prescribe PrEP in the next 6 months. After the intervention, 94% of trainees believed PrEP was effective (P < 0.001), 92% believed PrEP was safe (P < 0.001), and two-thirds believed they were likely to prescribe PrEP in the next 6 months. Brief, focused training on HIV prevention promotes awareness, acceptance, and likelihood of prescribing PrEP by internal medicine trainees.

PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers.

PubMed

Zablotska, Iryna; Grulich, Andrew E; Phanuphak, Nittaya; Anand, Tarandeep; Janyam, Surang; Poonkasetwattana, Midnight; Baggaley, Rachel; van Griensven, Frits; Lo, Ying-Ru

2016-01-01

HIV epidemics in the Asia-Pacific region are concentrated among men who have sex with men (MSM) and other key populations. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention and could be a potential game changer in the region. We discuss the progress towards PrEP implementation in the Asia-Pacific region, including opportunities and barriers. Awareness about PrEP in the Asia-Pacific is still low and so are its levels of use. A high proportion of MSM who are aware of PrEP are willing to use it. Key PrEP implementation barriers include poor knowledge about PrEP, limited access to PrEP, weak or non-existent HIV prevention programmes for MSM and other key populations, high cost of PrEP, stigma and discrimination against key populations and restrictive laws in some countries. Only several clinical trials, demonstration projects and a few larger-scale implementation studies have been implemented so far in Thailand and Australia. However, novel approaches to PrEP implementation have emerged: researcher-, facility- and community-led models of care, with PrEP services for fee and for free. The WHO consolidated guidelines on HIV testing, treatment and prevention call for an expanded access to PrEP worldwide and have provided guidance on PrEP implementation in the region. Some countries like Australia have released national PrEP guidelines. There are growing community leadership and consultation processes to initiate PrEP implementation in Asia and the Pacific. Countries of the Asia-Pacific region will benefit from adding PrEP to their HIV prevention packages, but for many this is a critical step that requires resourcing. Having an impact on the HIV epidemic requires investment. The next years should see the region transitioning from limited PrEP implementation projects to growing access to PrEP and expansion of HIV prevention programmes.

Distinguishing hypothetical willingness from behavioral intentions to initiate HIV pre-exposure prophylaxis (PrEP): Findings from a large cohort of gay and bisexual men in the U.S.

PubMed

Rendina, H Jonathon; Whitfield, Thomas H F; Grov, Christian; Starks, Tyrel J; Parsons, Jeffrey T

2017-01-01

Much of the data on the acceptability of HIV Pre-Exposure Prophylaxis (PrEP) is based on willingness to take PrEP (i.e., hypothetical receptivity) rather than actual intentions (i.e., planned behavioral action) to do so. We sought to examine differences between hypothetical willingness and behavioral intentions to begin PrEP in a national sample of gay and bisexual men (GBM) across the U.S. We utilized data collected in 2015 to examine differences between those Unwilling (42.6% n = 375), Willing but not intending (41.4%, n = 365), and willing and Intending to take PrEP (15.9%, n = 140) in a multivariable, multinomial logistic regression. Men with less education had higher odds of Intending to take PrEP. Compared to men unsure about PrEP's efficacy, those who believed PrEP was at least 90% efficacious had higher odds of Intending to take PrEP. Those who saw themselves as appropriate candidates for PrEP had higher odds of Intending to take PrEP while those who saw themselves as inappropriate candidates for PrEP had lower odds of Intending to take PrEP in comparison to men unsure if they were appropriate candidates. Increased motivation for condom non-use because of perceived sexual pressure by partners was associated with higher odds of Intending to take PrEP. The groups did not differ by risk behavior nor recent STI diagnosis. Overall, the distinction between willingness and intentions to take PrEP was meaningful and may help explain disparities between PrEP acceptability and uptake. While much of the literature has focused on hypothetical willingness to take PrEP, these results highlight the importance of simultaneously assessing willingness and intentions when examining correspondence with uptake and developing interventions to increase PrEP uptake. Copyright © 2016 Elsevier Ltd. All rights reserved.

Space Station Freedom electric power system availability study

NASA Technical Reports Server (NTRS)

Turnquist, Scott R.

1990-01-01

The results are detailed of follow-on availability analyses performed on the Space Station Freedom electric power system (EPS). The scope includes analyses of several EPS design variations, these are: the 4-photovoltaic (PV) module baseline EPS design, a 6-PV module EPS design, and a 3-solar dynamic module EPS design which included a 10 kW PV module. The analyses performed included: determining the discrete power levels that the EPS will operate at upon various component failures and the availability of each of these operating states; ranking EPS components by the relative contribution each component type gives to the power availability of the EPS; determining the availability impacts of including structural and long-life EPS components in the availability models used in the analyses; determining optimum sparing strategies, for storing space EPS components on-orbit, to maintain high average-power-capability with low lift-mass requirements; and analyses to determine the sensitivity of EPS-availability to uncertainties in the component reliability and maintainability data used.

Incorporation of bacterial extracellular polysaccharide by black fly larvae (Simuliidae)

USGS Publications Warehouse

Couch, C.A.; Meyer, J.L.; Hall, R.O.

1996-01-01

Black fly larvae (Simulium) assimilated, with high efficiency (80-90%), bacterial extracellular polysaccharide (EPS) extracted from laboratory cultures of a pseudomonad isolated from the Ogeechee River. Incorporation was traced using 13C-labelled EPS offered to larvae as a coating on a mixture of 1-??m latex beads and kaolin particles. These EPS-coated particles were used to simulate natural particles, both living and dead. Solubility, protein, and nitrogen content of the EPS suggested it was a slime rather than a capsular polysaccharide. Glycosyl composition of the EPS was glucose and galactose in ?? and ?? linkages, with pyruvate, succinate, and possibly malonate constituent groups. To evaluate the incorporation of C derived from protein associated with the EPS matrix, feeding experiments were conducted using EPS with and without proteins extracted. Black fly larvae incorporated 7.2 ??g EPS C larva-1 d-1 from EPS that did not have proteins extracted, and 19.5 ??g EPS C larva-1 d-1 from EPS with proteins extracted. Carbon in protein that is typically associated with EPS was not solely or selectively incorporated. EPS incorporation rates are similar to rates of cellular bacterial carbon incorporation previously estimated for Ogeechee River black fly larvae. If EPS is generally available as a food resource, the importance of bacteria in detrital food webs may be underestimated by studies that examine only the consumption of bacterial cells.

Contribution of extracellular polymeric substances from Shewanella sp. HRCR-1 biofilms to U(VI) immobilization.

PubMed

Cao, Bin; Ahmed, Bulbul; Kennedy, David W; Wang, Zheming; Shi, Liang; Marshall, Matthew J; Fredrickson, Jim K; Isern, Nancy G; Majors, Paul D; Beyenal, Haluk

2011-07-01

The goal of this study was to quantify the contribution of extracellular polymeric substances (EPS) to U(VI) immobilization by Shewanella sp. HRCR-1. Through comparison of U(VI) immobilization using cells with bound EPS (bEPS) and cells with minimal EPS, we show that (i) bEPS from Shewanella sp. HRCR-1 biofilms contribute significantly to U(VI) immobilization, especially at low initial U(VI) concentrations, through both sorption and reduction; (ii) bEPS can be considered a functional extension of the cells for U(VI) immobilization and they likely play more important roles at lower initial U(VI) concentrations; and (iii) the U(VI) reduction efficiency is dependent upon the initial U(VI) concentration and decreases at lower concentrations. To quantify the relative contributions of sorption and reduction to U(VI) immobilization by EPS fractions, we isolated loosely associated EPS (laEPS) and bEPS from Shewanella sp. HRCR-1 biofilms grown in a hollow fiber membrane biofilm reactor and tested their reactivity with U(VI). We found that, when reduced, the isolated cell-free EPS fractions could reduce U(VI). Polysaccharides in the EPS likely contributed to U(VI) sorption and dominated the reactivity of laEPS, while redox active components (e.g., outer membrane c-type cytochromes), especially in bEPS, possibly facilitated U(VI) reduction.

Contribution of Extracellular Polymeric Substances from Shewanella sp. HRCR-1 Biofilms to U(VI) Immobilization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cao, Bin; Ahmed, B.; Kennedy, David W.

2011-06-05

The goal of this study was to quantify the contribution of extracellular polymeric substances (EPS) in U(VI) immobilization by Shewanella sp. HRCR-1. Through comparison of U(VI) immobilization using cells with bound EPS (bEPS) and cells without EPS, we showed that i) bEPS from Shewanella sp. HRCR-1 biofilms contributed significantly to U(VI) immobilization, especially at low initial U(VI) concentrations, through both sorption and reduction; ii) bEPS could be considered as a functional extension of the cells for U(VI) immobilization and they likely play more important roles at initial U(VI) concentrations; and iii) U(VI) reduction efficiency was found to be dependent uponmore » initial U(VI) concentration and the efficiency decreased at lower concentrations. To quantify relative contribution of sorption and reduction in U(VI) immobilization by EPS fractions, we isolated loosely associated EPS (laEPS) and bEPS from Shewanella sp. HRCR-1 biofilms grown in a hollow fiber membrane biofilm reactor and tested their reactivity with U(V). We found that, when in reduced form, the isolated cell-free EPS fractions could reduce U(VI). Polysaccharides in the EPS likely contributed to U(VI) sorption and dominated reactivity of laEPS while redox active components (e.g., outer membrane c-type cytochromes), especially in bEPS, might facilitate U(VI) reduction.« less

Pre-Exposure Prophylaxis (PrEP) Use and Condomless Anal Sex: Evidence of Risk Compensation in a Cohort of Young Men Who Have Sex with Men.

PubMed

Newcomb, Michael E; Moran, Kevin; Feinstein, Brian A; Forscher, Emily; Mustanski, Brian

2018-04-01

Young men who have sex with men (YMSM) are disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition. It remains unclear if PrEP use increases rates of condomless sex (ie, risk compensation), which may increase risk of infection if PrEP adherence is not optimal. This study aimed to examine whether PrEP use and PrEP adherence were associated with change in sexual risk behaviors in a large longitudinal cohort of YMSM reporting on multiple sexual partnerships over time. Data were obtained from the first 3 visits of an ongoing cohort study of YMSM in Chicago (analytic N = 953; 14.1% HIV-positive at baseline). Participants reported up to 4 sexual partnerships at each visit, including sexual behavior, PrEP use, and PrEP adherence within partnerships. YMSM reported higher rates of receptive condomless anal sex (CAS) in partnerships during which they were on PrEP compared with those when they were not on PrEP. This association was consistent across both HIV-negative and HIV-positive participants reporting on partnerships with both perceived HIV-negative/unknown and HIV-positive partners. The rate of receptive CAS was higher in PrEP nonadherent partnerships compared with non-PrEP partnerships. The rate of receptive CAS was also higher in PrEP nonadherent than adherent partnerships, but this was not statistically significant. These analyses provide compelling data suggesting that YMSM are engaging in risk compensation when on PrEP. If rates of receptive CAS are highest among YMSM who are PrEP nonadherent, PrEP as a prevention strategy could fail to curb HIV incidence among YMSM.

Abnormal placental development and early embryonic lethality in EpCAM-null mice.

PubMed

Nagao, Keisuke; Zhu, Jianjian; Heneghan, Mallorie B; Hanson, Jeffrey C; Morasso, Maria I; Tessarollo, Lino; Mackem, Susan; Udey, Mark C

2009-12-31

EpCAM (CD326) is encoded by the tacstd1 gene and expressed by a variety of normal and malignant epithelial cells and some leukocytes. Results of previous in vitro experiments suggested that EpCAM is an intercellular adhesion molecule. EpCAM has been extensively studied as a potential tumor marker and immunotherapy target, and more recent studies suggest that EpCAM expression may be characteristic of cancer stem cells. To gain insights into EpCAM function in vivo, we generated EpCAM -/- mice utilizing an embryonic stem cell line with a tacstd1 allele that had been disrupted. Gene trapping resulted in a protein comprised of the N-terminus of EpCAM encoded by 2 exons of the tacstd1 gene fused in frame to betageo. EpCAM +/- mice were viable and fertile and exhibited no obvious abnormalities. Examination of EpCAM +/- embryos revealed that betageo was expressed in several epithelial structures including developing ears (otocysts), eyes, branchial arches, gut, apical ectodermal ridges, lungs, pancreas, hair follicles and others. All EpCAM -/- mice died in utero by E12.5, and were small, developmentally delayed, and displayed prominent placental abnormalities. In developing placentas, EpCAM was expressed throughout the labyrinthine layer and by spongiotrophoblasts as well. Placentas of EpCAM -/- embryos were compact, with thin labyrinthine layers lacking prominent vascularity. Parietal trophoblast giant cells were also dramatically reduced in EpCAM -/- placentas. EpCAM was required for differentiation or survival of parietal trophoblast giant cells, normal development of the placental labyrinth and establishment of a competent maternal-fetal circulation. The findings in EpCAM-reporter mice suggest involvement of this molecule in development of vital organs including the gut, kidneys, pancreas, lungs, eyes, and limbs.

The anti-inflammatory effects of PGE2 on human lung macrophages are mediated by the EP4 receptor.

PubMed

Gill, Sharonjit K; Yao, Yiwen; Kay, Linda J; Bewley, Martin A; Marriott, Helen M; Peachell, Peter T

2016-11-01

PGE 2 inhibits cytokine generation from human lung macrophages. However, the EP receptor that mediates this beneficial anti-inflammatory effect of PGE 2 has not been defined. The aim of this study was to identify the EP receptor by which PGE 2 inhibits cytokine generation from human lung macrophages. This was determined by using recently developed EP receptor ligands. The effects of PGE 2 and EP-selective agonists on LPS-induced generation of TNF-α and IL-6 from macrophages were evaluated. The effects of EP 2 -selective (PF-04852946, PF-04418948) and EP 4 -selective (L-161,982, CJ-042794) receptor antagonists on PGE 2 responses were studied. The expression of EP receptor subtypes by human lung macrophages was determined by RT-PCR. PGE 2 inhibited LPS-induced and Streptococcus pneumoniae-induced cytokine generation from human lung macrophages. Analysis of mRNA levels indicated that macrophages expressed EP 2 and EP 4 receptors. L-902,688 (EP 4 receptor-selective agonist) was considerably more potent than butaprost (EP 2 receptor-selective agonist) as an inhibitor of TNF-α generation from macrophages. EP 2 receptor-selective antagonists had marginal effects on the PGE 2 inhibition of TNF-α generation, whereas EP 4 receptor-selective antagonists caused rightward shifts in the PGE 2 concentration-response curves. These studies demonstrate that the EP 4 receptor is the principal receptor that mediates the anti-inflammatory effects of PGE 2 on human lung macrophages. This suggests that EP 4 receptor agonists could be effective anti-inflammatory agents in human lung disease. © 2016 The British Pharmacological Society.

Pre-Exposure Prophylaxis: A Narrative Review of Provider Behavior and Interventions to Increase PrEP Implementation in Primary Care.

PubMed

Silapaswan, Andrew; Krakower, Douglas; Mayer, Kenneth H

2017-02-01

Since FDA approval of HIV pre-exposure prophylaxis (PrEP) for HIV prevention, attention has been focused on PrEP implementation. The CDC estimates that 1.2 million U.S. adults might benefit from PrEP, but only a minority are using PrEP, so there is a significant unmet need to increase access for those at risk for HIV. Given the large numbers of individuals who have indications for PrEP, there are not enough practicing specialists to meet the growing need for providers trained in providing PrEP. Moreover, since PrEP is a preventive intervention for otherwise healthy individuals, primary care providers (PCPs) should be primary prescribers of PrEP. There are important clinical considerations that providers should take into account when planning to prescribe PrEP, which are highlighted in the clinical case discussed. A growing body of research also suggests that some providers may be cautious about prescribing PrEP because of concerns regarding its "real-world" effectiveness, anticipated unintended consequences associated with its use, and ambiguity as to who should prescribe it. This review summarizes findings from studies that have assessed prescriber behavior regarding provision of PrEP, and offers recommendations on how to optimize PrEP implementation in primary care settings. Development and dissemination of educational interventions for PCPs and potential PrEP users are needed, including improved methods to assist clinicians in identifying appropriate PrEP candidates, and programs to promote medication adherence and access to social and behavioral health services. PCPs are well-positioned to prescribe PrEP and coordinate health-related services to improve the sexual health of their patients, but tailored educational programs are needed.

Characterization of the EP receptor types that mediate longitudinal smooth muscle contraction of human colon, mouse colon and mouse ileum.

PubMed

Fairbrother, S E; Smith, J E; Borman, R A; Cox, H M

2011-08-01

Prostaglandin E(2) (PGE(2) ) is an inflammatory mediator implicated in several gastrointestinal pathologies that affect normal intestinal transit. The aim was to establish the contribution of the four EP receptor types (EP(1-4) ), in human colon, that mediate PGE(2) -induced longitudinal smooth muscle contraction. Changes in isometric muscle tension of human colon, mouse colon and mouse ileum were measured in organ baths in response to receptor-specific agonists and antagonists. In addition, lidocaine was used to block neurogenic activity to investigate whether EP receptors were pre- or post-junctional. PGE(2) contracted longitudinal muscle from human and mouse colon and mouse ileum. These contractions were inhibited by the EP(1) receptor antagonist, EP(1) A in human colon, whereas a combination of EP(1) A and the EP(3) antagonist, L798106 inhibited agonist responses in both mouse preparations. The EP(3) agonist, sulprostone also increased muscle tension in both mouse tissues, and these responses were inhibited by lidocaine in the colon but not in the ileum. Although PGE(2) consistently contracted all three muscle preparations, butaprost decreased tension by activating smooth muscle EP(2) receptors in both colonic tissues. Alternatively, in mouse ileum, butaprost responses were lidocaine-sensitive, suggesting that it was activating prejunctional EP(2) receptors on inhibitory motor neurons. Conversely, EP(4) receptors were not functional in all the intestinal muscle preparations tested. PGE(2) -induced contraction of longitudinal smooth muscle is mediated by EP(1) receptors in human colon and by a combination of EP(1) and EP(3) receptors in mouse intestine, whereas EP(2) receptors modulate relaxation in all three preparations. © 2011 Blackwell Publishing Ltd.

Engaging healthcare providers to implement HIV pre-exposure prophylaxis.

PubMed

Krakower, Douglas; Mayer, Kenneth H

2012-11-01

Recent randomized controlled trials have demonstrated that HIV pre-exposure prophylaxis (PrEP) can decrease HIV incidence among several at-risk populations, including men who have sex with men, serodiscordant couples, and heterosexual men and women. As PrEP is a biomedical intervention that requires clinical monitoring and a high level of medication adherence, maximizing the public health effectiveness of PrEP in real-world settings will require the training of a cadre of healthcare providers to prescribe PrEP. Therefore it is critical to understand provider knowledge, practices, and attitudes towards PrEP prescribing, and to develop strategies for engaging and training providers to provide PrEP. Limited numbers of studies have focused on PrEP implementation by healthcare providers. These studies suggest that some providers are knowledgeable about PrEP, but many are not, or express misgivings. Although many clinicians report willingness to provide PrEP, few have prescribed PrEP in clinical practice. Provider comfort and skills in HIV risk assessment are suboptimal, which could limit identification of individuals who are most likely to benefit from PrEP use. Further studies to understand facilitators and barriers to HIV-risk assessment and PrEP prescribing by practicing clinicians are needed. Innovative training strategies and decision-support interventions for providers could optimize PrEP implementation and therefore merit additional research.

How biological crusts are stabilizing the soil surface? The devolpment of organo-mineral interactions in the initial phase

NASA Astrophysics Data System (ADS)

Fischer, T.; Veste, M.; Wiehe, W.; Lange, P.

2009-04-01

First colonizers of new land surfaces are cryptogames which often form biological soil crusts (BSC) covering the first millimetre of the top soil in many ecosystems from polar to desert ecosystems. These BSC are assemblages of cyanobacteria, green algae, mosses, liverworts, fungi and/or lichens. The development of soil surface crusts plays a major role for the further vegetation pattern through changes to the physico-chemical conditions and influencing various ecosystem processes. We studied the development of BSC on quaternary substrate of an initial artificial water catchment in Lusatia, Germany. Due to lack of organic matter in the geological substrate, photoautotrophic organisms like green algae and cyanobacteria dominated the initial phases of ecosystem development and, hence, of organo-mineral ineractions. We combined SEM/EDX and FTIR microscopy to study the contact zone of extracellular polymeric substances (EPS) of green algae and cyanobacteria with quartz, spars and mica on a >40 µm scale in undisturbed biological soil crusts, which had a maximum thickness of approx. 2 mm. SEM/EDX microscopy was used to determine the spatial distribution of S, Ca, Fe, Al, Si and K in the profiles, organic compounds were identified using FTIR microscopy. Exudates of crust organisms served as cementing material between sand particles. The crust could be subdivided into two horizontal layers. The upper layer, which had a thickness of approx. 200 µm, is characterized by accumulation of Al and K, but absence of Fe in microbial derived organic matter, indicating capture of weathering products of feldspars and mica by microbial exudates. The pore space between mineral particles was entirely filled with organic matter here. The underlying layer can be characterized by empty pores and organo-mineral bridges between the sand particles. Contrarily to the upper layer of the crust, Fe, Al and Si were associated with organic matter here but K was absent. Highest similarity of the FTIR spectra of EPS was observed with carbohydrates, using cellulose, dextran and humic acid Na salt as controls. Obviously, humification does not play a key role during this initial phase of soil formation. It was hypothesized that biological soil crusts facilitate the weathering of mineral substrate by (I) circumventing loss of fine particles with erosion, (II) by chemical treatment of minerals and (III) by catching small mineral-particles by glutinous EPS on the soil surface from the surrounding area.

Modelled thermal and dynamical responses of the middle atmosphere to EPP-induced ozone changes

NASA Astrophysics Data System (ADS)

Karami, K.; Braesicke, P.; Kunze, M.; Langematz, U.; Sinnhuber, M.; Versick, S.

2015-11-01

Energetic particles including protons, electrons and heavier ions, enter the Earth's atmosphere over the polar regions of both hemispheres, where they can greatly disturb the chemical composition of the upper and middle atmosphere and contribute to ozone depletion in the stratosphere and mesosphere. The chemistry-climate general circulation model EMAC is used to investigate the impact of changed ozone concentration due to Energetic Particle Precipitation (EPP) on temperature and wind fields. The results of our simulations show that ozone perturbation is a starting point for a chain of processes resulting in temperature and circulation changes over a wide range of latitudes and altitudes. In both hemispheres, as winter progresses the temperature and wind anomalies move downward with time from the mesosphere/upper stratosphere to the lower stratosphere. In the Northern Hemisphere (NH), once anomalies of temperature and zonal wind reach the lower stratosphere, another signal develops in mesospheric heights and moves downward. Analyses of Eliassen and Palm (EP) flux divergence show that accelerating or decelerating of the stratospheric zonal flow is in harmony with positive and negative anomalies of the EP flux divergences, respectively. This results suggest that the oscillatory mode in the downwelling signal of temperature and zonal wind in our simulations are the consequence of interaction between the resolved waves in the model and the mean stratospheric flow. Therefore, any changes in the EP flux divergence lead to anomalies in the zonal mean zonal wind which in turn feed back on the propagation of Rossby waves from the troposphere to higher altitudes. The analyses of Rossby waves refractive index show that the EPP-induced ozone anomalies are capable of altering the propagation condition of the planetary-scale Rossby waves in both hemispheres. It is also found that while ozone depletion was confined to mesospheric and stratospheric heights, but it is capable to alter Rossby wave propagation down to tropospheric heights. In response to an accelerated polar vortex in the Southern Hemisphere (SH) late wintertime, we found almost two weeks delay in the occurrence of mean dates of Stratospheric Final Warming (SFW). These results suggest that the stratosphere is not merely a passive sink of wave activity from below, but it plays an active role in determining its own budget of wave activity.

A Novel Workflow to Enrich and Isolate Patient-Matched EpCAMhigh and EpCAMlow/negative CTCs Enables the Comparative Characterization of the PIK3CA Status in Metastatic Breast Cancer

PubMed Central

Lampignano, Rita; Yang, Liwen; Neumann, Martin H. D.; Franken, André; Fehm, Tanja; Niederacher, Dieter; Neubauer, Hans

2017-01-01

Circulating tumor cells (CTCs), potential precursors of most epithelial solid tumors, are mainly enriched by epithelial cell adhesion molecule (EpCAM)-dependent technologies. Hence, these approaches may overlook mesenchymal CTCs, considered highly malignant. Our aim was to establish a workflow to enrich and isolate patient-matched EpCAMhigh and EpCAMlow/negative CTCs within the same blood samples, and to investigate the phosphatidylinositol 3-kinase catalytic subunit alpha (PIK3CA) mutational status within single CTCs. We sequentially processed metastatic breast cancer (MBC) blood samples via CellSearch® (EpCAM-based) and via Parsortix™ (size-based) systems. After enrichment, cells captured in Parsortix™ cassettes were stained in situ for nuclei, cytokeratins, EpCAM and CD45. Afterwards, sorted cells were isolated via CellCelector™ micromanipulator and their genomes were amplified. Lastly, PIK3CA mutational status was analyzed by combining an amplicon-based approach with Sanger sequencing. In 54% of patients′ blood samples both EpCAMhigh and EpCAMlow/negative cells were identified and successfully isolated. High genomic integrity was observed in 8% of amplified genomes of EpCAMlow/negative cells vs. 28% of EpCAMhigh cells suggesting an increased apoptosis in the first CTC-subpopulation. Furthermore, PIK3CA hotspot mutations were detected in both EpCAMhigh and EpCAMlow/negative CTCs. Our workflow is suitable for single CTC analysis, permitting—for the first time—assessment of the heterogeneity of PIK3CA mutational status within patient-matched EpCAMhigh and EpCAMlow/negative CTCs. PMID:28858218

Extracellular Polymeric Substance Production and Aggregated Bacteria Colonization Influence the Competition of Microbes in Biofilms.

PubMed

Jayathilake, Pahala G; Jana, Saikat; Rushton, Steve; Swailes, David; Bridgens, Ben; Curtis, Tom; Chen, Jinju

2017-01-01

The production of extracellular polymeric substance (EPS) is important for the survival of biofilms. However, EPS production is costly for bacteria and the bacterial strains that produce EPS (EPS+) grow in the same environment as non-producers (EPS-) leading to competition between these strains for nutrients and space. The outcome of this competition is likely to be dependent on factors such as initial attachment, EPS production rate, ambient nutrient levels and quorum sensing. We use an Individual-based Model (IbM) to study the competition between EPS+ and EPS- strains by varying the nature of initial colonizers which can either be in the form of single cells or multicellular aggregates. The microbes with EPS+ characteristics obtain a competitive advantage if they initially colonize the surface as smaller aggregates and are widely spread-out between the cells of EPS-, when both are deposited on the substratum. Furthermore, the results show that quorum sensing-regulated EPS production may significantly reduce the fitness of EPS producers when they initially deposit as aggregates. The results provide insights into how the distribution of bacterial aggregates during initial colonization could be a deciding factor in the competition among different strains in biofilms.

The Dutch EPS Registry: increasing the knowledge of encapsulating peritoneal sclerosis.

PubMed

Korte, M R; Boeschoten, E W; Betjes, M G H

2009-09-01

Encapsulating peritoneal sclerosis (EPS) is a rare condition characterised by fibrotic thickening of the visceral peritoneum, leading to encapsulating of the intestines with partial or total intestinal obstruction. EPS is a serious complication of peritoneal dialysis (PD) with high morbidity and a mortality exceeding 50%. At present, there is uncertainty concerning the incidence and the risk factors involved in the development of EPS. To address these questions a nationwide registry has been initiated. The primary goals of the registry are to record the incidence of EPS and investigate the association of different variables, such as PD duration, medication, dialysis solutions and kidney transplantation with EPS. The registry will improve the knowledge of EPS and will serve to develop guidelines and necessary management strategies. From the registry different research activities can be initiated. A major challenge lies in the establishment of criteria that allow a timely diagnosis of EPS. At present, there are no diagnostic tools that can accurately detect EPS at an early stage. For this reason, besides patients with proven EPS, the clinical suspicion of EPS will be a sufficient criterion for inclusion in the registry. This nationwide EPS registry is currently enrolling patients.

Composition and functional group characterization of extracellular polymeric substances (EPS) in activated sludge: the impacts of polymerization degree of proteinaceous substrates.

PubMed

Wang, Bin-Bin; Liu, Xue-Ting; Chen, Jian-Meng; Peng, Dang-Cong; He, Feng

2018-02-01

Characteristics of extracellular polymeric substances (EPS) in activated sludge strongly depend on wastewater substrates. Proteinaceous substrates (ProS) present in heterogeneous polymeric form are intrinsic and important parts of wastewater substrates for microorganisms in activated sludge systems. However, correlations between ProS and characteristics of EPS are scarce. This study systematically explored the impacts of monomeric (Mono-), low polymeric (LoP-) and high polymeric (HiP-) ProS on compositions and functional groups of EPS in activated sludge. The results showed that the change of polymerization degree of ProS significantly altered the composition of EPS. Compared to EPS Mono-ProS , the proportion of proteins in EPS LoP-ProS and EPS HiP-ProS increased by 12.8% and 27.7%, respectively, while that of polysaccharides decreased by 22.9% and 63.6%, respectively. Moreover, the proportion of humic compounds in EPS LoP-ProS and EPS HiP-ProS were ∼6 and ∼16-fold higher than that in EPS Mono-ProS , respectively. The accumulation of humic compounds in EPS increased the unsaturation degree of EPS molecules, and thereby reduced the energy requirement for electrons transition of amide bonds and aromatic groups. Size exclusion chromatography (SEC) analyses detected more molecular clusters in EPS HiP-ProS , indicating more complex composition of EPS in HiP-ProS fed activated sludge. Spectroscopic characterization revealed the dominance of hydrocarbon, protein, polysaccharide and aromatic associated bonds in all three EPS. Nevertheless, with the increase of polymerization degree of ProS, the protein associated bonds (such as CONH, CO, NC, NH) increased, while the polysaccharide associated bonds (such as COC, COH, OCOH) decreased. This paper paves a path to understand the role of ProS in affecting the production and characteristics of EPS in biological wastewater treatment systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Extracellular polysaccharides produced by cooling water tower biofilm bacteria and their possible degradation.

PubMed

Ceyhan, Nur; Ozdemir, Guven

2008-01-01

The extracellular polymers (EPS) of biofilm bacteria that can cause heat and mass transfer problems in cooling water towers in the petrochemical industry were investigated. In addition, these microorganisms were screened for their ability to grow and degrade their own EPS and the EPS of other species. Twelve bacteria producing the most EPS were isolated from cooling water towers and characterized biochemically by classic and commercial systems. These were species of Pseudomonas, Burkholderia, Aeromonas, Pasteurella, Pantoea, Alcaligenes and Sphingomonas. EPS of these species were obtained by propan-2-ol precipitation and centrifugation from bacterial cultures in media enriched with glucose, sucrose or galactose. EPS yields were of 1.68-4.95 g l(-1). These EPS materials were characterized for total sugar and protein contents. Their total sugar content ranged from 24 to 56% (g sugar g(-1) EPS), and their total protein content ranged from 10 to 28% (g protein g(-1) EPS). The monosaccharide compositions of EPS were determined by HPLC. Generally, these compositions were enriched in galactose and glucose, with lesser amounts of mannose, rhamnose, fructose and arabinose. All bacteria were investigated in terms of EPS degradation. Eight of the bacteria were able to utilize EPS from Burkholderia cepacia, seven of the bacteria were able to utilize EPS from Pseudomonas sp. and Sphingomonas paucimobilis. The greatest viscosity reduction of B. cepacia was obtained with Pseudomonas sp. The results show that the bacteria in this study are able to degrade EPS from biofilms in cooling towers.

Optical Aptamer Probes of Fluorescent Imaging to Rapid Monitoring of Circulating Tumor Cell

PubMed Central

Hwang, Ji Yeon; Kim, Sang Tae; Han, Ho-Seong; Kim, Kyunggon; Han, Jin Soo

2016-01-01

Fluorescence detecting of exogenous EpCAM (epithelial cell adhesion molecule) or muc1 (mucin1) expression correlated to cancer metastasis using nanoparticles provides pivotal information on CTC (circulating tumor cell) occurrence in a noninvasive tool. In this study, we study a new skill to detect extracellular EpCAM/muc1 using quantum dot-based aptamer beacon (QD-EpCAM/muc1 ALB (aptamer linker beacon). The QD-EpCAM/muc1 ALB was designed using QDs (quantum dots) and probe. The EpCAM/muc1-targeting aptamer contains a Ep-CAM/muc1 binding sequence and BHQ1 (black hole quencher 1) or BHQ2 (black hole quencher2). In the absence of target EpCAM/muc1, the QD-EpCAM/muc1 ALB forms a partial duplex loop-like aptamer beacon and remained in quenched state because the BHQ1/2 quenches the fluorescence signal-on of the QD-EpCAM/muc1 ALB. The binding of EpCAM/muc1 of CTC to the EpCAM/muc1 binding aptamer sequence of the EpCAM/muc1-targeting oligonucleotide triggered the dissociation of the BHQ1/2 quencher and subsequent signal-on of a green/red fluorescence signal. Furthermore, acute inflammation was stimulated by trigger such as caerulein in vivo, which resulted in increased fluorescent signal of the cy5.5-EpCAM/muc1 ALB during cancer metastasis due to exogenous expression of EpCAM/muc1 in Panc02-implanted mouse model. PMID:27886058

Extracellular polymeric substances facilitate the biosorption of phenanthrene on cyanobacteria Microcystis aeruginosa.

PubMed

Bai, Leilei; Xu, Huacheng; Wang, Changhui; Deng, Jiancai; Jiang, Helong

2016-11-01

Phytoplankton-derived extracellular polymeric substances (EPS) are of vital importance for the biogeochemical cycles of hydrophobic organic pollutants in lake ecosystems. In this study, roles of loosely-bound EPS (LB-EPS) and tightly bound EPS (TB-EPS) in biosorption of phenanthrene (PHE) on a typical cyanobacteria Microcystis aeruginosa were investigated. The results showed that the biosorption of PHE on M. aeruginosa cell varied lasted 24 h, while the binding of PHE to LB-EPS and TB-EPS reached equilibrium within less than 2 h. The equilibrium biosorption capacities of M. aeruginosa cell, LB-EPS and TB-EPS were 6.78, 12.31, and 9.47 μg mg(-1), respectively, indicating that the binding of PHE to EPS was a considerable process involved in biosorption. Fluorescence quenching titration revealed that increasing temperature induced more binding sites in EPS for PHE and the binding process was driven by electrostatic force and hydrophobic interactions. Interestingly, dynamic and static quenching processes occurred simultaneously for the binding of PHE to protein-like substances in EPS, whereas the binding of PHE to humic-like substances belonged to static quenching. The relatively higher contents of proteins in LB-EPS produced a stronger binding capacity of PHE. Overall, the interactions between hydrophobic organic pollutants and cyanobacterial EPS are favorable to the bioaccumulation of hydrophobic organic pollutants in cyanobacteria and facilitate the regulatory function of cyanobacterial biomass as a biological pump. Copyright © 2016 Elsevier Ltd. All rights reserved.

Network Meta-Analysis Comparing the Efficacy of Therapeutic Treatments for Bronchiolitis in Children.

PubMed

Guo, Caili; Sun, Xiaomin; Wang, Xiaowen; Guo, Qing; Chen, Dan

2018-01-01

This study aims to compare placebo (PBO) and 7 therapeutic regimens-namely, bronchodilator agents (BAs), hypertonic saline (HS), BA ± HS, corticosteroids (CS), epinephrine (EP), EP ± CS, and EP ± HS-to determine the optimal bronchiolitis treatment. We plotted networks using the curative outcome of several studies and specified the relations among the experiments by using mean difference, standardized mean difference, and corresponding 95% credible interval. The surface under the cumulative ranking curve (SUCRA) was used to separately rank each therapy on clinical severity score (CSS) and length of hospital stay (LHS). This network meta-analysis included 40 articles from 1995 to 2016 concerning the treatment of bronchiolitis in children. All 7 therapeutic regimens displayed no significant difference to PBO with regard to CSS in our study. Among the 7 therapies, BA performed better than CS. As for LHS, EP and EP ± HS had an advantage over PBO. Moreover, EP and EP ± HS were also more efficient than BA. The SUCRA results showed that EP ± CS is most effective, and EP ± HS is second most effective with regard to CSS. With regard to LHS, EP ± HS ranked first, EP ± CS ranked second, and EP ranked third. We recommend EP ± CS and EP ± HS as the first choice for bronchiolitis treatment in children because of their outstanding performance with regard to CSS and LHS. © 2017 American Society for Parenteral and Enteral Nutrition.

E-type prostanoid receptor 4 (EP4) in disease and therapy

PubMed Central

Konya, Viktoria; Marsche, Gunther; Schuligoi, Rufina; Heinemann, Akos

2013-01-01

The large variety of biological functions governed by prostaglandin (PG) E2 is mediated by signaling through four distinct E-type prostanoid (EP) receptors. The availability of mouse strains with genetic ablation of each EP receptor subtype and the development of selective EP agonists and antagonists have tremendously advanced our understanding of PGE2 as a physiologically and clinically relevant mediator. Moreover, studies using disease models revealed numerous conditions in which distinct EP receptors might be exploited therapeutically. In this context, the EP4 receptor is currently emerging as most versatile and promising among PGE2 receptors. Anti-inflammatory, anti-thrombotic and vasoprotective effects have been proposed for the EP4 receptor, along with its recently described unfavorable tumor-promoting and pro-angiogenic roles. A possible explanation for the diverse biological functions of EP4 might be the multiple signaling pathways switched on upon EP4 activation. The present review attempts to summarize the EP4 receptor-triggered signaling modules and the possible therapeutic applications of EP4-selective agonists and antagonists. PMID:23523686

Objective correlate of subjective pain perception by contact heat-evoked potentials.

PubMed

Granovsky, Yelena; Granot, Michal; Nir, Rony-Reuven; Yarnitsky, David

2008-01-01

The method of pain-evoked potentials has gained considerable acceptance over the last 3 decades regarding its objectivity, repeatability, and quantifiability. The present study explored whether the relationship between pain-evoked potentials and pain psychophysics obtained by contact heat stimuli is similar to those observed for the conventionally used laser stimulation. Evoked potentials (EPs) were recorded in response to contact heat stimuli at different body sites in 24 healthy volunteers. Stimuli at various temperatures were applied to the forearm (43 degrees C, 46 degrees C, 49 degrees C, and 52 degrees C) and leg (46 degrees C and 49 degrees C). The amplitudes of both components (N2 and P2) were strongly associated with the intensity of the applied stimuli and with subjective pain perception. Yet, regression analysis revealed pain perception and not stimulus intensity as the major contributing factor. A significant correlation was found between the forearm and the leg for both psychophysics and EPs amplitude. Contact heat can generate readily distinguishable evoked potentials on the scalp, consistent between upper and lower limbs. Although these potentials bear positive correlation with both stimulus intensity and pain magnitude, the latter is the main contributor to the evoked brain response.

Erect panicle2 encodes a novel protein that regulates panicle erectness in indica rice.

PubMed

Zhu, Keming; Tang, Ding; Yan, Changjie; Chi, Zhengchang; Yu, Hengxiu; Chen, Jianmin; Liang, Jiansheng; Gu, Minghong; Cheng, Zhukuan

2010-02-01

Rice (Oryza sativa L.) inflorescence (panicle) architecture is an important agronomic trait for rice breeding. A number of high-yielding japonica rice strains, characterized by an erect panicle (EP) of their architecture, have been released as commercial varieties in China. But no EP-type indica varieties are released so far. Here, we identified two allelic erect-panicle mutants in indica rice, erect panicle2-1 (ep2-1) and erect panicle2-2 (ep2-2), exhibiting the characteristic erect panicle phenotype. Both mutants were derived from spontaneous mutation. We cloned the EP2 gene by way of a map-based cloning strategy, and a transgenic complementation test rescued the phenotype of ep2-1. Anatomical investigations revealed that the ep2 mutants have more vascular bundles and a thicker stem than that of wild-type plants, explaining the panicle erectness phenotype in ep2 mutants. It was shown that EP2 was specifically expressed in the vascular bundles of internodes by GUS staining and RT-PCR. EP2 encodes a novel plant-specific protein, which localizes to the endoplasmic reticulum with unknown biochemical function. In addition, EP2 also regulates other panicle characteristics, such as panicle length and grain size, but grain number per panicle shows little change, indicating that the mutation of the ep2 gene could be applied in EP-type indica rice breeding.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saeed, Noha M.; El-Demerdash, Ebtehal; Abdel-Rahman, Hanaa M.

Methyl palmitate (MP) and ethyl palmitate (EP) are naturally occurring fatty acid esters reported as inflammatory cell inhibitors. In the current study, the potential anti-inflammatory activity of MP and EP was evaluated in different experimental rat models. Results showed that MP and EP caused reduction of carrageenan-induced rat paw edema in addition to diminishing prostaglandin E2 (PGE2) level in the inflammatory exudates. In lipopolysaccharide (LPS)-induced endotoxemia in rats, MP and EP reduced plasma levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). MP and EP decreased NF-κB expression in liver and lung tissues and ameliorated histopathological changes caused by LPS.more » Topical application of MP and EP reduced ear edema induced by croton oil in rats. In the same animal model, MP and EP reduced neutrophil infiltration, as indicated by decreased myeloperoxidase (MPO) activity. In conclusion, this study demonstrates the effectiveness of MP and EP in combating inflammation in several experimental models. -- Highlights: ► Efficacy of MP and EP in combating inflammation was displayed in several models. ► MP and EP reduced carrageenan-induced rat paw edema and prostaglandin E2 level. ► MP and EP decreased TNF-α and IL-6 levels in experimental endotoxemia. ► MP and EP reduced NF-κB expression and histological changes in rat liver and lung. ► MP and EP reduced croton oil-induced ear edema and neutrophil infiltration.« less

The impact of EpCAM expression on response to chemotherapy and clinical outcomes in patients with epithelial ovarian cancer.

PubMed

Tayama, Shingo; Motohara, Takeshi; Narantuya, Dashdemberel; Li, Chenyan; Fujimoto, Koichi; Sakaguchi, Isao; Tashiro, Hironori; Saya, Hideyuki; Nagano, Osamu; Katabuchi, Hidetaka

2017-07-04

Epithelial ovarian cancer is a highly lethal malignancy; moreover, overcoming chemoresistance is the major challenging in treating ovarian cancer patients. The cancer stem cell (CSC) hypothesis considers CSCs to be the main culprits in driving tumor initiation, metastasis, and resistance to conventional therapy. Although growing evidence suggest that CSCs are responsible for chemoresistance, the contribution of CSC marker EpCAM to resistance to chemotherapy remains unresolved.Here we have demonstrated that ovarian cancers containing high levels of EpCAM have a significantly much lower probability of achieving overall responsive rates after first-line chemotherapy. In addition, multivariate analysis revealed that EpCAM expression is an independent risk factor for chemoresistance, indicating that EpCAM expression is a predictive biomarker of chemotherapeutic response. Consistent with these clinical observations, in vitro assays, we found that the subpopulation of EpCAM-positive ovarian cancer cells shows a significantly higher viability compared with EpCAM-negative cells in response to cisplatin treatment by preventing chemotherapy-induced apoptosis, which is regulated by EpCAM-Bcl-2 axis. Furthermore, in an in vivo mouse model, platinum agents preferentially eliminated EpCAM-negative cells in comparison with EpCAM-positive cells, suggesting that the remaining subpopulation of EpCAM-positive cells contributes to tumor recurrence after chemotherapy. Finally, we also found that an increased expression of EpCAM is associated with poor prognosis in ovarian cancer patients.Our findings highlight the clinical significance of EpCAM in the resistance to chemotherapy and provide a rationale for EpCAM-targeted therapy to improve chemoresistance. Targeting EpCAM should be a promising approach to effectively extirpate the CSCs as the putative root of ovarian cancer.

Widespread detection of a brominated flame retardant, hexabromocyclododecane, in expanded polystyrene marine debris and microplastics from South Korea and the Asia-Pacific coastal region.

PubMed

Jang, Mi; Shim, Won Joon; Han, Gi Myung; Rani, Manviri; Song, Young Kyoung; Hong, Sang Hee

2017-12-01

The role of marine plastic debris and microplastics as a carrier of hazardous chemicals in the marine environment is an emerging issue. This study investigated expanded polystyrene (EPS, commonly known as styrofoam) debris, which is a common marine debris item worldwide, and its additive chemical, hexabromocyclododecane (HBCD). To obtain a better understanding of chemical dispersion via EPS pollution in the marine environment, intensive monitoring of HBCD levels in EPS debris and microplastics was conducted in South Korea, where EPS is the predominant marine debris originate mainly from fishing and aquaculture buoys. At the same time, EPS debris were collected from 12 other countries in the Asia-Pacific region, and HBCD concentrations were measured. HBCD was detected extensively in EPS buoy debris and EPS microplastics stranded along the Korean coasts, which might be related to the detection of a quantity of HBCD in non-flame-retardant EPS bead (raw material). The wide detection of the flame retardant in sea-floating buoys, and the recycling of high-HBCD-containing EPS waste inside large buoys highlight the need for proper guidelines for the production and use of EPS raw materials, and the recycling of EPS waste. HBCD was also abundantly detected in EPS debris collected from the Asia-Pacific coastal region, indicating that HBCD contamination via EPS debris is a common environmental issue worldwide. Suspected tsunami debris from Alaskan beaches indicated that EPS debris has the potential for long-range transport in the ocean, accompanying the movement of hazardous chemicals. The results of this study indicate that EPS debris can be a source of HBCD in marine environments and marine food web. Copyright © 2017 Elsevier Ltd. All rights reserved.

Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi.

PubMed

Arnold, Trisha; Brinkley-Rubinstein, Lauren; Chan, Philip A; Perez-Brumer, Amaya; Bologna, Estefany S; Beauchamps, Laura; Johnson, Kendra; Mena, Leandro; Nunn, Amy

2017-01-01

Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care.

EpCAM expression in primary tumour tissues and metastases: an immunohistochemical analysis.

PubMed

Spizzo, Gilbert; Fong, Dominic; Wurm, Martin; Ensinger, Christian; Obrist, Peter; Hofer, Carina; Mazzoleni, Guido; Gastl, Guenther; Went, Philip

2011-05-01

Epithelial cell adhesion molecule (EpCAM) is a cell surface protein with oncogenic features that is expressed on healthy human epithelia and corresponding malignant tumours. EpCAM expression frequently correlates with more aggressive tumour behaviour and new EpCAM-specific therapeutic agents have recently been approved for clinical use in patients with cancer. However, no consensus exists on how and when to evaluate EpCAM expression in patients with cancer. EpCAM expression was assessed by a well-established immunohistochemical staining protocol in 2291 primary tumour tissues and in 108 metastases using the EpCAM-specific antibody clone VU1D9. A total immunostaining score was calculated as the product of a proportion score and an intensity score. Four expression subgroups (no, weak, moderate and intense) were defined. As described previously, the term 'EpCAM overexpression' was reserved for tissues showing a total immunostaining score >4. EpCAM was highly expressed in most tumours of gastrointestinal origin and in some carcinomas of the genitourinary tract. However, hepatocellular carcinomas, clear cell renal cell cancer, urothelial cancer and squamous cell cancers were frequently EpCAM negative. EpCAM expression in breast cancer depended on the histological subtype; lobular histology usually showed no or weak expression. Most metastases were EpCAM positive and they frequently reflected the expression phenotype of the primary tumour. EpCAM expression was detected on adenocarcinomas of various primary sites. If EpCAM-specific antibodies are intended to be used in patients with cancer, we recommend prior immunohistochemical evaluation of EpCAM expression, particularly in patients with renal cell cancer, hepatocellular carcinoma, urothelial carcinoma, breast cancer and squamous cell carcinomas.

HIV Care Providers' Intentions to Prescribe and Actual Prescription of Pre-Exposure Prophylaxis to At-Risk Adolescents and Adults.

PubMed

Mullins, Tanya L Kowalczyk; Zimet, Gregory; Lally, Michelle; Xu, Jiahong; Thornton, Sarah; Kahn, Jessica A

2017-12-01

Pre-exposure prophylaxis (PrEP) is indicated for use in US adults, and little is known about clinician intentions to prescribe and actual prescription of PrEP to adolescents younger than 18. Fifty-six clinicians who care for HIV-infected and at-risk youth completed an anonymous online survey in 2014. Primary outcomes were (1) intentions to prescribe PrEP to adolescents and adults in four risk categories [men who have sex with men (MSM), transgender women, heterosexuals with multiple partners of unknown HIV status, heterosexuals with HIV-infected partners]; and (2) actual prescription of PrEP to adolescents and adults in these risk groups. Independent variables included clinician characteristics, experience prescribing nonoccupational postexposure prophylaxis, familiarity with and knowledge of PrEP and PrEP guidance, attitudes toward PrEP, and facilitating factors for prescribing PrEP and incorporation of PrEP guidance into practice. Variables associated with intention to prescribe ("very likely to prescribe" vs. other responses) and actual prescription of PrEP stratified by age and risk category were identified in logistic regression models. Mean age was 45.9 years (standard deviation 10.7); 64% were physicians. More clinicians reported high intention to prescribe PrEP to adult versus adolescent MSM (p = 0.02) and transgender women (p = 0.001). Variables associated with intention to prescribe and prescription of PrEP differed by age and risk category. In adolescents, those variables included positive beliefs, higher number of facilitating factors, and fewer barriers to PrEP prescription. Designing strategies based on these findings that address both facilitating factors and barriers to PrEP prescription may improve PrEP uptake by at-risk youth.

"I Did Not Want to Give Birth to a Child Who has HIV": Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples.

PubMed

Pintye, Jillian; Beima-Sofie, Kristin M; Kimemia, Grace; Ngure, Kenneth; Trinidad, Susan Brown; Heffron, Renee A; Baeten, Jared M; Odoyo, Josephine; Mugo, Nelly; Bukusi, Elizabeth A; Kelley, Maureen C; John-Stewart, Grace C

2017-11-01

The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy. Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence. HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.

PGE2 maintains the tone of the guinea pig trachea through a balance between activation of contractile EP1 receptors and relaxant EP2 receptors

PubMed Central

Säfholm, J; Dahlén, S-E; Delin, I; Maxey, K; Stark, K; Cardell, L-O; Adner, M

2013-01-01

Background and Purpose The guinea pig trachea (GPT) is commonly used in airway pharmacology. The aim of this study was to define the expression and function of EP receptors for PGE2 in GPT as there has been ambiguity concerning their role. Experimental Approach Expression of mRNA for EP receptors and key enzymes in the PGE2 pathway were assessed by real-time PCR using species-specific primers. Functional studies of GPT were performed in tissue organ baths. Key Results Expression of mRNA for the four EP receptors was found in airway smooth muscle. PGE2 displayed a bell-shaped concentration–response curve, where the initial contraction was inhibited by the EP1 receptor antagonist ONO-8130 and the subsequent relaxation by the EP2 receptor antagonist PF-04418948. Neither EP3 (ONO-AE5-599) nor EP4 (ONO-AE3-208) selective receptor antagonists affected the response to PGE2. Expression of COX-2 was greater than COX-1 in GPT, and the spontaneous tone was most effectively abolished by selective COX-2 inhibitors. Furthermore, ONO-8130 and a specific PGE2 antibody eliminated the spontaneous tone, whereas the EP2 antagonist PF-04418948 increased it. Antagonists of other prostanoid receptors had no effect on basal tension. The relaxant EP2 response to PGE2 was maintained after long-term culture, whereas the contractile EP1 response showed homologous desensitization to PGE2, which was prevented by COX-inhibitors. Conclusions and Implications Endogenous PGE2, synthesized predominantly by COX-2, maintains the spontaneous tone of GPT by a balance between contractile EP1 receptors and relaxant EP2 receptors. The model may be used to study interactions between EP receptors. PMID:22934927

Demographic differences in PrEP–related stereotypes: Implications for implementation

PubMed Central

Golub, Sarit. A.; Gamarel, Kristi E.; Surace, Anthony

2015-01-01

Qualitative interviews about pre-exposure prophylaxis (PrEP) stereotypes were conducted with a subsample of 160 MSM who participated in a PrEP messaging study. Negative stereotypes about PrEP users were identified by 80% of participants. Two types of stereotypes were most common: PrEP users are HIV-infected (and lying about it), and PrEP users are promiscuous and resistant to condom use. Participants’ identification of these stereotype categories differed significantly by demographic factors (i.e. race/ethnicity, education). Expanding access to PrEP requires recognizing potential differences in the experience or anticipation of PrEP-related stereotypes that might impact willingness to discuss PrEP with providers, friends, or partners. PMID:26143247

Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

PubMed

Patel, Rupa R; Mena, Leandro; Nunn, Amy; McBride, Timothy; Harrison, Laura C; Oldenburg, Catherine E; Liu, Jingxia; Mayer, Kenneth H; Chan, Philip A

2017-01-01

Pre-exposure prophylaxis (PrEP) can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island) from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%), 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003). Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

Inappropriate erythropoietin secretion in polycythemia vera

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chikkappa, G.; Burlington, H.; Chanana, A.D.

1977-01-01

A patient with classical polycythemia vera (PV) was found to have an inappropriately elevated serum erythropoietin (Ep) level. Investigations did not reveal any lesion or blood abnormality known to be associated with excessive Ep production and erythrocytosis. Sudden withdrawal of blood to reduce the Hb and Hct from 18.5 gm% and 56% to 13.6 gm% and 41.5%, respectively, resulted in an increment of serum Ep to abnormal level. With iron treatment there was a brisk return of Hb and Hct to prebleeding levels which was associated with reduction in the serum Ep. The inverse relationship between the EP and Hbmore » or Hct is inconsistent with the presence of excessive Ep-producing lesion. These results suggested that the threshold for Ep secretion from normal Ep-secreting tissue to Hb and Hct levels is set at an abnormal level. This patient's marrow cells when cultured in vitro in the absence of Ep, unlike other PV patients' (except one) marrow cells, did not grow erythroid colonies. In the presence of Ep, however, the colonies comparable to those formed from normal marrow cultures were obtained. These results suggested that his marrow erythropoietic cells were neither Ep independent nor Ep-hyperresponsive, as has been suggested by some investigators for erythropoiesis in PV. This patient presents phenomena that hitherto have not been reported.« less

Misoprostol, an anti-ulcer agent and PGE2 receptor agonist, protects against cerebral ischemia.

PubMed

Li, Jun; Liang, Xibin; Wang, Qian; Breyer, Richard M; McCullough, Louise; Andreasson, Katrin

2008-06-20

Induction of COX-2 activity in cerebral ischemia results in increased neuronal injury and infarct size. Recent studies investigating neurotoxic mechanisms of COX-2 demonstrate both toxic and paradoxically protective effects of downstream prostaglandin receptor signaling pathways. We tested whether misoprostol, a PGE(2) receptor agonist that is utilized clinically as an anti-ulcer agent and signals through the protective PGE(2) EP2, EP3, and EP4 receptors, would reduce brain injury in the murine middle cerebral artery occlusion-reperfusion (MCAO-RP) model. Administration of misoprostol, at the time of MCAO or 2h after MCAO, resulted in significant rescue of infarct volume at 24 and 72h. Immunocytochemistry demonstrated dynamic regulation of the EP2 and EP4 receptors during reperfusion in neurons and endothelial cells of cerebral cortex and striatum, with limited expression of EP3 receptor. EP3-/- mice had no significant changes in infarct volume compared to control littermates. Moreover, administration of misoprostol to EP3+/+ and EP3-/- mice showed similar levels of infarct rescue, indicating that misoprostol protection was not mediated through the EP3 receptor. Taken together, these findings suggest a novel function for misoprostol as a protective agent in cerebral ischemia acting via the PGE(2) EP2 and/or EP4 receptors.

The effects of three commonly used extraction methods on the redox properties of extracellular polymeric substances from activated sludge.

PubMed

Lu, Qin; Chang, Ming; Yu, Zhen; Zhou, Shungui

2015-01-01

Recently, the redox properties of extracellular polymeric substances (EPS) have attracted the attention of scientists due to their associated environmental significance, such as organic pollutant (e.g. nitroaromatics and substituted nitrobenzenes) degradation and heavy metal (e.g. Cr(VI) and U(VI)) detoxification. Although the separation of EPS from bacterial cells is more often the first step in studies on EPS, and studies have demonstrated that extraction procedures can influence the sorption properties of EPS, few attempts have been made to investigate how separation methods affect the redox properties of the obtained EPS. In this study, three common extraction approaches, that is, centrifugation, formaldehyde+NaOH and ethylene diamine tetra-acetic acid (EDTA), were employed to extract EPS from activated sludge, and the obtained EPS were evaluated for their redox properties using electrochemical means, including cyclic voltammetry and chronoamperometry. In addition, spectroscopic techniques were utilized to explore the structural characteristics and composition of EPS. The results indicated that EPS extracted by EDTA clearly displayed reversible oxidation-reduction peaks in cyclic voltammograms and significantly higher electron-accepting capacity compared with EPS extracted using the other two approaches. Fourier transform infrared spectra and three-dimensional excitation-emission matrix spectra suggested that the EPS extracted with EDTA presented better redox properties because of the effective and efficient extraction of the humic substances, which are important components of the EPS of activated sludge. Therefore, extraction method has an impact on the composition and redox properties of EPS and should be chosen according to research purpose and EPS source.

Structure and biosynthesis of two exopolysaccharides produced by Lactobacillus johnsonii FI9785.

PubMed

Dertli, Enes; Colquhoun, Ian J; Gunning, A Patrick; Bongaerts, Roy J; Le Gall, Gwénaëlle; Bonev, Boyan B; Mayer, Melinda J; Narbad, Arjan

2013-11-01

Exopolysaccharides were isolated and purified from Lactobacillus johnsonii FI9785, which has previously been shown to act as a competitive exclusion agent to control Clostridium perfringens in poultry. Structural analysis by NMR spectroscopy revealed that L. johnsonii FI9785 can produce two types of exopolysaccharide: EPS-1 is a branched dextran with the unusual feature that every backbone residue is substituted with a 2-linked glucose unit, and EPS-2 was shown to have a repeating unit with the following structure: -6)-α-Glcp-(1-3)-β-Glcp-(1-5)-β-Galf-(1-6)-α-Glcp-(1-4)-β-Galp-(1-4)-β-Glcp-(1-. Sites on both polysaccharides were partially occupied by substituent groups: 1-phosphoglycerol and O-acetyl groups in EPS-1 and a single O-acetyl group in EPS-2. Analysis of a deletion mutant (ΔepsE) lacking the putative priming glycosyltransferase gene located within a predicted eps gene cluster revealed that the mutant could produce EPS-1 but not EPS-2, indicating that epsE is essential for the biosynthesis of EPS-2. Atomic force microscopy confirmed the localization of galactose residues on the exterior of wild type cells and their absence in the ΔepsE mutant. EPS2 was found to adopt a random coil structural conformation. Deletion of the entire 14-kb eps cluster resulted in an acapsular mutant phenotype that was not able to produce either EPS-2 or EPS-1. Alterations in the cell surface properties of the EPS-specific mutants were demonstrated by differences in binding of an anti-wild type L. johnsonii antibody. These findings provide insights into the biosynthesis and structures of novel exopolysaccharides produced by L. johnsonii FI9785, which are likely to play an important role in biofilm formation, protection against harsh environment of the gut, and colonization of the host.

"How I Wish This Thing Was Initiated 100 Years Ago!" Willingness to Take Daily Oral Pre-Exposure Prophylaxis among Men Who Have Sex with Men in Kenya.

PubMed

Karuga, Robinson Njoroge; Njenga, Serah Nduta; Mulwa, Rueben; Kilonzo, Nduku; Bahati, Prince; O'reilley, Kevin; Gelmon, Lawrence; Mbaabu, Stephen; Wachihi, Charles; Githuka, George; Kiragu, Michael

2016-01-01

The MSM population in Kenya contributes to 15% of HIV incidence. This calls for innovative HIV prevention interventions. Pre-exposure prophylaxis (PrEP) has been efficacious in preventing HIV among MSM in trials. There is limited data on the willingness to take daily oral PrEP in sub-Sahara Africa. PrEP has not been approved for routine use in most countries globally. This study aimed to document the willingness to take PrEP and barriers to uptake and adherence to PrEP in Kenya. The findings will inform the design of a PrEP delivery program as part of the routine HIV combination prevention. Eighty MSM were recruited in 2 Counties in December 2013. Quantitative data on sexual behaviour and willingness to take PrEP were collected using semi-structured interviews and analysed using SPSS. Qualitative data on knowledge of PrEP, motivators and barriers to uptake and adherence to PrEP were collected using in-depth interviews and FGDs and analysed using Nvivo. Analysis of data in willingness to take PrEP was conducted on the HIV negative participants (n = 55). 83% of MSM were willing to take daily oral HIV PrEP. Willingness to take PrEP was higher among the bi-sexual and younger men. Motivators for taking PrEP were the need to stay HIV negative and to protect their partners. History of poor medication adherence, fear of side effects and HIV stigma were identified as potential barriers to adherence. Participants were willing to buy PrEP at a subsidized price. There is willingness to take PrEP among MSM in Kenya and there is need to invest in targeted education and messaging on PrEP to enhance adherence, proper use and reduce stigma in the general population and among policy makers.

Ambiguity, ambivalence, and apprehensions of taking HIV-1 pre-exposure prophylaxis among male couples in San Francisco: a mixed methods study.

PubMed

Saberi, Parya; Gamarel, Kristi E; Neilands, Torsten B; Comfort, Megan; Sheon, Nicolas; Darbes, Lynae A; Johnson, Mallory O

2012-01-01

We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIV-positive) male couples' PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple. Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants' awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM). Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level of agreement with health care providers offering PrEP to anyone requesting it. We used multivariable regression to examine associations between PrEP questions and covariates of interest and employed an inductive approach to identify key qualitative themes. Among 328 men (164 couples), 62% had heard about PrEP, but approximately one-quarter were mistaking it with post-exposure prophylaxis. The majority of participants had low endorsement of PrEP uptake and 40% were uncertain if health care providers should offer PrEP to anyone requesting it. Qualitative interviews with 32 men suggest that this uncertainty likely stems from concerns regarding increased risk compensation. Likelihood of future PrEP uptake by the HIV-negative member of the couple was positively associated with unprotected insertive anal intercourse but negatively correlated with unprotected receptive anal intercourse. Findings suggest that those at greatest risk may not be receptive of PrEP. Those who engage in moderate risk express more interest in PrEP; however, many voice concerns of increased risk behavior in tandem with PrEP use. Results indicate a need for further education of MSM communities and the need to determine appropriate populations in which PrEP can have the highest impact.

Structure and Biosynthesis of Two Exopolysaccharides Produced by Lactobacillus johnsonii FI9785*

PubMed Central

Dertli, Enes; Colquhoun, Ian J.; Gunning, A. Patrick; Bongaerts, Roy J.; Le Gall, Gwénaëlle; Bonev, Boyan B.; Mayer, Melinda J.; Narbad, Arjan

2013-01-01

Exopolysaccharides were isolated and purified from Lactobacillus johnsonii FI9785, which has previously been shown to act as a competitive exclusion agent to control Clostridium perfringens in poultry. Structural analysis by NMR spectroscopy revealed that L. johnsonii FI9785 can produce two types of exopolysaccharide: EPS-1 is a branched dextran with the unusual feature that every backbone residue is substituted with a 2-linked glucose unit, and EPS-2 was shown to have a repeating unit with the following structure: -6)-α-Glcp-(1–3)-β-Glcp-(1–5)-β-Galf-(1–6)-α-Glcp-(1–4)-β-Galp-(1–4)-β-Glcp-(1-. Sites on both polysaccharides were partially occupied by substituent groups: 1-phosphoglycerol and O-acetyl groups in EPS-1 and a single O-acetyl group in EPS-2. Analysis of a deletion mutant (ΔepsE) lacking the putative priming glycosyltransferase gene located within a predicted eps gene cluster revealed that the mutant could produce EPS-1 but not EPS-2, indicating that epsE is essential for the biosynthesis of EPS-2. Atomic force microscopy confirmed the localization of galactose residues on the exterior of wild type cells and their absence in the ΔepsE mutant. EPS2 was found to adopt a random coil structural conformation. Deletion of the entire 14-kb eps cluster resulted in an acapsular mutant phenotype that was not able to produce either EPS-2 or EPS-1. Alterations in the cell surface properties of the EPS-specific mutants were demonstrated by differences in binding of an anti-wild type L. johnsonii antibody. These findings provide insights into the biosynthesis and structures of novel exopolysaccharides produced by L. johnsonii FI9785, which are likely to play an important role in biofilm formation, protection against harsh environment of the gut, and colonization of the host. PMID:24019531

beta-Endorphin-induced analgesia is inhibited by synthetic analogs of beta-endorphin.

PubMed

Nicolas, P; Hammonds, R G; Li, C H

1984-05-01

Competitive antagonism of human beta-endorphin (beta h-EP)-induced analgesia by synthetic beta h-EP analogs with high in vitro opiate receptor binding to in vivo analgesic potency ratio has been demonstrated. A parallel shift of the dose-response curve for analgesia to the right was observed when either beta h-EP or [ Trp27 ] -beta h-EP was coinjected with various doses of [Gln8, Gly31 ]-beta h-EP-Gly-Gly-NH2, [Arg9,19,24,28,29]-beta h-EP, or [ Cys11 ,26, Phe27 , Gly31 ]-beta h-EP. It was estimated that the most potent antagonist, [Gln8, Gly31 ]-beta h-EP-Gly-NH2, is at least 200 times more potent than naloxone.

Knowledge of and interest in using preexposure prophylaxis for HIV prevention among men who have sex with men in Thailand.

PubMed

Sineath, R Craig; Finneran, Catherine; Sullivan, Patrick; Sanchez, Travis; Smith, Dawn K; Griensven, Frits van; Wimonsate, Wipas; Stephenson, Rob

2013-01-01

Little is known about HIV preexposure prophylaxis (PrEP) acceptability among men who have sex with men (MSM) in Thailand. The authors recruited an online convenience sample of Thai MSM (n = 404) to assess the knowledge of and interest in PrEP. Less than 7% had heard of PrEP; however, 35% indicated interest in PrEP after an explanation of its possible efficacy. Regression modeling demonstrated that HIV knowledge and risk behavior, but not demographics, are significant predictors of PrEP interest. More information and education about PrEP is necessary and more research is needed to examine PrEP acceptability and to inform the message for PrEP uptake.

How Stigma Surrounding the Use of HIV Preexposure Prophylaxis Undermines Prevention and Pleasure: A Call to Destigmatize "Truvada Whores".

PubMed

Calabrese, Sarah K; Underhill, Kristen

2015-10-01

Antiretroviral preexposure prophylaxis (PrEP; emtricitabine and tenofovir disoproxil fumarate [Truvada]) prevents HIV without penalizing sexual pleasure, and may even enhance pleasure (e.g., by reducing HIV-related anxiety). However, concern about sexual risk behavior increasing with PrEP use (risk compensation) and corresponding stereotypes of promiscuity may undermine PrEP's preventive potential. In this commentary, we review literature on sexual behavior change accompanying PrEP use, discuss risk compensation concerns and the "Truvada whore" stereotype as PrEP barriers, question the appropriateness of restricting PrEP access because of risk compensation, and consider sexual pleasure as a benefit of PrEP, an acceptable motive for seeking PrEP, and a core element of health. It is essential for science to trump stereotypes and sex-negative messaging in guiding decision-making affecting PrEP access and uptake.

Purification and properties of extracellular polysaccharide (EPS) antigens produced by different mould species.

PubMed

Notermans, S; Wieten, G; Engel, H W; Rombouts, F M; Hoogerhout, P; van Boom, J H

1987-02-01

Extracellular polysaccharide (EPS) antigens produced by different mould species were purified and partially characterized. Purification included (NH4)2SO4 treatment, Sepharose CL-4B column chromatography and Con A-sepharose chromatography. The EPS of Penicillium digitatum, Mucor racemosus and Cladosporium cladosporioides showed high antigenic capacities. Immunologically the EPS were partially genus-specific, but cross-reactivity was observed. The EPS antigens produced by species of Penicillium, Aspergillus repens and Geotrichum candidum lost their immunological activity upon heating (100 degrees C) at pH 1.8, while the EPS antigen of M. racemosus, Rhizopus oligosporus and C. cladosporioides were stable under the same conditions. The dominant monosaccharides present in the EPS antigen were mannose, galactose and glucose. The EPS obtained from cultures of M. racemosus and R. oligosporus also contained rhamnose. In the EPS produced by Penicillium spp. and A. repens the galactose residues were determined to be immunodominant.

Threefold Increase in PrEP Uptake Over Time with High Adherence Among Young Men Who Have Sex With Men in Chicago.

PubMed

Morgan, Ethan; Moran, Kevin; Ryan, Daniel T; Mustanski, Brian; Newcomb, Michael E

2018-05-04

The goal of this work is to better understand utilization and uptake of pre-exposure prophylaxis (PrEP) among young men who have sex with men (YMSM) and transgender women (TGW). We assessed trends and correlates of PrEP use and adherence across three time points of longitudinal data collection among 885 YMSM and TGW (aged 16-29) from the RADAR cohort in Chicago, 2015-2017. Past 6-month PrEP use increased across three visits: from 6.6 to 17.5%. In multivariable models, past 6-month PrEP use was significantly associated with participation in condomless sex, having more sexual partners, and older age. At least three-quarters of current PrEP users reported being ≥ 90% adherent to PrEP medication across all visits. Past 6-month PrEP use increased over time with those who participated in high-risk HIV behaviors also those most likely to have taken PrEP. As PrEP uptake continues to rise, more research will be needed to understand predictors of PrEP usage, as well as patterns of sexual behavior change following uptake.

Willingness to Self-Pay for Pre-exposure Prophylaxis in Men Who Have Sex With Men: A National Online Survey in Taiwan.

PubMed

Ko, Nai-Ying; Chen, Bo-Jie; Li, Chia-Wen; Ku, Wen-Wei; Hsu, Su-Ting

2016-04-01

High cost of pre-exposure prophylaxis (PrEP) is a major concern for acceptability. This study determined the willingness of men who have sex with men to self-pay for PrEP and factors associated with the likelihood of condom use if taking PrEP. The Taiwan 2014 MSM Online Sex Survey was conducted and data such as demographics, attitudes toward PrEP, and sexual behaviors in the previous 3 months were collected. Of the 1,151 MSM who participated, 56% were willing to take PrEP, but only 23% were willing to self-pay $340 for PrEP. Willingness to self-pay for PrEP was significantly associated with the previous receipt of nonoccupational post-exposure prophylaxis (adjusted odds ratio [AOR], 3.02, 95%CI [1.49, 6.12]), and positive attitudes toward PrEP (AOR, 3.02, 95%CI [2.19, 4.17]). Of MSM who are willing to use PrEP, 73.6% would maintain condom use if taking PrEP. If PrEP is made available in Taiwan, more efforts should be focused on increasing awareness of MSM who are practicing risky behaviors.

Thermal and rheological properties of a family of botryosphaerans produced by Botryosphaeria rhodina MAMB-05.

PubMed

Fonseca, Paulo R M S; Dekker, Robert F H; Barbosa, Aneli M; Silveira, Joana L M; Vasconcelos, Ana F D; Monteiro, Nilson K; Aranda-Selverio, Gabriel; da Silva, Maria de Lourdes Corradi

2011-09-02

Differential scanning calorimetry (DSC), thermogravimetry (TG) and Fourier-transform infra-red spectroscopy (FT-IR) analyses were performed to investigate changes in the physico-chemical properties of botryosphaerans, a family of exopolysaccharides (EPS) produced by the fungus Botryosphaeria rhodina MAMB-05 grown on glucose (EPS(GLC)), sucrose (EPS(SUC)) and fructose (EPS(FRU)). A slight endothermic transition and small mass loss attributable to the removal of water of hydration were observed in the DSC and TG analyses, respectively, for the three EPS samples. The FT-IR spectra confirmed no structural changes occurred during thermal treatment. Viscometry was utilized to obtain information on the rheological behaviour of the EPS in aqueous solutions. The Power Law and Cross Equations determined the natural pseudoplastic characteristics of the EPS. Comparatively, results obtained for EPS produced when B. rhodina MAMB-05 was grown on each of the three carbohydrate sources demonstrated similar apparent viscosity values for EPS(GLC) and EPS(SUC), while EPS(FRU) displayed the lowest apparent viscosity of the three botryosphaerans, suggesting a higher degree of ramification and lower Mw. EPS(GLC) and EPS(SUC) possessed similar degrees of ramification. The slight differences found in their viscosities can be explained by the differences in the type of branching among the three botryosphaerans, thus varying the strength of intermolecular interactions and consequently, consistency and viscosity. The physico-chemical studies of botryosphaerans represent the originality of this work, and the knowledge of these properties is an important criterion for potential applications.

Extrapyramidal Signs and Cognitive Subdomains in Alzheimer Disease.

PubMed

Park, Jin Hong; Myung, Woojae; Choi, Junbae; Kim, Sangha; Chung, Jae Won; Kang, Hyo Shin; Na, Duk L; Kim, Seong Yoon; Lee, Jae-Hong; Han, Seol-Heui; Choi, Seong Hye; Kim, Sang Yun; Kim, Doh Kwan

2016-07-01

Extrapyramidal signs (EPS), commonly observed in Alzheimer disease (AD), predict cognitive impairment and functional decline. This study investigated the association between EPS and five cognitive subdomains in a large number of participants with AD. Cross-sectional analyses of the nationwide Clinical Research of Dementia of South Korea (CREDOS) study, 2005-2012. Multicenter clinical settings. 1,737 participants with AD drawn from the CREDOS study. The EPS group was defined by the presence of at least one EPS based on neurologic examination. We assessed five cognitive subdomains: attention, language, visuospatial function, memory, and frontal/executive function using the Seoul Neuropsychological Screening Battery-Dementia version. The associations of EPS with each cognitive subdomain were analyzed with a multiple linear regression model after controlling for confounding factors: sex, age, years of education, severity of dementia (Clinical Dementia Rating Sum of Boxes), and white matter hyperintensities. 164 AD participants (9.4%) had EPS. AD participants with EPS showed lower performance compared with those without EPS in two cognitive subdomains: attention and visuospatial function. The language, memory, and frontal/executive subdomains did not differ between the EPS-positive and the EPS-negative groups. In addition, we found a significant moderating relationship between EPS and deep white matter hyperintensities on visuospatial function score. EPS in AD are associated with severe cognitive impairment in attention and visuospatial function. Careful screening for EPS in patients with AD may assist in prediction of cognitive profile. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

HIV-negative male couples' attitudes about pre-exposure prophylaxis (PrEP) and using PrEP with a sexual agreement.

PubMed

Mitchell, Jason W; Lee, Ji-Young; Woodyatt, Cory; Bauermeister, José; Sullivan, Patrick; Stephenson, Rob

2016-08-01

One efficacious strategy to help prevent HIV is oral pre-exposure prophylaxis (PrEP), a daily regimen of antiretroviral treatment taken by HIV-negative individuals. Two of the recommendations of Centers for Disease Control and Prevention (CDC) guidelines for PrEP pertain to being in a relationship (i.e., male couples). Despite the recognition of how primary partners in male couples' relationships shape HIV risk and CDC's PrEP guidelines, there is a paucity of data that examine HIV-negative male couples' attitudes toward PrEP use and using PrEP with a sexual agreement. A sexual agreement is an explicit agreement made between two individuals about what sex and other related behaviors may occur within and outside of their relationship. In this qualitative study, we examine HIV-negative male couples' attitudes toward PrEP use and whether they thought PrEP could be integrated into a sexual agreement. Data for this study are drawn from couple-level interviews conducted in 2014 with 29 HIV-negative male couples who had a sexual agreement and were from Atlanta or Detroit. Both passive (e.g., flyers) and active (e.g., targeted Facebook advertisements) recruitment methods were used; the sample was stratified by agreement type. Thematic analysis was applied to identify the following themes regarding HIV-negative male couples' attitudes toward PrEP use: (1) PrEP and condom use; (2) concerns about PrEP (e.g., effectiveness, side effects, and promoting sexually risky behavior); and (3) accessibility of PrEP. Some thought PrEP could be a part of couples' agreement because it could help reduce sexual anxiety and sexual risk, and would help keep the couple safe. Others described PrEP use with an agreement as something for "others". Some were also concerned that incorporating PrEP could usurp the need for a sexual agreement in a couples' relationship. These themes highlight the need to improve informational messaging and promotion efforts about PrEP among HIV-negative male couples who may benefit from using it.

Immunolocalization of adipocytes and prostaglandin E2 and its four receptor proteins EP1, EP2, EP3, and EP4 in the caprine cervix during spontaneous term labor.

PubMed

Gu, Guosheng; Gao, Qian; Yuan, Xuejun; Huang, Libo; Ge, Lijiang

2012-05-01

The mechanisms of cervical ripening and dilation in mammals remain obscure. Information is lacking about the localization of prostaglandin E(2) (PGE(2))-producing cells and PGE(2) receptors (EP) in intrapartum cervix and whether cervical dilation at parturition is an active process. To reveal these mechanisms, immunolocalization of EP1-EP4 (official gene symbols PTGER1-PTGER4) and PGE(2)-producing cells in caprine cervix during nonpregnancy, pregnancy, and parturition was assayed by immunohistochemistry (IHC); the mRNA expression levels of PTGS2, PTGER2 (EP2), and PTGER4 (EP4) were determined using quantitative PCR; and the existence of adipocytes in the cervix at various stages was demonstrated with Oil Red O staining and IHC of perilipin A. The results suggested that in intrapartum caprine cervix staining of the PGE(2) was observed in the overall tissues, for example, blood vessels, canal or glandular epithelia, serosa, circular and longitudinal muscles, and stroma in addition to adipocytes; EP2 was detectable in all the tissues other than glandular epithelia; EP4 was strongly expressed in all the tissues other than serosa; EP1 was detected mainly in arterioles and canal or glandular epithelia; and EP3 was poorly expressed only in stroma, canal epithelia, and circular muscles. Little or no expression of EP2, EP3, and EP4 as well as PGE(2) in all cervical tissues was observed during nonpregnancy and pregnancy except for the strong expression of EP1 in canal or glandular epithelia during pregnancy. The mRNA expression levels of PTGS2, PTGER2, and PTGER4 were significantly higher in intrapartum than nonpregnant and midpregnant cervices (P < 0.01). Adipocytes appear only in the intrapartum cervix. These results support the concept that PGE(2) modulates specific functions in various anatomical structures of the caprine cervix at labor and the appearance of adipocytes at labor is likely related to caprine cervical dilation.

Design and Implementation of a 200kW, 28GHz gyrotron system for the Compact Toroidal Hybrid Experiment

NASA Astrophysics Data System (ADS)

Hartwell, G. J.; Knowlton, S. F.; Ennis, D. A.; Maurer, D. A.; Bigelow, T.

2016-10-01

The Compact Toroidal Hybrid (CTH) is an l = 2 , m = 5 torsatron/tokamak hybrid (R0 = 0.75 m, ap 0.2 m, and | B | <= 0.7 T). It can generate its highly configurable confining magnetic fields solely with external coils, but typically operates with up to 80 kA of ohmically-generated plasma current for heating. New studies of edge plasma transport in stellarator geometries will benefit from CTH operating as a pure torsatron with a high temperature edge plasma. Accordingly, a 28 GHz, 200 kW gyrotron operating at 2nd harmonic for ECRH is being installed to supplement the existing 15 kW klystron system operating at the fundamental frequency; the latter will be used to initially generate the plasma. Ray-tracing calculations that guide the selection of launching position, antenna focal length, and beam-steering characteristics of the ECRH have been performed with the TRAVIS code [ 1 ] . The calculated absorption is up to 95.7% for vertically propagating rays, however, the absorption is more sensitive to magnetic field variations than for a side launch where the field gradient is tokamak-like. The design of the waveguide path and components for the top-launch scenario will be presented. This work is supported by U.S. Department of Energy Grant No. DE-FG02-00ER54610.

A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians.

PubMed

Blackstock, Oni J; Moore, Brent A; Berkenblit, Gail V; Calabrese, Sarah K; Cunningham, Chinazo O; Fiellin, David A; Patel, Viraj V; Phillips, Karran A; Tetrault, Jeanette M; Shah, Minesh; Edelman, E Jennifer

2017-01-01

Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. Cross-sectional online survey conducted in April and May 2015. Members of a national professional organization for academic primary care physicians (n = 266). PrEP awareness, PrEP adoption (ever prescribed or referred a patient for PrEP [yes/no]), provider and practice characteristics, and self-rated knowledge, attitudes, and beliefs associated with adoption. The survey response rate was 8.6 % (266/2093). Ninety-three percent of respondents reported prior awareness of PrEP. Of these, 34.9 % reported PrEP adoption. In multivariable analysis of provider and practice characteristics, compared with non-adopters, adopters were more likely to provide care to more than 50 HIV-positive patients (vs. 0, aOR = 6.82, 95 % CI 2.06-22.52). Compared with non-adopters, adopters were also more likely to report excellent, very good, or good self-rated PrEP knowledge (15.1 %, 33.7 %, 30.2 % vs. 2.5 %, 18.1 %, 23.8 %, respectively; p < 0.001) and to perceive PrEP as extremely safe (35.1 % vs. 10.7 %; p = 0.002). Compared with non-adopters, adopters were less likely to perceive PrEP as being moderately likely to increase risk behaviors ("risk compensation") (12.8 % vs. 28.8 %, p = 0.02). While most respondents were aware of PrEP, only one-third of PrEP-aware PCPs reported adoption. Adopters were more likely to have experience providing HIV care and to perceive PrEP as extremely safe, and were less likely to perceive PrEP use as leading to risk compensation. To enhance PCP adoption of PrEP, educational efforts targeting PCPs without HIV care experience should be considered, as well as training those with HIV care experience to be PrEP "clinical champions". Concerns about safety and risk compensation must also be addressed.

Suppression of inflammation with conditional deletion of the prostaglandin E2 EP2 receptor in macrophages and brain microglia.

PubMed

Johansson, Jenny U; Pradhan, Suraj; Lokteva, Ludmila A; Woodling, Nathaniel S; Ko, Novie; Brown, Holden D; Wang, Qian; Loh, Christina; Cekanaviciute, Egle; Buckwalter, Marion; Manning-Bog, Amy B; Andreasson, Katrin I

2013-10-02

Prostaglandin E2 (PGE2), a potent lipid signaling molecule, modulates inflammatory responses through activation of downstream G-protein coupled EP(1-4) receptors. Here, we investigated the cell-specific in vivo function of PGE2 signaling through its E-prostanoid 2 (EP2) receptor in murine innate immune responses systemically and in the CNS. In vivo, systemic administration of lipopolysaccharide (LPS) resulted in a broad induction of cytokines and chemokines in plasma that was significantly attenuated in EP2-deficient mice. Ex vivo stimulation of peritoneal macrophages with LPS elicited proinflammatory responses that were dependent on EP2 signaling and that overlapped with in vivo plasma findings, suggesting that myeloid-lineage EP2 signaling is a major effector of innate immune responses. Conditional deletion of the EP2 receptor in myeloid lineage cells in Cd11bCre;EP2(lox/lox) mice attenuated plasma inflammatory responses and transmission of systemic inflammation to the brain was inhibited, with decreased hippocampal inflammatory gene expression and cerebral cortical levels of IL-6. Conditional deletion of EP2 significantly blunted microglial and astrocytic inflammatory responses to the neurotoxin MPTP and reduced striatal dopamine turnover. Suppression of microglial EP2 signaling also increased numbers of dopaminergic (DA) neurons in the substantia nigra independent of MPTP treatment, suggesting that microglial EP2 may influence development or survival of DA neurons. Unbiased microarray analysis of microglia isolated from adult Cd11bCre;EP2(lox/lox) and control mice demonstrated a broad downregulation of inflammatory pathways with ablation of microglial EP2 receptor. Together, these data identify a cell-specific proinflammatory role for macrophage/microglial EP2 signaling in innate immune responses systemically and in brain.

Suppression of Inflammation with Conditional Deletion of the Prostaglandin E2 EP2 Receptor in Macrophages and Brain Microglia

PubMed Central

Johansson, Jenny U.; Pradhan, Suraj; Lokteva, Ludmila A.; Woodling, Nathaniel S.; Ko, Novie; Brown, Holden D.; Wang, Qian; Loh, Christina; Cekanaviciute, Egle; Buckwalter, Marion; Manning-Boğ, Amy B.

2013-01-01

Prostaglandin E2 (PGE2), a potent lipid signaling molecule, modulates inflammatory responses through activation of downstream G-protein coupled EP1–4 receptors. Here, we investigated the cell-specific in vivo function of PGE2 signaling through its E-prostanoid 2 (EP2) receptor in murine innate immune responses systemically and in the CNS. In vivo, systemic administration of lipopolysaccharide (LPS) resulted in a broad induction of cytokines and chemokines in plasma that was significantly attenuated in EP2-deficient mice. Ex vivo stimulation of peritoneal macrophages with LPS elicited proinflammatory responses that were dependent on EP2 signaling and that overlapped with in vivo plasma findings, suggesting that myeloid-lineage EP2 signaling is a major effector of innate immune responses. Conditional deletion of the EP2 receptor in myeloid lineage cells in Cd11bCre;EP2lox/lox mice attenuated plasma inflammatory responses and transmission of systemic inflammation to the brain was inhibited, with decreased hippocampal inflammatory gene expression and cerebral cortical levels of IL-6. Conditional deletion of EP2 significantly blunted microglial and astrocytic inflammatory responses to the neurotoxin MPTP and reduced striatal dopamine turnover. Suppression of microglial EP2 signaling also increased numbers of dopaminergic (DA) neurons in the substantia nigra independent of MPTP treatment, suggesting that microglial EP2 may influence development or survival of DA neurons. Unbiased microarray analysis of microglia isolated from adult Cd11bCre;EP2lox/lox and control mice demonstrated a broad downregulation of inflammatory pathways with ablation of microglial EP2 receptor. Together, these data identify a cell-specific proinflammatory role for macrophage/microglial EP2 signaling in innate immune responses systemically and in brain. PMID:24089506

Characteristics of thermoregulatory and febrile responses in mice deficient in prostaglandin EP1 and EP3 receptors

PubMed Central

Oka, Takakazu; Oka, Kae; Kobayashi, Takuya; Sugimoto, Yukihiko; Ichikawa, Atsushi; Ushikubi, Fumitaka; Narumiya, Shuh; Saper, Clifford B

2003-01-01

Previous studies have disagreed about whether prostaglandin EP1 or EP3 receptors are critical for producing febrile responses. We therefore injected lipopolysaccharide (LPS) at a variety doses (1 μg kg−1−1 mg kg−1) intraperitoneally (I.P.) into wild-type (WT) mice and mice lacking the EP1 or the EP3 receptors and measured changes in core temperature (Tc) by using telemetry. In WT mice, I.P. injection of LPS at 10 μg kg−1 increased Tc about 1 °C, peaking 2 h after injection. At 100 μg kg−1, LPS increased Tc, peaking 5–8 h after injection. LPS at 1 mg kg−1 decreased Tc, reaching a nadir at 5–8 h after injection. In EP1 receptor knockout (KO) mice injected with 10 μg kg−1 LPS, only the initial (< 40 min) increase in Tc was lacking; with 100 μg kg−1 LPS the mice showed no febrile response. In EP3 receptor KO mice, LPS decreased Tc in a dose- and time-dependent manner. Furthermore, in EP3 receptor KO mice subcutaneous injection of turpentine did not induce fever. Both EP1 and EP3 receptor KO mice showed a normal circadian cycle of Tc and brief hyperthermia following psychological stress (cage-exchange stress and buddy-removal stress). The present study suggests that both the EP1 and the EP3 receptors play a role in fever induced by systemic inflammation but neither EP receptor is involved in the circadian rise in Tc or psychological stress-induced hyperthermia in mice. PMID:12837930

Ependymin as a substrate for outgrowth of axons from cultured explants of goldfish retina.

PubMed

Schmidt, J T; Schmidt, R; Lin, W C; Jian, X Y; Stuermer, C A

1991-01-01

Ependymin, a prominent protein of the brain's extracellular fluid (ECF) was previously implicated in the consolidation of memory and in the activity-driven sharpening of the retinotectal projection. Because both these phenomena probably involve the growth and elaboration of appropriate synapses, we have tested whether ependymin can serve as a substrate for the growth of axons from goldfish retinal ganglion cells in a culture assay. Ependymin (Ep), laminin (LAM), polylysine (PL), and Concanavalin A (Con A) were plated on glass coverslips either uniformly or in striped patterns. Ep alone, either soluble or partly polymerized (by dropping calcium concentration and pH), was a good substrate for axonal outgrowth, as good or better than PL and Con A, but not as good as LAM. Neurites grew faster on LAM (71 microns/h) than on Ep (32 microns/h) or on PL (22 microns/h). Fasciculation was low on LAM, intermediate on Ep, and highest on PL. In exclusive side-by-side stripe assays, axons preferred LAM over Ep, but gave weak or no preference for Ep over Con A or PL. With stripes of LAM + Ep alongside pure LAM, the axons preferred the mixture of LAM + Ep. When antibodies to Ep were plated in stripes over continuous Ep substrate, the axons avoided the antibody-blocked stripes and grew on the Ep stripes. Antibodies to Ep did not, however, block growth on laminin substrates, nor did antibodies to LAM block growth on Ep. Dot blots and western blots showed very little cross recognition between the antibodies. Ependymin is a good substrate for neurite outgrowth, which is normally present in ECF, and adhesion to Ep is independent of LAM and possibly additive to it.

Primary care clinicians' experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters.

PubMed

Krakower, Douglas S; Maloney, Kevin M; Grasso, Chris; Melbourne, Katherine; Mayer, Kenneth H

2016-01-01

An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Thirty-two clinicians (response rate=91%) completed the surveys. Nearly all clinicians (97%) had prescribed PrEP (median 20 patients, interquartile range 11-33). Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians' practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79%) rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this efficacious intervention.

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

PubMed Central

Kalichman, Seth C.; Price, Devon; Finneran, Stephanie; Allen, Aerielle; Maksut, Jessica

2018-01-01

The HIV/AIDS epidemic in the US continues to persist, in particular, among race, sexual orientation, and gender minority populations. Pre-exposure prophylaxis (PrEP), or using antiretroviral medications for HIV prevention, is an effective option, but uptake of PrEP has been slow. Sociocultural barriers to using PrEP have been largely underemphasized, yet have the potential to stall uptake and, therefore, warrant further understanding. In order to assess the relationships between potential barriers to PrEP (i.e., PrEP stigma and conspiracy beliefs), and interest in PrEP, Black men and transgender women who have sex with men (BMTW, N = 85) and White MTW (WMTW, N = 179) were surveyed at a gay pride event in 2015 in a large southeastern US city. Bivariate and multivariate logistic regression analyses were completed to examine factors associated with PrEP interest. Among the full sample, moderate levels of PrEP awareness (63%) and low levels of use (9%) were observed. Believing that PrEP is for people who are promiscuous (stigma belief) was strongly associated with lack of interest in using PrEP, and individuals who endorsed this belief were more likely to report sexual risk taking behavior. Conspiracy beliefs related to PrEP were reported among a large minority of the sample (42%) and were more frequently reported among BMTW than WMTW. Given the strong emphasis on the use of biomedical strategies for HIV prevention, addressing sociocultural barriers to PrEP access is urgently needed and failure to do so will weaken the potential benefits of biomedical prevention. PMID:28108878

Long-term effects of CuO nanoparticles on the surface physicochemical properties of biofilms in a sequencing batch biofilm reactor.

PubMed

Hou, Jun; You, Guoxiang; Xu, Yi; Wang, Chao; Wang, Peifang; Miao, Lingzhan; Li, Yi; Ao, Yanhui; Lv, Bowen; Yang, Yangyang

2016-11-01

In this study, we examined the long-term effects of copper oxide nanoparticles (CuO NPs) on the production and properties of EPS and the resulting variations in surface physicochemical characteristics of biofilms in a sequencing batch biofilm reactor. After exposure to 50 mg/L CuO NPs for 45 days, the protein (PRO) and polysaccharide (PS) contents in loosely bound EPS (LB-EPS) decreased as the production of LB-EPS decreased from 34.4 to 30 mg TOC/g EPS. However, the production of tightly bound EPS (TB-EPS) increased by 16.47 % as the PRO and PS contents increased. The content of humic-like substances (HS) increased significantly, becoming the predominant constituent in EPS with the presence of 50 mg/L CuO NPs. Furthermore, the results of three-dimensional excitation-emission fluorescence spectra confirmed the various changes in terms of the LB-EPS and TB-EPS contents after exposure to CuO NPs. Fourier transform infrared spectroscopy showed that the -OH and -NH 2 groups of proteins in EPS were involved in the reaction with CuO NPs. Moreover, the chronic exposure to CuO NPs induced a negative impact on the flocculating efficiency of EPS and on the hydrophobicity and aggregation ability of microbial cells. The PRO/PS ratios of different EPS fractions were consistent with their hydrophobicities (R 2 >0.98) and bioflocculating efficiencies (R 2 >0.95); however, there was no correlation with aggregation ability. Additionally, the presence of bovine serum albumin (BSA) prevented the physical contact between CuO NPs and EPS as a result of NP aggregation and electrostatic repulsion.

Prostaglandin receptor EP3 regulates cell proliferation and migration with impact on survival of endometrial cancer patients

PubMed Central

Zhu, Junyan; Trillsch, Fabian; Mayr, Doris; Kuhn, Christina; Rahmeh, Martina; Hofmann, Simone; Vogel, Marianne; Mahner, Sven; Jeschke, Udo; von Schönfeldt, Viktoria

2018-01-01

Background Prostaglandin E2 (PGE2) receptor 3 (EP3) regulates tumor cell proliferation, migration, and invasion in numerous cancers. The role of EP3 as a prognostic biomarker in endometrial cancer remains unclear. The primary aim of this study was to analyze the prognostic significance of EP3 expression in endometrial cancer. Methods We analyzed the EP3 expression of 140 endometrial carcinoma patients by immunohistochemistry. RL95-2 endometrial cancer cell line was chosen from four endometrial cancer cell lines (RL95-2, Ishikawa, HEC-1-A, and HEC-1-B) according to EP3 expression level. Treated with PGE2 and EP3 antagonist, RL95-2 cells were investigated by MTT, BrdU, and wound healing assay for functional assessment of EP3. Results EP3 staining differed significantly according to WHO tumor grading in both whole cohort (p = 0.01) and the subgroup of endometrioid carcinoma (p = 0.01). Patients with high EP3 expression in their respective tumors had impaired progression-free survival as well as overall survival in both cohorts above. EP3 expression in the overall cohort was identified as an independent prognostic marker for progression-free survival (HR 1.014, 95%CI 1.003-1.024, p = 0.01) when adjusted for age, stage, grading, and recurrence. Treatment with EP3 antagonists induced upregulation of estrogen receptor β and decreased activity of Ras and led to attenuated proliferation and migration of RL95-2 cells. Conclusions EP3 seems to play a crucial role in endometrial cancer progression. In the context of limited systemic treatment options for endometrial cancer, this explorative analysis identifies EP3 as a potential target for diagnostic workup and therapy. PMID:29416671

Prostaglandin receptor EP3 regulates cell proliferation and migration with impact on survival of endometrial cancer patients.

PubMed

Zhu, Junyan; Trillsch, Fabian; Mayr, Doris; Kuhn, Christina; Rahmeh, Martina; Hofmann, Simone; Vogel, Marianne; Mahner, Sven; Jeschke, Udo; von Schönfeldt, Viktoria

2018-01-02

Prostaglandin E2 (PGE2) receptor 3 (EP3) regulates tumor cell proliferation, migration, and invasion in numerous cancers. The role of EP3 as a prognostic biomarker in endometrial cancer remains unclear. The primary aim of this study was to analyze the prognostic significance of EP3 expression in endometrial cancer. We analyzed the EP3 expression of 140 endometrial carcinoma patients by immunohistochemistry. RL95-2 endometrial cancer cell line was chosen from four endometrial cancer cell lines (RL95-2, Ishikawa, HEC-1-A, and HEC-1-B) according to EP3 expression level. Treated with PGE2 and EP3 antagonist, RL95-2 cells were investigated by MTT, BrdU, and wound healing assay for functional assessment of EP3. EP3 staining differed significantly according to WHO tumor grading in both whole cohort (p = 0.01) and the subgroup of endometrioid carcinoma (p = 0.01). Patients with high EP3 expression in their respective tumors had impaired progression-free survival as well as overall survival in both cohorts above. EP3 expression in the overall cohort was identified as an independent prognostic marker for progression-free survival (HR 1.014, 95%CI 1.003-1.024, p = 0.01) when adjusted for age, stage, grading, and recurrence. Treatment with EP3 antagonists induced upregulation of estrogen receptor β and decreased activity of Ras and led to attenuated proliferation and migration of RL95-2 cells. EP3 seems to play a crucial role in endometrial cancer progression. In the context of limited systemic treatment options for endometrial cancer, this explorative analysis identifies EP3 as a potential target for diagnostic workup and therapy.

XAS analysis of iron and palladium bonded to a polysaccharide produced anaerobically by a strain of Klebsiella oxytoca.

PubMed

Arčon, Iztok; Paganelli, Stefano; Piccolo, Oreste; Gallo, Michele; Vogel-Mikuš, Katarina; Baldi, Franco

2015-09-01

Klebsiella oxytoca BAS-10 ferments citrate to acetic acid and CO2, and secretes a specific exopolysaccharide (EPS), which is able to bind different metallic species. These biomaterials may be used for different biotechnological purposes, including applications as innovative green biogenerated catalysts. In production of biogenerated Pd species, the Fe(III) as ferric citrate is added to anaerobic culture of K. oxytoca BAS-10, in the presence of palladium species, to increase the EPS secretion and improve Pd-EPS yield. In this process, bi-metallic (FePd-EPS) biomaterials were produced for the first time. The morphology of bi-metallic EPS, and the chemical state of the two metals in the FePd-EPS, are investigated by transmission electron microscopy, Fourier transform infra-red spectroscopy, micro-X-ray fluorescence, and X-ray absorption spectroscopy methods (XANES and EXAFS), and compared with mono-metallic Pd-EPS and Fe-EPS complexes. Iron in FePd-EPS is in the mineralized form of iron oxides/hydroxides, predominantly in the form of Fe(3+), with a small amount of Fe(2+) in the structure, most probably a mixture of different nano-crystalline iron oxides and hydroxides, as in mono-metallic Fe-EPS. Palladium is found as Pd(0) in the form of metallic nanoparticles with face-centred cubic structure in both bi-metallic (FePd-EPS) and mono-metallic (Pd-EPS) species. In bi-metallic species, Pd and Fe nanoparticles agglomerate in larger clusters, but they remain spatially separated. The catalytic ability of bi-metallic species (FePd-EPS) in a hydrodechlorination reaction is improved in comparison with mono-metallic Pd-EPS.

Composition and morphology characterization of exopolymeric substances produced by the PAH-degrading fungus of Mucor mucedo.

PubMed

Jia, Chunyun; Li, Xiaojun; Allinson, Graeme; Liu, Changfeng; Gong, Zongqiang

2016-05-01

To explore the role of exopolymeric substances (EPS) in the process of polycyclic aromatic hydrocarbons (PAH) biodegradation, the characteristics of EPS isolated from a PAH-degrading fungus were investigated firstly by spectrometric determination, microscopic observation, Fourier transform-infrared spectroscopy (FT-IR), and three-dimensional excitation-emission matrix fluorescence spectroscopy (3D-EEM), and then the PAH-degrading ability of isolated EPS was evaluated. The EPS compositions and morphology varied significantly with the extraction methods. EPS were mainly composed of proteins, carbohydrate, and humic-like substances, and the cation exchange resin (CER)-extracted EPS were granular while other EPS samples were all powders. Heating was the most effective treatment method, followed by the CER, centrifugation, and ultrasonication methods. However, 3D-EEM data demonstrated that heating treatment makes the mycelia lyse the most. Overall, therefore, the CER was the best EPS extraction method for Mucor mucedo (M. mucedo). The PAH degradation results indicated that 87 % of pyrene and 81 % of benzo[a]pyrene (B[a]P) were removed by M. mucedo over 12 days and 9 % more pyrene and 7 % more B[a]P were reduced after CER-extracted EPS addition of 465 mg l(-1). The investigation of EPS characterization and EPS enhancing PAH biodegradation is the premise for further in-depth exploration of the role of EPS contribution to PAH biodegradation.

Perceptions of and intentions to adopt HIV pre-exposure prophylaxis among black men who have sex with men in Los Angeles.

PubMed

Brooks, Ronald A; Landovitz, Raphael J; Regan, Rotrease; Lee, Sung-Jae; Allen, Vincent C

2015-12-01

This study assessed perceptions of pre-exposure prophylaxis (PrEP) and their association with PrEP adoption intention among a convenience sample of 224 low socioeconomic status black men who have sex with men (BMSM) residing in Los Angeles. Participants received educational information about PrEP and completed an in-person interview. More than half (60%) of the participants indicated a high intention to adopt PrEP. Younger BMSM (18-29 years) were twice as likely to report a high intention to adopt PrEP compared to older BMSM (30+ years). Only 33% of participants were aware of PrEP and no participant had ever used PrEP. Negative perceptions were associated with a lower PrEP adoption intention and included being uncomfortable taking an HIV medicine when HIV-negative and not knowing if there are long-term side effects of taking an HIV medication. These findings suggest that BMSM may adopt PrEP but that negative perceptions may limit its uptake among this population. In order to facilitate PrEP adoption among BMSM targeted educational and community awareness programmes are needed to provide accurate information on the benefits of PrEP and to address the negative perceptions of PrEP held by local BMSM populations. © The Author(s) 2015.

What people want from sex and preexposure prophylaxis.

PubMed

Grant, Robert M; Koester, Kimberly A

2016-01-01

As demand for preexposure prophylaxis (PrEP) increases, we are learning more about what people want from sex and PrEP. PrEP demand has reached a tipping point in the USA and is increasing rapidly. Although the primary benefit of PrEP use is biological, to reduce risk of HIV infection, PrEP users often express an alternative set of social and emotional benefits that are provided by PrEP. These collateral benefits of PrEP have salience, affect, and are experienced in the present, which are compelling drivers of human behavior. PrEP use has been associated with feeling safe during sex, usually in contrast to ruminations related to fear of HIV or intimate partner violence or control. PrEP can create empowerment, or agency, defined as the capacity and autonomy to act on one's own behalf, because it provides control over one's vulnerability to HIV and relief to women and men who may otherwise worry about whether their partners will use a condom, take antiretroviral therapy, or disclose their HIV status accurately. Planning for sexual and social goals in calm moments is also empowering. These highly desired collateral benefits of PrEP could be undermined, or eliminated, if PrEP is implemented in ways that are coercive or that foment fear of sexual risk compensation, drug resistance, toxicity, or moral judgment. Current PrEP implementation provides direct and indirect benefits that are highly desired.

Effect of pretreatment with epoxy compounds on the mechanical properties of bovine pericardial bioprosthetic materials.

PubMed

Xi, T; Liu, F; Xi, B

1992-07-01

Early failures of bovine pericardial heart valves are due to leaflet perforation, tearing and calcification. Since glutaraldehyde fixation has been shown to produce marked changes in leaflet mechanics and has been linked to development of calcification, bovine pericardium fixed with the four hydrophilic epoxy formulations and their mechanical properties are studied in this paper. We measured the thicknesses, shrinkage temperatures, stress relaxations and stress-strain curves of bovine pericardiums after different treatments with (1) non-treatment (fresh), (2) glutaraldehyde (GA), (3) epoxy compounds followed by the posttreatment with GA (EP 1#, EP 2#), and (4) epoxy compounds (EP 3# and EP 4#). Results of this study showed that the hydrophilic epoxy compounds are good crosslinking agents. There are no significant differences of shrinkage temperature and ultimate tensile stress among all tissue samples pretreated with GA, EP 1# and EP 2#. However, the stress relaxations of tissue-samples pretreated with epoxy compounds followed by the posttreatment with GA (EP 1# and EP 2#) are significantly slower than that pretreated with GA, and the strains at fracture of EP 1# and EP 2# are also significantly larger than that of GA or epoxy compounds. These facts show that the bovine pericardium pretreated with the epoxy compound followed by the posttreatment with GA (EP 1# and EP 2#) possesses greater tenacity and potential durability in dynamic stress.

Using Educational Prescriptions to Teach Medical Students Evidence-based Medicine

PubMed Central

Umscheid, Craig A.; Maenner, Matthew J.; Mull, Nikhil; Veesenmeyer, Angela F.; Farrar, John T.; Goldfarb, Stanley; Morrison, Gail; Albanese, Mark A.; Frohna, John G.; Feldstein, David A.

2018-01-01

Purpose To evaluate feasibility and impact of evidence-based medicine (EBM) educational prescriptions (EPs) in medical student clerkships. Methods Students answered clinical questions during clerkships using EPs, which guide learners through the “four As” of EBM. Epidemiology fellows graded EPs using a rubric. Feasibility was assessed using descriptive statistics and student and fellow end-of-study questionnaires, which also measured impact. In addition, for each EP, students reported patient impact. Impact on EBM skills was assessed by change in EP scores over time and scores on an EBM objective structured clinical exam (OSCE) that were compared to controls from the prior year. Results 117 students completed 402 EPs evaluated by 24 fellows. Average score was 7.34/9.00 (SD 1.58). 69 students (59%) and 21 fellows (88%) completed questionnaires. Most students thought EPs improved “Acquiring” and “Appraising.” Almost half thought EPs improved “Asking” and “Applying.” Fellows did not value grading EPs. For 18%of EPs, students reported a “change” or “potential change” in treatment. 56% “confirmed” treatment. EP scores increased by 1.27 (95% CI: 0.81–1.72). There were no differences in OSCE scores between cohorts. Conclusions Integrating EPs into clerkships is feasible and has impact, yet OSCEs were unchanged, and research fellows had limitations as evaluators. PMID:27075864

Preparing for pre-exposure prophylaxis: perceptions and readiness of Canadian pharmacists for the implementation of HIV pre-exposure prophylaxis.

PubMed

Yoong, Deborah; Naccarato, Mark; Sharma, Malika; Wilton, James; Senn, Heather; Tan, Darrell Hs

2016-07-01

Pre-exposure prophylaxis (PrEP) has been shown to reduce the risk of HIV transmission but has the potential to cause harm if not used properly. Pharmacists are well-positioned to foster PrEP's efficacy but little is known whether they would endorse it as an HIV prevention tool. The objective of the study was to determine Canadian HIV pharmacists' support for PrEP and to identify current barriers to promoting PrEP. Canadian pharmacists with experience in HIV care were invited to complete an online survey about their experiences, opinions, and learning needs regarding PrEP from December 2012 to January 2013. Among the 59 surveys received, 48 met criteria for final analysis. Overall, 33 (69%) respondents would provide education positively supporting the use of PrEP and 26 (54%) believed Health Canada should approve PrEP for use in Canada. Familiarity with the concept of PrEP and practice characteristics examined did not appear to be significantly associated with support for PrEP in univariable analyses. The principal barriers to promoting PrEP included inadequate drug coverage and insufficient knowledge to educate others. Many Canadian HIV pharmacists would endorse PrEP for high-risk patients; however, wider dissemination of information and lower drug costs may be needed to make PrEP more widely promoted. © The Author(s) 2015.

Exploratory survey of Florida pharmacists' experience, knowledge, and perception of HIV pre-exposure prophylaxis.

PubMed

Shaeer, Kristy M; Sherman, Elizabeth M; Shafiq, Sami; Hardigan, Patrick

2014-01-01

To assess Florida pharmacists' experience, knowledge, and perception of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) and to identify areas for pharmacist training. Cross-sectional survey. Florida in March through July 2013. Florida pharmacists. In-person and online anonymous survey. Florida pharmacists' experience, knowledge, and perceptions of PrEP. 225 completed surveys were analyzed. Survey respondents were predominantly community pharmacists with mean age of 45.7 years and less than 20 years of experience. Only 22% of respondents reported dispensing PrEP to patients. Although 75% had completed HIV-related continuing education in the last 2 years, 63% were unaware of Centers for Disease Control and Prevention PrEP guidelines and 71% answered that they did not have sufficient knowledge to counsel patients with PrEP prescriptions. Importantly, 47% of respondents answered they were uncomfortable counseling patients about PrEP. By self-report, most pharmacists agreed PrEP leads to risky behavior (68%) and increased rates of sexually transmitted infections (65%), and is too costly to promote patient access (92%). Surveyed Florida pharmacists reported limited understanding of PrEP. As a widely accessible health care counseling resource, pharmacists are positioned to improve patient understanding, promote medication adherence, and enhance PrEP efficacy. Especially during PrEP implementation, when patients may receive PrEP prescriptions from non-HIV specialist prescribers, improving pharmacists' PrEP education presents a salient opportunity.

Dual-tasks and walking fast: relationship to extra-pyramidal signs in advanced Alzheimer disease.

PubMed

Camicioli, Richard; Bouchard, Thomas; Licis, Lisa

2006-10-25

Extra-pyramidal signs (EPS) and cadence predicted falls risk in patients with advanced Alzheimer disease (AD). Dual task performance predicts falls with variable success. Dual-task performance and walking fast were examined in advanced AD patients with EPS (EPS+, >3 modified Unified Parkinson's Disease Rating Scale [UPDRS] signs) or without EPS (EPS-, three or less UPDRS signs). Demographics, mental and functional status, behavioral impairment, EPS, and quantitative gait measures (GaitRite) were determined. The effects of an automatic dual-task (simple counting) and of walking fast on spatial and temporal gait characteristics were compared between EPS+ and EPS- subjects using a repeated measures design. Cadence decreased, while stride time, swing time and variability in swing time increased with the dual task. Results were insignificant after adjusting for secondary task performance. With walking fast, speed, cadence and stride length increased while stride time, swing time and double support time decreased. Although EPS+ subjects were slower and had decreased stride length, dual task and walking fast effects did not differ from EPS- subjects. Patient characteristics, the type of secondary task and the specific gait measures examined vary in the literature. In this moderately to severely demented population, EPS did not affect "unconscious" (dual task) or "conscious" (walking fast) gait modulation. Given their high falls risk, and retained ability to modulate walking, EPS+ AD patients may be ideal candidates for interventions aimed at preventing falls.

Success rates of single-dose methotrexate and additional dose requirements among women with first and previous ectopic pregnancies.

PubMed

Cirik, Derya Akdag; Kinay, Tugba; Keskin, Ugur; Ozden, Eda; Altay, Metin; Gelisen, Orhan

2016-04-01

To compare the success of the single-dose methotrexate regimen and the requirement for a second or third dose of methotrexate between women with their first ectopic pregnancy (EP) and those with previous EP. In a retrospective cohort study, data were analyzed from women treated for EP by single-dose methotrexate at a Turkish tertiary referral center between January 2010 and December 2013. Data were compared between women with at least one previous EP and those with their first EP. The success rate of the protocol in the first and previous EP groups was similar: 93.0% (320/344) and 87.3% (48/55), respectively. History of previous EP was not a predictor of treatment failure. However, the requirement for additional methotrexate doses was significantly higher in the previous EP group (16/48 [33.4%]) than in the first EP group (55/320 [17.2%]; P=0.03). Multivariate analysis showed that history of tubal surgery (P=0.006) and initial levels of the β-subunit of human chorionic gonadotropin (P=0.001) were significant predictors of treatment failure. Although the single-dose regimen had similar success rates in the previous EP and first EP groups, additional doses of methotrexate were more frequently required in the previous EP group. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

30 CFR 250.211 - What must the EP include?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What must the EP include? 250.211 Section 250.211 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF... Information Contents of Exploration Plans (ep) § 250.211 What must the EP include? Your EP must include the...

Microcalorimetric and potentiometric titration studies on the adsorption of copper by extracellular polymeric substances (EPS), minerals and their composites.

PubMed

Fang, Linchuan; Huang, Qiaoyun; Wei, Xing; Liang, Wei; Rong, Xinming; Chen, Wenli; Cai, Peng

2010-08-01

Equilibrium adsorption experiments, isothermal titration calorimetry and potentiometric titration techniques were employed to investigate the adsorption of Cu(II) by extracellular polymeric substances (EPS) extracted from Pseudomonas putida X4, minerals (montmorillonite and goethite) and their composites. Compared with predicted values of Cu(II) adsorption on composites, the measured values of Cu(II) on EPS-montmorillonite composite increased, however, those on EPS-goethite composite decreased. Potentiometric titration results also showed that more surface sites were observed on EPS-montmorillonite composite and less reactive sites were found on EPS-goethite composite. The adsorption of Cu(II) on EPS molecules and their composites with minerals was an endothermic reaction, while that on minerals was exothermic. The positive values of enthalpy change (Delta H) and entropy change (DeltaS) for Cu(II) adsorption on EPS and mineral-EPS composites indicated that Cu(II) mainly interacts with carboxyl and phosphoryl groups as inner-sphere complexes on EPS molecules and their composites with minerals. (c) 2010 Elsevier Ltd. All rights reserved.

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support.

PubMed

Calabrese, Sarah K; Underhill, Kristen; Earnshaw, Valerie A; Hansen, Nathan B; Kershaw, Trace S; Magnus, Manya; Krakower, Douglas S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

2016-07-01

Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting ("beneficiary") and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.

A Closer Look at Racism and Heterosexism in Medical Students' Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education.

PubMed

Calabrese, Sarah K; Earnshaw, Valerie A; Krakower, Douglas S; Underhill, Kristen; Vincent, Wilson; Magnus, Manya; Hansen, Nathan B; Kershaw, Trace S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

2018-04-01

Social biases among healthcare providers could limit PrEP access. In this survey study of 115 US medical students, we examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. After viewing a vignette about a PrEP-seeking MSM patient, participants reported anticipated patient behavior (condomless sex, extra-relational sex, and adherence), intention to prescribe PrEP to the patient, biases, and background characteristics. Minimal evidence for racism affecting clinical decision-making emerged. In unadjusted analyses, heterosexism indirectly affected prescribing intention via all anticipated behaviors, tested as parallel mediators. Participants expressing greater heterosexism more strongly anticipated increased risk behavior and adherence problems, which were associated with lower prescribing intention. The indirect effect via condomless sex remained significant adjusting for background characteristics. Prior PrEP education did not buffer any indirect effects. Heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education.

Acceptability of Pre-Exposure Prophylaxis (PrEP) as an HIV prevention strategy: Barriers and facilitators to PrEP uptake among at-risk Peruvian populations

PubMed Central

Galea, Jerome T.; Kinsler, Janni J.; Salazar, Ximena; Lee, Sung-Jae; Giron, Maziel; Sayles, Jennifer N.; Cáceres, Carlos; Cunningham, William E.

2010-01-01

This study examined Pre-Exposure Prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons, and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, p <0.001), followed by efficacy (21.4, p <0.001) and potential side effects (14.7, p <0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out if proven efficacious in ongoing clinical trials. PMID:21571973

Acceptability of Daily Use of Free Oral Pre-exposure Prophylaxis (PrEP) Among Transgender Women Sex Workers in Shenyang, China.

PubMed

Wang, Zixin; Lau, Joseph T F; Yang, Xueying; Cai, Yong; Gross, Danielle L; Ma, Tiecheng; Liu, Yan

2017-12-01

This study investigated the acceptability of daily use of free oral pre-exposure prophylaxis (PrEP) and associated factors among transgender women sex workers in Shenyang, China, following a briefing on PrEP. A total of 183 HIV negative or sero-status unknown participants completed the cross-sectional survey. The prevalence of acceptability of daily use of free oral PrEP was 61.2%. Adjusting for education level and monthly income, variables on negative attitudes toward PrEP (i.e., having concerns about the side-effects of PrEP) [Adjusted odds ratios (AOR): 0.26], perceived subjective norms (i.e., perceiving support from male partners to take PrEP) (AOR: 2.08), and perceived behavioral control (e.g., perceiving complete control over using PrEP) (AOR: 2.10-16.72) were significantly associated with acceptability of daily use of free oral PrEP. In addition, experiencing violence during sex work, perceived risk of contracting HIV from clients and probable anxiety were also significant. Future PrEP promotion campaigns should consider these factors.

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support

PubMed Central

Calabrese, Sarah K.; Underhill, Kristen; Earnshaw, Valerie A.; Hansen, Nathan B.; Kershaw, Trace S.; Magnus, Manya; Krakower, Douglas S.; Mayer, Kenneth H.; Betancourt, Joseph R.; Dovidio, John F.

2016-01-01

Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting (“beneficiary”) and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts. PMID:26891840

EpCAM-Independent Enrichment of Circulating Tumor Cells in Metastatic Breast Cancer.

PubMed

Schneck, Helen; Gierke, Berthold; Uppenkamp, Frauke; Behrens, Bianca; Niederacher, Dieter; Stoecklein, Nikolas H; Templin, Markus F; Pawlak, Michael; Fehm, Tanja; Neubauer, Hans

2015-01-01

Circulating tumor cells (CTCs) are the potential precursors of metastatic disease. Most assays established for the enumeration of CTCs so far-including the gold standard CellSearch-rely on the expression of the cell surface marker epithelial cell adhesion molecule (EpCAM). But, these approaches may not detect CTCs that express no/low levels of EpCAM, e.g. by undergoing epithelial-to-mesenchymal transition (EMT). Here we present an enrichment strategy combining different antibodies specific for surface proteins and extracellular matrix (ECM) components to capture an EpCAMlow/neg cell line and EpCAMneg CTCs from blood samples of breast cancer patients depleted for EpCAM-positive cells. The expression of respective proteins (Trop2, CD49f, c-Met, CK8, CD44, ADAM8, CD146, TEM8, CD47) was verified by immunofluorescence on EpCAMpos (e.g. MCF7, SKBR3) and EpCAMlow/neg (MDA-MB-231) breast cancer cell lines. To test antibodies and ECM proteins (e.g. hyaluronic acid (HA), collagen I, laminin) for capturing EpCAMneg cells, the capture molecules were first spotted in a single- and multi-array format onto aldehyde-coated glass slides. Tumor cell adhesion of EpCAMpos/neg cell lines was then determined and visualized by Coomassie/MitoTracker staining. In consequence, marginal binding of EpCAMlow/neg MDA-MB-231 cells to EpCAM-antibodies could be observed. However, efficient adhesion/capturing of EpCAMlow/neg cells could be achieved via HA and immobilized antibodies against CD49f and Trop2. Optimal capture conditions were then applied to immunomagnetic beads to detect EpCAMneg CTCs from clinical samples. Captured CTCs were verified/quantified by immunofluorescence staining for anti-pan-Cytokeratin (CK)-FITC/anti-CD45 AF647/DAPI. In total, in 20 out of 29 EpCAM-depleted fractions (69%) from 25 metastatic breast cancer patients additional EpCAMneg CTCs could be identified [range of 1-24 CTCs per sample] applying Trop2, CD49f, c-Met, CK8 and/or HA magnetic enrichment. EpCAMneg dual-positive (CKpos/CD45pos) cells could be traced in 28 out of 29 samples [range 1-480]. By single-cell array-based comparative genomic hybridization we were able to demonstrate the malignant nature of one EpCAMneg subpopulation. In conclusion, we established a novel enhanced CTC enrichment strategy to capture EpCAMneg CTCs from clinical blood samples by targeting various cell surface antigens with antibody mixtures and ECM components.

Interdecadal Change in the Tropical Pacific Precipitation Anomaly Pattern around the Late 1990s during Boreal Spring

NASA Astrophysics Data System (ADS)

Wen, Zhiping; Guo, Yuanyuan; Wu, Renguang

2017-04-01

The leading mode of boreal spring precipitation variability over the tropical Pacific experienced a pronounced interdecadal change around the late 1990s. The pattern before 1998 features positive precipitation anomalies over the equatorial eastern Pacific (EP) with positive principle component years. The counterpart after 1998 exhibits a westward shift of the positive center to the equatorial central Pacific (CP). Observational evidence shows that this interdecadal change in the leading mode of precipitation variability is closely associated with a distinctive sea surface temperature (SST) anomaly pattern. The westward shift of the anomalous precipitation center after 1998 is in tandem with a similar shift of maximum warming from the EP to CP. Diagnostic analyses based on a linear equation of the mixed layer temperature anomaly exhibit that an interdecadal enhancement of zonal advection (ZA) feedback process plays a vital role in the shift in the leading mode of both the tropical Pacific SST and the precipitation anomaly during spring. Moreover, the variability of the anomalous zonal current at the upper ocean dominates the ZA feedback change, while the mean zonal SST gradient associated with a La Niña-like pattern of the mean state only accounts for a relatively trivial proportion of the ZA feedback change. It was found that both the relatively rapid decaying of the SST anomalies in the EP and the La Niña-like mean state make it conceivable that the shift of the leading mode of the tropical precipitation anomaly only occurs in spring. In addition, the largest variance of the anomalous zonal current in spring might contribute to the unique interdecadal change in the tropical spring precipitation anomaly pattern.

beta-Endorphin-induced analgesia is inhibited by synthetic analogs of beta-endorphin.

PubMed Central

Nicolas, P; Hammonds, R G; Li, C H

1984-01-01

Competitive antagonism of human beta-endorphin (beta h-EP)-induced analgesia by synthetic beta h-EP analogs with high in vitro opiate receptor binding to in vivo analgesic potency ratio has been demonstrated. A parallel shift of the dose-response curve for analgesia to the right was observed when either beta h-EP or [ Trp27 ] -beta h-EP was coinjected with various doses of [Gln8, Gly31 ]-beta h-EP-Gly-Gly-NH2, [Arg9,19,24,28,29]-beta h-EP, or [ Cys11 ,26, Phe27 , Gly31 ]-beta h-EP. It was estimated that the most potent antagonist, [Gln8, Gly31 ]-beta h-EP-Gly-NH2, is at least 200 times more potent than naloxone. PMID:6328494

Efferent projections of the ectostriatum in the pigeon (Columba livia)

NASA Technical Reports Server (NTRS)

Husband, S. A.; Shimizu, T.

1999-01-01

The ectostriatum is a major visual component of the avian telencephalon. The core region of the ectostriatum (Ec) receives visual input from the optic tectum through thalamic nuclei. In the present study, the efferent projections of the ectostriatum were investigated by using the anterograde tracers Phaseolus vulgaris leucoagglutinin and biotinylated dextran amine. Projection patterns resulting from these tracers were confirmed by the retrograde tracer cholera toxin subunit B. When anterograde tracers were injected in Ec, primary projections were seen traveling dorsolaterally to the belt region of the ectostriatum (Ep) and the neostriatal area immediately surrounding Ep (Ep2). Neurons in Ep sent projections primarily to the overlying Ep2. The efferents of Ep2 traveled dorsolaterally to terminate in three telencephalic regions, from anterior to posterior: (1) neostriatum frontale, pars lateralis (NFL), (2) area temporo-parieto-occipitalis (TPO), and (3) neostriatum intermedium, pars lateralis (NIL). A part of the archistriatum intermedium and the lateral part of the neostriatum caudale also received somewhat minor projections. In addition, some neurons in Ec were also the source of direct, but minor, projections to the NFL, TPO, NIL, and archistriatum intermedium. The topographical relationship among the primary (Ec), secondary (Ep and Ep2), and tertiary (NFL, TPO, NIL) areas indicate that the neural populations for visual processing are organized along the rostral-caudal axis. Thus, the anterior Ec sent efferents to the anterior Ep, which in turn sent projections to anterior Ep2. Neurons in the anterior Ep2 sent projections to NFL and the anterior TPO. Similarly, the intermediate and posterior Ec sent projections to corresponding parts of Ep, whose efferents projected to intermediate and posterior Ep2, respectively. The intermediate Ep2 gave rise to major projections to TPO, whereas posterior Ep2 neurons sent efferents primarily to NIL. The organization of this neural circuit is compared with those of other sensory circuits in the avian telencephalon, as well as the laminar arrangement of the mammalian isocortex.

Gold nanoparticles and electroporation impose both separate and synergistic radiosensitizing effects in HT-29 tumor cells: an in vitro study.

PubMed

Rezaee, Zohre; Yadollahpour, Ali; Bayati, Vahid; Negad Dehbashi, Fereshteh

2017-01-01

Radiation therapy (RT) is the gold standard treatment for more than half of known tumors. Despite recent improvements in RT efficiency, the side effects of ionizing radiation (IR) in normal tissues are a dose-limiting factor that restricts higher doses in tumor treatment. One approach to enhance the efficiency of RT is the application of radiosensitizers to selectively increase the dose at the tumor site. Gold nanoparticles (GNPs) and electroporation (EP) have shown good potential as radiosensitizers for RT. This study aims to investigate the sensitizing effects of EP, GNPs, and combined GNPs-EP on the dose enhancement factor (DEF) for 6 MV photon energy. Radiosensitizing effects of EP, GNPs, and combinations of GNPs-EP were comparatively investigated in vitro for intestinal colon cancer (HT-29) and Chinese hamster ovary (CHO) cell lines by MTT assay and colony formation assay at 6 MV photon energy in six groups: IR (control group), GNPs+IR, GNPs (24 h)+IR, EP+IR, GNPs+EP+IR, and GNPs (24 h)+EP+IR. Treatment of both cell lines with EP, GNPs, and combined GNPs-EP significantly enhanced the response of cells to irradiation. However, the HT-29 showed higher DEF values for all groups. In addition, the DEF value for HT-29 cells for GNPs+IR, GNPs (24 h)+IR, EP+IR, GNPs+EP+IR, and GNPs (24 h)+EP+IR was, respectively, 1.17, 1.47, 1.36, 2.61, and 2.89, indicating synergistic radiosensitizing effect for the GNPs (24 h)+EP+IR group. Furthermore, the synergistic effect was observed just for HT-29 tumor cell lines. Combined GNPs-EP protocols induced synergistic radiosensitizing effect in HT-29 cells, and the effect is also tumor specific. This combined therapy can be beneficially used for the treatment of intrinsically less radiosensitive tumors.

Encapsulating Peritoneal Sclerosis in Peritoneal Dialysis Patients After Kidney Transplantation.

PubMed

Ayar, Y; Ersoy, A; Ocakoglu, G; Gullulu, E; Kagızmanlı, H; Yıldız, A; Oruc, A; Yavuz, M; Gullulu, M; Dilek, K

Encapsulating peritoneal sclerosis (EPS) is a serious complication for patients with chronic kidney disease (CKD) who were treated with long-term peritoneal dialysis (PD). The risk of EPS was increased after kidney transplantation. In our study we evaluated risk factors for EPS patients after kidney transplantation who were treated before with PD. In our study, between January 2008 and August 2015, 47 PD patients (12 had EPS) who underwent kidney transplantation were analyzed. Age, gender, time of PD treatment, human leukocyte antigen (HLA) matching, cold ischemia time, kidney function (serum urea, creatinine, etc), comorbidities, immunosuppressive therapy, clinical features, and outcomes of PD patients were retrospectively evaluated in both groups. Mean age was 42 (range, 25-60) years in EPS patients, versus 43 (range, 22-77) years without EPS (P = .798). Distribution of gender was similar in both groups (P = .154). The C-reactive protein levels (P < .001), number of patients with peritonitis (P = .001), length of time on PD (P < .001), and serum ferritin levels (P = .020) were higher in EPS patients. The immunosuppressive therapy was changed; tamoxifen and steroids were used after diagnosis in EPS patients. HLA matching was higher in the non-EPS group (P = .006). EPS was more often seen in patients who were treated with continuous ambulatory peritoneal dialysis (CAPD; 75%; P = .036). EPS was more often detected in cadaveric transplant recipients (83.3%; P = .024). High peritoneal transmittance rate was more identified in EPS (+) patients (P = .001). EPS was more often seen in patients who were treated with icodextrin-based regimens in PD before transplantation (91.7%; P = .037). The length of time on PD and high ferritin levels increased EPS 1.08 and 1.01, respectively (P = .036 and .049, respectively), in multivariate analysis. The length of time on PD, type of PD, PD regimens with icodextrin, episodes of peritonitis, and peritoneal transmittance in patients with CKD affect the development of EPS after transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

Pharmacokinetics of erythropoietin in intact and anephric dogs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fu, J.S.; Lertora, J.J.; Brookins, J.

1988-06-01

The present studies were performed to determine the pharmacokinetic parameters of erythropoietin in intact and anephric dogs by use of unlabeled crude native erythropoietin (nEp) and iodine 125-labeled purified recombinant erythropoietin (rEp) given by intravenous infusion for 15 minutes. Sephadex G-75 gel filtration was used to confirm that the 125I-rEp molecule remained iodinated in dog plasma during the 24-hour period of these studies. The plasma disappearance of erythropoietin conformed to a biexponential equation for both nEp and 125I-rEp, with the central compartment being larger than the peripheral compartment. The mean distribution half-life of 75.3 +/- 21.2 minutes for nEp wasmore » significantly (p less than 0.05) longer than that of 125I-rEp (23.7 +/- 5.0 minutes) in intact dogs. The intercompartmental clearance (CIic) for nEp (0.018 +/- 0.006 L/kg/hr) was significantly smaller than that of 125I-rEp (0.068 +/- 0.018 L/kg/hr) in intact dogs (p less than 0.05). There were no significant differences in apparent volume of distribution, elimination half-life, and elimination clearance (CIe) for nEp and rEp in intact dogs. The mean elimination half-life for 125I-rEp in intact dogs (9.0 +/- 0.6 hours) and anephric dogs (13.8 +/- 1.4 hours) was significantly different (p less than 0.05). The CIe for 125I-rEp in anephric dogs (0.008 +/- 0.001 L/kg/hr) was significantly (p less than 0.05) smaller than that of 125I-rEp in intact dogs (0.011 +/- 0.001 L/kg/hr). There were no significant differences in apparent volume of distribution, distribution half-life, and CIic for 125I-rEp in intact and anephric dogs.« less

A deletion mutation at the ep locus causes low seed coat peroxidase activity in soybean.

PubMed

Gijzen, M

1997-11-01

The Ep locus severely affects the amount of peroxidase enzyme in soybean seed coats. Plants containing the dominant Ep allele accumulate large amounts of peroxidase in the hourglass cells of the sub-epidermis. Homozygous recessive epep genotypes do not accumulate peroxidase in the hourglass cells and are much reduced in total seed coat peroxidase activity. To isolate the gene encoding the seed coat peroxidase and to determine whether it corresponds to the Ep locus, a cDNA library was constructed from developing seed coats and an abundant 1.3 kb peroxidase transcript was cloned. The corresponding structural gene was also isolated from a genomic library. Sequence analysis shows that the seed coat peroxidase is translated as a 352 amino acid precursor protein of 38 kDa. Processing of a putative 26 amino acid signal sequence results in a mature protein of 326 residues with a calculated mass of 35 kDa and a pl of 4.4. Using probes derived from the cDNA, genomic DNA blot hybridization and polymerase chain reaction analysis detected polymorphisms that distinguished EpEp and epep genotypes. Co-segregation of the polymorphisms in an F2 population from a cross of EpEp and epep plants shows that the Ep locus encodes the seed coat peroxidase protein. Comparison of Ep and ep alleles indicates that the recessive gene lacks 87 bp of sequence encompassing the translation start codon. Analysis by RNA blot hybridization shows that epep plants have drastically reduced amounts of peroxidase transcript compared with EpEp plants. The peroxidase mRNA is abundant in seed coat tissues of EpEp plants during the late stages of seed maturation, and could also be detected in root tissues, but not in the flower, embryo, pod or leaf. The results indicate that the lack of peroxidase accumulation in seed coats of homozygous recessive epep plants is due to a mutation of the structural gene that reduces transcript abundance.

Unilateral Salpingectomy and Methotrexate Are Associated With a Similar Recurrence Rate of Ectopic Pregnancy in Patients Undergoing In Vitro Fertilization.

PubMed

Irani, Mohamad; Robles, Alex; Gunnala, Vinay; Spandorfer, Steven D

To determine whether different treatment approaches of ectopic pregnancy (EP), particularly unilateral salpingectomy and methotrexate, affect its recurrence rate in patients undergoing in vitro fertilization (IVF). A retrospective cohort study (Canadian Task Force classification II-2). An academic medical center. Patients with a history of a previous EP who achieved pregnancy after IVF cycles between January 2004 and August 2015 were included. The recurrence rate of EP was compared between patients who underwent different treatment approaches for a previous EP. IVF. A total of 594 patients were included. Seventeen patients had a recurrence of EP (2.9%). Patients with a history of ≥2 EPs were associated with a significantly higher recurrence rate of EP than those with 1 previous EP (8.5% vs. 1.8%; p = .01; odds ratio [OR] = 2.2; 95% confidence interval [CI], 1.2-4.4). Patients who underwent unilateral salpingectomy (n = 245) had a comparable recurrence rate of EP after IVF with those who received methotrexate (n = 283) (3.6% vs. 2.8%; p = .5; OR = 1.3; 95% CI, 0.4-3.4). This OR remained unchanged after adjusting for patient's age, number of previous EPs, number of transferred embryos, and peak estradiol level during stimulation (adjusted OR = 1.4; 95% CI, 0.5-3.8). None of the patients who underwent bilateral salpingectomy (n = 45) or salpingostomy (n = 21) had a recurrence of EP after IVF. The recurrence rate of EP significantly correlates with the number of previous EPs. Treatment of EP with methotrexate has a comparable recurrence rate of EP after IVF with unilateral salpingectomy. Therefore, the risk of recurrence should not be a reason to favor salpingectomy over methotrexate in this population. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

ARES I Upper Stage Subsystems Design and Development

NASA Technical Reports Server (NTRS)

Frate, David T.; Senick, Paul F.; Tolbert, Carol M.

2011-01-01

From 2005 through early 2011, NASA conducted concept definition, design, and development of the Ares I launch vehicle. The Ares I was conceived to serve as a crew launch vehicle for beyond-low-Earth-orbit human space exploration missions as part of the Constellation Program Architecture. The vehicle was configured with a single shuttle-derived solid rocket booster first stage and a new liquid oxygen/liquid hydrogen upper stage, propelled by a single, newly developed J-2X engine. The Orion Crew Exploration Vehicle was to be mated to the forward end of the Ares I upper stage through an interface with fairings and a payload adapter. The vehicle design passed a Preliminary Design Review in August 2008, and was nearing the Critical Design Review when efforts were concluded as a result of the Constellation Program s cancellation. At NASA Glenn Research Center, four subsystems were developed for the Ares I upper stage. These were thrust vector control (TVC) for the J-2X, electrical power system (EPS), purge and hazardous gas (P&HG), and development flight instrumentation (DFI). The teams working each of these subsystems achieved 80 percent or greater design completion and extensive development testing. These efforts were extremely successful representing state-of-the-art technology and hardware advances necessary to achieve Ares I reliability, safety, availability, and performance requirements. This paper documents the designs, development test activity, and results.

An EP2 Agonist Facilitates NMDA-Induced Outward Currents and Inhibits Dendritic Beading through Activation of BK Channels in Mouse Cortical Neurons

PubMed Central

Hayashi, Yoshinori; Morinaga, Saori; Liu, Xia; Zhang, Jing; Wu, Zhou; Yokoyama, Takeshi; Nakanishi, Hiroshi

2016-01-01

Prostaglandin E2 (PGE2), a major metabolite of arachidonic acid produced by cyclooxygenase pathways, exerts its bioactive responses by activating four E-prostanoid receptor subtypes, EP1, EP2, EP3, and EP4. PGE2 enables modulating N-methyl-D-aspartate (NMDA) receptor-mediated responses. However, the effect of E-prostanoid receptor agonists on large-conductance Ca2+-activated K+ (BK) channels, which are functionally coupled with NMDA receptors, remains unclear. Here, we showed that EP2 receptor-mediated signaling pathways increased NMDA-induced outward currents (I NMDA-OUT), which are associated with the BK channel activation. Patch-clamp recordings from the acutely dissociated mouse cortical neurons revealed that an EP2 receptor agonist activated I NMDA-OUT, whereas an EP3 receptor agonist reduced it. Agonists of EP1 or EP4 receptors showed no significant effects on I NMDA-OUT. A direct perfusion of 3,5′-cyclic adenosine monophosphate (cAMP) through the patch pipette facilitated I NMDA-OUT, which was abolished by the presence of protein kinase A (PKA) inhibitor. Furthermore, facilitation of I NMDA-OUT caused by an EP2 receptor agonist was significantly suppressed by PKA inhibitor. Finally, the activation of BK channels through EP2 receptors facilitated the recovery phase of NMDA-induced dendritic beading in the primary cultured cortical neurons. These results suggest that a direct activation of BK channels by EP2 receptor-mediated signaling pathways plays neuroprotective roles in cortical neurons. PMID:27298516

Safety and efficacy of pancreatic sphincterotomy in chronic pancreatitis.

PubMed

Ell, C; Rabenstein, T; Schneider, H T; Ruppert, T; Nicklas, M; Bulling, D

1998-09-01

Endoscopic pancreatic sphincterotomy (EPS) is being performed with increasing frequency as a prerequisite to interventional measures in the pancreatic duct. The aim of this study was to evaluate EPS with regard to technique, success, complications, and mortality in patients with chronic pancreatitis. Between January 1989 and September 1996, the results of all consecutive EPSs in patients with chronic pancreatitis were documented in a standardized form. Patients were followed by clinical investigation and blood sample analysis at 4, 24, and 48 hours after EPS. Complications were classified according to commonly accepted criteria. EPS was performed in 118 patients with chronic pancreatitis (men 75%, women 25%, 48+/-10 years). Ninety-four patients (80%) underwent guidewire-assisted EPS, and 24 patients (20%) underwent needle-knife EPS. Seventy-seven EPS procedures (65%) were primarily successful (guidewire EPS: 60 of 94, 64%; needle-knife EPS: 17 of 24, 71%). Additional endoscopic cutting techniques (needle-knife papillotomy, biliary endoscopic sphincterotomy) were required in 41 patients (35%). In total, EPS was successful in 116 patients (98%). The complication rate was 4.2% (4 cases of moderate pancreatitis, 1 severe bleeding, no deaths). All complications were managed nonoperatively. In patients with chronic pancreatitis, EPS with a standard sphincterotome or with a needle-knife offers an effective and reliable approach to the pancreatic duct system. Additional cutting techniques may be necessary in approximately one third of cases before an EPS can be successfully performed. The complication rate of EPS in patients with chronic pancreatitis appears to be lower than the complication rate of biliary sphincterotomy for other indications.

Influence of sulphate on the composition and antibacterial and antiviral properties of the exopolysaccharide from Porphyridium cruentum.

PubMed

Raposo, Maria Filomena de Jesus; de Morais, Alcina Maria Miranda Bernardo; de Morais, Rui Manuel Santos Costa

2014-04-17

The influence of two culture media and three different concentrations of sulphate in the medium on the growth of two strains of Porphyridium cruentum and on the production, composition and viscoelastic characteristics, and antimicrobial properties of the sulphated exopolysaccharide (EPS) were studied. A Bohlin C50 rheometer was used to evaluate the viscosity and elasticity of the EPS solutions. HSV virus, types 1 and 2, Vaccinia virus and Vesicular stomatitis virus were used along with two Gram-negative (Escherichia coli and Salmonella enteritidis) and one Gram-positive (Staphylococcus aureus) bacteria, for testing the antimicrobial activity of EPS. The growth of microalgae was higher in NTIP medium and the production of EPS was enhanced by sulphate 21mM. The protein content of the EPS was enhanced by the addition of sulphate 52mM and 104mM; this concentration also induced an increase in sulphate content of the EPS. However, neither the contents of EPS in carbohydrates and uronic acids were affected by the culture medium supplementation in sulphate. In general, the EPS from the Spanish strain presented a higher antiviral activity than the EPS from the Israeli strain. All EPS extracts revealed a strong activity against V. stomatitis virus, higher than the activity of all chemical compounds tested. The EPS from the Israeli strain also presented antibacterial activity against S. enteritidis. Enrichment of the culture medium with sulphate improved protein and sulphate content of EPS. EPS extracts presented a relevant activity against V. stomatitis virus and S. enteritidis bacterium. Copyright © 2014 Elsevier Inc. All rights reserved.

In vitro pharmacological characterization of CJ-042794, a novel, potent, and selective prostaglandin EP(4) receptor antagonist.

PubMed

Murase, Akio; Taniguchi, Yasuhito; Tonai-Kachi, Hiroko; Nakao, Kazunari; Takada, Junji

2008-01-16

Activation of the prostaglandin E(2) (PGE(2)) EP(4) receptor, a G-protein-coupled receptor (GPCR), results in increases in intracellular cyclic AMP (cAMP) levels via stimulation of adenylate cyclase. Here we describe the in vitro pharmacological characterization of a novel EP(4) receptor antagonist, CJ-042794 (4-{(1S)-1-[({5-chloro-2-[(4-fluorophenyl)oxy]phenyl}carbonyl)amino]ethyl}benzoic acid). CJ-042794 inhibited [(3)H]-PGE(2) binding to the human EP(4) receptor with a mean pK(i) of 8.5, a binding affinity that was at least 200-fold more selective for the human EP(4) receptor than other human EP receptor subtypes (EP(1), EP(2), and EP(3)). CJ-042794 did not exhibit any remarkable binding to 65 additional proteins, including GPCRs, enzymes, and ion channels, suggesting that CJ-042794 is highly selective for the EP(4) receptor. CJ-042794 competitively inhibited PGE(2)-evoked elevations of intracellular cAMP levels in HEK293 cells overexpressing human EP(4) receptor with a mean pA(2) value of 8.6. PGE(2) inhibited the lipopolysaccharide (LPS)-induced production of tumor necrosis factor alpha (TNFalpha) in human whole blood (HWB); CJ-042794 reversed the inhibitory effects of PGE(2) on LPS-induced TNFalpha production in a concentration-dependent manner. These results suggest that CJ-042794, a novel, potent, and selective EP(4) receptor antagonist, has excellent pharmacological properties that make it a useful tool for exploring the physiological role of EP(4) receptors.

The Influence of pH of Extracting Water on the Composition of Seaweed Extracts and Their Beneficial Properties on Lepidium sativum.

PubMed

Godlewska, Katarzyna; Michalak, Izabela; Tuhy, Łukasz; Chojnacka, Katarzyna

2017-01-01

Baltic seaweeds were used to obtain aqueous extracts (E) through changing initial pH of deionised water added to algal biomass (EpH3·H 2 O, EpH7·H 2 O, and EpH10·H 2 O) and through changing pH of the mixture of algae and deionised water (EpH3, EpH7, and EpH10). Algal extracts were characterized in terms of the concentration of polyphenols and micro- and macroelements. The highest concentration of polyphenols was determined in extract EpH3 and the lowest in extract EpH10·H 2 O. It was found that the obtained extracts had similar concentrations of elements (except EpH3). The phytotoxicity of algal extracts (0.5, 2.5, and 10%) was examined in the germination tests on Lepidium sativum . No phytotoxic effects were observed. It was found that they had beneficial effects on the cultivated plants (length and weight). The best biostimulant effect was observed in the groups treated with EpH3 (2.5%), EpH7 (2.5%), and EpH7 (10%). The dry weight of plants was similar in all the groups. Algal extract also improved the multielemental composition of plant. The greatest concentration of total chlorophyll in plants was obtained by using extract EpH10·H 2 O, 0.5%. These results proved that algal extracts have high potential to be applied in cultivation of plants.

The Influence of pH of Extracting Water on the Composition of Seaweed Extracts and Their Beneficial Properties on Lepidium sativum

PubMed Central

Tuhy, Łukasz; Chojnacka, Katarzyna

2017-01-01

Baltic seaweeds were used to obtain aqueous extracts (E) through changing initial pH of deionised water added to algal biomass (EpH3·H2O, EpH7·H2O, and EpH10·H2O) and through changing pH of the mixture of algae and deionised water (EpH3, EpH7, and EpH10). Algal extracts were characterized in terms of the concentration of polyphenols and micro- and macroelements. The highest concentration of polyphenols was determined in extract EpH3 and the lowest in extract EpH10·H2O. It was found that the obtained extracts had similar concentrations of elements (except EpH3). The phytotoxicity of algal extracts (0.5, 2.5, and 10%) was examined in the germination tests on Lepidium sativum. No phytotoxic effects were observed. It was found that they had beneficial effects on the cultivated plants (length and weight). The best biostimulant effect was observed in the groups treated with EpH3 (2.5%), EpH7 (2.5%), and EpH7 (10%). The dry weight of plants was similar in all the groups. Algal extract also improved the multielemental composition of plant. The greatest concentration of total chlorophyll in plants was obtained by using extract EpH10·H2O, 0.5%. These results proved that algal extracts have high potential to be applied in cultivation of plants. PMID:28480222

The risk of ectopic pregnancy following tubal reconstructive microsurgery and assisted reproductive technology procedures.

PubMed

Schippert, Cordula; Soergel, Philipp; Staboulidou, Ismini; Bassler, Christina; Gagalick, Susanne; Hillemanns, Peter; Buehler, Klaus; Garcia-Rocha, Guillermo-José

2012-03-01

The incidence of ectopic pregnancy (EP) in the general population is 2%, whereas the EP rate following assisted reproductive technologies (ART) is between 2.1 and 11%. EP is also an adverse effect of tubal surgery with incidences up to 40% depending on the type, location, and severity of tubal disease and the surgical procedure. This paper looks at the incidence of EP following tubal reconstructive microsurgery, analyzes risk factors for EP following own 1,295 ART cycles and looks on the incidence of EP in 128,314 pregnancies following ART according to the presence or absence of tubal infertility using data from the German IVF Registry (DIR). In our clinic, the EP rate following resterilization was 6.7%. In the presence of acquired tubal disease, the EP rate following adhesiolysis, salpingostomy, salpingoneostomy, fimbrioplasty, and anastomosis was 7.9%. The EP rate following ART in our clinic was 5.6%. Previous abdominal surgeries, microsurgical procedures, hydro-/sactosalpinges, salpingitis, salpingitis isthmica nodosa, and periadnexal adhesions showed a significant positive correlation with EP as outcome. Data of DIR demonstrate a significantly increased incidence of EP in the presence of tubal pathology. The highest EP rate related to all clinical pregnancies was 4.5% (95% CI 3.0-6.0) in smoking women <30 years with tubal pathology following IVF. In the presence of tubal infertility, the incidence of EP following ART and tubal microsurgery are approximately comparable with each other and higher than in women without tubal infertility. The success of infertility surgery depends on a careful selection of appropriate patients.

Adolescent Health Providers' Willingness to Prescribe Pre-Exposure Prophylaxis (PrEP) to Youth at Risk of HIV Infection in the United States.

PubMed

Hart-Cooper, Geoffrey D; Allen, Isabel; Irwin, Charles E; Scott, Hyman

2018-05-26

HIV disproportionately affects young men who have sex with men. Pre-exposure prophylaxis (PrEP) can prevent HIV acquisition; however, youth access to PrEP is limited by provider willingness to prescribe PrEP. We conducted an online survey of clinicians working with adolescents (aged 13-17 years) and young adults (aged 18-26 years) in the United States through the Society of Adolescent Health and Medicine. We used multivariate logistic regression to assess provider beliefs associated with willingness to provide PrEP. Nearly all (93.2%) providers had heard of PrEP, and 57 (35.2%) had prescribed PrEP. While almost all providers (95%) agreed that PrEP prevents HIV, fewer were willing to prescribe to young adults (77.8%) or adolescents (64.8%). Willingness to prescribe PrEP was strongly associated with the belief that providers had enough knowledge to safely provide PrEP to adolescents (OR 2.11, confidence interval [CI]: 1.18-3.76, p = .01) and young adults (odds ratio 5.19, CI: 2.15-12.50, p ≤ .001), and that adolescents would be adherent (odds ratio 3, CI: 1.30-6.90, p = .01). Response rate was 17%. Almost all providers had heard of PrEP and most providers were willing to prescribe PrEP. Provider education and tools to promote provider self-efficacy and adolescent adherence might improve provider willingness to provide PrEP. Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Relationship between empathic processing and drinking behavior in project MATCH.

PubMed

Robinson, Charles S H; Fokas, Kathryn; Witkiewitz, Katie

2018-02-01

Family relationships, social connectedness and a greater network of supportive others each predict better drinking outcomes among individuals with alcohol use disorder (AUD). The association between social factors and drinking may be related to the ability of individuals to take the perspectives of others' mental and emotional states, defined as empathic processing (EP). As such, it may be the case that EP is associated with social support (SS) and drinking behavior among individuals with AUD, yet few prior studies have attempted to define EP in an AUD sample. The current study was a secondary data analysis of Project MATCH (N=1726) using structural equation modeling to model EP as a latent factor. The study also sought to test the baseline associations between EP, SS, and drinking behavior, as well as sex differences in the associations between EP, SS, and drinking. It was hypothesized that EP would be positively associated with SS and negatively associated with drinking behavior. Results suggested adequate model fit of the EP construct. Structural equation models indicated significant associations between EP, SS, and both drinking consequences and percent drinking days, but only for males. Males reported significantly lower EP and SS from friends, but more SS from family, compared to females. EP was not related to drinking among females. The current study validated a model of EP in a treatment-seeking sample of individuals with alcohol use disorder. Future work may consider EP as a treatment-modifiable risk factor for drinking frequency and consequences in males. Copyright © 2017. Published by Elsevier Ltd.

Fluoride Penetration and Clearance Are Higher in Exopolysaccharide-Containing Bacterial Pellets.

PubMed

Spinola, Manuela S; Nóbrega, Diego Figueiredo; Del Bel Cury, Altair Antoninha; Ricomini Filho, Antonio Pedro; Cury, Jaime Aparecido; Tenuta, Livia Maria Andaló

2018-06-06

Extracellular polysaccharides (EPS) could increase the penetration of fluoride through dental biofilm, reducing its cariogenicity. We measured the concentration of fluoride in EPS-containing (EPS+) or not-containing (EPS-) Streptococcus mutans bacterial pellets resembling test biofilms, before and up to 60 min after a 0.05% NaF rinse in situ. Fluoride penetration and clearance were higher in EPS+ bacterial pellets. The data suggest that EPS enhances fluoride penetration, but also accelerates fluoride clearance from dental biofilms. © 2018 S. Karger AG, Basel.

Exopolymer alteration of physical properties of sea ice and implications for ice habitability and biogeochemistry in a warmer Arctic

PubMed Central

Krembs, Christopher; Eicken, Hajo; Deming, Jody W.

2011-01-01

The physical properties of Arctic sea ice determine its habitability. Whether ice-dwelling organisms can change those properties has rarely been addressed. Following discovery that sea ice contains an abundance of gelatinous extracellular polymeric substances (EPS), we examined the effects of algal EPS on the microstructure and salt retention of ice grown from saline solutions containing EPS from a culture of the sea-ice diatom, Melosira arctica. We also experimented with xanthan gum and with EPS from a culture of the cold-adapted bacterium Colwellia psychrerythraea strain 34H. Quantitative microscopic analyses of the artificial ice containing Melosira EPS revealed convoluted ice-pore morphologies of high fractal dimension, mimicking features found in EPS-rich coastal sea ice, whereas EPS-free (control) ice featured much simpler pore geometries. A heat-sensitive glycoprotein fraction of Melosira EPS accounted for complex pore morphologies. Although all tested forms of EPS increased bulk ice salinity (by 11–59%) above the controls, ice containing native Melosira EPS retained the most salt. EPS effects on ice and pore microstructure improve sea ice habitability, survivability, and potential for increased primary productivity, even as they may alter the persistence and biogeochemical imprint of sea ice on the surface ocean in a warming climate. PMID:21368216

Exopolymer alteration of physical properties of sea ice and implications for ice habitability and biogeochemistry in a warmer Arctic.

PubMed

Krembs, Christopher; Eicken, Hajo; Deming, Jody W

2011-03-01

The physical properties of Arctic sea ice determine its habitability. Whether ice-dwelling organisms can change those properties has rarely been addressed. Following discovery that sea ice contains an abundance of gelatinous extracellular polymeric substances (EPS), we examined the effects of algal EPS on the microstructure and salt retention of ice grown from saline solutions containing EPS from a culture of the sea-ice diatom, Melosira arctica. We also experimented with xanthan gum and with EPS from a culture of the cold-adapted bacterium Colwellia psychrerythraea strain 34H. Quantitative microscopic analyses of the artificial ice containing Melosira EPS revealed convoluted ice-pore morphologies of high fractal dimension, mimicking features found in EPS-rich coastal sea ice, whereas EPS-free (control) ice featured much simpler pore geometries. A heat-sensitive glycoprotein fraction of Melosira EPS accounted for complex pore morphologies. Although all tested forms of EPS increased bulk ice salinity (by 11-59%) above the controls, ice containing native Melosira EPS retained the most salt. EPS effects on ice and pore microstructure improve sea ice habitability, survivability, and potential for increased primary productivity, even as they may alter the persistence and biogeochemical imprint of sea ice on the surface ocean in a warming climate.

Oxidized Low-Density Lipoprotein Suppresses Expression of Prostaglandin E Receptor Subtype EP3 in Human THP-1 Macrophages

PubMed Central

Sui, Xuxia; Liu, Yanmin; Li, Qi; Liu, Gefei; Song, Xuhong; Su, Zhongjing; Chang, Xiaolan; Zhou, Yingbi; Liang, Bin; Huang, Dongyang

2014-01-01

EP3, one of four prostaglandin E2 (PGE2) receptors, is significantly lower in atherosclerotic plaques than in normal arteries and is localized predominantly in macrophages of the plaque shoulder region. However, mechanisms behind this EP3 expression pattern are still unknown. We investigated the underlying mechanism of EP3 expression in phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 macrophages with oxidized low-density lipoprotein (oxLDL) treatment. We found that oxLDL decreased EP3 expression, in a dose-dependent manner, at both the mRNA and protein levels. Moreover, oxLDL inhibited nuclear factor-κB (NF-κB)-dependent transcription of the EP3 gene by the activation of peroxisome proliferator-activated receptor-γ (PPAR-γ). Finally, chromatin immunoprecipitation revealed decreased binding of NF-κB to the EP3 promoter with oxLDL and PPAR-γ agonist treatment. Our results show that oxLDL suppresses EP3 expression by activation of PPAR-γ and subsequent inhibition of NF-κB in macrophages. These results suggest that down-regulation of EP3 expression by oxLDL is associated with impairment of EP3-mediated anti-inflammatory effects, and that EP3 receptor activity may exert a beneficial effect on atherosclerosis. PMID:25333975

Baseline Preferences for Daily, Event-Driven, or Periodic HIV Pre-Exposure Prophylaxis among Gay and Bisexual Men in the PRELUDE Demonstration Project.

PubMed

Vaccher, Stefanie J; Gianacas, Christopher; Templeton, David J; Poynten, Isobel M; Haire, Bridget G; Ooi, Catriona; Foster, Rosalind; McNulty, Anna; Grulich, Andrew E; Zablotska, Iryna B

2017-01-01

The effectiveness of daily pre-exposure prophylaxis (PrEP) is well established. However, there has been increasing interest in non-daily dosing schedules among gay and bisexual men (GBM). This paper explores preferences for PrEP dosing schedules among GBM at baseline in the PRELUDE demonstration project. Individuals at high-risk of HIV were enrolled in a free PrEP demonstration project in New South Wales, Australia, between November 2014 and April 2016. At baseline, they completed an online survey containing detailed behavioural, demographic, and attitudinal questions, including their ideal way to take PrEP: daily (one pill taken every day), event-driven (pills taken only around specific risk events), or periodic (daily dosing during periods of increased risk). Overall, 315 GBM (98% of study sample) provided a preferred PrEP dosing schedule at baseline. One-third of GBM expressed a preference for non-daily PrEP dosing: 20% for event-driven PrEP, and 14% for periodic PrEP. Individuals with a trade/vocational qualification were more likely to prefer periodic to daily PrEP [adjusted odds ratio (aOR) = 4.58, 95% confidence intervals (95% CI): (1.68, 12.49)], compared to individuals whose highest level of education was high school. Having an HIV-positive main regular partner was associated with strong preference for daily, compared to event-driven PrEP [aOR = 0.20, 95% CI: (0.04, 0.87)]. Participants who rated themselves better at taking medications were more likely to prefer daily over periodic PrEP [aOR = 0.39, 95% CI: (0.20, 0.76)]. Individuals' preferences for PrEP schedules are associated with demographic and behavioural factors that may impact on their ability to access health services and information about PrEP and patterns of HIV risk. At the time of data collection, there were limited data available about the efficacy of non-daily PrEP schedules, and clinicians only recommended daily PrEP to study participants. Further research investigating how behaviours and PrEP preferences change correspondingly over time is needed. ClinicalTrials.gov NCT02206555. Registered 28 July 2014.

Biogeomorphic and pedogenic impact of trees in three soil regions

NASA Astrophysics Data System (ADS)

Pawlik, Łukasz; Šamonil, Pavel

2017-04-01

Vegetation is an important factor of soil formation which together with topography, geology, climate and time modulates chemical and physical soil characteristics. Tree/soils/regolith interaction was recognized in recently uprooted trees and relict treethrow mounds and pits. In our present study we focus on effects of individual standing trees in pedogenesis and biogeomorphic processes. Constant pressure of tree root systems, changing hydric and temperature regime, together with rhizospheric microbes and root mycorrhizal associations may cause multiscale alterations to regolith and soils. We hypothesize different soil chemical properties under old tree stumps compared to unaffected control pedon resulted from affected pedogenetical pathways at the analyzed microsites. The present project highlights changes in soil properties under tree stumps in three different soil regions: Haplic Cambisols (Turbacz Reserve, Gorce Mts., Poland, hereafter HC), Entic Podzols (Zofin Reserve, Novohradske Mts., the Czech Republic, hereafter EP), Albic Podzols (Upper Peninsula, Michigan, USA, hereafter AP). These three regions represent different degrees of soil weathering and leaching. Pedons under fir, beech and hemlock stumps, as well as unaffected control pedons were sampled and laboratory analyzed for several chemical properties; active and exchangeable soil reaction, oxidized carbon, total nitrogen, and various forms of Fe, Al, Mn and Si. At the same time we studied age of the sampled tree stumps, as well as age of their death using radiocarbon technique and dendrochronology. While no effects of the soil-trees interactions can be visible on hillslope surface, we found important evidence of biomechanical activities of tree roots (e.g. root channels) and biochemical changes which add to the discussion about biogeomorphic and pedogenic significance of trees and tree roots as drivers of biomechanical weathering and soil processes in the decadal and centennial time scales. Preliminary results from the first site at Turbacz (fir tree stump) indicate some significant differences with higher amount of Cox, clay and C-THS (carbon content in total humus substances), pHH2O and Fe in the control soil profile as compared to stump soil profiles. Content of various chemical indicators were more homogenous between soil profiles at the second microsite (beech). There were significant differences between soil regions for the following chemical properties: N (nitrogen) (AP vs. EP), Cox (oxidized carbon) (AP vs. EP), C-HA (carbon content in humic acids) (AP vs. HC), C-FA (carbon content in fulvic acids) (AP vs. EP), Fed (crystalline forms of iron) (AP and EP vs. HC).

Gendered Differences in the Perceived Risks and Benefits of Oral PrEP Among HIV Serodiscordant Couples in Kenya

PubMed Central

Carroll, Jennifer J.; Ngure, Kenneth; Heffron, Renee; Curran, Kathryn; Mugo, Nelly R.

2016-01-01

Pre-exposure prophylaxis (PrEP) is effective for preventing HIV among HIV serodiscordant heterosexual couples. Gender roles may influence perceived personal and social risks related to HIV prevention behaviors and may affect use of PrEP. In this study, interviews and focus groups were conducted with 68 individuals from 34 mutually disclosed serodiscordant heterosexual partnerships in Thika, Kenya. Socio-cultural factors that affect adherence to PrEP were explored using grounded analysis. Three factors were identified, which shape perceptions of PrEP: gendered power dynamics and control over decision-making in the household; conflicts between risk reduction strategies and male sexual desire; culture bound definitions of women’s work. Adherence to PrEP in the Partners PrEP Study was high; however, participants articulated conflicting interests related to PrEP in connection with traditional gender roles. The successful delivery of PrEP will require understanding of key social factors, particularly related to gender and dyadic dynamics around HIV serostatus. PMID:26754017

The mutual co-regulation of extracellular polymeric substances and iron ions in biocorrosion of cast iron pipes.

PubMed

Jin, Juntao; Guan, Yuntao

2014-10-01

New insights into the biocorrosion process may be gained through understanding of the interaction between extracellular polymeric substances (EPS) and iron. Herein, the effect of iron ions on the formation of biofilms and production of EPS was investigated. Additionally, the impact of EPS on the corrosion of cast iron coupons was explored. The results showed that a moderate concentration of iron ions (0.06 mg/L) promoted both biofilm formation and EPS production. The presence of EPS accelerated corrosion during the initial stage, while inhibited corrosion at the later stage. The functional groups of EPS acted as electron shuttles to enable the binding of iron ions. Binding of iron ions with EPS led to anodic dissolution and promoted corrosion, while corrosion was later inhibited through oxygen reduction and availability of phosphorus from EPS. The presence of EPS also led to changes in crystalline phases of corrosion products. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of EPS Content on Activated Sludge Reduction in Process of Predation by T. tubifex

NASA Astrophysics Data System (ADS)

Lei, Yingjie; Ai, Cuiling; Zhang, Guochun

2017-12-01

A Sludge reduction in a conventional activated sludge process combined with a membrane biofilm inoculated with T. tubifex was investigated. The influence of microbial extracellular polymeric substances (EPS) extracted in forms of LB-EPS and TB-EPS respectively on the surface properties of biomass was studied. Results showed that variations of polysaccharides and protein along with the increasing of EPS feeding would affect the existence of T. tubifex. When the amount of EPS varied from 10 to 50μg/mg, the specific resistance of a sludge suspension was obtained from 3.5×107 to 1.4×107 S2/g. Meanwhile, polysaccharides content in EPS was to be positively correlated with the SSR of sludge suspension whereas protein content would be not. Anyway, it can be argued that an increase in LB-EPS not TB-EPS may affect the performance of activated sludge reduction with efficiency about 40.1% to 31.6%.

Extracellular polymeric substances govern the development of biofilm and mass transfer of polycyclic aromatic hydrocarbons for improved biodegradation.

PubMed

Zhang, Yinping; Wang, Fang; Zhu, Xiaoshu; Zeng, Jun; Zhao, Qiguo; Jiang, Xin

2015-10-01

The hypothesis that extracellular polymeric substances (EPS) affect the formation of biofilms for subsequent enhanced biodegradation of polycyclic aromatic hydrocarbons was tested. Controlled formation of biofilms on humin particles and biodegradation of phenanthrene and pyrene were performed with bacteria and EPS-extracted bacteria of Micrococcus sp. PHE9 and Mycobacterium sp. NJS-P. Bacteria without EPS extraction developed biofilms on humin, in contrast the EPS-extracted bacteria could not attach to humin particles. In the subsequent biodegradation of phenanthrene and pyrene, the biodegradation rates by biofilms were significantly higher than those of EPS-extracted bacteria. Although, both the biofilms and EPS-extracted bacteria showed increases in EPS contents, only the EPS contents in biofilms displayed significant correlations with the biodegradation efficiencies of phenanthrene and pyrene. It is proposed that the bacterial-produced EPS was a key factor to mediate bacterial attachment to other surfaces and develop biofilms, thereby increasing the bioavailability of poorly soluble PAH for enhanced biodegradation. Copyright © 2015. Published by Elsevier Ltd.

Characterization of extracellular polymeric substances in the biofilms of typical bacteria by the sulfur K-edge XANES spectroscopy.

PubMed

Lin, Huirong; Ye, Chengsong; Lv, Lu; Zheng, Clark Renjun; Zhang, Shenghua; Zheng, Lei; Zhao, Yidong; Yu, Xin

2014-08-01

A combined approach of physicochemical extraction and sulfur K-edge X-ray absorption near-edge structure (XANES) spectroscopy was applied to characterize the extracellular polymeric substances (EPS) of typical bacterial biofilms in this study. Physicochemical analysis showed variation of the contents of DNA, polysaccharide and protein in different fractions of EPS in different mediums. The sulfur K-edge XANES analysis yielded a variety of spectra. Spectral fitting of the XANES spectra utilizing a large set of model compounds showed that there was more reduced sulfur in both LB-EPS (loosely bound EPS) and TB-EPS (tightly bound EPS) of all the biofilms in LB medium than in R2A medium. More oxidized sulfur was identified in LB-EPS than that in TB-EPS, suggesting different niches and physiological heterogeneity in the biofilms. Our results suggested that the sulfur K-edge XANES can be a useful tool to analyze the sulfur speciation in EPS of biofilms. Copyright © 2014. Published by Elsevier B.V.

Applying a PrEP Continuum of Care for Men Who Have Sex With Men in Atlanta, Georgia

PubMed Central

Kelley, Colleen F.; Kahle, Erin; Siegler, Aaron; Sanchez, Travis; del Rio, Carlos; Sullivan, Patrick S.; Rosenberg, Eli S.

2015-01-01

Reductions in human immunodeficiency virus (HIV) incidence with pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) will require significant coverage of those at risk. We propose a simplified framework, similar to the HIV care continuum, to achieve protection with PrEP as follows: 1. At-risk MSM; 2. Awareness of and willingness to take PrEP; 3. Access to healthcare; 4. Receiving a prescription; and 5. Adhering to effective PrEP. We evaluated the PrEP care continuum on an Atlanta cohort of MSM and projected how many MSM might achieve protection from HIV. Even with optimistic estimates, few Atlanta MSM (15%) are projected to achieve protection from HIV with PrEP given the significant barriers described. Each continuum step represents an important point for intervention that could substantially increase the overall effectiveness of PrEP. In addition, novel strategies for PrEP delivery are needed to achieve the necessary effectiveness for Atlanta MSM at risk of HIV. PMID:26270691

Antiobesity Effect of Exopolysaccharides Isolated from Kefir Grains.

PubMed

Lim, Juha; Kale, Madhuvanti; Kim, Dong-Hyeon; Kim, Hong-Seok; Chon, Jung-Whan; Seo, Kun-Ho; Lee, Hyeon Gyu; Yokoyama, Wallace; Kim, Hyunsook

2017-11-22

Physiological properties of water-soluble exopolysaccharides (EPS) and residues after EPS removal (Res) from the probiotic kefir were determined in high-fat (HF) diet-fed C57BL/6J mice. EPS solutions showed rheological properties and lower viscosity compared to those of β-glucan (BG). EPS significantly suppressed the adipogenesis of 3T3-L1 preadipocytes in a dose-dependent manner. Mice were fed HF diets containing 5% EPS, 5% BG, 8% Res, or 5% microcrystalline cellulose (control) for 4 weeks. Compared with the control, EPS supplementation significantly reduced HF diet-induced body weight gain, adipose tissue weight, and plasma very-low-density lipoprotein cholesterol concentration (P < 0.05). Res and BG significantly reduced body weight gain; however, reduction in adipose tissue weight was not statistically significant, suggesting that the antiobesity effect of EPS occurs due to viscosity and an additional factor. EPS supplementation significantly enhanced abundance of Akkermansia spp. in feces. These data indicate that EPS shows significant antiobesity effects possibly via intestinal microbiota alterations.

Acceptability of PrEP among HIV negative Portuguese men who have sex with men that attended 2014 Lisbon pride fair.

PubMed

Rocha, Luís Miguel; Campos, Maria José; Brito, João; Fuertes, Ricardo; Rojas, Jesus; Pinto, Nuno; Mendão, Luís; Esteves, Julio

2014-01-01

Consistent use of PrEP reduces HIV transmission from sexual practices amongst men who have sex with men (MSM) up to 92% [1]. Lisbon MSM cohort study estimates point that 59.3% of their participants at entrance (1593 HIV negative MSM enrolled between April 2011 and May 2013) were eligible for PrEP [2], according to the 2014 USA PrEP guidelines [3]. Studies about PrEP acceptability and implementation support policies aimed at increasing and rolling out its use. Hence, the exploratory study about PrEP acceptability in MSM at Lisbon. A street-based intercept survey, adapted from Mantell et al. study [4], was the one used on MSM attending the 2014 Lisbon pride fair. The survey included socio-demographic data, PrEP awareness and readiness to use it, probability of MSM's social network to also use it, promptness to join PrEP-related studies, type of PrEP warranted and condomless anal sex practice in the last six months. A total of 110 HIV negative Portuguese MSM responded, with a median age of 33% and 84% of them identified themselves as gay. A majority of MSM were unaware of PrEP (59%); those that were aware, had heard of it trough CheckpointLx (31%), internet (22%) or health professionals (20%). 66% were likely or very likely to participate in PrEP-related studies. 57% of MSM were likely or very likely to use PrEP if available and reported that some, if not almost all of their social network, will do it too (70%). Type of PrEP preferred was oral, a pill a day (43%), followed by oral, intermittent intake (32%). Overall 41% of MSM had condomless anal sex practice in the last six months. In this MSM Portuguese sample, a general willingness to adopt PrEP was predominant, specially the oral daily intake. Forty-one percent of participants had had condomless anal sex practice in the last six months and therefore fitted within the criteria to be on Pre-Exposure Prophylaxis (PrEP), according to MSM Risk Index in 2014 USA PrEP guidelines. PrEP, when available in Portugal, should be a powerful tool for HIV prevention in this key population.

Awareness and attitudes of pre-exposure prophylaxis for HIV prevention among physicians in Guatemala: Implications for country-wide implementation.

PubMed

Ross, Ian; Mejia, Carlos; Melendez, Johanna; Chan, Philip A; Nunn, Amy C; Powderly, William; Goodenberger, Katherine; Liu, Jingxia; Mayer, Kenneth H; Patel, Rupa R

2017-01-01

HIV continues to be a major health concern with approximately 2.1 million new infections occurring worldwide in 2015. In Central America, Guatemala had the highest incident number of HIV infections (3,700) in 2015. Antiretroviral pre-exposure prophylaxis (PrEP) was recently recommended by the World Health Organization (WHO) as an efficacious intervention to prevent HIV transmission. PrEP implementation efforts are underway in Guatemala and success will require providers that are knowledgeable and willing to prescribe PrEP. We sought to explore current PrEP awareness and prescribing attitudes among Guatemalan physicians in order to inform future PrEP implementation efforts. We conducted a cross-sectional survey of adult internal medicine physicians at the main teaching hospital in Guatemala City in March 2015. The survey included demographics, medical specialty, years of HIV patient care, PrEP awareness, willingness to prescribe PrEP, previous experience with post-exposure prophylaxis, and concerns about PrEP. The primary outcome was willingness to prescribe PrEP, which was assessed using a 5-point Likert scale for different at-risk population scenarios. Univariate and multivariate logistic regression was performed to identify predictors for willingness to prescribe PrEP. Eighty-seven physicians completed the survey; 66% were male, 64% were internal medicine residency trainees, and 10% were infectious disease (ID) specialists. Sixty-nine percent of physicians were PrEP aware, of which 9% had previously prescribed PrEP. Most (87%) of respondents were willing to prescribe PrEP to men who have sex with men (MSM), sex workers, injection drug users, or HIV-uninfected persons having known HIV-positive sexual partners. Concerns regarding PrEP included development of resistance (92%), risk compensation (90%), and cost (64%). Univariate logistic regression showed that younger age, being a resident trainee, and being a non-ID specialist were significant predictors for willingness to prescribe PrEP. In multivariate logistic regression, being a non-ID specialist was a significant predictor. Guatemalan physicians at an urban public hospital were PrEP aware and willing to prescribe, but few have actually done so yet. Future education programs should address the concerns identified, including the low potential for the development of antiretroviral resistance. These findings can aid PrEP implementation efforts in Guatemala.

Revisiting the relationship between environmental and financial performance in Chinese industry.

PubMed

Qi, G Y; Zeng, S X; Shi, Jonathan J; Meng, X H; Lin, H; Yang, Q X

2014-12-01

The debate on the relationship between corporate or industrial environmental performance (EP) and financial performance (FP) has yet to be resolved, and studies need to examine the possible moderating effects on the EP-FP link. We argue that industrial EP has a positive effect on FP and that industrial munificence and resource slack can moderate the EP-FP link. Using a dataset from Chinese industrial firms, we examine the direct effect of industrial EP on FP and the indirect effects of industrial munificence and resource slack on the EP-FP link. Our results show that improving corporate or industrial-level EP significantly influences FP and that slack resources play a significant role on the EP-FP link. However, we found no significant moderating effect of industrial munificence on the link. Copyright © 2014 Elsevier Ltd. All rights reserved.

Extracellular polymeric substances (EPS) producing bacterial strains of municipal wastewater sludge: isolation, molecular identification, EPS characterization and performance for sludge settling and dewatering.

PubMed

Bala Subramanian, S; Yan, S; Tyagi, R D; Surampalli, R Y

2010-04-01

Wastewater treatment plants often face the problems of sludge settling mainly due to sludge bulking. Generally, synthetic organic polymer and/or inorganic coagulants (ferric chloride, alum and quick lime) are used for sludge settling. These chemicals are very expensive and further pollute the environment. Whereas, the bioflocculants are environment friendly and may be used to flocculate the sludge. Extracellular polymeric substances (EPS) produced by sludge microorganisms play a definite role in sludge flocculation. In this study, 25 EPS producing strains were isolated from municipal wastewater treatment plant. Microorganisms were selected based on EPS production properties on solid agar medium. Three types of EPS (slime, capsular and bacterial broth mixture of both slime and capsular) were harvested and their characteristics were studied. EPS concentration (dry weight), viscosity and their charge (using a Zetaphoremeter) were also measured. Bioflocculability of obtained EPS was evaluated by measuring the kaolin clay flocculation activity. Six bacterial strains (BS2, BS8, BS9, BS11, BS15 and BS25) were selected based on the kaolin clay flocculation. The slime EPS was better for bioflocculation than capsular EPS and bacterial broth. Therefore, extracted slime EPS (partially purified) from six bacterial strains was studied in terms of sludge settling [sludge volume index (SVI)] and dewatering [capillary suction time (CST)]. Biopolymers produced by individual strains substantially improved dewaterability. The extracted slime EPS from six different strains were partially characterized. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

The Endocytic Adaptor Eps15 Controls Marginal Zone B Cell Numbers

PubMed Central

Pozzi, Benedetta; Amodio, Stefania; Lucano, Caterina; Sciullo, Anna; Ronzoni, Simona; Castelletti, Daniela; Adler, Thure; Treise, Irina; Betsholtz, Ingrid Holmberg; Rathkolb, Birgit; Busch, Dirk H.; Wolf, Eckhard; Fuchs, Helmut; Gailus-Durner, Valérie; de Angelis, Martin Hrabě; Betsholtz, Christer; Casola, Stefano; Di Fiore, Pier Paolo; Offenhäuser, Nina

2012-01-01

Eps15 is an endocytic adaptor protein involved in clathrin and non-clathrin mediated endocytosis. In Caenorhabditis elegans and Drosophila melanogaster lack of Eps15 leads to defects in synaptic vesicle recycling and synapse formation. We generated Eps15-KO mice to investigate its function in mammals. Eps15-KO mice are born at the expected Mendelian ratio and are fertile. Using a large-scale phenotype screen covering more than 300 parameters correlated to human disease, we found that Eps15-KO mice did not show any sign of disease or neural deficits. Instead, altered blood parameters pointed to an immunological defect. By competitive bone marrow transplantation we demonstrated that Eps15-KO hematopoietic precursor cells were more efficient than the WT counterparts in repopulating B220+ bone marrow cells, CD19− thymocytes and splenic marginal zone (MZ) B cells. Eps15-KO mice showed a 2-fold increase in MZ B cell numbers when compared with controls. Using reverse bone marrow transplantation, we found that Eps15 regulates MZ B cell numbers in a cell autonomous manner. FACS analysis showed that although MZ B cells were increased in Eps15-KO mice, transitional and pre-MZ B cell numbers were unaffected. The increase in MZ B cell numbers in Eps15 KO mice was not dependent on altered BCR signaling or Notch activity. In conclusion, in mammals, the endocytic adaptor protein Eps15 is a regulator of B-cell lymphopoiesis. PMID:23226392

When and why women might suspend PrEP use according to perceived seasons of risk: implications for PrEP-specific risk-reduction counselling

PubMed Central

Namey, Emily; Agot, Kawango; Ahmed, Khatija; Odhiambo, Jacob; Skhosana, Joseph; Guest, Greg; Corneli, Amy

2016-01-01

Oral pre-exposure prophylaxis (PrEP) using the antiretroviral drug emtricitabine/tenofovir disoproxil fumarate (Truvada) has been shown to dramatically reduce the risk of HIV acquisition for women at higher risk of infection if taken daily. Understanding when and why women would intentionally stop using an efficacious oral PrEP drug within the context of their “normal” daily lives is essential for delivering effective PrEP risk-reduction counselling. We conducted 60 qualitative interviews with women at higher risk of HIV in Bondo, Kenya, and Pretoria, South Africa, as part of a larger study. Participants charted their sexual contacts over the previous six months, indicated whether they would have taken PrEP if available, and discussed whether and why they would have suspended PrEP use. Nearly all participants said they would have used PrEP in the previous six months; half indicated they would have suspended PrEP use at some point. Participants’ reasons for an extended break from PrEP were related to partnership dynamics (e.g., perceived low risk of a stable partner) and phases of life (e.g., trying to conceive). Life events (e.g., holidays and travel) could prompt shorter breaks in PrEP use. These circumstances may or may not correspond to actual contexts of lower risk, highlighting the importance of tailored PrEP risk-reduction counselling. PMID:27093238

Differential Protection from Tobramycin by Extracellular Polymeric Substances from Acinetobacter baumannii and Staphylococcus aureus Biofilms

PubMed Central

Davenport, Emily K.; Call, Douglas R.

2014-01-01

We investigated biofilms of two pathogens, Acinetobacter baumannii and Staphylococcus aureus, to characterize mechanisms by which the extracellular polymeric substance (EPS) found in biofilms can protect bacteria against tobramycin exposure. To do so, it is critical to study EPS-antibiotic interactions in a homogeneous environment without mass transfer limitations. Consequently, we developed a method to grow biofilms, harvest EPS, and then augment planktonic cultures with isolated EPS and tobramycin. We demonstrated that planktonic cultures respond differently to being treated with different types of EPS (A. baumannii versus S. aureus) in the presence of tobramycin. By harvesting EPS from the biofilms, we found that A. baumannii EPS acts as a “universal protector” by inhibiting tobramycin activity against bacterial cells regardless of species; S. aureus EPS did not show any protective ability in cell cultures. Adding Mg2+ or Ca2+ reduced the protective effect of A. baumannii EPS. Finally, when we selectively digested the proteins or DNA of the EPS, we found that the protective ability did not change, suggesting that neither has a significant role in protection. To the best of our knowledge, this is the first study that demonstrates how EPS protects pathogens against antibiotics in a homogeneous system without mass transfer limitations. Our results suggest that EPS protects biofilm communities, in part, by adsorbing antibiotics near the surface. This may limit antibiotic diffusion to the bottom of the biofilms but is not likely to be the only mechanism of protection. PMID:24913166

ECRH System For ITER

NASA Astrophysics Data System (ADS)

Darbos, C.; Henderson, M.; Albajar, F.; Bigelow, T.; Bomcelli, T.; Chavan, R.; Denisov, G.; Farina, D.; Gandini, F.; Heidinger, R.; Goodman, T.; Hogge, J. P.; Kajiwara, K.; Kasugai, A.; Kern, S.; Kobayashi, N.; Oda, Y.; Ramponi, G.; Rao, S. L.; Rasmussen, D.; Rzesnicki, T.; Saibene, G.; Sakamoto, K.; Sauter, O.; Scherer, T.; Strauss, D.; Takahashi, K.; Zohm, H.

2009-11-01

A 26 MW Electron Cyclotron Heating and Current Drive (EC H&CD) system is to be installed for ITER. The main objectives are to provide, start-up assist, central H&CD and control of MHD activity. These are achieved by a combination of two types of launchers, one located in an equatorial port and the second type in four upper ports. The physics applications are partitioned between the two launchers, based on the deposition location and driven current profiles. The equatorial launcher (EL) will access from the plasma axis to mid radius with a relatively broad profile useful for central heating and current drive applications, while the upper launchers (ULs) will access roughly the outer half of the plasma radius with a very narrow peaked profile for the control of the Neoclassical Tearing Modes (NTM) and sawtooth oscillations. The EC power can be switched between launchers on a time scale as needed by the immediate physics requirements. A revision of all injection angles of all launchers is under consideration for increased EC physics capabilities while relaxing the engineering constraints of both the EL and ULs. A series of design reviews are being planned with the five parties (EU, IN, JA, RF, US) procuring the EC system, the EC community and ITER Organization (IO). The review meetings qualify the design and provide an environment for enhancing performances while reducing costs, simplifying interfaces, predicting technology upgrades and commercial availability. In parallel, the test programs for critical components are being supported by IO and performed by the Domestic Agencies (DAs) for minimizing risks. The wide participation of the DAs provides a broad representation from the EC community, with the aim of collecting all expertise in guiding the EC system optimization. Still a strong relationship between IO and the DA is essential for optimizing the design of the EC system and for the installation and commissioning of all ex-vessel components when several teams from several DAs will be involved together in the tests on the ITER site.

Rome III functional dyspepsia subdivision in PDS and EPS: recognizing postprandial symptoms reduces overlap.

PubMed

Carbone, F; Holvoet, L; Tack, J

2015-08-01

The Rome III consensus proposed to subdivide functional dyspepsia (FD) into two groups: meal-related dyspepsia or postprandial distress syndrome (PDS), and meal-unrelated dyspepsia or epigastric pain syndrome (EPS). However, in clinical practice, overlap between both has been reported to be as high as 50%, thereby hampering clinical applicability. Although EPS is referred to as meal-unrelated dyspepsia, relationship of symptoms to meal ingestion in this category is not formally addressed in the Rome III criteria. The aim of our study was to investigate whether taking into account the relationship of epigastric pain and nausea to meal ingestion may help to improve separation between EPS and PDS. Consecutive ambulatory tertiary-care patients with epigastric symptoms filled out Rome III gastro-duodenal questionnaires with supplementary questions. Those fulfilling Rome III FD criteria and a negative endoscopy were identified and subdivided into 'pure' PDS patients (i.e., meeting criteria for PDS without EPS symptoms), 'pure' EPS (i.e., meeting criteria for EPS without PDS symptoms), and overlapping PDS-EPS (i.e., symptoms of both PDS and EPS). Out of 1029 patients coming to endoscopy, 199 patients (73% females, 45.9 ± 1.0 years, BMI: 23.7 ± 0.35) fulfilled Rome III FD diagnostic criteria, and could be subdivided into pure PDS (69% females, 49 ± 2 years, BMI: 24.2 ± 0.61), pure EPS (59% females, 47.4 ± 2 years, BMI: 23.2 ± 0.97) and overlapping PDS-EPS (64% females, age 43 ± 5 years, BMI: 26 ± 0.46). Compared with pure EPS patients, the overlap PDS-EPS patients were characterized by a higher occurrence of postprandial epigastric pain (70% vs 31%, p < 0.0001), while the occurrence of epigastric pain in between meals was borderline (48% vs 38%, p = 0.05). In addition, the overlap PDS-EPS patients reported a higher occurrence of postprandial nausea (23% vs 0%, p < 0.0001), and bloating (79% vs 28%, p = 0.0001). When postprandial epigastric pain and postprandial nausea were considered as PDS symptoms, the 'adapted' subdivision identified 48% pure PDS, 16% pure EPS, and 36% overlapping PDS-EPS patients. EPS and PDS symptoms frequently coexist in FD patients, with postprandial symptoms substantially contributing to the overlap. A more rigorous linking of postprandially occurring symptoms to PDS, regardless of their qualitative nature, may improve the separation between PDS and EPS. © 2015 John Wiley & Sons Ltd.

beta-endorphin: synthesis of analogs with extension at the carboxyl terminus with high radioreceptor binding activity.

PubMed

Yamashiro, D; Ferrara, P; Li, C H

1980-07-01

Four analogs of human beta-endorphin (beta h-EP) have been synthesized: [Gly31]-Beta h-EP-Gly-NH2, [CH3(CH2)4NH231]-beta h-EP, [Gly31]-beta h-EP-Gly-Gly-NH2, and [Gln8, Gly31]-betah-EP-Gly-Gly-NH2. All are more active than beta h-EP in an opiate receptor binding assay. Stepwise extension at the COOH-terminus shows a progressive increase in binding activity. The last analog, which combines extension at the COOH-terminus with elimination of the remaining anionic charge in beta h-EP, is nine times more active than the parent molecule.

Beta-Endorphin: dissociation of receptor binding activity from analgesic potency.

PubMed

Li, C H; Tseng, L F; Ferrara, P; Yamashiro, D

1980-04-01

Biological activities of synthetic camel beta-endorphin and human beta-endorphin (beta h-EP) have been measured by the radioreceptor binding assay, using [Tyr27-3H]-beta h-EP as the primary ligand and by the tail-flick test for analgesic potency. Four synthetic analogs of beta h-EP, namely [Gly31]-beta h-EP-Gly-NH2, [Gly31]-beta h-EP-Gly-Gly-NH2, [Gln8,Gly31]-beta h-EP-Gly-Gly-NH2, and [CH3(CH2)4NH231]-beta h-EP, have also been assayed by the same procedures. Results indicate a clear dissociation of radioreceptor binding activity from analgesic potency.

Beta-Endorphin: dissociation of receptor binding activity from analgesic potency.

PubMed Central

Li, C H; Tseng, L F; Ferrara, P; Yamashiro, D

1980-01-01

Biological activities of synthetic camel beta-endorphin and human beta-endorphin (beta h-EP) have been measured by the radioreceptor binding assay, using [Tyr27-3H]-beta h-EP as the primary ligand and by the tail-flick test for analgesic potency. Four synthetic analogs of beta h-EP, namely [Gly31]-beta h-EP-Gly-NH2, [Gly31]-beta h-EP-Gly-Gly-NH2, [Gln8,Gly31]-beta h-EP-Gly-Gly-NH2, and [CH3(CH2)4NH231]-beta h-EP, have also been assayed by the same procedures. Results indicate a clear dissociation of radioreceptor binding activity from analgesic potency. PMID:6246537

Inhibitory effects of ethyl pyruvate on platelet aggregation and phosphatidylserine exposure.

PubMed

Li, Wenjin; Yang, Xinyu; Peng, Minyuan; Li, Can; Mu, Guangfu; Chen, Fangping

2017-06-03

Ethyl pyruvate (EP) is a stable lipophilic pyruvate derivative. Studies demonstrated that EP shows potent anti-oxidation, anti-inflammatory and anti-coagulant effects. Inflammation and coagulation are closely interacted with platelet activation. However, it is unclear whether EP has anti-platelet effects. Therefore, we investigated the anti-platelet effect of EP in this study in vitro. We found that EP inhibited agonists induced platelets aggregation, ATP release and adhesion to collagen. Flow cytometric analysis revealed that EP inhibited agonist induced platelets PAC-1 binding, as well as P-selectin and CD40L expression. The underlying mechanism of action may involve the inhibition of platelet PI3K/Akt and Protein Kinase C (PKC) signaling pathways. Additionally, EP dose dependently inhibited platelet PS exposure induced by high concentration thrombin. Lactate dehydrogenase (LDH) activity assay and mice platelet count implied that EP may have no toxic effect on platelets. Therefore, we are the first to report that EP has potent anti-platelet activity and attenuates platelet PS exposure in vitro, suggesting that the inhibitory effects of EP on platelets may also play important roles in improvement of inflammation and coagulation disorder in related animal models. Copyright © 2017 Elsevier Inc. All rights reserved.

Roles of prostaglandin E2 in the cochlea.

PubMed

Nakagawa, Takayuki

2011-06-01

Prostaglandins are one of the major groups of chemical mediators in the mammalian body. Among prostaglandins, prostaglandin E2 (PGE2) is the most abundant prostanoid in humans and involved in regulating many different fundamental biological functions. PGE2 signaling is mediated by four distinct E-prostanoid receptors (EPs) namely EP1-4. Recently, accumulating evidence indicates critical, but complex roles of EP signaling in the pathogenesis of neuronal diseases depending on the context of neuronal injury. Four distinct EPs are expressed in the stria vascularis, spiral ligament, spiral ganglion and organ of Corti, indicating an involvement of EP signaling in the cochlear function. Activation of EP4 in cochleae significantly attenuates noise-induced damage in cochleae, and activation of EP2 or EP4 induces the formation of vascular endothelial growth factor in cochleae. These findings strongly suggest that individual EP signaling may be involved in the maintenance of the cochlear sensory system similarly to the central nervous system. This review highlights recent findings on EP signaling in the central nervous system, and presents its possible roles in regulation of blood flow, protection of sensory cells and immune responses in cochleae. Copyright © 2011 Elsevier B.V. All rights reserved.

The dimer formed by the periplasmic domain of EpsL from the Type 2 Secretion System of Vibrio parahaemolyticus

PubMed Central

Abendroth, Jan; Kreger, Allison C.; Hol, Wim G. J.

2010-01-01

The Type 2 Secretion System (T2SS), occurring in many Gram-negative bacteria, is responsible for the transport of a diversity of proteins from the periplasm across the outer membrane into the extracellular space. In Vibrio cholerae, the T2SS secretes several unrelated proteins including the major virulence factor cholera toxin. The T2SS consists of three subassemblies, one of which is the Inner Membrane Complex which contains multiple copies of five proteins, including the bitopic membrane protein EpsL. Here we report the 2.3 Å resolution crystal structure of the periplasmic domain of EpsL (peri-EpsL) from V. parahaemolyticus, which is 56 % identical in sequence to its homolog in V. cholerae. The domain adopts a circular permutation of the “common” ferredoxin fold with two contiguous sub-domains. Remarkably, this permutation has so far only been observed once before: in the periplasmic domain of EpsM (peri-EpsM), another T2SS protein which interacts with EpsL. These two domains are 18 % identical in sequence which may indicate a common evolutionary origin. Both peri-EpsL and peri-EpsM form dimers, but the organization of the subunits in these dimers appears to be entirely different. We have previously shown that the cytoplasmic domain of EpsL is also dimeric and forms a heterotetramer with the first domain of the “secretion ATPase” EpsE. The latter enzyme is most likely hexameric. The possible consequences of the combination of the different symmetries of EpsE and EpsL for the architecture of the T2SS are discussed. PMID:19646531

Transitioning to HIV Pre-Exposure Prophylaxis (PrEP) from Non-Occupational Post-Exposure Prophylaxis (nPEP) in a Comprehensive HIV Prevention Clinic: A Prospective Cohort Study.

PubMed

Siemieniuk, Reed A C; Sivachandran, Nirojini; Murphy, Pauline; Sharp, Andrea; Walach, Christine; Placido, Tania; Bogoch, Isaac I

2015-08-01

The uptake of pre-exposure prophylaxis (PrEP) for HIV prevention remains low. We hypothesized that a high proportion of patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP) would be candidates for PrEP based on current CDC guidelines. Outcomes from a comprehensive HIV Prevention Clinic are described. We evaluated all patients who attended the HIV Prevention Clinic for nPEP between January 1, 2013 and September 30, 2014. Each patient was evaluated for PrEP candidacy based on current CDC-guidelines and subjectively based on physician opinion. Patients were then evaluated for initiation of PrEP if they met guideline suggestions. Demographic, social, and behavioral factors were then analyzed with logistic regression for associations with PrEP candidacy and initiation. 99 individuals who attended the nPEP clinic were evaluated for PrEP. The average age was 32 years (range, 18-62), 83 (84%) were male, of whom 46 (55%) men who had have sex with men (MSM). 31 (31%) met CDC guidelines for PrEP initiation, which had very good agreement with physician recommendation (kappa=0.88, 0.78-0.98). Factors associated with PrEP candidacy included sexual exposure to HIV, prior nPEP use, and lack of drug insurance (p<0.05 for all comparisons). Combining nPEP and PrEP services in a dedicated clinic can lead to identification of PrEP candidates and may facilitate PrEP uptake. Strategies to ensure equitable access of PrEP should be explored such that those without drug coverage may also benefit from this effective HIV prevention modality.

Missed Opportunities to Prescribe HIV Pre-Exposure Prophylaxis by Primary Care Providers in Saint Louis, Missouri

PubMed Central

Chan, Philip A.; Harrison, Laura C.; Mayer, Kenneth H.; Nunn, Amy; Mena, Leandro A.; Powderly, William G.

2018-01-01

Abstract Purpose: Optimal HIV pre-exposure prophylaxis (PrEP) scale-up in the United States requires prescribing by primary care providers (PCPs). We assessed barriers to patients obtaining PrEP from their PCPs. Methods: Patients seeking PrEP at an Infectious Diseases (ID) Clinic in St. Louis, Missouri from 2014 to 2016 were asked about demographics, sexual behaviors, whether PrEP was initially sought from their PCP, and barriers to obtaining PrEP from their PCP. Multivariable logistic regression was performed to identify predictors for having asked a PCP for PrEP. Results: Among 102 patients, the median age was 29 years, 58% were white, and 88% were men who have sex with men. Most (65%) had a PCP and, of these, 48% had asked their PCP for PrEP, but were not prescribed it. About half (52%) reported that their PCPs perceived prescribing PrEP as specialty care. Many (39%) indicated that they felt uncomfortable discussing their sexual behaviors with their PCP. Patients with an HIV-positive sex partner in the last 3 months were less likely to ask for PrEP from their PCPs than others (Adjusted Odds Ratio: 0.07; 95% CI: 0.01–0.53). Eighty-three percent of patients were referred to a new PCP with whom they could feel more comfortable discussing PrEP. Conclusions: During initial PrEP implementation, ID specialists can play an important role in providing education and linking PrEP patients to PCPs. However, PCPs may need additional training about PrEP and how to provide culturally sensitive sexual healthcare, if widespread scale-up is to be effective in decreasing HIV incidence. PMID:29688800

Willingness to use HIV pre-exposure prophylaxis among gay men, other men who have sex with men and transgender women in Myanmar.

PubMed

Draper, Bridget L; Fowkes, Freya J I; Oo, Zaw Min; Thein, Zaw Win; Aung, Poe Poe; Veronese, Vanessa; Ryan, Claire; Thant, Myo; Hughes, Chad; Stoové, Mark

2017-07-26

HIV pre-exposure prophylaxis (PrEP) has emerged as a key component of contemporary HIV combination prevention strategies. To explore the local suitability of PrEP, country-specific acceptability studies are needed to inform potential PrEP implementation. In the context of Myanmar, in addition to resource constraints, HIV service access by gay men, other men who have sex with men, and transgender women (GMT) continues to be constrained by legislative and community stigma and marginalization. We aimed to determine PrEP acceptability among GMT in Myanmar and explore the factors associated with willingness to use PrEP. GMT were recruited in Yangon and Mandalay through local HIV prevention outreach programmes in November and December 2014. Quantitative surveys were administered by trained peer educators and collected data on demographics, sexual risk, testing history and PrEP acceptability. A modified six-item PrEP acceptability scale classified self-reported HIV undiagnosed GMT as willing to use PrEP. Multivariable logistic regression identified factors associated with willingness to use PrEP. Among 434 HIV undiagnosed GMT, PrEP awareness was low (5%). PrEP acceptability was high, with 270 (62%) GMT classified as willing to use PrEP. GMT recruited in Mandalay (adjusted odds ratio (aOR) = 1.79; 95%CI = 1.05-3.03), who perceived themselves as likely to become HIV positive (aOR = 1.82; 95%CI = 1.10-3.02), who had more than one recent regular partner (aOR = 2.94; 95%CI = 1.41-6.14), no regular partners (aOR = 2.05; 95%CI = 1.10-3.67), more than five casual partners (aOR = 2.05; 95%CI = 1.06-3.99) or no casual partners (aOR = 2.25; 95%CI = 1.23-4.11) were more likely to be willing to use PrEP. The association between never or only occasionally using condoms with casual partners and willingness to use PrEP was marginally significant (aOR = 2.02; 95%CI = 1.00-4.10). GMT who reported concern about side effects and long-term use of PrEP were less likely (aOR = 0.35; 95%CI = 0.21-0.59) to be willing to use PrEP. This is the first study to assess PrEP acceptability in Myanmar. Findings suggest PrEP is an acceptable prevention option among GMT in Myanmar, providing they are not required to pay for it. Implementation/demonstration projects are needed to explore the feasibility and cost-effectiveness of PrEP as a prevention option for GMT in Myanmar.

Overview of ECRH experimental results

NASA Astrophysics Data System (ADS)

Lloyd, Brian

1998-08-01

A review of the present status of electron cyclotron heating and current drive experiments in toroidal fusion devices is presented. In addition to basic heating and current drive studies the review also addresses advances in wave physics and the application of electron cyclotron waves for instability control, transport studies, pre-ionization/start-up assist, etc. A comprehensive overview is given with particular emphasis on recent advances since the major review of Erckmann and Gasparino (1994) ( 36 1869), including results from the latest generation of high-power, high-frequency experiments.

PrEP in Italy: The time may be ripe but who's paying the bill? A nationwide survey on physicians' attitudes towards using antiretrovirals to prevent HIV infection.

PubMed

Di Biagio, Antonio; Riccardi, Niccolò; Signori, Alessio; Maserati, Renato; Nozza, Silvia; Gori, Andrea; Bonora, Stefano; Borderi, Marco; Ripamonti, Diego; Rossi, Maria Cristina; Orofino, Giancarlo; Quirino, Tiziana; Nunnari, Giuseppe; Celesia, Benedetto Maurizio; Martini, Salvatore; Sagnelli, Caterina; Mazzola, Giovanni; Colletti, Pietro; Bartolozzi, Dario; Bini, Teresa; Ladisa, Nicoletta; Castelnuovo, Filippo; Saracino, Annalisa; Lo Caputo, Sergio

2017-01-01

Several studies have demonstrated the efficacy of the oral pre-exposure prophylaxis (PrEP) with tenofovir (with or without emtricitabine) on preventing HIV-negative partners of HIV infected patients to become infected through sexual contacts. PrEP is already available in the United States and now is approved by European Medicine Agency. In this setting we would like to gauge physicians' knowledge, acquaintance with and attitude to include PrEP in their clinical practice. A cross sectional survey was conducted among Italian physicians expert on antiretroviral therapy. Out of 146 physicians, 35% of participants declared to be familiar with PrEP but only 46% of them believed that, currently, there are not enough reasons to make it available in Italy. 51% of physicians have already been attracted to prescribe it and 63.4% have been openly asked about PrEP. The main concerns noticed were: the risk of acquire other sexual transmitted diseases (STDs) (70% of physicians feared that PrEP could favor STDs spread), the potential harmful of PrEP if not adequately implemented and, especially the risk of possible side effects if not properly used. Nevertheless, 55.9% of participants believed that Health Authorities face an ethical obligation to make PrEP available as part of the strategies to protect from HIV transmission and half of the respondents asked for further researches to better define the role for PrEP. Attitudes regarding PrEP impact on Italian National Health Organization were also very interesting: 57.5% of participants did not believe that investing in PrEP would be an appropriate use of healthcare resources, while 70.6% affirmed that PrEP's financial coverage should not be funded by the Italian National System of Health (SSN). This survey showed a high awareness of PrEP potential among Italian physicians coupled with a great deal of skepticism about how and if implementing it in clinical practice.

Interaction of prostanoid EP3 and TP receptors in guinea-pig isolated aorta: contractile self-synergism of 11-deoxy-16,16-dimethyl PGE2

PubMed Central

Jones, RL; Woodward, DF

2011-01-01

BACKGROUND AND PURPOSE Surprisingly high contractile activity was reported for 11-deoxy-16,16-dimethyl prostaglandin E2 (DX-DM PGE2) on pig cerebral artery when used as a selective EP3 receptor agonist. This study investigated the selectivity profile of DX-DM PGE2, focusing on the interaction between its EP3 and TP (thromboxane A2-like) agonist activities. EXPERIMENTAL APPROACH Contraction of guinea-pig trachea (EP1 system) and aorta (EP3 and TP systems) was measured in conventional organ baths. KEY RESULTS Strong contraction of guinea-pig aorta to sulprostone and 17-phenyl PGE2 (EP3 agonists) was only seen under priming with a second contractile agent such as phenylephrine, histamine or U-46619 (TP agonist). In contrast, DX-DM PGE2 induced strong contraction, which on the basis of treatment with (DG)-3ap (EP3 antagonist) and/or BMS-180291 (TP antagonist) was attributed to self-synergism arising from co-activation of EP3 and TP receptors. EP3/TP self-synergism also accounted for contraction induced by PGF2α and its analogues (+)-cloprostenol and latanoprost-FA. DX-DM PGE2 also showed significant EP1 agonism on guinea-pig trachea as defined by the EP1 antagonists SC-51322, (ONO)-5-methyl-1 and AH-6809, although AH-6809 exhibited poor specificity at concentrations ≥3 µM. CONCLUSIONS AND IMPLICATIONS EP3/TP self-synergism, as seen with PGE/PGF analogues in this study, may confound EP3 agonist potency comparisons and the characterization of prostanoid receptor systems. The competitive profile of a TP antagonist may be distorted by variation in the silent/overt contraction profile of the EP3 system in different studies. The relevance of self-synergism to in vivo actions of natural prostanoid receptor agonists is discussed. PMID:20955363

Pre-exposure prophylaxis of HIV

PubMed Central

Naswa, Smriti; Marfatia, Y. S.

2011-01-01

Pre-exposure prophylaxis (PrEP) is an experimental approach to HIV prevention and consists of antiretroviral drugs to be taken before potential HIV exposure in order to reduce the risk of HIV infection and continued during periods of risk. An effective PrEP could provide an additional safety net to sexually active persons at risk, when combined with other prevention strategies. Women represent nearly 60% of adults infected with HIV and PrEP can be a female-controlled prevention method for women who are unable to negotiate condom use. Two antiretroviral nucleoside analog HIV-1 reverse transcriptase inhibitor drugs are currently under trial as PrEP drugs, namely tenofovirdisoproxilfumarate (TDF) alone and TDF in combination with emricitabine (FTC), to be taken as daily single dose oral drugs. There are 11 ongoing trials of ARV-based prevention in different at risk populations across the world. The iPrex trial showed that daily use of oral TDF/FTC by MSM resulted in 44% reduction in the incidence of HIV. This led to publication of interim guidance by CDC to use of PrEP by health providers for MSM. Few other trials are Bangkok Tenofovir Study, Partners PrEP Study, FEM-PrEP study, and VOICE (MTN-003) study. Future trials are being formulated for intermittent PrEP (iPrEP) where drugs are taken before and after sex, “stand-in dose” iPrEP, vaginal or rectal PrEP, etc. There are various issues/concerns with PrEP such as ADRs and resistance to TDF/FTC, adherence to drugs, acceptability, sexual disinhibition, use of PrEP as first line of defense for HIV without other prevention strategies, and cost. The PrEP has a potential to address unmet need in public health if delivered as a part of comprehensive toolkit of prevention services, including risk-reduction, correct and consistent use of condoms, and diagnosis and treatment of sexually transmitted infections. PMID:21799568

Pre-Exposure Prophylaxis for HIV Prevention: Safety Concerns.

PubMed

Tetteh, Raymond A; Yankey, Barbara A; Nartey, Edmund T; Lartey, Margaret; Leufkens, Hubert G M; Dodoo, Alexander N O

2017-04-01

Available evidence supports the efficacy of pre-exposure prophylaxis (PrEP) in decreasing the incidence of human immunodeficiency virus (HIV) infection among high-risk individuals, especially when used in combination with other behavioural preventive methods. Safety concerns about PrEP present challenges in the implementation and use of PrEP. The aim of this review is to discuss safety concerns observed in completed clinical trials on the use of PrEP. We performed a literature search on PrEP in PubMed, global advocacy for HIV prevention (Aids Vaccine Advocacy Coalition) database, clinical trials registry " http://www.clinicaltrials.gov " and scholar.google, using combination search terms 'pre-exposure prophylaxis', 'safety concerns in the use of pre-exposure prophylaxis', 'truvada use as PrEP', 'guidelines for PrEP use', 'HIV pre-exposure prophylaxis' and 'tenofovir' to identify clinical trials and literature on PrEP. We present findings associated with safety issues on the use of PrEP based on a review of 11 clinical trials on PrEP with results on safety and efficacy as at April 2016. We also reviewed findings from routine real-life practice reports. The pharmacological intervention for PrEP was tenofovir disoproxil fumarate/emtricitabine in a combined form as Truvada ® or tenofovir as a single entity. Both products are efficacious for PrEP and seem to have a good safety profile. Regular monitoring is recommended to prevent long-term toxic effects. The main adverse effects observed with PrEP are gastrointestinal related; basically mild to moderate nausea, vomiting and diarrhea. Other adverse drug effects worth monitoring are liver enzymes, renal function and bone mineral density. PrEP as an intervention to reduce HIV transmission appears to have a safe benefit-risk profile in clinical trials. It is recommended for widespread use but adherence monitoring and real-world safety surveillance are critical in the post-marketing phase to ensure that the benefits observed in clinical trials are maintained in real-world use.

EPS-LASSO: Test for High-Dimensional Regression Under Extreme Phenotype Sampling of Continuous Traits.

PubMed

Xu, Chao; Fang, Jian; Shen, Hui; Wang, Yu-Ping; Deng, Hong-Wen

2018-01-25

Extreme phenotype sampling (EPS) is a broadly-used design to identify candidate genetic factors contributing to the variation of quantitative traits. By enriching the signals in extreme phenotypic samples, EPS can boost the association power compared to random sampling. Most existing statistical methods for EPS examine the genetic factors individually, despite many quantitative traits have multiple genetic factors underlying their variation. It is desirable to model the joint effects of genetic factors, which may increase the power and identify novel quantitative trait loci under EPS. The joint analysis of genetic data in high-dimensional situations requires specialized techniques, e.g., the least absolute shrinkage and selection operator (LASSO). Although there are extensive research and application related to LASSO, the statistical inference and testing for the sparse model under EPS remain unknown. We propose a novel sparse model (EPS-LASSO) with hypothesis test for high-dimensional regression under EPS based on a decorrelated score function. The comprehensive simulation shows EPS-LASSO outperforms existing methods with stable type I error and FDR control. EPS-LASSO can provide a consistent power for both low- and high-dimensional situations compared with the other methods dealing with high-dimensional situations. The power of EPS-LASSO is close to other low-dimensional methods when the causal effect sizes are small and is superior when the effects are large. Applying EPS-LASSO to a transcriptome-wide gene expression study for obesity reveals 10 significant body mass index associated genes. Our results indicate that EPS-LASSO is an effective method for EPS data analysis, which can account for correlated predictors. The source code is available at https://github.com/xu1912/EPSLASSO. hdeng2@tulane.edu. Supplementary data are available at Bioinformatics online. © The Author (2018). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

PrEP awareness and perceived barriers among single young men who have sex with men.

PubMed

Bauermeister, Jose A; Meanley, Steven; Pingel, Emily; Soler, Jorge H; Harper, Gary W

2013-10-01

Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV infections among young men who have sex with men (YMSM). Using a cross-sectional survey of YMSM (N=1,507; ages 18-24), we gauged YMSM's PrEP awareness and PrEP-related beliefs regarding side effects, accessibility, and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older, more educated, were residentially unstable in the prior 30 days, had insurance, or reported having at least one sexually transmitted infection in their lifetime. We found no differences by race/ethnicity, history of incarceration, or recent sexual risk behavior. In multivariate linear regression models, Black and Latino YMSM were more likely than Whites to state they would not use PrEP because of side effect concerns. YMSM were more likely to indicate that they would not be able to afford PrEP if they did not have insurance or if they had a prior sexually transmitted infection, PrEP rollout may be hindered due to lack of awareness, as well as perceived barriers regarding its use. We propose strategies to maximize equity in PrEP awareness and access if it is to be scaled up among YMSM.

Role of calcitonin gene-related peptide in cardioprotection of short-term and long-term exercise preconditioning.

PubMed

Sun, Xiao-Juan; Pan, Shan-Shan

2014-07-01

To examine the role of calcitonin gene-related peptide (CGRP) in cardioprotection of short-term and long-term exercise preconditioning (EP). Male Sprague-Dawley rats were, respectively, subjected to continuous intermittent treadmill training 3 days or 3 weeks as short-term or long-term EP protocols. The myocardial injury induced by isoproterenol (ISO) was performed 24 hours after short-term and long-term EP. The myocardial injury was evaluated in terms of the serum cardiac troponin levels and the hematoxylin-basic fuchsin-picric acid staining. Additionally, serum CGRP levels, CGRP expression in the dorsal root ganglion (DRG), and heart were analyzed as possible mechanisms to explain short-term and long-term EP-induced cardioprotection. Both short-term and long-term EP markedly attenuated the isoproterenol-induced myocardial ischemia with lower serum cardiac troponin levels. Short-term EP does not alter serum CGRP levels and CGRP expression in the DRG and heart. Long-term EP significantly increases serum CGRP levels and CGRP expression in the DRG and heart. The results indicate that short-term EP does not increase the synthesis and release of CGRP. Therefore, the cardioprotective effect of short-term EP does not involve CGRP adaptation. Furthermore, long-term EP increases CGRP synthesis in the DRG and promotes CGRP release in the blood and heart. Hence, CGRP may play an important role in the cardioprotective effect of long-term EP.

The Fate of Marine Bacterial Exopolysaccharide in Natural Marine Microbial Communities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Zilian; Chen, Yi; Wang, Rui

Most marine bacteria produce exopolysaccharides (EPS), and bacterial EPS represent an important source of dissolved organic carbon in marine ecosystems. It was proposed that bacterial EPS rich in uronic acid is resistant to mineralization by microbes and thus has a long residence time in global oceans. To confirm this hypothesis, bacterial EPS rich in galacturonic acid was isolated from Alteromonas sp. JL2810. The EPS was used to amend natural seawater to investigate the bioavailability of this EPS by native populations, in the presence and absence of ammonium and phosphate amendment. The data indicated that the bacterial EPS could not bemore » completely consumed during the cultivation period and that the bioavailability of EPS was not only determined by its intrinsic properties, but was also determined by other factors such as the availability of inorganic nutrients. During the experiment, the humic-like component of fluorescent dissolved organic matter (FDOM) was freshly produced. Bacterial community structure analysis indicated that the class Flavobacteria of the phylum Bacteroidetes was the major contributor for the utilization of EPS. This report is the first to indicate that Flavobacteria are a major contributor to bacterial EPS degradation. Finally, the fraction of EPS that could not be completely utilized and the FDOM (e.g., humic acid-like substances) produced de novo may be refractory and may contribute to the carbon storage in the oceans.« less

Construction of a Cordyceps sinensis exopolysaccharide-conjugated selenium nanoparticles and enhancement of their antioxidant activities.

PubMed

Xiao, Yidong; Huang, Qilin; Zheng, Zhaomin; Guan, Han; Liu, Shiyu

2017-06-01

A Cordyceps sinensis exopolysaccharide (EPS)-conjugated selenium nanoparticles (SeNPs) were successfully constructed through the reduction of SeO 3 2- . The EPS-SeNPs were characterized in terms of formation, morphology, size, Se distribution and phase by UV-vis, FT-IR, transmission electron microscopy (TEM), dynamic light scattering (DLS), energy dispersive X-ray (EDX) and wide angle X-ray diffraction (WAXD) measurements. Results revealed that the SeNPs conjugated to EPS were amorphous and could be well dispersed at a size range of 80-125nm. The interactions between the OH groups of EPS and SeNPs substituted for intermolecular interaction in native EPS to form new CO⋯Se bonds, resulting in good dispersion of SeNPs in the EPS matrix. Besides, the EPS-SeNPs at different Se/P ratios exhibited significant scavenging ability on superoxide anion radical (O 2 - ) and ABTS radical cation (ABTS + ) when compared to pure EPS, indicating that the conjugated SeNPs reinforced antioxidant effect of EPS. This work not only provides a simple and efficient way to construct well-dispersed SeNPs in aqueous system, and demonstrates the vital role of the EPS as a biopolymer template for dispersion, stabilization and size control of SeNPs, but also finds the EPS-SeNPs can potentially serve as a good antioxidant towards O 2 - and ABTS + . Copyright © 2017 Elsevier B.V. All rights reserved.

Composition and aggregation of extracellular polymeric substances (EPS) in hyperhaline and municipal wastewater treatment plants

PubMed Central

Zeng, Jie; Gao, Jun-Min; Chen, You-Peng; Yan, Peng; Dong, Yang; Shen, Yu; Guo, Jin-Song; Zeng, Ni; Zhang, Peng

2016-01-01

As important constituents of activated sludge flocs, extracellular polymeric substances (EPS) play significant roles in pollutants adsorption, the formation and maintenance of microbial aggregates, and the protection of microbes from external environmental stresses. In this work, EPS in activated sludge from a municipal wastewater treatment plant (M-WWTP) with anaerobic/anoxic/oxic (A2/O) process and a hyperhaline wastewater treatment plant (H-WWTP) with anaerobic/oxic (A/O) process were extracted by ultrasound method. The proteins and polysaccharides contents in EPS were determined by using a modified Lowry method and anthrone colorimetry respectively to analyze the detail differences in two types of WWTPs. Fourier transform-infrared spectroscopy and three-dimensional excitation-emission matrix fluorescence spectroscopy demonstrated proteins and polysaccharides were the dominant components of the two types of EPS, and the aromatic protein-like substances accounted for a larger proportion in EPS proteins. The results of the aggregation test indicated that EPS were good for the sludge aggregation, and the EPS in oxic sludge were more beneficial to sludge aggregation than that in anoxic sludge. Anoxic sludge EPS in H-WWTP showed a negligible effect on sludge aggregation. Comparative study on EPS of different tanks in the M-WWTP and H-WWTP was valuable for understanding the characteristics of EPS isolated from two typical wastewater treatment processes. PMID:27220287

The Fate of Marine Bacterial Exopolysaccharide in Natural Marine Microbial Communities

DOE PAGES

Zhang, Zilian; Chen, Yi; Wang, Rui; ...

2015-11-16

Most marine bacteria produce exopolysaccharides (EPS), and bacterial EPS represent an important source of dissolved organic carbon in marine ecosystems. It was proposed that bacterial EPS rich in uronic acid is resistant to mineralization by microbes and thus has a long residence time in global oceans. To confirm this hypothesis, bacterial EPS rich in galacturonic acid was isolated from Alteromonas sp. JL2810. The EPS was used to amend natural seawater to investigate the bioavailability of this EPS by native populations, in the presence and absence of ammonium and phosphate amendment. The data indicated that the bacterial EPS could not bemore » completely consumed during the cultivation period and that the bioavailability of EPS was not only determined by its intrinsic properties, but was also determined by other factors such as the availability of inorganic nutrients. During the experiment, the humic-like component of fluorescent dissolved organic matter (FDOM) was freshly produced. Bacterial community structure analysis indicated that the class Flavobacteria of the phylum Bacteroidetes was the major contributor for the utilization of EPS. This report is the first to indicate that Flavobacteria are a major contributor to bacterial EPS degradation. Finally, the fraction of EPS that could not be completely utilized and the FDOM (e.g., humic acid-like substances) produced de novo may be refractory and may contribute to the carbon storage in the oceans.« less

Experimental research in the phase change materials based on paraffin and expanded perlite

NASA Astrophysics Data System (ADS)

Jiesheng, Liu; Faping, Li; Xiaoqiang, Gong; Rongtang, Zhang

2018-06-01

In this study, paraffin (PA)/expanded perlite (EP) form-stable phase change material (PCM) was first fabricated using the direct impregnation method without vacuum treatment. Absorptive capacity results showed that the PA/EP composite can obtain good absorptive capacity with the temperature 80 °C and the time 2 h. Compared with the water absorption of EP, the decrease in the water absorption of PA/EP form-stable proved that the absorption of PA into porous EP has been carried out successfully. Scanning electron microscope (SEM) and Fourier transform infrared (FT-IR) results show that paraffin can be well impregnated into EP pores and has good compatibility with it. Differential scanning calorimetry (DSC) results reveal that paraffin/EP composite PCM has melting temperature and latent heat of 53.6 °C and 91.3 J/g, respectively. The durability cycles results suggest that form-stable PA/EP PCM shows good durability.

Multiple forms of endopeptidase activity from jojoba seeds.

PubMed

Wolf, M J; Storey, R D

1990-01-01

The cotyledons of 27 day post-germination jojoba seedlings (Simmondsia chinensis) contained five distinct endopeptidase activities separable by DEAE Bio-Gel and CM-cellulose ion exchange chromatography. The endopeptidases were purified 108- to 266-fold and their individuality was confirmed by activity-specific assays in native acrylamide gels along with differences in their Mr and catalytic properties. The five endopeptidases, which showed activity on model substrates and protein, were named EP Ia, EP Ib, EP II, EP III and EP IV. EP Ia was a serine proteinase with a pH optimum of ca 8 and Mr of 58,000. EP Ib, II and III were discrete cysteine proteinases showing pH optima of ca 6.8, 6.0 and 5.4 and Mr of 41,000, 47,000 and 35,000 respectively. EP IV was an aspartic acid proteinase with a ca pH optimum of 3.5 and Mr of 33,000.

Biodiversity of Exopolysaccharides Produced by Streptococcus thermophilus Strains Is Reflected in Their Production and Their Molecular and Functional Characteristics

PubMed Central

Vaningelgem, Frederik; Zamfir, Medana; Mozzi, Fernanda; Adriany, Tom; Vancanneyt, Marc; Swings, Jean; De Vuyst, Luc

2004-01-01

Twenty-six lactic acid bacterium strains isolated from European dairy products were identified as Streptococcus thermophilus and characterized by bacterial growth and exopolysaccharide (EPS)-producing capacity in milk and enriched milk medium. In addition, the acidification rates of the different strains were compared with their milk clotting behaviors. The majority of the strains grew better when yeast extract and peptone were added to the milk medium, although the presence of interfering glucomannans was shown, making this medium unsuitable for EPS screening. EPS production was found to be strain dependent, with the majority of the strains producing between 20 and 100 mg of polymer dry mass per liter of fermented milk medium. Furthermore, no straightforward relationship between the apparent viscosity and EPS production could be detected in fermented milk medium. An analysis of the molecular masses of the isolated EPS by gel permeation chromatography revealed a large variety, ranging from 10 to >2,000 kDa. A distinction could be made between high-molecular-mass EPS (>1,000 kDa) and low-molecular-mass EPS (<1,000 kDa). Based on the molecular size of the EPS, three groups of EPS-producing strains were distinguished. Monomer analysis of the EPS by high-performance anion-exchange chromatography with amperometric detection was demonstrated to be a fast and simple method. All of the EPS from the S. thermophilus strains tested were classified into six groups according to their monomer compositions. Apart from galactose and glucose, other monomers, such as (N-acetyl)galactosamine, (N-acetyl)glucosamine, and rhamnose, were also found as repeating unit constituents. Three strains were found to produce EPS containing (N-acetyl)glucosamine, which to our knowledge was never found before in an EPS from S. thermophilus. Furthermore, within each group, differences in monomer ratios were observed, indicating possible novel EPS structures. Finally, large differences between the consistencies of EPS solutions from five different strains were assigned to differences in their molecular masses and structures. PMID:14766570

Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa

PubMed Central

Heffron, Renee; Ngure, Kenneth; Odoyo, Josephine; Bulya, Nulu; Tindimwebwa, Edna; Hong, Ting; Kidoguchi, Lara; Donnell, Deborah; Mugo, Nelly R.; Bukusi, Elizabeth A.; Katabira, Elly; Asiimwe, Stephen; Morton, Jennifer; Morrison, Susan; Haugen, Harald; Mujugira, Andrew; Haberer, Jessica E.; Ware, Norma C.; Wyatt, Monique A.; Marzinke, Mark A.; Frenkel, Lisa M.; Celum, Connie; Baeten, Jared M.

2017-01-01

Introduction: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods: We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results: We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services.   Conclusions: PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation. PMID:29355231

Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa.

PubMed

Heffron, Renee; Ngure, Kenneth; Odoyo, Josephine; Bulya, Nulu; Tindimwebwa, Edna; Hong, Ting; Kidoguchi, Lara; Donnell, Deborah; Mugo, Nelly R; Bukusi, Elizabeth A; Katabira, Elly; Asiimwe, Stephen; Morton, Jennifer; Morrison, Susan; Haugen, Harald; Mujugira, Andrew; Haberer, Jessica E; Ware, Norma C; Wyatt, Monique A; Marzinke, Mark A; Frenkel, Lisa M; Celum, Connie; Baeten, Jared M

2017-11-06

Introduction : Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods : We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results : We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services.   Conclusions : PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.

PubMed

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK – A Mixed Methods Study

PubMed Central

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Background Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Methods Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Results Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18–25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. Conclusion These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities. PMID:27093430

Solution structure and dynamics of C-terminal regulatory domain of Vibrio vulnificus extracellular metalloprotease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yun, Ji-Hye; Kim, Heeyoun; Park, Jung Eun

Highlights: Black-Right-Pointing-Pointer We have determined solution structures of vEP C-terminal regulatory domain. Black-Right-Pointing-Pointer vEP C-ter100 has a compact {beta}-barrel structure with eight anti-parallel {beta}-strands. Black-Right-Pointing-Pointer Solution structure of vEP C-ter100 shares its molecular topology with that of the collagen-binding domain of collagenase. Black-Right-Pointing-Pointer Residues in the {beta}3 region of vEP C-ter100 might be important in putative ligand/receptor binding. Black-Right-Pointing-Pointer vEP C-ter100 interacts strongly with iron ion. -- Abstract: An extracellular metalloprotease (vEP) secreted by Vibrio vulnificus ATCC29307 is a 45-kDa proteolytic enzyme that has prothrombin activation and fibrinolytic activities during bacterial infection. The action of vEP could result in clottingmore » that could serve to protect the bacteria from the host defense machinery. Very recently, we showed that the C-terminal propeptide (C-ter100), which is unique to vEP, is involved in regulation of vEP activity. To understand the structural basis of this function of vEP C-ter100, we have determined the solution structure and backbone dynamics using multidimensional nuclear magnetic resonance spectroscopy. The solution structure shows that vEP C-ter100 is composed of eight anti-parallel {beta}-strands with a unique fold that has a compact {beta}-barrel formation which stabilized by hydrophobic and hydrogen bonding networks. Protein dynamics shows that the overall structure, including loops, is very rigid and stabilized. By structural database analysis, we found that vEP C-ter100 shares its topology with that of the collagen-binding domain of collagenase, despite low sequence homology between the two domains. Fluorescence assay reveals that vEP C-ter100 interacts strongly with iron (Fe{sup 3+}). These findings suggest that vEP protease might recruit substrate molecules, such as collagen, by binding at C-ter100 and that vEP participates in iron uptake from iron-withholding proteins of the host cell during infection.« less

Loss of membranous Ep-CAM in budding colorectal carcinoma cells.

PubMed

Gosens, Marleen J E M; van Kempen, Léon C L; van de Velde, Cornelis J H; van Krieken, J Han J M; Nagtegaal, Iris D

2007-02-01

Tumor budding is a histological feature that reflects loss of adhesion of tumor cells and is associated with locoregional metastasis of colorectal carcinoma. Although nuclear localization of beta-catenin is associated with tumor budding, the molecular mechanism remains largely elusive. In this study, we hypothesize that the epithelial cell adhesion molecule (Ep-CAM) is involved in tumor budding. In order to address this question, we performed immunohistochemistry on Ep-CAM using three different antibodies (monoclonal antibodies Ber-ep4 and 311-1K1 and a polyclonal antibody) and a double staining on beta-catenin and Ep-CAM. In addition, Ep-CAM mRNA was monitored with mRNA in situ hybridization. Subsequently, we determined the effect of Ep-CAM staining patterns on tumor spread in rectal cancer. In contrast to the tumor mass, budding cells of colorectal carcinoma displayed lack of membranous but highly increased cytoplasmic Ep-CAM staining and nuclear translocation of beta-catenin. mRNA in situ hybridization suggested no differences in Ep-CAM expression between the invasive front and the tumor mass. Importantly, reduced Ep-CAM staining at the invasive margin of rectal tumor specimens (n=133) correlated significantly with tumor budding, tumor grade and an increased risk of local recurrence (P=0.001, P=0.04 and P=0.03, respectively). These data demonstrate abnormal processing of Ep-CAM at the invasive margin of colorectal carcinomas. Our observations indicate that loss of membranous Ep-CAM is associated with nuclear beta-catenin localization and suggest that this contributes to reduced cell-cell adhesions, increased migratory potential and tumor budding.

Identification of Biofilm Matrix-Associated Proteins from an Acid Mine Drainage Microbial Community

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiao, Yongqin; D'Haeseleer, Patrik M; Dill, Brian

2011-01-01

In microbial communities, extracellular polymeric substances (EPS), also called the extracellular matrix, provide the spatial organization and structural stability during biofilm development. One of the major components of EPS is protein, but it is not clear what specific functions these proteins contribute to the extracellular matrix or to microbial physiology. To investigate this in biofilms from an extremely acidic environment, we used shotgun proteomics analyses to identify proteins associated with EPS in biofilms at two developmental stages, designated DS1 and DS2. The proteome composition of the EPS was significantly different from that of the cell fraction, with more than 80%more » of the cellular proteins underrepresented or undetectable in EPS. In contrast, predicted periplasmic, outer membrane, and extracellular proteins were overrepresented by 3- to 7-fold in EPS. Also, EPS proteins were more basic by 2 pH units on average and about half the length. When categorized by predicted function, proteins involved in motility, defense, cell envelope, and unknown functions were enriched in EPS. Chaperones, such as histone-like DNA binding protein and cold shock protein, were overrepresented in EPS. Enzymes, such as protein peptidases, disulfide-isomerases, and those associated with cell wall and polysaccharide metabolism, were also detected. Two of these enzymes, identified as -N-acetylhexosaminidase and cellulase, were confirmed in the EPS fraction by enzymatic activity assays. Compared to the differences between EPS and cellular fractions, the relative differences in the EPS proteomes between DS1 and DS2 were smaller and consistent with expected physiological changes during biofilm development.« less

Factors influencing uptake of pre-exposure prophylaxis: some qualitative insights from an intervention study of men who have sex with men in China.

PubMed

Liu, Chunxing; Ding, Yingying; Ning, Zhen; Gao, Meiyang; Liu, Xing; Wong, Frank Y; He, Na

2018-02-01

Pre-exposure prophylaxis (PrEP) is a biomedical approach for preventing the acquisition of HIV in populations at substantial risk for HIV. However, its uptake among men who have sex with men (MSM) is low in China. The study aimed to identify factors that might influence MSM's uptake and use of PrEP. In-depth interviews were conducted with 32 self-identified MSM from a PrEP intervention study evaluating daily oral tenofovir disoproxil fumarate (TDF) to prevent HIV infection. Of these men, 11 were presently using the 'TDF' group; 8 from the 'change-over' group (i.e. initially used PrEP but subsequently quitted); and 13 from the non-user group. Data were analysed using thematic approach. Perception of low HIV risk, mistrust of the national PrEP program, and concerns of side effects were the main reasons for not wanting to use PrEP. Also, lack of main sexual partner's support, difficulties in adhering to the daily TDF regimen, and the inconvenient schedules in securing the medicine were the major reasons for not wanting to use or quitting the use of PrEP. On the other hand, perceived high HIV risk, beliefs in efficacy of PrEP, and worries of transmitting HIV to families were the major motives for PrEP uptake. Findings suggest that PrEP implementation strategies should first address issues including but not limited to accurate self-assessment of HIV risk, mistrust and limited knowledge about medical trials and PrEP, and ease of accessing PrEP.

Knowledge, attitudes, and beliefs about HIV pre-exposure prophylaxis among US Air Force Health Care Providers

PubMed Central

Hakre, Shilpa; Blaylock, Jason M; Dawson, Peter; Beckett, Charmagne; Garges, Eric C; Michael, Nelson L; Danaher, Patrick J; Scott, Paul T; Okulicz, Jason F

2016-01-01

Abstract Providers are central to effective implementation of HIV pre-exposure prophylaxis (PrEP). Primary care providers (PCP) and infectious disease physicians (ID) in the US Air Force (USAF) participated in a cross-sectional survey regarding knowledge, attitudes, and beliefs toward HIV PrEP. Characteristics associated with PrEP knowledge were assessed in univariate and multivariate analyses. Among 403 (40% of 1015 providers) participants, 9% (PCP 383, ID 20) ever prescribed PrEP. In univariate analysis, years in practice, number of HIV-infected patients treated in the past 12 months, past prescription of antiretrovirals for HIV prevention, frequency of prescribing PrEP in the past 12 months, and ever being questioned by a patient about PrEP were associated with PrEP knowledge (P < 0.05). In multivariate analysis, providers who had ever prescribed antiretrovirals to prevent HIV (AOR: 2.37, 95% CI: 1.27–4.42) had greater odds of high PrEP knowledge. Despite concerns about medication side effects (overall 67%: PCP 68%, ID 85%) and prescribing PrEP without clear evidence (overall 60%: PCP 65%, ID 62%), 64% (PCP 65%, ID 85%) of participants indicated PrEP should be offered in the Military Health System and 68% (PCP 70%, ID 100%) disagreed with the statement that their patient population was not at risk for HIV infection. Successful PrEP implementation in the USAF will require continued education and training of primary care providers to improve knowledge and mitigate concerns about PrEP. PMID:27512869

40 CFR 158.2120 - Microbial pesticides product analysis data requirements table.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Test substance MP EP Test notes Product Chemistry and Composition 885.1100 Product identity R MP EP 885... and EP 2 885.1500 Certification of limits R MP EP Physical and Chemical Characteristics 830.6302 Color...

40 CFR 158.2120 - Microbial pesticides product analysis data requirements table.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Test substance MP EP Test notes Product Chemistry and Composition 885.1100 Product identity R MP EP 885... and EP 2 885.1500 Certification of limits R MP EP Physical and Chemical Characteristics 830.6302 Color...

Global distribution of vertical wavenumber spectra in the lower stratosphere observed using high-vertical-resolution temperature profiles from COSMIC GPS radio occultation

NASA Astrophysics Data System (ADS)

Noersomadi; Tsuda, T.

2016-02-01

We retrieved temperature (T) profiles with a high vertical resolution using the full spectrum inversion (FSI) method from the Constellation Observing System for Meteorology, Ionosphere and Climate (COSMIC) GPS radio occultation (GPS-RO) data from January 2007 to December 2009. We studied the characteristics of temperature perturbations in the stratosphere at 20-27 km altitude. This height range does not include a sharp jump in the background Brunt-Väisälä frequency squared (N2) near the tropopause, and it was reasonably stable regardless of season and latitude. We analyzed the vertical wavenumber spectra of gravity waves (GWs) with vertical wavelengths ranging from 0.5 to 3.5 km, and we integrated the (total) potential energy EpT. Another integration of the spectra from 0.5 to 1.75 km was defined as EpS for short vertical wavelength GWs, which was not studied with the conventional geometrical optics (GO) retrievals. We also estimated the logarithmic spectral slope (p) for the saturated portion of spectra with a linear regression fitting from 0.5 to 1.75 km.Latitude and time variations in the spectral parameters were investigated in two longitudinal regions: (a) 90-150° E, where the topography was more complicated, and (b) 170-230° E, which is dominated by oceans. We compared EpT, EpS, and p, with the mean zonal winds (U) and outgoing longwave radiation (OLR). We also show a ratio of EpS to EpT and discuss the generation source of EpS. EpT and p clearly showed an annual cycle, with their maximum values in winter at 30-50° N in region (a), and 50-70° N in region (b), which was related to the topography. At 30-50° N in region (b), EpT and p exhibited some irregular variations in addition to an annual cycle. In the Southern Hemisphere, we also found an annual oscillation in EpT and p, but it showed a time lag of about 2 months relative to U. Characteristics of EpTand p in the tropical region seem to be related to convective activity. The ratio of EpT to the theoretical model value, assuming saturated GWs, became larger in the equatorial region and over mountainous regions.

Lack of mixed agonist-antagonist properties of [Gln8-Gly31]-beta h-EP-Gly-Gly-NH2 and [Arg9,19,24,28,29]-beta h-EP in the rat vas deferens neuroeffector junction: studies with naloxone, beta-funaltrexamine and ICI 174,864.

PubMed

Valenzuela, R; Li, C H; Huidobro-Toro, J P

1989-02-01

The 1-27 truncated fragment of beta h-endorphin (beta h-EP) as well as [Gln8,Gly31]-beta h-EP-Gly-Gly-NH2 or [Arg9,19,24,28,29]-beta h-EP exhibited opiate agonist activity in the rat vas deferens bioassay; the potency of these peptides was 3 to 6 times less than that of beta h-EP. None of these compounds exhibited any degree of antagonism towards the inhibitory action of beta h-EP. Naloxone antagonized and reversed the inhibitory action of beta h-EP and its analogues though with varying potencies. The apparent naloxone-pA2 value for beta h-EP was 8.94; that for [Gln8-Gly31]-beta h-EP-Gly-Gly-NH2 was 8.08 and that for [Arg9,19,24,28,29]-beta h-EP was 8.38. beta-Funaltrexamine (beta-FNA) potently antagonized the inhibitory action of beta h-EP following non-equilibrium kinetics. Tissue preincubation with 10 nM beta-FNA for 60 min followed by extensive washing caused a 10-fold increase in the beta h-EP IC50. However, 10 nM beta-FNA caused only a 1.2 increase in the IC50 of [Gln8,Gly31]-beta h-EP-Gly-Gly-NH2 and a 4.1-fold increase in the IC50 of [Arg9,19,24,28,29]-beta h-EP. In contrast, preincubation of the tissue with 3 microM ICI 174,864 did not modify the potency of beta h-EP or its structural analogues. However, a 60 min pretreatment with 10 microM beta-FNA followed by the addition of 3 microM ICI 174,864 revealed a further decrease in the potency of the opiopeptins compared with tissues exposed to beta-FNA alone or ICI 174,864 alone. In conclusion, the inhibitory action of these peptides is remarkably sensitive to beta-FNA antagonism; in addition the peptides act as pure opiate agonists in marked contrast with the agonist-antagonist properties described in the CNS.

Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians.

PubMed

Palummieri, Antonio; De Carli, Gabriella; Rosenthal, Éric; Cacoub, Patrice; Mussini, Cristina; Puro, Vincenzo

2017-11-28

Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in Italy, a significant number of PLWHA were aware of it, and approximately 10% reported PrEP use in their close circle, although they rarely shared their ARVs with uninfected people for this purpose. Official policies and PrEP availability, along with implementation programs, could avoid risks from uncontrolled PrEP procurement and self-administration practices.

Deep brain stimulation changes basal ganglia output nuclei firing pattern in the dystonic hamster.

PubMed

Leblois, Arthur; Reese, René; Labarre, David; Hamann, Melanie; Richter, Angelika; Boraud, Thomas; Meissner, Wassilios G

2010-05-01

Dystonia is a heterogeneous syndrome of movement disorders characterized by involuntary muscle contractions leading to abnormal movements and postures. While medical treatment is often ineffective, deep brain stimulation (DBS) of the internal pallidum improves dystonia. Here, we studied the impact of DBS in the entopeduncular nucleus (EP), the rodent equivalent of the human globus pallidus internus, on basal ganglia output in the dt(sz)-hamster, a well-characterized model of dystonia by extracellular recordings. Previous work has shown that EP-DBS improves dystonic symptoms in dt(sz)-hamsters. We report that EP-DBS changes firing pattern in the EP, most neurons switching to a less regular firing pattern during DBS. In contrast, EP-DBS did not change the average firing rate of EP neurons. EP neurons display multiphasic responses to each stimulation impulse, likely underlying the disruption of their firing rhythm. Finally, neurons in the substantia nigra pars reticulata display similar responses to EP-DBS, supporting the idea that EP-DBS affects basal ganglia output activity through the activation of common afferent fibers. Copyright 2010 Elsevier Inc. All rights reserved.

Mutation Breeding of Extracellular Polysaccharide-Producing Microalga Crypthecodinium cohnii by a Novel Mutagenesis with Atmospheric and Room Temperature Plasma

PubMed Central

Liu, Bin; Sun, Zheng; Ma, Xiaonian; Yang, Bo; Jiang, Yue; Wei, Dong; Chen, Feng

2015-01-01

Extracellular polysaccharides (EPS) produced by marine microalgae have the potential to be used as antioxidants, antiviral agents, immunomodulators, and anti-inflammatory agents. Although the marine microalga Crypthecodinium cohnii releases EPS during the process of docosahexaenoic acid (DHA) production, the yield of EPS remains relatively low. To improve the EPS production, a novel mutagenesis of C. cohnii was conducted by atmospheric and room temperature plasma (ARTP). Of the 12 mutants obtained, 10 mutants exhibited significantly enhanced EPS yield on biomass as compared with the wild type strain. Among them, mutant M7 was the best as it could produce an EPS volumetric yield of 1.02 g/L, EPS yield on biomass of 0.39 g/g and EPS yield on glucose of 94 mg/g, which were 33.85%, 85.35% and 57.17% higher than that of the wild type strain, respectively. Results of the present study indicated that mutagenesis of the marine microalga C. cohnii by ARTP was highly effective leading to the high-yield production of EPS. PMID:25872142

Daily short message service surveys to measure sexual behavior and pre-exposure prophylaxis use among Kenyan men and women.

PubMed

Curran, Kathryn; Mugo, Nelly R; Kurth, Ann; Ngure, Kenneth; Heffron, Renee; Donnell, Deborah; Celum, Connie; Baeten, Jared M

2013-11-01

Pre-exposure prophylaxis (PrEP) is a novel HIV prevention strategy which requires high adherence. We tested the use of daily short message service (i.e., SMS/text message) surveys to measure sexual behavior and PrEP adherence in Kenya. Ninety-six HIV-uninfected adult individuals, taking daily oral PrEP in a clinical trial, received daily SMS surveys for 60 days. Most participants (96.9 %) reported taking PrEP on ≥80 % days, but 69.8 % missed at least one dose. Unprotected sex was reported on 4.9 % of days; however, 47.9 % of participants reported unprotected sex at least once. Unprotected sex was not correlated with PrEP use (OR = 0.95). Participants reporting more sex were less likely to report PrEP non-adherence and those reporting no sex were most likely to report missing a PrEP dose (adjusted OR = 1.87). PrEP adherence was high, missed doses were correlated with sexual abstinence, and unprotected sex was not associated with decreased PrEP adherence.

PrEParing Women to Prevent HIV: An Integrated Theoretical Framework to PrEP Black Women in the United States.

PubMed

Chapman Lambert, Crystal; Marrazzo, Jeanne; Amico, K Rivet; Mugavero, Michael J; Elopre, Latesha

2018-04-05

Preexposure prophylaxis (PrEP) with optimal adherence has demonstrated efficacy in reducing HIV incidence in women. Black women are disproportionately burdened by the HIV epidemic, accounting for more than half of all new HIV cases in women, thereby making PrEP an ideal prevention strategy for this group. However, to date, PrEP uptake by women in the United States has been slow. Further domestic research is needed to understand the multilevel factors related to PrEP awareness, uptake, and implementation in Black women. Our purpose was to review the current status of HIV prevention in Black women. We summarize clinical trials germane to federal approval of PrEP; discuss important PrEP studies focused on women, including non-oral options; and review multilevel barriers to PrEP uptake. Lastly, we discuss the use of an integrated theoretical framework to organize multilevel factors related to PrEP uptake by Black women in order to guide intervention development. Copyright © 2018 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Characterization of an exopolysaccharide produced by Lactobacillus plantarum YW11 isolated from Tibet Kefir.

PubMed

Wang, Ji; Zhao, Xiao; Tian, Zheng; Yang, Yawei; Yang, Zhennai

2015-07-10

An exopolysaccharide (EPS)-producing strain YW11 isolated from Tibet Kefir was identified as Lactobacillus plantarum, and the strain was shown to produce 90 mgL(-1) of EPS when grown in a semi-defined medium. The molecular mass of the EPS was 1.1 × 10(5)Da. The EPS was composed of glucose and galactose in a molar ratio of 2.71:1, with possible presence of N-acetylated sugar residues in the polysaccharide as confirmed by NMR spectroscopy. Rheological studies showed that the EPS had higher viscosity in skim milk, at lower temperature, or at acidic pH. The viscous nature of the EPS was confirmed by observation with scanning electron microscopy that demonstrated a highly branched and porous structure of the polysaccharide. The atomic force microscopy of the EPS further revealed presence of many spherical lumps, facilitating binding with water in aqueous solution. The EPS had a higher degradation temperature (287.7°C), suggesting high thermal stability of the EPS. Copyright © 2015 Elsevier Ltd. All rights reserved.

42 CFR 495.102 - Incentive payments to EPs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... qualifying EP is 2014, then the payment limit for a payment year for the qualifying EP is the same as the... first payment year is 2013. (ii) If the first payment year for a qualifying EP is after 2014, then the...

Synthesis and Characterization of a Polyimide-Epoxy Composite for Dental Applications

NASA Astrophysics Data System (ADS)

Yang, An; Xu, Chun

2018-03-01

Epoxy (EP) resins have been employed in dentistry for years, but their intrinsic brittleness demands a reinforcement to make them an ideal dental material that combines strength, toughness, and aesthetics. In this study, an EP resin was reinforced with a low-molecular-weight polyimide (PI). The PI/EP composites were subjected to three-point bending tests and examined by the scanning electron microscopy. It was found that blending PI with EP in proper proportions strengthened EP without sacrificing its toughness. The PI/EP composite could be employed in dentistry as the matrix of fiber-reinforced dental root canal posts.

Human beta-endorphin: synthesis and biological activity of analogs with substitutions in positions 2, 9, 18, 27 and 31.

PubMed

Yeung, H W; Yamashiro, D; Tseng, L F; Chang, W C; Li, C H

1981-02-01

Four analogs of the opioid peptide human beta-endorphin (Bh-EP) have been synthesized: [D-Lys9, Phe27, Gly31]-beta h-EP, [D-PHe18,Phe27,Gly31]-beta h-EP, [D-Thr2,D-Lys9,Phe27,Gly31]-beta h-EP, and [D-Thr2,D-Phe18,Phe27,Gly31]-beta h-EP. All are practically indistinguishable from beta h-EP in the guinea pig ileum assay. All show diminished analgesic potency in the mouse tail-flick assay.

Does Alport syndrome affect the basement membrane of peritoneal vessels?

PubMed

Sampimon, Denise E; Vlijm, Anniek; Struijk, Dirk G; Krediet, Raymond T

2010-01-01

Alport syndrome and encapsulating peritoneal sclerosis (EPS) are both rare diseases. Their joint occurrence is highly unlikely. Two patients at our center with Alport syndrome developed EPS. We therefore hypothesized that Alport syndrome might predispose to the development of EPS and that this predisposition might be reflected in a fast peritoneal transport rate at baseline. We compared the mass transfer area coefficient (MTAC) of creatinine and the clearances of albumin, immunoglobulin G, and alpha2-macroglobulin at baseline and for all subsequent available measurements in four patient groups: EPS patients with Alport syndrome, EPS patients without Alport syndrome, Alport patients without EPS, and long-term peritoneal dialysis (PD) patients without EPS. The transport characteristics were obtained during a standard peritoneal permeability analysis. Between July 1995 and December 2008, 5 of 417 PD patients treated at our center had Alport syndrome as their primary kidney disease, and 13 of the 417 developed EPS. Of those 13 EPS patients, 2 had Alport syndrome. We observed no differences in the baseline transport characteristics of the four groups under consideration. Taking all measures of transport characteristics into account, only the MTAC of creatinine was higher in the two EPS groups than in the other two groups (p = 0.01). We could not confirm our hypothesis that Alport syndrome affects peritoneal solute clearances.

The Importance of Sexual History Taking for PrEP Comprehension Among Young People of Color.

PubMed

Golub, Sarit A; Gamarel, Kristi E; Lelutiu-Weinberger, Corina

2017-05-01

Despite demonstrated efficacy, uptake of pre-exposure prophylaxis (PrEP) remains low, especially among highest priority populations. This study examined four PrEP messaging factors hypothesized to impact comprehension of PrEP educational information: (1) modality (video versus in-person message delivery); (2) frame (risk versus health focus); (3) specificity (gist versus verbatim efficacy information); and (4) sexual history (administered either before or after PrEP education). We examined message comprehension among 157 young people of color (YPoC) eligible for PrEP, using a series of multiple choice questions. Overall, 65.6 % (n = 103) got all message comprehension questions correct. In multivariate analyses, engaging in a sexual history before receiving PrEP education was associated with increased odds of message comprehension (aOR 2.23; 95 % CI 1.06-4.72). This effect was even stronger among those who received PrEP education via video (aOR 3.53; 95 % CI 1.16-10.81) compared to via health educator. This research underscores the importance of sexual history-taking as part of PrEP education and clinical practice for YPoC, and suggests that engaging patients in a sexual history prior to providing them with PrEP education may be key to increasing comprehension.

The Role of Social Relationships in PrEP Uptake and Use Among Transgender Women and Men Who Have Sex with Men.

PubMed

Mehrotra, Megha L; Rivet Amico, K; McMahan, Vanessa; Glidden, David V; Defechereux, Patricia; Guanira, Juan V; Grant, Robert M

2018-05-12

Qualitative studies suggest that social relationships play an important role in HIV pre-exposure prophylaxis (PrEP) use, but there have been few quantitative assessments of the role of social relationships in PrEP uptake or adherence. We examined the association between disclosure of study participation or LGBT identity and PrEP use in the 1603 HIV-negative participants enrolled in the iPrEx OLE study. We also evaluated the association between LGBT social group involvement and PrEP use. Study participation disclosure to parents and LGBT identity disclosure to anyone in a participant's social network were associated with greater PrEP uptake. Study participation disclosure to partners was associated with higher probability of having protective PrEP drug concentrations compared [risk difference 0.15 95% CI (0.01, 0.30)]. For each additional type of LGBT organization a participant was involved in, the probability of PrEP uptake and having protective drug concentrations increased by 0.04 [95% CI (0.03, 0.06)] and 0.04 (95% CI (0.02, 0.07)] respectively. Overall, social context was associated with PrEP use in iPrEx OLE, and should be taken into consideration when designing future PrEP implementation programs.

Interactions of EPS with soil minerals: A combination study by ITC and CLSM.

PubMed

Lin, Di; Ma, Wenting; Jin, Zhaoxia; Wang, Yixuan; Huang, Qiaoyun; Cai, Peng

2016-02-01

The adsorption of extracellular polymeric substances (EPS) from Pseudomonas putida on montmorillonite, kaolinite and goethite was investigated as a function of pH using batch studies coupled with confocal laser scanning microscopy (CLSM) and isothermal titration calorimetry (ITC). Characterization by Raman spectroscopy, X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared (FTIR) spectroscopy showed that the extracted EPS contained carboxyl, phosphoryl, amino, and hydroxyl on functional groups as well as polysaccharides, protein and nucleic acid on components. The mass fraction of EPS adsorption on minerals decreased with the final pH increased from 3.0 to 9.0. The mass fraction of EPS-N adsorption varied with pH values and was higher than that of EPS-C or EPS-P on montmorillonite and kaolinite, while the mass fraction of EPS-P adsorption was the highest on goethite. CLSM results further demonstrated that proteins were predominantly distributed on the montmorillonite and kaolinite surfaces, while nucleic acids were mainly on the goethite surface. ITC results revealed that the adsorption process in all mineral systems was exothermic, and pH altered the heat effect of EPS-mineral reactions. The data obtained in this study would facilitate a better understanding of the adsorption mechanisms of EPS on minerals. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of trichostatin A on Burkitt's lymphoma cells: Inhibition of EPS8 activity through Phospho-Erk1/2 pathway.

PubMed

Sun, Peipei; Zhou, Xin; He, Yingzhi; Liu, Huimin; Wang, Yuxin; Chen, Yiran; Li, Meifang; He, Yanjie; Li, Guowei; Li, Yuhua

2018-03-18

Histone deacetylase inhibitors (HDACi) manifest great potential for treatment of Burkitt's lymphoma (BL), an aggressive B-cell lymphoma. Epidermal growth factor receptor pathway substrate 8 (EPS8) is confirmed overexpressed and associated with poor prognosis in solid tumors and leukemia. However, EPS8 expression and the relationship between EPS8 and HDACi on BL remains obscure. Here, we hypothesized that trichostatin A (TSA), a pan-HDACi, could inhibit BL cells by downregulating EPS8. We demonstrated that TSA reduced cell viability, induced apoptosis and cell arrest at G0/G1. Mechanismly, TSA attenuated EPS8 and downstream Phospho-Erk1/2 pathway. Knockdown of EPS8 resulted in a significant reduction in cellular proliferation and suppressed Phospho-Erk1/2 pathway activity, particularly when combined with TSA. Conversely, overexpression of EPS8 rescued this phenomenon. Then we showed that the combination of TSA and Epirubicin had a more significant effect when compared with TSA or Epirubicin alone. Finally, knockdown of EPS8 and TSA had a synergistic suppression effect on BALB/c nude mice. In conclusion, this study reveals that TSA affects BL cells by suppressing Phospho-Erk1/2 pathway through downregulating EPS8. Copyright © 2018 Elsevier Inc. All rights reserved.

Bidirectional modulation of endogenous EpCAM expression to unravel its function in ovarian cancer

PubMed Central

van der Gun, B T F; Huisman, C; Stolzenburg, S; Kazemier, H G; Ruiters, M H J; Blancafort, P; Rots, M G

2013-01-01

Background: The epithelial cell adhesion molecule (EpCAM) is overexpressed on most carcinomas. Dependent on the tumour type, its overexpression is either associated with improved or worse patient survival. For ovarian cancer, however, the role of EpCAM remains unclear. Methods: Cell survival of ovarian cancer cell lines was studied after induction or repression of endogenous EpCAM expression using siRNA/cDNA or artificial transcription factors (ATF) consisting of engineered zinc-fingers fused to either a transcriptional activator or repressor domain. Results: Two ATFs were selected as the most potent down- and upregulator, showing at least a two-fold alteration of EpCAM protein expression compared with control. Downregulation of EpCAM expression resulted in growth inhibition in breast cancer, but showed no effect on cell growth in ovarian cancer. Induction or further upregulation of EpCAM expression decreased ovarian cancer cell survival. Conclusion: The bidirectional ATF-based approach is uniquely suited to study cell-type-specific biological effects of EpCAM expression. Using this approach, the oncogenic function of EpCAM in breast cancer was confirmed. Despite its value as a diagnostic marker and for immunotherapy, EpCAM does not seem to represent a therapeutic target for gene expression silencing in ovarian cancer. PMID:23403823

PGE2 signaling through the EP4 receptor on fibroblasts upregulates RANKL and stimulates osteolysis.

PubMed

Tsutsumi, Ryosuke; Xie, Chao; Wei, Xiaochao; Zhang, Minjie; Zhang, Xinping; Flick, Lisa M; Schwarz, Edward M; O'Keefe, Regis J

2009-10-01

Periprosthetic osteolysis is the most common cause of aseptic loosening in total joint arthroplasty. The role of inflammatory mediators such as prostaglandin E2 (PGE2) and osteoclast promoting factors including RANKL in the pathogenesis of osteolysis has been well characterized. However, the PGE2 receptor (EP1, EP2, or EP4), and cell type in which it is expressed, which is responsible for PGE2 induction of RANKL during wear debris-induced osteolysis, has yet to be elucidated. To address this, we used mice genetically deficient in these EP receptors to assess PGE2 and wear debris responses in vitro and in vivo. Wear debris-induced osteolysis and RANKL expression were observed at similar levels in WT, EP1(-/-), and EP2(-/-) mice, indicating that these receptors do not mediate PGE2 signals in this process. A conditional knockout approach was used to eliminate EP4 expression in FSP1(+) fibroblasts that are the predominant source of RANKL. In the absence of EP4, fibroblasts do not express RANKL after stimulation with particles or PGE2, nor do they exhibit high levels of osteoclasts and osteolysis. These results show that periprosthetic fibroblasts are important mediators of osteolysis through the expression of RANKL, which is induced after PGE2 signaling through the EP4 receptor.

Impact of the exopolysaccharide layer on biofilms, adhesion and resistance to stress in Lactobacillus johnsonii FI9785.

PubMed

Dertli, Enes; Mayer, Melinda J; Narbad, Arjan

2015-02-04

The bacterial cell surface is a crucial factor in cell-cell and cell-host interactions. Lactobacillus johnsonii FI9785 produces an exopolysaccharide (EPS) layer whose quantity and composition is altered in mutants that harbour genetic changes in their eps gene clusters. We have assessed the effect of changes in EPS production on cell surface characteristics that may affect the ability of L. johnsonii to colonise the poultry host and exclude pathogens. Analysis of physicochemical cell surface characteristics reflected by Zeta potential and adhesion to hexadecane showed that an increase in EPS gave a less negative, more hydrophilic surface and reduced autoaggregation. Autoaggregation was significantly higher in mutants that have reduced EPS, indicating that EPS can mask surface structures responsible for cell-cell interactions. EPS also affected biofilm formation, but here the quantity of EPS produced was not the only determinant. A reduction in EPS production increased bacterial adhesion to chicken gut explants, but made the bacteria less able to survive some stresses. This study showed that manipulation of EPS production in L. johnsonii FI9785 can affect properties which may improve its performance as a competitive exclusion agent, but that positive changes in adhesion may be compromised by a reduction in the ability to survive stress.

PrEP as a feature in the optimal landscape of combination HIV prevention in sub-Saharan Africa

PubMed Central

McGillen, Jessica B; Anderson, Sarah-Jane; Hallett, Timothy B

2016-01-01

Introduction The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape. Methods We use a model that was previously developed to capture subnational HIV transmission in sub-Saharan Africa. With this model, we can consider how prevention funds could be distributed across and within countries throughout sub-Saharan Africa to enable optimal HIV prevention (that is, avert the greatest number of infections for the lowest cost). Here, we focus on PrEP to elucidate where, and to whom, it would optimally be offered in portfolios of interventions (alongside voluntary medical male circumcision, treatment as prevention, and behaviour change communication). Over a range of continental expenditure levels, we use our model to explore prevention patterns that incorporate PrEP, exclude PrEP, or implement PrEP according to a fixed incidence threshold. Results At low-to-moderate levels of total prevention expenditure, we find that the optimal intervention portfolios would include PrEP in only a few regions and primarily for female sex workers (FSW). Prioritisation of PrEP would expand with increasing total expenditure, such that the optimal prevention portfolios would offer PrEP in more subnational regions and increasingly for men who have sex with men (MSM) and the lower incidence general population. The marginal benefit of including PrEP among the available interventions increases with overall expenditure by up to 14% (relative to excluding PrEP). The minimum baseline incidence for the optimal offer of PrEP declines for all population groups as expenditure increases. We find that using a fixed incidence benchmark to guide PrEP decisions would incur considerable losses in impact (up to 7%) compared with an approach that uses PrEP more flexibly in light of prevailing budget conditions. Conclusions Our findings suggest that, for an optimal distribution of prevention resources, choices of whether to implement PrEP in subnational regions should depend on the scope for impact of other possible interventions, local incidence in population groups, and total resources available. If prevention funding were to become restricted in the future, it may be suboptimal to use PrEP according to a fixed incidence benchmark, and other prevention modalities may be more cost-effective. In contrast, expansions in funding could permit PrEP to be used to its full potential in epidemiologically driven prevention portfolios and thereby enable a more cost-effective HIV response across Africa. PMID:27760682

Enrichment, Isolation and Molecular Characterization of EpCAM-Negative Circulating Tumor Cells.

PubMed

Lampignano, Rita; Schneck, Helen; Neumann, Martin; Fehm, Tanja; Neubauer, Hans

2017-01-01

The presence of EpCAM-positive circulating tumor cells (CTCs) in the peripheral blood is associated with poor clinical outcomes in breast, colorectal and prostate cancer, as well as the prognosis of other tumor types. In addition, recent studies have suggested that the presence of CTCs undergoing epithelial-to-mesenchymal transition and, as such, may exhibit reduced or no expression of epithelial proteins e.g. EpCAM, might be related to disease progression in metastatic breast cancer (MBC) patients. Analyzing the neoplastic nature of this EpCAM-low/negative (EpCAM-neg) subpopulation remains an open issue as the current standard detection methods for CTCs are not efficient at identifying this subpopulation of cells. The possible association of EpCAM-neg CTCs with EpCAM-positive (EpCAM-pos) CTCs and role in the clinicopathological features and prognosis of MBC patients has still to be demonstrated. Several technologies have been developed and are currently being tested for the identification and the downstream analyses of EpCAM-pos CTCs. These technologies can be adapted and implemented into workflows to isolate and investigate EpCAM-neg cells to understand their biology and clinical relevance. This chapter will endeavour to explain the rationale behind the identification and analyses of all CTC subgroups, as well as to review the current strategies employed to enrich, isolate and characterize EpCAM-negative CTCs. Finally, the latest findings in the field will briefly be discussed with regard to their clinical relevance.

Poppers and PrEP: Use of Pre-exposure Prophylaxis Among Men Who Have Sex with Men Who Use Inhaled Nitrites.

PubMed

Hambrick, H Rhodes; Park, Su Hyun; Schneider, John A; Mayer, Kenneth H; Carrico, Adam W; Sherman, Scott E; Duncan, Dustin T

2018-05-09

Men who have sex with men (MSM) commonly use inhaled nitrites, or poppers, though their use is a risk factor HIV seroconversion. Pre-exposure prophylaxis, or PrEP, is effective for HIV prevention, but is not widely used, and little is known regarding PrEP use and acceptability among MSM who use inhaled nitrites. We surveyed 580 MSM in Paris, France in 2016 about popper use, sexual behaviors including condomless anal intercourse (CAI), serosorting, and sexual positioning, PrEP use, PrEP candidacy, and interest in alternate PrEP delivery modalities. We included 444 HIV negative participants for the current study. 46.2% reported popper use in the prior 3 months. Using multivariate adjusted logistic regression, we found that popper users were more likely than non-users to consider themselves candidates for PrEP [adjusted relative risk ratio (aRRR) = 2.73; 95% CI 1.54-4.83], but they were not more likely to be current (aRRR = 1.54; 95% CI 0.71-3.33) or past (aRRR = 1.37; 95% CI 0.44-4.28) PrEP users. Mediation analyses indicated that increased CAI and serosorting partly explained the relationship between popper use and PrEP candidacy. There was considerable interest in alternate proposed PrEP delivery modalities, particularly long-acting injectable PrEP [adjusted risk ratio (aRR) = 1.43; 95% CI 1.15-1.79].

When the science fails and the ethics works: 'Fail-safe' ethics in the FEM-PrEP study.

PubMed

Kingori, Patricia

2015-12-01

This paper will explore the concept of 'fail safe' ethics in the FEM PrEP trial, and the practice of research and ethics on the ground. FEM-PrEP examined the efficacy of PrEP in African women after promising outcomes in research conducted with MSM. This was a hugely optimistic time and FEM-PrEP was mobilised using rights-based ethical arguments that women should have access to PrEP. This paper will present data collected during an ethnographic study of frontline research workers involved in FEM-PrEP. During our discussions, 'fail-safe' ethics emerged as concept that encapsulated their confidence that their ethics could not fail. However, in 2011, FEM-PrEP was halted and deemed a failure. The women involved in the study were held responsible because contrary to researcher's expectations they were not taking the oral PrEP being researched. This examination of FEM-PrEP will show that ethical arguments are increasingly deployed to mobilise, maintain and in some cases stop trials in ways which, at times, are superseded or co-opted by other interests. While promoting the interests of women, rights-based approaches are argued to indirectly justify the continuation of individualised, biomedical interventions which have been problematic in other women-centred trials. In this examination of FEM-PrEP, the rights-based approach obscured: ethical concerns beyond access to PrEP; the complexities of power relationships between donor and host countries; the operations of the HIV industry in research-saturated areas and the cumulative effect of unfilled expectations in HIV research and how this has shaped ideas of research and ethics.

Acceptability and willingness to use HIV pre-exposure prophylaxis among HIV-negative men who have sex with men in Switzerland.

PubMed

Gredig, Daniel; Uggowitzer, Franziska; Hassler, Benedikt; Weber, Patrick; Nideröst, Sibylle

2016-01-01

Pre-exposure prophylaxis (PrEP) is discussed as an additional HIV prevention method targeting men who have sex with men (MSM). So far, PrEP has not been approved in Switzerland and only little is known about the acceptability of PrEP among MSM living in Switzerland. Given the slow uptake of PrEP among MSM in the USA, the objectives of the study were to investigate the acceptability for PrEP and to identify factors influencing the acceptability for this prevention method and the willingness to adopt it. During a 4-month period we conducted five focus group discussions with 23 consecutively sampled HIV-negative MSM aged 22-60 years living in Switzerland. We analyzed the data according to qualitative content analysis. The acceptability of PrEP varied considerably among the participants. Some would use PrEP immediately after its introduction in Switzerland because it provides an alternative to condoms which they are unable or unwilling to use. Others were more ambivalent towards PrEP but still considered it (1) an additional or alternative protection to regular condom use, (2) an option to engage in sexual activities with less worries and anxieties or (3) a protection during receptive anal intercourse independently of the sexual partner's protective behaviour. Some participants would not consider using PrEP at all: they do not see any benefit in PrEP as they have adopted safer sex practices and did not mention any problems with condom use. Others are still undecided and could imagine using an improved form of PrEP. The results provide a valuable basis for a model explaining the acceptability of PrEP among MSM and suggest including the personal HIV protection strategy in the considerations adopted.

Bacterial cell surface properties: role of loosely bound extracellular polymeric substances (LB-EPS).

PubMed

Zhao, Wenqiang; Yang, Shanshan; Huang, Qiaoyun; Cai, Peng

2015-04-01

This study investigated the effect of loosely bound extracellular polymeric substances (LB-EPS) on the comprehensive surface properties of four bacteria (Bacillus subtilis, Streptococcus suis, Escherichia coli and Pseudomonas putida). The removal of LB-EPS from bacterial surfaces by high-speed centrifugation (12,000×g) was confirmed by SEM images. Viability tests showed that the percentages of viable cells ranged from 95.9% to 98.0%, and no significant difference was found after treatment (P>0.05). FTIR spectra revealed the presence of phosphodiester, carboxylic, phosphate, and amino functional groups on bacteria surfaces, and the removal of LB-EPS did not alter the types of cell surface functional groups. Potentiometric titration results suggested the total site concentrations on the intact bacteria were higher than those on LB-EPS free bacteria. Most of the acidity constants (pKa) were almost identical, except the increased pKa values of phosphodiester groups on LB-EPS free S. suis and E. coli surfaces. The electrophoretic mobilities and hydrodynamic diameters of the intact and LB-EPS free bacteria were statistically unchanged (P>0.05), indicating LB-EPS had no influence on the net surface charges and size distribution of bacteria. However, LB-ESP could enhance cell aggregation processes. The four LB-EPS free bacteria all exhibited fewer hydrophobicity values (26.1-65.0%) as compared to the intact cells (47.4-69.3%), suggesting the removal of uncharged nonpolar compounds (e.g., carbohydrates) in LB-EPS. These findings improve our understanding of the changes in cell surface characterizations induced by LB-EPS, and have important implications for assessing the role of LB-EPS in bacterial adhesion and transport behaviors. Copyright © 2015 Elsevier B.V. All rights reserved.

Ectopic Pregnancy Among American Indian and Alaska Native Women, 2002–2009

PubMed Central

Folkema, Arianne; Tulloch, Scott; Taylor, Melanie; Reilley, Brigg; Hoover, Karen; Holman, Robert; Creanga, Andreea

2015-01-01

To examine rates of ectopic pregnancy (EP) among American Indian and Alaska Native (AI/AN) women aged 15–44 years seeking care at Indian Health Service (IHS), Tribal, and urban Indian health facilities during 2002–2009. We used 2002–2009 inpatient and outpatient data from the IHS National Patient Information Reporting System to identify EP-associated visits and obtain the number of pregnancies among AI/AN women. Repeat visits for the same EP were determined by calculating the interval between visits; if more than 90 days between visits, the visit was considered related to a new EP. We identified 229,986 pregnancies among AI/AN women 15–44 years receiving care at IHS-affiliated facilities during 2002–2009. Of these, 2,406 (1.05 %) were coded as EPs, corresponding to an average annual rate of 10.5 per 1,000 pregnancies. The EP rate among AI/AN women was lowest in the 15–19 years age group (5.5 EPs per 1,000 pregnancies) and highest among 35–39 year olds (18.7 EPs per 1,000 pregnancies). EP rates varied by geographic region, ranging between 6.9 and 24.4 per 1,000 pregnancies in the Northern Plains East and the East region, respectively. The percentage of ectopic pregnancies found among AI/AN women is within the national 1–2 % range. We found relatively stable annual rates of EP among AI/AN women receiving care at IHS-affiliated facilities during 2002–2009, but considerable variation by age group and geographic region. Coupling timely diagnosis and management with public health interventions focused on tobacco use and sexually transmitted diseases may provide opportunities for reducing EP and EP-associated complications among AI/AN women. PMID:25023759

Ectopic pregnancy among American Indian and Alaska Native women, 2002-2009.

PubMed

de Ravello, Lori; Folkema, Arianne; Tulloch, Scott; Taylor, Melanie; Reilley, Brigg; Hoover, Karen; Holman, Robert; Creanga, Andreea

2015-04-01

To examine rates of ectopic pregnancy (EP) among American Indian and Alaska Native (AI/AN) women aged 15-44 years seeking care at Indian Health Service (IHS), Tribal, and urban Indian health facilities during 2002-2009. We used 2002-2009 inpatient and outpatient data from the IHS National Patient Information Reporting System to identify EP-associated visits and obtain the number of pregnancies among AI/AN women. Repeat visits for the same EP were determined by calculating the interval between visits; if more than 90 days between visits, the visit was considered related to a new EP. We identified 229,986 pregnancies among AI/AN women 15-44 years receiving care at IHS-affiliated facilities during 2002-2009. Of these, 2,406 (1.05 %) were coded as EPs, corresponding to an average annual rate of 10.5 per 1,000 pregnancies. The EP rate among AI/AN women was lowest in the 15-19 years age group (5.5 EPs per 1,000 pregnancies) and highest among 35-39 year olds (18.7 EPs per 1,000 pregnancies). EP rates varied by geographic region, ranging between 6.9 and 24.4 per 1,000 pregnancies in the Northern Plains East and the East region, respectively. The percentage of ectopic pregnancies found among AI/AN women is within the national 1-2 % range. We found relatively stable annual rates of EP among AI/AN women receiving care at IHS-affiliated facilities during 2002-2009, but considerable variation by age group and geographic region. Coupling timely diagnosis and management with public health interventions focused on tobacco use and sexually transmitted diseases may provide opportunities for reducing EP and EP-associated complications among AI/AN women.

The role of alginate in Pseudomonas aeruginosa EPS adherence, viscoelastic properties and cell attachment.

PubMed

Orgad, Oded; Oren, Yoram; Walker, Sharon L; Herzberg, Moshe

2011-08-01

Among various functions, extracellular polymeric substances (EPS) provide microbial biofilms with mechanical stability and affect initial cell attachment, the first stage in the biofilm formation process. The role of alginate, an abundant polysaccharide in Pseudomonas aeruginosa biofilms, in the viscoelastic properties and adhesion kinetics of EPS was analyzed using a quartz crystal microbalance with dissipation (QCM-D) monitoring technology. EPS was extracted from two P. aeruginosa biofilms, a wild type strain, PAO1, and a mucoid strain, PAOmucA22 that over-expresses alginate production. The higher alginate content in the EPS originating from the mucoid biofilms was clearly shown to increase both the rate and the extent of attachment of the EPS, as well as the layer's thickness. Also, the presence of calcium and elevated ionic strength increased the thickness of the EPS layer. Dynamic light scattering (DLS) showed that the presence of calcium and elevated ionic strength induced intermolecular attractive interactions in the mucoid EPS molecules. For the wild type EPS, in the presence of calcium, an elevated shift in the distribution of the diffusion coefficients was observed with DLS due to a more compacted conformation of the EPS molecules. Moreover, the alginate over-expression effect on EPS adherence was compared to the effect of alginate over-expression on P. aeruginosa cell attachment. In a parallel plate flow cell, under similar hydraulic and aquatic conditions as those applied for the EPS adsorption tests in the QCM-D flow cell, reduced adherence of the mucoid strain was clearly observed compared to the wild type isogenic bacteria. The results suggest that alginate contributes to steric hindrance and shielding of cell surface features and adhesins that are known to promote cell attachment. © 2011 Taylor & Francis

Step-by-step strategy for protein enrichment and proteome characterisation of extracellular polymeric substances in wastewater treatment systems.

PubMed

Silva, Ana F; Carvalho, Gilda; Soares, Renata; Coelho, Ana V; Barreto Crespo, M Teresa

2012-08-01

Extracellular polymeric substances (EPS) are keys in biomass aggregation and settleability in wastewater treatment systems. In membrane bioreactors (MBR), EPS are an important factor as they are considered to be largely responsible for membrane fouling. Proteins were shown to be the major component of EPS produced by activated sludge and to be correlated with the properties of the sludge, like settling, hydrophobicity and cell aggregation. Previous EPS proteomic studies of activated sludge revealed several problems, like the interference of other EPS molecules in protein analysis. In this study, a successful strategy was outlined to identify the proteins from soluble and bound EPS extracted from activated sludge of a lab-scale MBR. EPS samples were first subjected to pre-concentration through lyophilisation, centrifugal ultrafiltration or concentration with a dialysis membrane coated by a highly absorbent powder of polyacrylate-polyalcohol, preceded or not by a dialysis step. The highest protein concentration factors were achieved with the highly absorbent powder method without previous dialysis step. Four protein precipitation methods were then tested: acetone, trichloroacetic acid (TCA), perchloric acid and a commercial kit. Protein profiles were compared in 4-12 % sodium dodecyl sulphate polyacrylamide gel electrophoresis gels. Both acetone and TCA should be applied for the highest coverage for soluble EPS proteins, whereas TCA was the best method for bound EPS proteins. All visible bands of selected profiles were subjected to mass spectrometry analysis. A high number of proteins (25-32 for soluble EPS and 17 for bound EPS) were identified. As a conclusion of this study, a workflow is proposed for the successful proteome characterisation of soluble and bound EPS from activated sludge samples.

Structural characterization and antioxidant property of released exopolysaccharides from Lactobacillus delbrueckii ssp. bulgaricus SRFM-1.

PubMed

Tang, Weizhi; Dong, Mingsheng; Wang, Weilu; Han, Shuo; Rui, Xin; Chen, Xiaohong; Jiang, Mei; Zhang, Qiuqin; Wu, Junjun; Li, Wei

2017-10-01

Three released exopolysaccharide fractions (r-EPS1, r-EPS2 and r-EPS3) were isolated from the fermented milk of Lactobacillus delbrueckii ssp. bulgaricus SRFM-1 and purified by anion exchange chromatography, and characterizations of the structures were conducted. The r-EPS1 and r-EPS2 were homogenous with the average molecular weights of 3.97×10 5 Da and 3.86×10 5 Da, respectively. Three r-EPS fractions were composed of galactose and glucose with a molar ratio of 1.23: 1.00, 1.33: 1.00 and 1.00: 1.34, respectively. Structural characterization indicated that the r-EPS1 contained a backbone of →6-β-d-Galp-(1→4)-β-d-Glcp-(1→4)-α-d-Galp-(1→4)-β-d-Galp-(1→6)-β-d-Galp-(1→4)-β-d-Glcp-(1→4)-α-d-Galp-(1→4)-β-d-Galp-(1→4)-α-d-Glcp-(1→, and had three branching points which existed in terminal with D-Glcp residues with α/β-d-(1→6) linkages. The r-EPS2 was composed of →6-β-d-Galp-(1→4)-β-d-Glcp-(1→6)-α-d-Galp-(1→ as the backbone chain with a branching point which also existed in terminal D-Glcp residue with β-(1→6) linkage. In addition, three r-EPS fractions exhibited strong scavenging activities on superoxide radical, hydroxyl radical, DPPH radical and chelating activity on ferrous ion, and their antioxidant activities decreased in the order of r-EPS1>r-EPS2>r-EPS3. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effect of oral preexposure prophylaxis on the progression of HIV-1 seroconversion

PubMed Central

Donnell, Deborah; Ramos, Eric; Celum, Connie; Baeten, Jared; Dragavon, Joan; Tappero, Jordan; Lingappa, Jairam R.; Ronald, Allan; Fife, Kenneth; Coombs, Robert W.

2017-01-01

Objective: To investigate whether oral preexposure prophylaxis (PrEP) alters timing and patterns of seroconversion when PrEP use continues after HIV-1 infection. Design: Retrospective testing of the timing of Fiebig stage HIV-1 seroconversion in the Partners PrEP Study, a randomized placebo-controlled clinical trial of PrEP conducted in Kenya and Uganda. Methods: Specimens from 138 seroconverters were collected every 3 months and when HIV-1 infection was suspected based on monthly rapid HIV-1 tests. Progression of seroconversion was compared between randomized groups (PrEP versus placebo) and per-protocol groups (placebo versus PrEP participants with detectable tenofovir during the seroconversion period) using laboratory assessment of Fiebig stage. Delay in site-detection of seroconversion and association with PrEP drug-regimen resistant virus were assessed using logistic regression. Analysis of time to each Fiebig stage used maximum likelihood estimation with a parametric model to accommodate the varying lengths of HIV-infection intervals. Results: There was a significant increase in delayed site detection of infection associated with PrEP (odds ratio = 3.49, P = 0.044). Delay in detection was not associated with increased risk of resistance in the PrEP arm (odds ratio = 0.93, P = 0.95). Estimated time to each Fiebig stage was elongated in seroconverters with evidence of ongoing PrEP use, significantly for only Stage 5 (28 versus 17 days, P = 0.05). Adjusted for Fiebig stage, viral RNA was ∼2/3 log lower in those assigned to PrEP compared with placebo; no differences were found in Architect signal to cut-off at any stage. Conclusion: Ongoing PrEP use in seroconverters may delay detection of infection and elongate seroconversion, although the delay does not increase risk of resistance. PMID:28692542

Deposition kinetics of extracellular polymeric substances (EPS) on silica in monovalent and divalent salts.

PubMed

Zhu, Pingting; Long, Guoyu; Ni, Jinren; Tong, Meiping

2009-08-01

The deposition kinetics of extracellular polymeric substances (EPS) on silica surfaces were examined in both monovalent and divalent solutions under a variety of environmentally relevant ionic strength and pH conditions by employing a quartz crystal microbalance with dissipation (DCM-D). Soluble EPS (SEPS) and bound EPS (BEPS) were extracted from four bacterial strains with different characteristics. Maximum favorable deposition rates (k(fa)) were observed for all EPS at low ionic strengths in both NaCl and CaCl2 solutions. With the increase of ionic strength, k(fa) decreased due to the simultaneous occurrence of EPS aggregation in solutions. Deposition efficiency (alpha; the ratio of deposition rates obtained under unfavorable versus corresponding favorable conditions) for all EPS increased with increasing ionic strength in both NaCl and CaCl2 solutions, which agreed with the trends of zeta potentials and was consistent with the classic Derjaguin-Landau-Verwey-Overbeek (DLVO) theory. Comparison of alpha for SEPS and BEPS extracted from the same strain showed that the trends of alpha did not totally agree with trends of zeta potentials, indicating the deposition kinetics of EPS on silica surfaces were not only controlled by DLVO interactions, but also non-DLVO forces. Close comparison of alpha for EPS extracted from different sources showed alpha increased with increasing proteins to polysaccharides ratio. Subsequent experiments for EPS extracted from the same strain but with different proteins to polysaccharides ratios and from activated sludge also showed that alpha were largest for EPS with greatest proteins to polysaccharides ratio. Additional experiments for pure protein and solutions with different pure proteins to pure saccharides ratios further corroborated that larger proteins to polysaccharides ratio resulted in greater EPS deposition.

Pre-exposure prophylaxis for HIV prevention in women: current perspectives

PubMed Central

Flash, Charlene A; Dale, Sannisha K; Krakower, Douglas S

2017-01-01

There are ~900,000 new HIV infections among women every year, representing nearly half of all new HIV infections globally. In the US, nearly one-fifth of all new HIV infections occur among women, and women from racial and ethnic minority communities experience disproportionately high rates of new HIV infections. Thus, there is a need to develop and implement effective HIV prevention strategies for women in the US and internationally, with a specific need to advance strategies in minority communities. Previous studies have demonstrated that oral HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral medications by HIV-uninfected persons to prevent HIV acquisition, can reduce HIV incidence among women who are adherent to PrEP. However, to date, awareness and uptake of PrEP among women have been very limited, suggesting a need for innovative strategies to increase the knowledge of and access to PrEP among women in diverse settings. This narrative review summarizes the efficacy and safety data of PrEP in women, discusses considerations related to medication adherence for women who use PrEP, and highlights behavioral, social, and structural barriers to maximize the effectiveness of PrEP in women. It also reviews novel modalities for PrEP in women which are being developed and tested, including topical formulations and long-acting injectable agents that may offer advantages as compared to oral PrEP and proposes a community-oriented, social networking framework to increase awareness of PrEP among women. If women are provided with access to PrEP and support to overcome social and structural barriers to adhere to PrEP, this prevention strategy holds great promise to impact the HIV epidemic among women in the US and globally. PMID:28615975

Acceptability of HIV Pre-Exposure Prophylaxis (PrEP) and Implementation Challenges Among Men Who Have Sex with Men in India: A Qualitative Investigation.

PubMed

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Mengle, Shruta; Varghese, Jarvis; Nelson, Ruban; Bharat, Shalini

2015-10-01

This qualitative study explored the acceptability of HIV pre-exposure prophylaxis (PrEP) among MSM in India, and identified facilitators and barriers to future PrEP uptake. In 2014, we conducted 10 focus groups (n=61) among a purposive sample of diverse MSM recruited through community-based organizations in Chennai and Mumbai, and 10 key informant interviews with community leaders and health care providers. Participants' mean age was 26.1 years (SD 4.8); 62% completed secondary education, and 42% engaged in sex work. No focus group participants had heard of PrEP, but once explained, most reported they would likely use it. PrEP was alternately perceived as a 'back-up plan', a condom substitute, or a burden with concurrent condom use. Facilitators were potential for covert use, sex without condoms, and anxiety-less sex. Potential barriers emerged around stigma associated with PrEP use, fear of disclosures to one's family, wife, or male steady partner, and being labeled as HIV-positive or promiscuous by peers. Preferences emerged for intermittent rather than daily PrEP use, injectable PrEP, and free or subsidized access through community organizations or government hospitals. Key informants expressed additional concerns about risk compensation, non-adherence, and impact on ART availability for treatment. Demonstration projects are needed in India to support PrEP implementation tailored for at-risk MSM. Educational interventions for MSM should address concerns about PrEP effectiveness, side effects, and mitigate risk compensation. Community engagement may facilitate broad acceptability and challenge stigma around PrEP use. Importantly, provision of free or subsidized PrEP is necessary to making implementation feasible among low socioeconomic status MSM in India.

Regulation of EPS production in Lactobacillus casei LC2W through metabolic engineering.

PubMed

Li, N; Huang, Y; Liu, Z; You, C; Guo, B

2015-12-01

Lactobacillus casei LC2W is an exopolysaccharide(EPS)-producing strain with probiotic effects. The low efficiency and unclear regulation mechanism of EPS biosynthesis have become main constraints for its application in food industry. To investigate the major rate-limiting factors of EPS biosynthesis and to improve its yield, metabolic engineering was applied to this strain. Eight relevant genes related to central metabolism, sugar-nucleotides supply, glycosyltransferase and cofactor engineering were cloned and overexpressed. The results suggested that nox, pfk, rfbB and galT genes were the largest contributors to EPS biosynthesis in this study, which elevated EPS yield by 46·0, 20, 17·4 and 19·6% respectively. Notably, under aerobic condition which was not a suitable condition for lactobacilli to grow in, recombinant strain LC-nox achieved the highest EPS yield of 263·7 mg l(-1) , which was increased by 75% compared to that of the starting strain. The oxygen stress was excluded since the phenomenon was not observed in the control strain under the same condition. Therefore, it was probably that higher NADH oxidase activity led to a decreased NADH availability and reduced lactate concentration, which resulted in the elevation of EPS yield. This study contributed to the understanding of EPS biosynthesis in Lact. casei through metabolic engineering and provided a starting point for introducing cofactor engineering into this strain. Overexpression of NADH oxidase was found to have a most significant effect on the EPS production. It is the first report that EPS could be accumulated to such a high level under aerobic condition in lactobacilli. Our results provided a novel strategy for the improvement of EPS production in lactic acid bacteria. © 2015 The Society for Applied Microbiology.

Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis (PrEP) in New York City

PubMed Central

Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Toohey, Christopher; Khademi, Amin; Cutler, Blayne; Braithwaite, R. Scott

2015-01-01

Objective To compare the value and effectiveness of different prioritization strategies of pre-exposure prophylaxis (PrEP) in New York City (NYC). Design Mathematical modeling utilized as clinical trial is not feasible. Methods Using a model accounting for both sexual and parenteral transmission of HIV we compare different prioritization strategies (PPS) for PrEP to two scenarios—no PrEP and PrEP for all susceptible at-risk individuals. The PPS included PrEP for all MSM, only high-risk MSM, high-risk heterosexuals, and injection drug users, and all combinations of these four strategies. Outcomes included HIV infections averted, and incremental cost effectiveness (per-infection averted) ratios. Initial assumptions regarding PrEP included a 44% reduction in HIV transmission, 50% uptake in the prioritized population and an annual cost per person of $9,762. Sensitivity analyses on key parameters were conducted. Results Prioritization to all MSM results in a 19% reduction in new HIV infections. Compared to PrEP for all persons at-risk this PPS retains 79% of the preventative effect at 15% of the total cost. PrEP prioritized to only high-risk MSM results in a reduction in new HIV infections of 15%. This PPS retains 60% of the preventative effect at 6% of the total cost. There are diminishing returns when PrEP utilization is expanded beyond this group. Conclusions PrEP implementation is relatively cost-inefficient under our initial assumptions. Our results suggest that PrEP should first be promoted among MSM who are at particularly high-risk of HIV acquisition. Further expansion beyond this group may be cost-effective, but is unlikely to be cost-saving. PMID:25493594

Adherence to Preexposure Prophylaxis: Current, Emerging, and Anticipated Bases of Evidence

PubMed Central

Amico, K. Rivet; Stirratt, Michael J.

2014-01-01

Despite considerable discussion and debate about adherence to preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV), scant data are available that characterize patterns of adherence to open-label PrEP. The current evidence base is instead dominated by research on adherence to placebo-controlled investigational drug by way of drug detection in active-arm participants of large randomized controlled trials (RCTs). Important differences between the context of blinded RCTs and open-label use suggest caution when generalizing from study product adherence to real-world PrEP use. Evidence specific to open-label PrEP adherence is presently sparse but will expand rapidly over the next few years as roll-out, demonstration projects, and more rigorous research collect and present findings. The current evidence bases established cannot yet predict uptake, adherence, or persistence with open-label effective PrEP. Emerging evidence suggests that some cohorts could execute better adherence in open-label use vs placebo-controlled research. Uptake of PrEP is presently slow in the United States; whether this changes as grassroots and community efforts increase awareness of PrEP as an effective HIV prevention option remains to be determined. As recommended by multiple guidelines for PrEP use, all current demonstration projects offer PrEP education and/or counseling. PrEP support approaches generally fall into community-based, technology, monitoring, and integrated sexual health promotion approaches. Developing and implementing research that moves beyond simple correlates of either study product use or open-label PrEP adherence toward more comprehensive models of sociobehavioral and socioecological adherence determinants would greatly accelerate progress. Intervention research is needed to identify effective models of support for open-label PrEP adherence. PMID:24926036

Proteinase-activated receptor-2 stimulates prostaglandin production in keratinocytes: analysis of prostaglandin receptors on human melanocytes and effects of PGE2 and PGF2alpha on melanocyte dendricity.

PubMed

Scott, Glynis; Leopardi, Sonya; Printup, Stacey; Malhi, Namrita; Seiberg, Miri; Lapoint, Randi

2004-05-01

Prostaglandins (PG) are key mediators of diverse functions in the skin and several reports suggest that PG mediate post-inflammatory pigmentary changes through modulation of melanocyte dendricity and melanin synthesis. The proteinase-activated receptor 2 (PAR-2) is important for skin pigmentation because activation of keratinocyte PAR-2 stimulates uptake of melanosomes through phagocytosis in a Rho-dependent manner. In this report, we show that activation of keratinocyte PAR-2 stimulates release of PGE(2) and PGF(2alpha) and that PGE(2) and PGF(2alpha) act as paracrine factors that stimulate melanocyte dendricity. We characterized the expression of the EP and FP receptors in human melanocytes and show that human melanocytes express EP1 and EP3, and the FP receptor, but not EP2 and EP4. Treatment of melanocytes with EP1 and EP3 receptor agonists resulted in increased melanocyte dendricity, indicating that both EP1 and EP3 receptor signaling contribute to PGE(2)-mediated melanocyte dendricity. Certain EP3 receptor subtypes have been shown to increase adenosine 3',5'-cyclic monophosphate (cAMP) through coupling to Gs, whereas EP1 is known to couple to Gq to activate phospholipase C with elevation in Ca(2+). The cAMP/protein kinase A system is known to modulate melanocyte dendrite formation through modulation of Rac and Rho activity. Neither PGF(2alpha) or PGE(2) elevated cAMP in human melanocytes showing that dendricity observed in response to PGE(2) and PGF(2alpha) is cAMP-independent. Our data suggest that PAR-2 mediates cutaneous pigmentation both through increased uptake of melanosomes by keratinocytes, as well as by release of PGE(2) and PGF(2alpha) that stimulate melanocyte dendricity through EP1, EP3, and FP receptors.

HIV Pre-Exposure Prophylaxis Interest among Female Sex Workers in Guangxi, China

PubMed Central

Zou, Yunfeng; Yang, Xiaobo; Abdullah, Abu S.; Zhong, Xiaoni; Ruan, Yuhua; Lin, Xinqin; Li, Mingqiang; Wu, Deren; Jiang, Junjun; Xie, Peiyan; Huang, Jiegang; Liang, Bingyu; Zhou, Bo; Su, Jinming; Liang, Hao; Huang, Ailong

2014-01-01

Objectives Acceptability of pre-exposure prophylaxis (PrEP) and willingness to participate in a clinical trial for both safety and efficacy of PrEP were investigated among female sex workers (FSWs) in Guangxi, China. Methods A cross-sectional study was performed in three cities in Guangxi. Structured, self-administered questionnaires were used to assess the acceptability of PrEP and the willingness to participate in a clinical trial. Multivariable logistic regression models were fitted to identify predictors. Results Among 405 participants, 15.1% had heard of PrEP. If PrEP was deemed to be effective, safe and provided for free, 85.9% reported that they would accept it, and 54.3% of those who accepted PrEP said that they would participate in a clinical trial. The increased acceptability of PrEP was associated with working in male dominated venues, higher income, a poor family relationship, better HIV/AIDS knowledge, not realizing HIV risk from unfamiliar clients, not being forced to use condoms by the gatekeepers, consistent use of condoms, and use of drugs to prevent STD infection. The increased willingness to participate in a clinical trial was associated with a poor family relationship, better HIV/AIDS knowledge, not realizing HIV risk from unfamiliar clients, a willingness to adhere to daily PreP use, and not being concerned about discrimination by others. The main reason for rejecting PrEP or participating in a clinical trial was the concern about the side effects of PrEP. Conclusions Acceptability of PrEP among Guangxi FSWs is relatively high, indicating that PrEP intervention programs may be feasible for Chinese FSWs. Given the fact that most of the participants had never heard of PrEP before, and that family, gatekeepers, and social discrimination could significantly affect its acceptability, a comprehensive mix of multiple interventions is necessary for the successful implementation of a PrEP program among this population in Guangxi. PMID:24465956

United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

PubMed

Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J

2016-05-01

The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods. Copyright © 2016 Elsevier Inc. All rights reserved.

PGE2 receptor EP3 inhibits water reabsorption and contributes to polyuria and kidney injury in a streptozotocin-induced mouse model of diabetes.

PubMed

Hassouneh, Ramzi; Nasrallah, Rania; Zimpelmann, Joe; Gutsol, Alex; Eckert, David; Ghossein, Jamie; Burns, Kevin D; Hébert, Richard L

2016-06-01

The first clinical manifestation of diabetes is polyuria. The prostaglandin E2 (PGE2) receptor EP3 antagonises arginine vasopressin (AVP)-mediated water reabsorption and its expression is increased in the diabetic kidney. The purpose of this work was to study the contribution of EP3 to diabetic polyuria and renal injury. Male Ep 3 (-/-) (also known as Ptger3 (-/-)) mice were treated with streptozotocin (STZ) to generate a mouse model of diabetes and renal function was evaluated after 12 weeks. Isolated collecting ducts (CDs) were microperfused to study the contribution of EP3 to AVP-mediated fluid reabsorption. Ep 3 (-/-)-STZ mice exhibited attenuated polyuria and increased urine osmolality compared with wild-type STZ (WT-STZ) mice, suggesting enhanced water reabsorption. Compared with WT-STZ mice, Ep 3 (-/-)-STZ mice also had increased protein expression of aquaporin-1, aquaporin-2, and urea transporter A1, and reduced urinary AVP excretion, but increased medullary V2 receptors. In vitro microperfusion studies indicated that Ep 3 (-/-) and WT-STZ CDs responded to AVP stimulation similarly to those of wild-type mice, with a 60% increase in fluid reabsorption. In WT non-injected and WT-STZ mice, EP3 activation with sulprostone (PGE2 analogue) abrogated AVP-mediated water reabsorption; this effect was absent in mice lacking EP3. A major finding of this work is that Ep 3 (-/-)-STZ mice showed blunted renal cyclooxygenase-2 protein expression, reduced renal hypertrophy, reduced hyperfiltration and reduced albuminuria, as well as diminished tubular dilation and nuclear cysts. Taken together, the data suggest that EP3 contributes to diabetic polyuria by inhibiting expression of aquaporins and that it promotes renal injury during diabetes. EP3 may prove to be a promising target for more selective management of diabetic kidney disease.

Absolute measurement of LDR brachytherapy source emitted power: Instrument design and initial measurements.

PubMed

Malin, Martha J; Palmer, Benjamin R; DeWerd, Larry A

2016-02-01

Energy-based source strength metrics may find use with model-based dose calculation algorithms, but no instruments exist that can measure the energy emitted from low-dose rate (LDR) sources. This work developed a calorimetric technique for measuring the power emitted from encapsulated low-dose rate, photon-emitting brachytherapy sources. This quantity is called emitted power (EP). The measurement methodology, instrument design and performance, and EP measurements made with the calorimeter are presented in this work. A calorimeter operating with a liquid helium thermal sink was developed to measure EP from LDR brachytherapy sources. The calorimeter employed an electrical substitution technique to determine the power emitted from the source. The calorimeter's performance and thermal system were characterized. EP measurements were made using four (125)I sources with air-kerma strengths ranging from 2.3 to 5.6 U and corresponding EPs of 0.39-0.79 μW, respectively. Three Best Medical 2301 sources and one Oncura 6711 source were measured. EP was also computed by converting measured air-kerma strengths to EPs through Monte Carlo-derived conversion factors. The measured EP and derived EPs were compared to determine the accuracy of the calorimeter measurement technique. The calorimeter had a noise floor of 1-3 nW and a repeatability of 30-60 nW. The calorimeter was stable to within 5 nW over a 12 h measurement window. All measured values agreed with derived EPs to within 10%, with three of the four sources agreeing to within 4%. Calorimeter measurements had uncertainties ranging from 2.6% to 4.5% at the k = 1 level. The values of the derived EPs had uncertainties ranging from 2.9% to 3.6% at the k = 1 level. A calorimeter capable of measuring the EP from LDR sources has been developed and validated for (125)I sources with EPs between 0.43 and 0.79 μW.

Aluminum ions induce oat protoplasts to produce an extracellular (1 yields 3). beta. -D-glucan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schaeffer, H.J.; Walton, J.D.

1990-09-01

Aluminum chloride induced mesophyll protoplasts of oat (Avena sativa) to produce an extracellular polysaccharide (EPS). EPS induced by AlCl{sub 3} appeared identical to that produced in response to the phytotoxin victorin. Al ions at 1 millimolar were toxic to protoplasts, but maximum EPS production occurred at a sublethal concentration of 200 micromolar, assayed at pH 6.0. As measured by incorporation of ({sup 14}C)glucose, AlCl{sub 3} stimulated EPS production 10- to 15-fold. Pretreatment of protoplasts with cycloheximide prevented EPS production but not cell death in response to AlCl{sub 3}, indicating that protein synthesis was necessary for EPS production but not formore » the phytotoxicity of Al ions. The trivalent salts of Y, Yb, Gd, and In also induced EPS production but those of Sc, Fe, Ga, Cr, and La did not. Mesophyll protoplasts from an acid-soil tolerant oat cultivar produced less EPS in response to AlCl{sub 3} than the acid-soil sensitive cultivar Fla 501. EPS was also produced by wheat (Triticum aestivum) and barley (Hordeum vulgare) protoplasts in response to AlCl{sub 3}. An Al-tolerant cultivar of wheat, Atlas, produced less EPS than an Al-sensitive cultivar, Scout, but an Al-tolerant cultivar of barley, Dayton, produced more than the Al-sensitive cultivar Kearney. Therefore, production of EPS by protoplasts in response to Al ions did not appear to be related to Al ion tolerance at the level of whole plants. EPS fluoresced in the presence of Calcofluor and Sirofluor and was degraded by purified laminarinase ((1{yields}3){beta}-D-glucanase) but did not pectinase (polygalacturonase). EPS was composed solely of glucose in 1{yields}3 linkages; hence it is a (1{yields}3){beta}-D-glucan (callose).« less

Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence - a narrative review.

PubMed

Haire, Bridget G

2015-01-01

Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP) as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings - whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma - unfavorable associations - can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use) and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity). PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. PrEP access needs to be reframed as a positive and responsible option to help people remain HIV-negative.

Delimitation of the Earliness per se D1 (Eps-D1) flowering gene to a subtelomeric chromosomal deletion in bread wheat (Triticum aestivum).

PubMed

Zikhali, Meluleki; Wingen, Luzie U; Griffiths, Simon

2016-01-01

Earliness per se (Eps) genes account for the variation in flowering time when vernalization and photoperiod requirements are satisfied. Genomics and bioinformatics approaches were used to describe allelic variation for 40 Triticum aestivum genes predicted, by synteny with Brachypodium distachyon, to be in the 1DL Eps region. Re-sequencing 1DL genes revealed that varieties carrying early heading alleles at this locus, Spark and Cadenza, carry a subtelomeric deletion including several genes. The equivalent region in Rialto and Avalon is intact. A bimodal distribution in the segregating Spark X Rialto single seed descent (SSD) populations enabled the 1DL QTL to be defined as a discrete Mendelian factor, which we named Eps-D1. Near isogenic lines (NILs) and NIL derived key recombinants between markers flanking Eps-D1 suggest that the 1DL deletion contains the gene(s) underlying Eps-D1. The deletion spans the equivalent of the Triticum monoccocum Eps-A (m) 1 locus, and hence includes MODIFIER OF TRANSCRIPTION 1 (MOT1) and FTSH PROTEASE 4 (FTSH4), the candidates for Eps-A (m) 1. The deletion also contains T. aestivum EARLY FLOWERING 3-D1 (TaELF3-D1) a homologue of the Arabidopsis thaliana circadian clock gene EARLY FLOWERING 3. Eps-D1 is possibly a homologue of Eps-B1 on chromosome 1BL. NILs carrying the Eps-D1 deletion have significantly reduced total TaELF3 expression and altered TaGIGANTEA (TaGI) expression compared with wild type. Altered TaGI expression is consistent with an ELF3 mutant, hence we propose TaELF3-D1 as the more likely candidate for Eps-D1. This is the first direct fine mapping of Eps effect in bread wheat. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

CD40 engagement on dendritic cells induces cyclooxygenase-2 and EP2 receptor via p38 and ERK MAPKs.

PubMed

Harizi, Hedi; Limem, Ilef; Gualde, Norbert

2011-02-01

We have previously reported that cyclooxygenase (COX)-2-derived prostaglandin (PG)E2 critically regulates dendritic cell (DC) inflammatory phenotype and function through EP2/EP4 receptor subtypes. As genes activated by CD40 engagement are directly relevant to inflammation, we examined the effects of CD40 activation on inflammatory PGs in murine bone marrow-derived DC (mBM-DC). We showed for the first time that activation of mBM-DC with agonist anti-CD40 monoclonal antibody (anti-CD40 mAb) dose dependently induces the synthesis of significant amounts of PGE2 via inducible expression of COX-2 enzyme, as NS-398, a COX-2-selective inhibitor reduces this upregulation. In contrast to lipopolysaccharide, which upregulates mBM-DC surface levels of EP2 and EP4 receptors, CD40 crosslinking on mBM-DC increases EP2, but not EP4, receptor expression. Flow cytometry analysis and radioligand-binding assay showed that EP2 was the major EP receptor subtype, which binds to PGE2 at the surface of anti-CD40-activated mBM-DC. Upregulation of COX-2 and EP2 levels by CD40 engagement was accompanied by dose-dependent phosphorylation of p38 and ERK1/2 mitogen-activated protein kinase (MAPK) and was abrogated by inhibitors of both pathways. Collectively, we demonstrated that CD40 engagement on mBM-DC upregulates COX-2 and EP2 receptor expression through activation of p38 and ERK1/2 MAPK signaling. Triggering the PGE2/EP2 pathway by anti-CD40 mAb resulted on the induction of Th2 immune response. Thus, CD40-induced production of PGE2 by mBM-DC could represent a negative feedback mechanism involving EP2 receptor and limiting the propagation of Th1 responses. Blocking CD40 pathway may represent a novel therapeutic pathway of inhibiting COX-2-derived prostanoids in chronically inflamed tissues (that is, arthritis).

Bioprospecting for Exopolysaccharides from Deep-Sea Hydrothermal Vent Bacteria: Relationship between Bacterial Diversity and Chemical Diversity

PubMed Central

Delbarre-Ladrat, Christine; Leyva Salas, Marcia; Zykwinska, Agata; Colliec-Jouault, Sylvia

2017-01-01

Many bacteria biosynthesize structurally diverse exopolysaccharides (EPS) and excrete them into their surrounding environment. The EPS functional features have found many applications in industries such as cosmetics and pharmaceutics. In particular, some EPS produced by marine bacteria are composed of uronic acids, neutral sugars, and N-acetylhexosamines, and may also bear some functional sulfate groups. This suggests that they can share common structural features with glycosaminoglycans (GAG) like the two EPS (HE800 and GY785) originating from the deep sea. In an attempt to discover new EPS that may be promising candidates as GAG-mimetics, fifty-one marine bacterial strains originating from deep-sea hydrothermal vents were screened. The analysis of the EPS chemical structure in relation to bacterial species showed that Vibrio, Alteromonas, and Pseudoalteromonas strains were the main producers. Moreover, they produced EPS with distinct structural features, which might be useful for targeting marine bacteria that could possibly produce structurally GAG-mimetic EPS. PMID:28930185

Biopolymers from lactic acid bacteria. Novel applications in foods and beverages

PubMed Central

Torino, María I.; Font de Valdez, Graciela; Mozzi, Fernanda

2015-01-01

Lactic acid bacteria (LAB) are microorganisms widely used in the fermented food industry worldwide. Certain LAB are able to produce exopolysaccharides (EPS) either attached to the cell wall (capsular EPS) or released to the extracellular environment (EPS). According to their composition, LAB may synthesize heteropolysaccharides or homopolysaccharides. A wide diversity of EPS are produced by LAB concerning their monomer composition, molecular mass, and structure. Although EPS-producing LAB strains have been traditionally applied in the manufacture of dairy products such as fermented milks and yogurts, their use in the elaboration of low-fat cheeses, diverse type of sourdough breads, and certain beverages are some of the novel applications of these polymers. This work aims to collect the most relevant issues of the former reviews concerning the monomer composition, structure, and yields and biosynthetic enzymes of EPS from LAB; to describe the recently characterized EPS and to present the application of both EPS-producing strains and their polymers in the fermented (specifically beverages and cereal-based) food industry. PMID:26441845

Hypocholesterolemic and bioactive potential of exopolysaccharide from a probiotic Enterococcus faecium K1 isolated from kalarei.

PubMed

Bhat, Bilqeesa; Bajaj, Bijender Kumar

2018-04-01

Bioprospecting of novel probiotic strains especially from unexplored eco-niches has been a continuous practice. Enterococcus faecium K1, an isolate from indigenously fermented milk product kalarei possesses numerous desirable functional attributes. In current study, E. faecium K1 has been used for EPS production, and it yielded 355 ± 0.019 mg/L EPS. EPS demonstrates remarkable hypocholesterolemic, antioxidant, antibiofilm, and emulsification characteristics. EPS is constituted of mannose, glucose and galactose. SEM analysis reveals flake like compact structure of EPS while TEM and X-ray diffractogram confirms the amorphous structure of EPS. FTIR substantiates the functional groups/bonds typical of polysaccharides. Thermal analysis indicates adequate stability of EPS at 237 °C with average weight loss of 22%. E. faecium K1 EPS possesses unique functional bioactivities and physicochemical characteristics, and may potentially be explored for applications in food/pharmaceutical industries. Copyright © 2018 Elsevier Ltd. All rights reserved.

Lead Optimization Studies of Cinnamic Amide EP2 Antagonists

PubMed Central

2015-01-01

Prostanoid receptor EP2 can play a proinflammatory role, exacerbating disease pathology in a variety of central nervous system and peripheral diseases. A highly selective EP2 antagonist could be useful as a drug to mitigate the inflammatory consequences of EP2 activation. We recently identified a cinnamic amide class of EP2 antagonists. The lead compound in this class (5d) displays anti-inflammatory and neuroprotective actions. However, this compound exhibited moderate selectivity to EP2 over the DP1 prostanoid receptor (∼10-fold) and low aqueous solubility. We now report compounds that display up to 180-fold selectivity against DP1 and up to 9-fold higher aqueous solubility than our previous lead. The newly developed compounds also display higher selectivity against EP4 and IP receptors and a comparable plasma pharmacokinetics. Thus, these compounds are useful for proof of concept studies in a variety of models where EP2 activation is playing a deleterious role. PMID:24773616

Effects of Exopolysaccharide Production on Liquid Vegetative Growth, Stress Survival and Stationary Phase Recovery in Myxococcus xanthus

PubMed Central

Hu, Wei; Wang, Jing; McHardy, Ian; Lux, Renate; Yang, Zhe; Li, Yuezhong; Shi, Wenyuan

2013-01-01

Exopolysaccharide (EPS) of Myxococcus xanthus is a well-regulated cell surface component. In addition to its known functions for social motility and fruiting body formation on solid surfaces, EPS has also been proposed to play a role in multi-cellular clumping in liquid medium, though this phenomenon has not been well studied. In this report, we confirmed that M. xanthus clumps formed in liquid were correlated with EPS levels and demonstrated that the EPS encased cell clumps exhibited biofilm-like structures. The clumps protected the cells at physiologically relevant EPS concentrations, while cells lacking EPS exhibited significant reduction in long-term viability and resistance to stressful conditions. However, excess EPS production was counterproductive to vegetative growth and viable cell recovery declined in extended late stationary phase as cells became trapped in the matrix of clumps. Therefore, optimal EPS production by M. xanthus is important for normal physiological functions in liquid. PMID:22538652

The future of pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection.

PubMed

Özdener, Ayşe Elif; Park, Tae Eun; Kalabalik, Julie; Gupta, Rachna

2017-05-01

People at high risk for HIV acquisition should be offered pre-exposure prophylaxis (PrEP). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) is currently the only medication recommended for pre-exposure prophylaxis (PrEP) by the Centers for Disease Control and Prevention (CDC) in people at high risk for HIV acquisition. This article will review medications currently under investigation and the future landscape of PrEP therapy. Areas covered: This article will review clinical trials that have investigated nontraditional regimens of TDF/FTC, antiretroviral agents from different drug classes such as integrase strand transfer inhibitors (INSTI), nucleoside reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) as potential PrEP therapies. Expert commentary: Currently, there are several investigational drugs in the pipeline for PrEP against HIV infection. Increased utilization of PrEP therapy depends on provider identification of people at high risk for HIV transmission. Advances in PrEP development will expand options and access for people and reduce the risk of HIV acquisition.

Vacuolar Localization of Endoproteinases EP(1) and EP(2) in Barley Mesophyll Cells.

PubMed

Thayer, S S; Huffaker, R C

1984-05-01

The localization of two previously characterized endoproteinases (EP(1) and EP(2)) that comprise more than 95% of the protease activity in primary Hordeum vulgare L. var Numar leaves was determined. Intact vacuoles released from washed mesophyll protoplasts by gentle osmotic shock and increase in pH, were purified by flotation through a four-step Ficoll gradient. These vacuoles contained endoproteinases that rapidly degraded purified barley ribulose-1,5-bisphosphate carboxylase (RuBPCase) substrate. Breakdown products and extent of digestion of RuBPCase were determined using 12% polyacrylamide-sodium dodecyl sulfate gels. Coomassie brilliant blue- or silver-stained gels were scanned, and the peaks were integrated to provide quantitative information. The characteristics of the vacuolar endoproteinases (e.g. sensitivity to various inhibitors and activators, and the molecular weights of the breakdown products, i.e. peptide maps) closely resembled those of purified EP(1) and partially purified EP(2). It is therefore concluded that EP(1) and EP(2) are localized in the vacuoles of mesophyll cells.

Performances of different protocols for exocellular polysaccharides extraction from milk acid gels: Application to yogurt.

PubMed

Nguyen, An Thi-Binh; Nigen, Michaël; Jimenez, Luciana; Ait-Abderrahim, Hassina; Marchesseau, Sylvie; Picart-Palmade, Laetitia

2018-01-15

Dextran or xanthan were used as model exocellular polysaccharides (EPS) to compare the extraction efficiency of EPS from skim milk acid gels using three different protocols. Extraction yields, residual protein concentrations and the macromolecular properties of extracted EPS were determined. For both model EPS, the highest extraction yield (∼80%) was obtained when samples were heated in acidic conditions at the first step of extraction (Protocol 1). Protocols that contained steps of acid/ethanol precipitation without heating (Protocols 2 and 3) show lower extraction yields (∼55%) but allow a better preservation of the EPS macromolecular properties. Changing the pH of acid gels up to 7 before extraction (Protocol 3) improved the extraction yield of anionic EPS without effect on the macromolecular properties of EPS. Protocol 1 was then applied for the quantification of EPS produced during the yogurt fermentation, while Protocol 3 was dedicated to their macromolecular characterization. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceived HIV risk, actual sexual HIV risk and willingness to take pre-exposure prophylaxis among men who have sex with men in Toronto, Canada.

PubMed

Kesler, Maya A; Kaul, Rupert; Myers, Ted; Liu, Juan; Loutfy, Mona; Remis, Robert S; Gesink, Dionne

2016-11-01

Pre-exposure prophylaxis (PrEP) reduces HIV acquisition. Our goal was to determine the willingness of men who have sex with men (MSM) to take PrEP given perceived and actual HIV risk. HIV-negative MSM were recruited from September 2010 to June 2012 and asked about PrEP willingness and perceived HIV risk. Actual sexual HIV risk was measured by three condom-use components generated through principal components analysis. General HIV risk was measured using the HIV Incidence Risk Index for MSM (HIRI-MSM). Model 1 measured PrEP willingness given perceived and actual sexual HIV risk. Model 2 included actual HIV sexual risk, perceived HIV risk and general HIV risk. Model 3 removed actual sexual HIV risk. We recruited 150 HIV-negative MSM. About 55% were willing to take PrEP. Reasons for PrEP unwillingness were: low perceived risk (64%), side-effect concerns (44%), daily pill burden (16%) and efficacy concerns (4%). Model 1: MSM with high compared to low actual sexual HIV risk were more willing to use PrEP (OR 27.11, 95% CI 1.33-554.43) after adjusting for perceived risk, which was not significantly associated with PrEP willingness (OR 4.79, 95% CI 0.72-31.96). Model 2: MSM with high compared to low actual sexual HIV risk were more willing to use PrEP (OR 29.85, 95% CI 1.39-640.53) after adjusting for perceived and general HIV risk, neither of which was significantly associated with PrEP willingness (OR 5.07, 95% CI 0.73-35.09) and (OR 1.58, 95% CI 0.37-6.79), respectively. Model 3: After removing actual sexual HIV risk, MSM with high compared to low perceived risk were more willing to use PrEP (OR 6.85, 95% CI 1.23-38.05), and the HIRI-MSM general risk index was not associated with PrEP willingness (OR 1.87, 95% CI 0.54-6.54). Therefore, actual sexual HIV risk was the best predictor of PrEP willingness and general HIV risk did not inform PrEP willingness.

Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey

PubMed Central

Pang, Joselyn; Wei, Clayton Koh Thuan; Yee, Ilias Adam; Wang, Bangyuan; Cassolato, Matteo

2017-01-01

Objective We examined willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia. Methods An online survey of 990 MSM was conducted between March and April 2016. Eligibility criteria included being biological male, Malaysian citizen, 18 years of age or above, identifying as MSM, and being HIV negative or unknown status. Participants’ demographics, sexual and drug use behaviors, attitudes towards PrEP, and preferences regarding future access to PrEP were collected. Bivariate analysis and logistic regression were performed to determine factors associated with willingness to use PrEP. Results Fewer than half of participants (44%) knew about PrEP before completing the survey. Overall, 39% of the sample were willing to take PrEP. Multivariate logistic regression indicated that Malay men (AOR: 1.73, 95% CI:1.12, 2.70), having 2 or more male anal sex partners in the past 6 months (AOR: 1.98, 95% CI: 1.29, 3.05), previous knowledge of PrEP (AOR: 1.40, 95%CI: 1.06, 1.86), lack of confidence in practising safer sex (AOR: 1.36, 95% CI: 1.02, 1.81), and having ever paid for sex with a male partner (AOR: 1.39, 95% CI: 1.01, 1.91) were independently associated with greater willingness to use PrEP, while men who identified as heterosexual were less willing to use PrEP (AOR, 0.36, 95% CI: 0.13, 0.97). Majority of participants preferred to access PrEP at affordable cost below 100 Malaysian Ringgit (USD25) per month from community based organisations followed by private or government hospitals. Conclusions Overall, MSM in Malaysia reported a relatively low level of willingness to use PrEP, although willingness was higher among those previously aware of PrEP. There is a need to provide PrEP at affordable cost, increase demand and awareness of PrEP, and to provide access to this preventative medication via diverse, integrated and tailored sexual health services. PMID:28902857

Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey.

PubMed

Lim, Sin How; Mburu, Gitau; Bourne, Adam; Pang, Joselyn; Wickersham, Jeffrey A; Wei, Clayton Koh Thuan; Yee, Ilias Adam; Wang, Bangyuan; Cassolato, Matteo; Azwa, Iskandar

2017-01-01

We examined willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia. An online survey of 990 MSM was conducted between March and April 2016. Eligibility criteria included being biological male, Malaysian citizen, 18 years of age or above, identifying as MSM, and being HIV negative or unknown status. Participants' demographics, sexual and drug use behaviors, attitudes towards PrEP, and preferences regarding future access to PrEP were collected. Bivariate analysis and logistic regression were performed to determine factors associated with willingness to use PrEP. Fewer than half of participants (44%) knew about PrEP before completing the survey. Overall, 39% of the sample were willing to take PrEP. Multivariate logistic regression indicated that Malay men (AOR: 1.73, 95% CI:1.12, 2.70), having 2 or more male anal sex partners in the past 6 months (AOR: 1.98, 95% CI: 1.29, 3.05), previous knowledge of PrEP (AOR: 1.40, 95%CI: 1.06, 1.86), lack of confidence in practising safer sex (AOR: 1.36, 95% CI: 1.02, 1.81), and having ever paid for sex with a male partner (AOR: 1.39, 95% CI: 1.01, 1.91) were independently associated with greater willingness to use PrEP, while men who identified as heterosexual were less willing to use PrEP (AOR, 0.36, 95% CI: 0.13, 0.97). Majority of participants preferred to access PrEP at affordable cost below 100 Malaysian Ringgit (USD25) per month from community based organisations followed by private or government hospitals. Overall, MSM in Malaysia reported a relatively low level of willingness to use PrEP, although willingness was higher among those previously aware of PrEP. There is a need to provide PrEP at affordable cost, increase demand and awareness of PrEP, and to provide access to this preventative medication via diverse, integrated and tailored sexual health services.

The cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil.

PubMed

Luz, Paula M; Osher, Benjamin; Grinsztejn, Beatriz; Maclean, Rachel L; Losina, Elena; Stern, Madeline E; Struchiner, Claudio J; Parker, Robert A; Freedberg, Kenneth A; Mesquita, Fabio; Walensky, Rochelle P; Veloso, Valdilea G; Paltiel, A David

2018-03-01

Men who have sex with men (MSM) and transgender women (TGW) in Brazil experience high rates of HIV infection. We examined the clinical and economic outcomes of implementing a pre-exposure prophylaxis (PrEP) programme in these populations. We used the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-International model of HIV prevention and treatment to evaluate two strategies: the current standard of care (SOC) in Brazil, including universal ART access (No PrEP strategy); and the current SOC plus daily tenofovir/emtracitabine PrEP (PrEP strategy) until age 50. Mean age (31 years, SD 8.4 years), age-stratified annual HIV incidence (age ≤ 40 years: 4.3/100 PY; age > 40 years: 1.0/100 PY), PrEP effectiveness (43% HIV incidence reduction) and PrEP drug costs ($23/month) were from Brazil-based sources. The analysis focused on direct medical costs of HIV care. We measured the comparative value of PrEP in 2015 United States dollars (USD) per year of life saved (YLS). Willingness-to-pay threshold was based on Brazil's annual per capita gross domestic product (GDP; 2015: $8540 USD). Lifetime HIV infection risk among high-risk MSM and TGW was 50.5% with No PrEP and decreased to 40.1% with PrEP. PrEP increased per-person undiscounted (discounted) life expectancy from 36.8 (20.7) years to 41.0 (22.4) years and lifetime discounted HIV-related medical costs from $4100 to $8420, which led to an incremental cost-effectiveness ratio (ICER) of $2530/YLS. PrEP remained cost-effective (<1x GDP) under plausible variation in key parameters, including PrEP effectiveness and cost, initial cohort age and HIV testing frequency on/off PrEP. Daily tenofovir/emtracitabine PrEP among MSM and TGW at high risk of HIV infection in Brazil would increase life expectancy and be highly cost-effective. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Effects of light intensity on components and topographical structures of extracellular polysaccharides from the cyanobacteria Nostoc sp.

PubMed

Ge, Hongmei; Xia, Ling; Zhou, Xuping; Zhang, Delu; Hu, Chunxiang

2014-02-01

A study on the effects of light intensity (40 and 80 μE/m(2)/sec) on the components and topographical structures of extracellular polysaccharides (EPS) was carried out in cyanobacteria Nostoc sp.. EPS yield increased with light intensity. However, light intensity did not significantly affect the EPS fractions and monosaccharide composition. Higher light intensity generally resulted in higher protein content of EPS in similar fractions. The topographical structure of EPS, investigated by atomic force microscopy, appeared as spherical lumps, chains and networks. The long chains were observed at higher light intensity. Thus, light intensity affected the yield and nature of EPS.

Using data from a behavioural survey of men who have sex with men (MSM) to estimate the number likely to present for HIV pre-exposure prophylaxis (PrEP) in Ireland, 2017.

PubMed

Nic Lochlainn, Laura; O'Donnell, Kate; Hurley, Caroline; Lyons, Fiona; Igoe, Derval

2017-11-01

In Ireland, men who have sex with men (MSM) have increased HIV risk. Pre-exposure prophylaxis (PrEP), combined with safe sex practices, can reduce HIV acquisition. We estimated MSM numbers likely to present for PrEP by applying French PrEP criteria to Irish MSM behavioural survey data. We adjusted for survey bias, calculated proportions accessing testing services and those likely to take PrEP. We estimated 1-3% of MSM in Ireland were likely to present for PrEP.

Overview of the 2014 Edition of the International Handbook of Evaluated Reactor Physics Benchmark Experiments (IRPhEP Handbook)

DOE Office of Scientific and Technical Information (OSTI.GOV)

John D. Bess; J. Blair Briggs; Jim Gulliford

2014-10-01

The International Reactor Physics Experiment Evaluation Project (IRPhEP) is a widely recognized world class program. The work of the IRPhEP is documented in the International Handbook of Evaluated Reactor Physics Benchmark Experiments (IRPhEP Handbook). Integral data from the IRPhEP Handbook is used by reactor safety and design, nuclear data, criticality safety, and analytical methods development specialists, worldwide, to perform necessary validations of their calculational techniques. The IRPhEP Handbook is among the most frequently quoted reference in the nuclear industry and is expected to be a valuable resource for future decades.

Space station electrical power system availability study

NASA Technical Reports Server (NTRS)

Turnquist, Scott R.; Twombly, Mark A.

1988-01-01

ARINC Research Corporation performed a preliminary reliability, and maintainability (RAM) anlaysis of the NASA space station Electric Power Station (EPS). The analysis was performed using the ARINC Research developed UNIRAM RAM assessment methodology and software program. The analysis was performed in two phases: EPS modeling and EPS RAM assessment. The EPS was modeled in four parts: the insolar power generation system, the eclipse power generation system, the power management and distribution system (both ring and radial power distribution control unit (PDCU) architectures), and the power distribution to the inner keel PDCUs. The EPS RAM assessment was conducted in five steps: the use of UNIRAM to perform baseline EPS model analyses and to determine the orbital replacement unit (ORU) criticalities; the determination of EPS sensitivity to on-orbit spared of ORUs and the provision of an indication of which ORUs may need to be spared on-orbit; the determination of EPS sensitivity to changes in ORU reliability; the determination of the expected annual number of ORU failures; and the integration of the power generator system model results with the distribution system model results to assess the full EPS. Conclusions were drawn and recommendations were made.

Preferences for Long-Acting Pre-Exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention among U.S. Men Who Have Sex with Men

PubMed Central

Greene, George J.; Swann, Greg; Fought, Angela J.; Carballo-Diéguez, Alex; Hope, Thomas J.; Kiser, Patrick F.; Mustanski, Brian; D’Aquila, Richard T.

2016-01-01

HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90% consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8%), followed by non-visible implants (21.5%), and oral PrEP (17.0%); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5% and 34.3%, respectively), followed by injections (25.2%) and visible implants (4.3%). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention. PMID:27770215

A study on resistance to ultraviolet radiation of POSS-TiO2/epoxy nanocomposites

NASA Astrophysics Data System (ADS)

Peng, Dequn; Qin, Wei; Wu, Xiaohong

2015-06-01

Ultraviolet (UV) radiation is a severe space environmental factor, which is harmful to the durability of the polymeric materials of the spacecraft. For this reason, a novel POSS-TiO2/EP nanocomposite was synthesized by incorporating the POSS-TiO2 organic-inorganic hybrid into the epoxy (EP) resin. The effects of UV radiation on EP resin and on POSS-TiO2/EP nanocomposites were investigated in a ground-based simulator that simulates space radiation conditions. Compared with EP resin, the value of bend strength for 5.0 wt% POSS-TiO2/EP varied in a small range before and after UV radiation. Meanwhile, a typical tough feature was observed from the SEM photo for POSS-TiO2/EP nanocomposite after UV exposure. This result indicated that the POSS-TiO2/EP exhibited the excellent properties of anti-space ultraviolet radiation. The thermo gravimetric (TG) results showed that the addition of POSS-TiO2 improved the thermal-stability of EP resin matrix. The synthesized nanocomposites in this work could be used in the satellites to enhance their adaptability to the space environment and extend their service life.

Effect of in situ exopolysaccharide production on physicochemical, rheological, sensory, and microstructural properties of the yogurt drink ayran: an optimization study based on fermentation kinetics.

PubMed

Yilmaz, M T; Dertli, E; Toker, O S; Tatlisu, N B; Sagdic, O; Arici, M

2015-03-01

Exopolysaccharide (EPS)-producing starter cultures are preferred for the manufacture of fermented milk products to improve rheological and technological properties. However, no clear correlation exists between EPS production and the rheological and technological properties of fermented milk products such as the yogurt drink ayran. In this study, 4 different strain conditions (EPS- and EPS+ Streptococcus thermophilus strains) were tested as a function of incubation temperature (32, 37, or 42°C) and time (2, 3, or 4 h) to determine the effect of culture type and in situ EPS production on physicochemical, rheological, sensory, and microstructural properties of ayran. Furthermore, we assessed the effect of fermentation conditions on amounts of EPS production by different EPS-producing strains during ayran production. A multifactorial design of response surface methodology was used to model linear, interaction, and quadratic effects of these variables on steady shear rheological properties of ayran samples and in situ EPS production levels. The physicochemical and microbiological characteristics of ayran samples altered depending on incubation conditions and strain selection. Steady shear tests showed that ayran samples inoculated with EPS+ strains exhibited pseudoplastic flow behavior. Production of ayran with EPS- strain (control sample) resulted in the lowest apparent viscosity values (η50), whereas those produced with the combination of 2 EPS+ strains yielded ayran with notably increased η50 values. We concluded that incubation time was the variable with the greatest effect on η50, consistency coefficient (K), and flow behavior index (n) values. In situ EPS production was also affected by these conditions during ayran fermentation in which strain-specific metabolism conditions were found to be the most important factor for EPS production. In addition, these findings correlated the amount of in situ EPS produced with the rheological properties of ayran. Scanning electron microscopy images of the samples showed differences in structural features, revealing a prominent network strand structure in the ayran samples inoculated with the admixture of 2 EPS-producing strains incubated at 37°C for 3 h. These results provide useful information for large-scale production of ayran by the dairy industry. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

7 CFR 3201.53 - Expanded polystyrene (EPS) foam recycling products.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Expanded polystyrene (EPS) foam recycling products... FOR FEDERAL PROCUREMENT Designated Items § 3201.53 Expanded polystyrene (EPS) foam recycling products... with this part, will give a procurement preference for qualifying biobased EPS foam recycling products...

7 CFR 3201.53 - Expanded polystyrene (EPS) foam recycling products.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Expanded polystyrene (EPS) foam recycling products... FOR FEDERAL PROCUREMENT Designated Items § 3201.53 Expanded polystyrene (EPS) foam recycling products... with this part, will give a procurement preference for qualifying biobased EPS foam recycling products...

7 CFR 2902.53 - Expanded polystyrene (EPS) foam recycling products.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Expanded polystyrene (EPS) foam recycling products... FEDERAL PROCUREMENT Designated Items § 2902.53 Expanded polystyrene (EPS) foam recycling products. (a..., will give a procurement preference for qualifying biobased EPS foam recycling products. By that date...

7 CFR 3201.53 - Expanded polystyrene (EPS) foam recycling products.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Expanded polystyrene (EPS) foam recycling products... FOR FEDERAL PROCUREMENT Designated Items § 3201.53 Expanded polystyrene (EPS) foam recycling products... with this part, will give a procurement preference for qualifying biobased EPS foam recycling products...

CXSFIT Code Application to Process Charge-Exchange Recombination Spectroscopy Data at the T-10 Tokamak

NASA Astrophysics Data System (ADS)

Serov, S. V.; Tugarinov, S. N.; Klyuchnikov, L. A.; Krupin, V. A.; von Hellermann, M.

2017-12-01

The applicability of the CXSFIT code to process experimental data from Charge-eXchange Recombination Spectroscopy (CXRS) diagnostics at the T-10 tokamak is studied with a view to its further use for processing experimental data at the ITER facility. The design and operating principle of the CXRS diagnostics are described. The main methods for processing the CXRS spectra of the 5291-Å line of C5+ ions at the T-10 tokamak (with and without subtraction of parasitic emission from the edge plasma) are analyzed. The method of averaging the CXRS spectra over several shots, which is used at the T-10 tokamak to increase the signal-to-noise ratio, is described. The approximation of the spectrum by a set of Gaussian components is used to identify the active CXRS line in the measured spectrum. Using the CXSFIT code, the ion temperature in ohmic discharges and discharges with auxiliary electron cyclotron resonance heating (ECRH) at the T-10 tokamak is calculated from the CXRS spectra of the 5291-Å line. The time behavior of the ion temperature profile in different ohmic heating modes is studied. The temperature profile dependence on the ECRH power is measured, and the dynamics of ECR removal of carbon nuclei from the T-10 plasma is described. Experimental data from the CXRS diagnostics at T-10 substantially contribute to the implementation of physical programs of studies on heat and particle transport in tokamak plasmas and investigation of geodesic acoustic mode properties.

Minimal Awareness and Stalled Uptake of Pre-Exposure Prophylaxis (PrEP) Among at Risk, HIV-Negative, Black Men Who Have Sex with Men

PubMed Central

Driffin, Daniel D.; Bauermeister, Jose; Smith, Harlan; Conway-Washington, Christopher

2015-01-01

Abstract In the United States, rates of HIV infection are highest among black men who have sex with men (BMSM). Pre-exposure prophylaxis (PrEP) is a highly effective form of HIV prevention, but the uptake of this strategy has been slow since FDA approval in 2012, and it is unknown whether information about PrEP is reaching BMSM. Four hundred and thirty-six BMSM in Atlanta, GA were surveyed from January 2012 (6 months prior to PrEP approval) to March 2014 (20 months after approval). Analyses revealed no association between date of survey assessment and awareness of PrEP (20.5% were aware of PrEP before approval and 23.4% were aware after approval; OR=0.99 [0.98–1.02], p=0.952). In a multivariate model, BMSM unaware of PrEP reported lower rates of HIV testing knowledge, fewer experiences with HIV testing, and higher rates of transactional sex than BMSM who were aware of PrEP. Our findings suggest that there is limited understanding of PrEP and that there is considerable groundwork that needs to be achieved in order to reap the full benefits of PrEP. The current findings call attention to the need to both prioritize and better understand how to strengthen the bridge between medical advances and community uptake. PMID:26083143

Transcriptional repression of epithelial cell adhesion molecule (EpCAM) contributes to p53 control of breast cancer invasion

PubMed Central

Sankpal, NV; Willman, MW; Fleming, TP; Mayfield, J; Gillanders, WE

2014-01-01

p53 is a tumor suppressor gene with well-characterized roles in cell cycle regulation, apoptosis and the maintenance of genome stability. Recent evidence suggests that p53 may also contribute to the regulation of migration and invasion. Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein that is overexpressed in the majority of human epithelial carcinomas, including breast and colorectal carcinomas. We demonstrate by chromatin immunoprecipitation assays that p53 interacts with a candidate p53 binding site within the EpCAM gene. p53-mediated transcriptional repression of EpCAM was confirmed in gain-of-function, and loss-of-function experimental systems. Induction of wildtype p53 was associated with a significant dose-dependent decrease in EpCAM expression; conversely, specific ablation of p53 was associated with a significant increase in EpCAM expression. At the functional level, specific ablation of p53 expression is associated with increased breast cancer invasion, and this effect is abrogated by concomitant specific ablation of EpCAM expression. Taken together, these biochemical and functional data are the first demonstration that (1) wildtype p53 protein binds to a response element within the EpCAM gene and negatively regulates EpCAM expression, and (2) transcriptional repression of EpCAM contributes to p53 control of breast cancer invasion. PMID:19141643

Effects of potassium ferrate on extracellular polymeric substances (EPS) and physicochemical properties of excess activated sludge.

PubMed

Ye, Fenxia; Liu, Xinwen; Li, Ying

2012-01-15

The activated sludge process of wastewater results in the generation of a considerable amount of excess activated sludge. In many wastewater treatment plants, the bottleneck of the sludge handling system is the dewatering operation. This paper investigated the effect of potassium ferrate pretreatment on the physicochemical properties of the excess activated sludge at various dosages of potassium ferrate. The particle size, extracellular polymeric substances (EPS) content and chemical components, and sludge disintegration degree were measured to explain the observed changes of physicochemical properties. It was expected that potassium ferrate could enhance the filterability and dewaterability of the sludge. However, the results showed that potassium ferrate had a negative effect on the filterability by measuring the capillary suction time (CST), but improved the settleability and dewaterability extent by determining the water content in the dewatered cake, although the flocs size reduced slightly. Loosely bound EPS (LB-EPS) content, polysaccharides (PS) and proteins (PN) contents in LB-EPS all increased with increasing the amount of potassium ferrate. However, Tightly bound EPS (TB-EPS) content, PS and PN contents in TB-EPS did not changed significantly at first, and decreased slightly under higher dosage of potassium ferrate. EPS, especially LB-EPS played more important role in the observed changes of the settleability and filterability than the sludge particle size. Copyright © 2011 Elsevier B.V. All rights reserved.

PrEP Whores and HIV Prevention: The Queer Communication of HIV Pre-Exposure Prophylaxis (PrEP).

PubMed

Spieldenner, Andrew

2016-12-01

HIV pre-exposure prophylaxis (PrEP) has been introduced as another biomedical tool in HIV prevention. Whereas other such tools-including post-exposure prophylaxis (PEP) and interruption of perinatal transmission-have been embraced by those impacted by HIV, PrEP has been met with more conflict, especially within the gay community and HIV organizations. The "PrEP whore" has come to designate the social value and personal practices of those taking PrEP. This study examines the "PrEP whore" discourse by using queer theory and quare theory. Within these theoretical vantage points, the study explicates four discursive areas: slut shaming, dirty/clean binaries, mourning the loss of condoms, and reclaiming the inner whore. The study illuminates possible discursive strategies that lie outside of the domains of public health and within the individual and community.

Rf-assisted current startup in the Fusion Engineering Device (FED)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borowski, S.K.; Peng, Y.K.M.; Kammash, T.

1982-08-01

Auxiliary rf heating of electrons before and during the current rise phase in the Fusion Engineering Device is examined as a means of reducing both the initiation loop voltage and resistive flux expenditure during startup. Prior to current initiation 1 to 2 MW of electron cyclotron resonance heating (ECRH) power at approx. 90 GHz is used to create a small volume of high conductivity plasma (T/sub e/ approx. = 100 eV, n/sub e/ approx. = 10/sup 13/ cm/sup -3/) near the upper hybrid resonance (UHR) region. This plasma conditioning permits a small radius (a/sub o/ approx. = 0.2 to 0.4more » m) current channel to be established with a relatively low initial loop voltage (less than or equal to 25 V). During the subsequent plasma expansion and current ramp phase, additional rf power is introduced to reduce volt-second consumption due to plasma resistance. A near classical particle and energy transport model has been developed to estimate the efficiency of electron heating in a currentless toroidal plasma. The model assumes that preferential electron heating at the UHR leads to the formation of an ambipolar sheath potential between the neutral plasma and the conducting vacuum vessel and limiter. The ambipolar electric field (E/sub AMB/) enables the plasma to neutralize itself via poloidal E vector/sub AMB/ x B vector drift. This form of effective rotational transform short-circuits the vertical charge separation and improves particle confinement.« less

Involvement of central, but not placental corticotropin releasing hormone (CRH) in heat stress induced immunosuppression during pregnancy.

PubMed

Nakamura, H; Nagase, H; Ogino, K; Hatta, K; Matsuzaki, I

2001-03-01

To clarify whether corticotropin releasing hormone (CRH) and beta-endorphin (betaEP) system mediate maternal immunosuppression in pregnant rats exposed to heat through central or placental pathway, we examined the effects of intravenous (iv) (100 or 500 microg) or intracerebroventricular (icv) (5 microg) administration of CRH receptor antagonist alpha-helical CRH (9-41) on splenic natural killer cell activity (NKCA) as well as betaEP in blood, pituitary lobes, and placenta in pregnant rats at 15 to 16 days gestation. Two-way ANOVA revealed that heat reduced NKCA and elevated blood and pituitary betaEP but did not change placental betaEP. Iv administered 500 microg and icv administered alpha-helical CRH reversed the reduced NKCA and the elevated pituitary betaEP, while iv administration of 100 microg alpha-helical CRH did not. The increased blood betaEP was reversed by iv 100 and 500 microg alpha-helical CRH and icv administration. Both iv and icv administrations reduced placental betaEP independent of heat exposure. Thus, the response of placental betaEP to iv administration of alpha-helical CRH seemed to be stronger than that of pituitary betaEP. These results indicate that alpha-helical CRH which acts on pituitary betaEP antagonizes heat-induced immunosuppression during pregnancy, suggesting that immunosuppression produced by heat stress during pregnancy is mediated by the central CRH system. The placental CRH-betaEP system seems unlikely to be involved in the immunosuppression. Physiologic roles of placental CRH and opioid system should be clarified by future in vitro experiments using placenta specimen including placental immunocyte.

Relationship between Glycolysis and Exopolysaccharide Biosynthesis in Lactococcus lactis

PubMed Central

Ramos, Ana; Boels, Ingeborg C.; de Vos, Willem M.; Santos, Helena

2001-01-01

The relationships between glucose metabolism and exopolysaccharide (EPS) production in a Lactococcus lactis strain containing the EPS gene cluster (Eps+) and in nonproducer strain MG5267 (Eps−) were characterized. The concentrations of relevant phosphorylated intermediates in EPS and cell wall biosynthetic pathways or glycolysis were determined by 31P nuclear magnetic resonance. The concentrations of two EPS precursors, UDP-glucose and UDP-galactose, were significantly lower in the Eps+ strain than in the Eps− strain. The precursors of the peptidoglycan pathway, UDP-N-acetylglucosamine and UDP-N-acetylmuramoyl-pentapeptide, were the major UDP-sugar derivatives detected in the two strains examined, but the concentration of the latter was greater in the Eps+ strain, indicating that there is competition between EPS synthesis and cell growth. An intermediate in biosynthesis of histidine and nucleotides, 5-phosphorylribose 1-pyrophosphate, accumulated at concentrations in the millimolar range, showing that the pentose phosphate pathway was operating. Fructose 1,6-bisphosphate and glucose 6-phosphate were the prominent glycolytic intermediates during exponential growth of both strains, whereas in the stationary phase the main metabolites were 3-phosphoglyceric acid, 2-phosphoglyceric acid, and phosphoenolpyruvate. The activities of relevant enzymes, such as phosphoglucose isomerase, α-phosphoglucomutase, and UDP-glucose pyrophosphorylase, were identical in the two strains. 13C enrichment on the sugar moieties of pure EPS showed that glucose 6-phosphate is the key metabolite at the branch point between glycolysis and EPS biosynthesis and ruled out involvement of the triose phosphate pool. This study provided clues for ways to enhance EPS production by genetic manipulation. PMID:11133425

Releasing of hexabromocyclododecanes from expanded polystyrenes in seawater -field and laboratory experiments.

PubMed

Rani, Manviri; Shim, Won Joon; Jang, Mi; Han, Gi Myung; Hong, Sang Hee

2017-10-01

Expanded polystyrene (EPS) is a major component of marine debris globally. Recently, hazardous hexabromocyclododecanes (HBCDDs) were detected in EPS buoys used for aquaculture farming. Subsequently, enrichment of HBCDDs was found in nearby marine sediments and mussels growing on EPS buoys. It was suspected that EPS buoys and their debris might be sources of HBCDDs. To confirm this, the release of HBCDDs from EPS spherules detached from a buoy to seawater was investigated under field (open sea surface and closed outdoor chambers with sun exposure and in the dark) and laboratory (particle-size) conditions. In all exposure groups, initial rapid leaching of HBCDDs was followed by slow desorption over time. Abundant release of HBCDDs was observed from EPS spherules exposed to the open sea surface (natural) and on exposure to sunlight irradiation or in the dark in controlled saline water. Water leaching and UV-light/temperature along with possibly biodegradation were responsible for about 37% and 12% of HBCDDs flux, respectively. Crumbled EPS particles (≤1 mm) in samples deployed on the sea surface for 6 months showed a high degree of weathering. This implies that surface erosion and further fragmentation of EPS via environmental weathering could enhance the leaching of HBCDDs from the surface of EPS. Overall, in the marine environment, HBCDDs could be released to a great extent from EPS products and their debris due to the cumulative effects of the movement of large volumes of water (dilution), biodegradation, UV-light/temperature, wave action (shaking), salinity and further fragmentation of EPS spherules. Copyright © 2017 Elsevier Ltd. All rights reserved.

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment.

PubMed

Shrestha, Roman; Altice, Frederick L; Huedo-Medina, Tania B; Karki, Pramila; Copenhaver, Michael

2017-05-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.

Views of HIV-negative partners in heterosexual serodiscordant relationships regarding HIV pre-exposure prophylaxis: a qualitative study.

PubMed

Falcão, Joana R S P; Bradshaw, Catriona C; Garrett, Cameryn C; Bilardi, Jade E; Chen, Marcus Y; Zablotska, Iryna; Fairley, Christopher K; Williams, Henrietta

2016-05-26

Background: Pre-exposure prophylaxis (PrEP) may be an effective option for HIV prevention among heterosexual serodiscordant couples. However, there are knowledge gaps in social research about PrEP in heterosexual serodiscordant relationships, including motivations and barriers to its use and possible impacts of PrEP uptake on the sexual practices of these couples. The aim of this study was to explore the views of HIV-negative men and women in stable serodiscordant heterosexual relationships about the possible use of PrEP. Methods: Semi-structured interviews were used to understand participants' views on the use of PrEP. Interviews were conducted face-to-face or by telephone and transcribed verbatim for thematic analysis. Results: In total, 13 HIV-negative partners were interviewed; six men and seven women. Participants demonstrated a high interest in the use of PrEP for conception. PrEP was also considered an option for general HIV prevention, although men saw more benefits for this use than women. Participants' main concerns around PrEP usage were about cost, efficacy, daily adherence and side-effects. HIV-positive partner support is likely to play a central role for PrEP uptake and adherence. Conclusions: This study is one of the first studies to explore the views of HIV-negative heterosexual partners in serodiscordant relationships around the use of PrEP while trying to conceive, as well as for general HIV prevention. These study results provide new insights for the further development of guidelines governing the use of PrEP for serodiscordant couples.

Function of bacterial cells and their exuded extracellular polymeric substances (EPS) in virus removal by red soils.

PubMed

Zhao, Bingzi; Jiang, Yan; Jin, Yan; Zhang, Jiabao

2014-01-01

The potential influence of autochthonous microorganisms on virus fate in soil is usually determined through extreme conditions of sterilization vs. nonsterilization; however, the relative importance of microbial cells and their exudates remains unclear. In this study, bacterial cells (cell) were harvested, and their exuded extracellular polymeric substances (EPS) were extracted from three strains of bacteria, namely, Gram-negative bacteria Pseudomonas putida and Pseudomonas aeruginosa as well as Gram-positive bacterium Bacillus subtilis. This study aimed to evaluate virus removal in solutions in the presence of cell, EPS, and their combination (cell/EPS), as well as to investigate how their presence affects virus removal efficiencies by four red soils based on batch experiments. Results showed that virus removal percentage in solutions ranged from 11 to 23 in the presence of cells only and from 12 to 15 in the presence of EPS only. The removal percentage in the combined cell/EPS treatment can be estimated by summing the results achieved by the cell and EPS treatments, separately. Meanwhile, cell presence had a negligible effect on virus removal by red soils. EPS and combined cell/EPS significantly reduced virus removal by 20 to 69% and 16 to 50%, respectively, which indicated that EPS served a dominant function in reducing virus removal. This study clearly demonstrated that the prediction of virus removal by red soils must consider the effect of bacteria, especially those producing large quantities of EPS, which can be responsible for the underestimation of viral load in certain studies.

Preparing for PrEP: Perceptions and Readiness of Canadian Physicians for the Implementation of HIV Pre-Exposure Prophylaxis

PubMed Central

Sharma, Malika; Wilton, James; Senn, Heather; Fowler, Shawn; Tan, Darrell H. S.

2014-01-01

Recent evidence has demonstrated the efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention, but concerns persist around its use. Little is known about Canadian physicians' knowledge of and willingness to prescribe PrEP. We disseminated an online survey to Canadian family, infectious disease, internal medicine, and public health physicians between September 2012–June 2013 to determine willingness to prescribe PrEP. Criteria for analysis were met by 86 surveys. 45.9% of participants felt “very familiar” with PrEP, 49.4% felt that PrEP should be approved by Health Canada, and 45.4% of respondents were willing to prescribe PrEP. Self-identifying as an HIV expert (odds ratio, OR = 4.1, 95% confidence interval, CI = 1.6–10.2), familiarity with PrEP (OR = 5.0, 95%CI = 1.3–19.0) and having been asked by patients about PrEP (OR = 4.0, 95%CI = 1.5–10.5) were positively associated with willingness to prescribe PrEP on univariable analysis. The latter two were the strongest predictors on multivariate analysis. Participants cited cost and efficacy as major concerns. 75.3% did not feel that information had been adequately disseminated among physicians. In summary, Canadian physicians demonstrate varying levels of support for PrEP and express concerns about its implementation. Further research on real-world effectiveness, continuing medical education, and clinical support is needed to prepare physicians for this prevention strategy. PMID:25133648

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment

PubMed Central

Shrestha, Roman; Altice, Frederick L.; Huedo-Medina, Tania B.; Karki, Pramila; Copenhaver, Michael

2016-01-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the Information-Motivation-Behavioral Skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP. PMID:27990587

Knowledge, Practices, and Barriers to HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Among Washington State Medical Providers.

PubMed

Wood, Brian R; McMahan, Vanessa M; Naismith, Kelly; Stockton, Jonathan B; Delaney, Lori A; Stekler, Joanne D

2018-01-04

We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. Of 735 eligible providers, 64.8% had heard of PrEP. Younger providers and providers with a Doctor of Medicine (MD) degree were more likely to be aware of PrEP compared to older providers (p=0.0001) and providers of other training backgrounds (Advanced Registered Nurse Practitioner [ARNP], Doctor of Osteopathic Medicine [DO], or Physician Assistant [PA]) (p=0.04). Among providers aware of PrEP, most frequent reported concerns about prescribing were adherence (46.0%) and costs (42.9%). Providers felt very (20.1%) or somewhat (33.8%) comfortable discussing PrEP overall, but very (26.8%) or somewhat (44.7%) uncomfortable discussing cost and insurance issues. The 124 PrEP prescribers reported a median of 2 (range 1-175, total 1,142) patients prescribed PrEP. Prior authorizations and insurance denials had prevented prescriptions for 28.7% and 12.1% of prescribers, respectively. Interventions to improve PrEP access should include education to inform medical providers about PrEP, with particular attention to provider types less likely to be aware. Continued efforts to eliminate cost and insurance barriers and educate providers regarding financial resources would help improve PrEP access.

Physician awareness of enhanced prenatal services for medicaid-insured pregnant women.

PubMed

Raffo, Jennifer E; Gary, Monica; Forde, Gareth K; Meghea, Cristian I; Roman, Lee Anne

2014-01-01

Medicaid enhanced prenatal service (EPS) programs, including care coordination, were developed to improve birth outcomes for low-income pregnant women. In Michigan, less than a third of eligible pregnant women are enrolled in services. Physician or medical clinics provide referrals to community-based EPS. The objective of this study was to examine physician knowledge and perceptions of EPS. A cross-sectional survey of obstetric providers was conducted in 2009. A questionnaire was created to assess understanding of the EPS program. The study was conducted in an urban Michigan community. Participants included a convenience sample (N = 56) of community Obstetrics and Gynecology attending physicians and resident physicians within a single, large health system. Outcome measures included knowledge of the program and patient participation, referral practices, perceptions of the program, value for patients and providers, appropriateness of physicians to provide program referrals, and barriers to referring. Findings indicated that most physicians (84%) had little familiarity with EPS, 60% did not personally refer to EPS, 54% did not know whether other office staff referred to EPS, and 65% were unaware whether their patients received EPS. Yet, more than 90% of physicians reported that EPS would benefit their patients and believed that it was appropriate for them to refer all their eligible patients. Further efforts should be made to better understand how physicians and EPS providers could function together on behalf of patients. Statewide Medicaid-sponsored EPS programs could serve as a valuable patient and physician resource for psychosocial risk screening, care management, education, and referral support if better utilized.

Development and implementation of an emergency practitioner-performed brief intervention for hazardous and harmful drinkers in the emergency department.

PubMed

D'Onofrio, Gail; Pantalon, Michael V; Degutis, Linda C; Fiellin, David A; O'connor, Patrick G

2005-03-01

1) To develop and teach a brief intervention (BI) for "hazardous and harmful" (HH) drinkers in the emergency department (ED); 2) to determine whether emergency practitioners (EPs) (faculty, residents, and physician associates) can demonstrate proficiency in the intervention; and 3) to determine whether it is feasible for EPs to perform the BI during routine clinical care. The Brief Negotiation Interview (BNI) was developed for a population of HH drinkers. EPs working in an urban, teaching hospital were trained during two-hour skills-based sessions. They were then tested for adherence to and competence with the BNI protocol using standardized patient scenarios and a checklist of critical components of the BNI. Finally, the EPs performed the BNI as part of routine ED clinical care in the context of a randomized controlled trial to test the efficacy of BI on patient outcomes. The BNI was developed, modified, and finalized in a manual, based on pilot testing. Eleven training sessions with 58 EPs were conducted from March 2002 to August 2003. Ninety-one percent (53/58) of the trained EPs passed the proficiency examination; 96% passed after remediation. Two EPs left prior to remediation. Subsequently, 247 BNIs were performed by 47 EPs. The mean (+/- standard deviation) number of BNIs per EP was 5.28 (+/- 4.91; range 0-28). The mean duration of the BNI was 7.75 minutes (+/- 3.18; range 4-24). A BNI for HH drinkers can be successfully developed for EPs. EPs can demonstrate proficiency in performing the BNI in routine ED clinical practice.

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines. Update April 2018.

PubMed

Wright, Edwina; Grulich, Andrew; Roy, Katy; Boyd, Mark; Cornelisse, Vincent; Russell, Darren; O'Donnell, Darryl; Whittaker, Bill; Crooks, Levinia; Zablotska, Iryna

2018-04-01

Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM) PrEP Guidelines are an updated adaptation of the 2014 US Centers for Disease Control's PrEP guidelines and are designed to: •Support the prescription of PrEP using forms of coformulated tenofovir and emtricitabine that have been registered in Australia by the Therapeutic Goods Administration and other bioequivalent generic drugs that are available in Australia through self-importation, private prescription or Australian PrEP clinical trials•Assist clinicians in the evaluation of patients who are seeking PrEP•Assist clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women, and people who inject drugs (PWID) at substantial risk of HIV acquisition. These guidelines were updated in April 2018 and include changes to the recommendations regarding the choice of daily or on-demand PrEP.

30 CFR 550.221 - What environmental monitoring information must accompany the EP?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What environmental monitoring information must... Information Contents of Exploration Plans (ep) § 550.221 What environmental monitoring information must accompany the EP? The following environmental monitoring information, as applicable, must accompany your EP...

30 CFR 250.221 - What environmental monitoring information must accompany the EP?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What environmental monitoring information must... Contents of Exploration Plans (ep) § 250.221 What environmental monitoring information must accompany the EP? The following environmental monitoring information, as applicable, must accompany your EP: (a...

30 CFR 550.221 - What environmental monitoring information must accompany the EP?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What environmental monitoring information must... Information Contents of Exploration Plans (ep) § 550.221 What environmental monitoring information must accompany the EP? The following environmental monitoring information, as applicable, must accompany your EP...

30 CFR 550.221 - What environmental monitoring information must accompany the EP?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What environmental monitoring information must... Information Contents of Exploration Plans (ep) § 550.221 What environmental monitoring information must accompany the EP? The following environmental monitoring information, as applicable, must accompany your EP...

30 CFR 250.228 - What administrative information must accompany the EP?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What administrative information must accompany the EP? 250.228 Section 250.228 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE... Contents of Exploration Plans (ep) § 250.228 What administrative information must accompany the EP? The...

Activation of macrophages by an exopolysaccharide isolated from Antarctic Psychrobacter sp. B-3

NASA Astrophysics Data System (ADS)

Yu, Leiye; Sun, Guojie; Wei, Jingfang; Wang, Yingze; Du, Chao; Li, Jiang

2016-09-01

An exopolysaccharide (EPS) was isolated and purified from an Antarctic psychrophilic bacterium B-3, identified as Psychrobacter sp., and the activation of RAW264.7 cells by B-3 EPS was investigated. The results show that B-3 EPS, over a certain concentration range, promoted cell viability, nitric oxide production, tumor necrosis factor (TNF)α secretion, and phagocytic ability. Furthermore, TAK-242, an inhibitor of the toll-like receptor 4 (TLR4) significantly reduced nitric oxide production by these cells after stimulation with B-3 EPS. Moreover, B-3 EPS induced p65 phosphorylation and IκBα degradation in these cells. In conclusion, B-3 EPS might have activated RAW264.7 cells by combining with TLR4 on cell surface and triggering activation of NF-κB signaling pathways, implying that this EPS could activate macrophages and regulate initial immune response.

Wash-free and selective imaging of epithelial cell adhesion molecule (EpCAM) expressing cells with fluorogenic peptide ligands.

PubMed

K C, Tara Bahadur; Suga, Kanako; Isoshima, Takashi; Aigaki, Toshiro; Ito, Yoshihiro; Shiba, Kiyotaka; Uzawa, Takanori

2018-06-02

Detection of the cells expressing an epithelial cell adhesion molecule (EpCAM) is a crucial step to identify circulating tumor cells (CTCs) from blood. To detect the EpCAM, we here designed and synthesized a series of fluorogenic peptides. Specifically, we functionalized an EpCAM-binding peptide, Ep114, by replacing its amino acids to an aminophenylalanine that was modified with environmentally sensitive 7-nitro-2,1,3-benzoxadiazole (NBD-amPhe). Among six synthesized peptides, we have found that two peptides, Q4X and V6X (X represents NBD-amPhe), retain the Ep114's binding ability and specifically mark EpCAM-expressing cells by just adding these peptides to the cultivation medium. Our wash-free, fluorogenic peptide ligands would boost the development of next generation devices for CTC diagnoses. Copyright © 2018 Elsevier Inc. All rights reserved.

Influence of culture medium growth variables on Ganoderma lucidum exopolysaccharides structural features.

PubMed

Fraga, Irene; Coutinho, João; Bezerra, Rui M; Dias, Albino A; Marques, Guilhermina; Nunes, Fernando M

2014-10-13

In this work the effect of carbon and nitrogen levels and initial pH of the wheat extract culture medium of submerged culture of Ganoderma lucidum on the amount, purity and structural features of exopolysaccharides (EPS) were studied. A low peptone level (1.65 g L(-1)) favored mycelium biomass, EPS purity, but a higher supply of peptone (4.80 g L(-1)) is needed for maximum EPS production. The carbohydrate composition of the EPS and structural features also changed significantly according to the different growing conditions, being observed significant differences in the (1 → 3)/(1 → 4)-Glcp ratio and also on the branching degree of EPS. As the biological activities of EPS are highly dependent on the polysaccharide structural features, this variability can have implications on the EPS biological activities, but can also be used advantageously to produce tailor made polysaccharides with specific applications. Copyright © 2014 Elsevier Ltd. All rights reserved.

Characterisation of biosynthesised silver nanoparticles by scanning electrochemical microscopy (SECM) and voltammetry.

PubMed

Battistel, Dario; Baldi, Franco; Gallo, Michele; Faleri, Claudia; Daniele, Salvatore

2015-01-01

Silver nanoparticles (AgNPs) were biosynthesised by a Klebsiella oxytoca strain BAS-10, which, during its growth, is known to produce a branched exopolysaccharide (EPS). Klebsiella oxytoca cultures, treated with AgNO3 and grown under either aerobic or anaerobic conditions, produced silver nanoparticles embedded in EPS (AgNPs-EPS) containing different amounts of Ag(0) and Ag(I) forms. The average size of the AgNPs-EPS was determined by transmission electron microscopy, while the relative abundance of Ag(0)- or Ag(I)-containing AgNPs-EPS was established by scanning electrochemical microscopy (SECM). Moreover, the release of silver(I) species from the various types of AgNPs-EPS was investigated by combining SECM with anodic stripping voltammetry. These measurements allowed obtaining information on the kinetic of silver ions release from AgNPs-EPS and their concentration profiles at the substrate/water interface. Copyright © 2014 Elsevier B.V. All rights reserved.

Migration of styrene and ethylbenzene from virgin and recycled expanded polystyrene containers and discrimination of these two kinds of polystyrene by principal component analysis.

PubMed

Lin, Qin-Bao; Song, Xue-Chao; Fang, Hong; Wu, Yu-Mei; Wang, Zhi-Wei

2017-01-01

The migration of styrene and ethylbenzene from virgin and recycled expanded polystyrene (EPS) containers into isooctane was investigated using gas chromatography-mass spectrometry (GC-MS). EPS containers were in two-sided contact with isooctane at temperatures of 25 and 40°C. It was shown that recycled EPS gave greater migration ratios compared with virgin EPS, which indicated that styrene and ethylbenzene migrated more easily from recycled EPS. In addition, an analytical method to distinguish between virgin and recycled EPS containers was established by GC-MS followed by principal component analysis (PCA). The relative peak area of the identified compounds was used as input data for PCA. Distinct separation between virgin and recycled EPS was achieved on a score plot. Extension of this method to other plastics may be of great interest for recycled plastics identification.

Antiarrhythmic and antioxidant activity of novel pyrrolidin-2-one derivatives with adrenolytic properties

PubMed Central

Nowaczyk, Alicja; Kulig, Katarzyna

2010-01-01

A series of novel pyrrolidin-2-one derivatives (17 compounds) with adrenolytic properties was evaluated for antiarrhythmic, electrocardiographic and antioxidant activity. Some of them displayed antiarrhythmic activity in barium chloride-induced arrhythmia and in the rat coronary artery ligation-reperfusion model, and slightly decreased the heart rate, prolonged P–Q, Q–T intervals and QRS complex. Among them, compound EP-40 (1-[2-hydroxy-3-[4-[(2-hydroxyphenyl)piperazin-1-yl]propyl]pyrrolidin-2-one showed excellent antiarrhythmic activity. This compound had significantly antioxidant effect, too. The present results suggest that the antiarrhythmic effect of compound EP-40 is related to their adrenolytic and antioxidant properties. A biological activity prediction using the PASS software shows that compound EP-35 and EP-40 can be characterized by antiischemic activity; whereas, compound EP-68, EP-70, EP-71 could be good tachycardia agents. PMID:20949258

Antiarrhythmic and antioxidant activity of novel pyrrolidin-2-one derivatives with adrenolytic properties.

PubMed

Sapa, Jacek; Nowaczyk, Alicja; Kulig, Katarzyna

2011-01-01

A series of novel pyrrolidin-2-one derivatives (17 compounds) with adrenolytic properties was evaluated for antiarrhythmic, electrocardiographic and antioxidant activity. Some of them displayed antiarrhythmic activity in barium chloride-induced arrhythmia and in the rat coronary artery ligation-reperfusion model, and slightly decreased the heart rate, prolonged P-Q, Q-T intervals and QRS complex. Among them, compound EP-40 (1-[2-hydroxy-3-[4-[(2-hydroxyphenyl)piperazin-1-yl]propyl]pyrrolidin-2-one showed excellent antiarrhythmic activity. This compound had significantly antioxidant effect, too. The present results suggest that the antiarrhythmic effect of compound EP-40 is related to their adrenolytic and antioxidant properties. A biological activity prediction using the PASS software shows that compound EP-35 and EP-40 can be characterized by antiischemic activity; whereas, compound EP-68, EP-70, EP-71 could be good tachycardia agents.

Brief Report: Medication Sharing Is Rare Among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention.

PubMed

Thomson, Kerry A; Haberer, Jessica E; Marzinke, Mark A; Mujugira, Andrew; Hendrix, Craig W; Celum, Connie; Ndase, Patrick; Ronald, Allan; Bangsberg, David R; Baeten, Jared M

2017-06-01

Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at <0.01% of visits, and 0%-1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

360 Degrees feedback for emergency physicians in Singapore.

PubMed

Tham, Kum-Ying

2007-08-01

To determine if emergency physicians (EPs) are ready to accept 360 degrees feedback, and agreement between self and colleagues' assessment in a 360 degrees feedback for EPs. Self-administered questionnaire to determine acceptability of 360 degrees feedback (n = 43). Each EP completed the Physician Achievement Review self-assessment and approached five colleagues to complete an assessment for him/her. Thirty-one responded: 77.4% preferred to select their appraisers, 90.3% wanted feedback to be confidential, 58.1% would share feedback with supervisors, but only 35.5% would link feedback to remuneration. Colleagues rated EPs' holistic management, humanistic aspects and patient communication, and professional relationship with colleagues as weak domains, weaknesses which EPs were only partially aware. EPs would accept 360 degrees feedback provided that they selected their appraisers and results were confidential. Colleagues reported that EPs were weak in "soft" and system skills.

360° feedback for emergency physicians in Singapore

PubMed Central

Tham, Kum‐Ying

2007-01-01

Objectives To determine if emergency physicians (EPs) are ready to accept 360° feedback, and agreement between self and colleagues' assessment in a 360° feedback for EPs. Methods Self‐administered questionnaire to determine acceptability of 360° feedback (n = 43). Each EP completed the Physician Achievement Review self‐assessment and approached five colleagues to complete an assessment for him/her. Results Thirty‐one responded: 77.4% preferred to select their appraisers, 90.3% wanted feedback to be confidential, 58.1% would share feedback with supervisors, but only 35.5% would link feedback to remuneration. Colleagues rated EPs' holistic management, humanistic aspects and patient communication, and professional relationship with colleagues as weak domains, weaknesses which EPs were only partially aware. Conclusions EPs would accept 360° feedback provided that they selected their appraisers and results were confidential. Colleagues reported that EPs were weak in “soft” and system skills. PMID:17652683

78 FR 76098 - Rail Transportation of Grain, Rate Regulation Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...) Opening 4-5, Rate Regulation Reforms, EP 715; Alliance for Rail Competition, Montana Wheat & Barley... Producers Board, and Washington Grain Commission Opening 6-12, Rate Regulation Reforms, EP 715. \\3\\ NGFA Opening 3-4, Rate Regulation Reforms, EP 715. \\4\\ BNSF Ry. Co. Reply 10, Rate Regulation Reforms, EP 715...

42 CFR 495.10 - Participation requirements for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... manner specified by CMS its CMS Certification Number (CCN) and its Taxpayer Identification Number (TIN... Number (TIN) which may be the EP's Social Security Number (SSN) to which the EP's incentive payment... CFR part 424 subpart F. (ii) Medicaid EPs may also assign their incentive payments to a TIN for an...

42 CFR 495.10 - Participation requirements for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... manner specified by CMS its CMS Certification Number (CCN) and its Taxpayer Identification Number (TIN... Number (TIN) which may be the EP's Social Security Number (SSN) to which the EP's incentive payment... CFR part 424 subpart F. (ii) Medicaid EPs may also assign their incentive payments to a TIN for an...

Polysulfide and bio-based EP additive performance in vegetable vs. paraffinic base oils

USDA-ARS?s Scientific Manuscript database

Twist compression test (TCT) and 4-ball extreme pressure (EP) methods were used to investigate commercial polysulfide (PS) and bio-based polyester (PE) EP additives in paraffinic (150N) and refined soybean (SOY) base oils of similar viscosity. Binary blends of EP additive and base oil were investiga...

30 CFR 250.223 - What mitigation measures information must accompany the EP?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What mitigation measures information must accompany the EP? 250.223 Section 250.223 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE... Contents of Exploration Plans (ep) § 250.223 What mitigation measures information must accompany the EP? (a...

30 CFR 250.222 - What lease stipulations information must accompany the EP?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What lease stipulations information must accompany the EP? 250.222 Section 250.222 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE... Contents of Exploration Plans (ep) § 250.222 What lease stipulations information must accompany the EP? A...

30 CFR 250.212 - What information must accompany the EP?

Code of Federal Regulations, 2011 CFR

2011-07-01

... management information required by § 250.226; (o) Environmental impact analysis information required by § 250... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What information must accompany the EP? 250.212... and Information Contents of Exploration Plans (ep) § 250.212 What information must accompany the EP...

The Educational Psychologist in the Early Years: Current Practice and Future Directions

ERIC Educational Resources Information Center

Shannon, Deborah; Posada, Susan

2007-01-01

Following suggestions for updated models of service within the early years educational psychologist (EP) role, the study aimed to provide exploratory research evidence of current models of service delivery and EP attitudes. Questionnaires were completed by 32 EPs. Interviews were conducted with three EPs. Quantitative data obtained were analysed…

Specific radioimmunoassay of human. beta. -endorphin in unextracted plasma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiedemann, E.; Saito, T.; Linfoot, J.A.

1979-09-01

With an antiserum against human ..beta..-endorphin (..beta..-EP) crossreacting <2% with human ..beta..-lipotropin (..beta..-LPH) by weight we have developed a radioimmunoassay that can detect 1 pg ..beta..-EP in diluted raw plasma. In a.m. fasting plasma of 14 normal subjects ..beta..-EP ranged from <5 to 45 pg/ml. ..beta..-EP was elevated in untreated, but normal in successfully treated Cushing's disease; undetectable in a patient with adrenal adenoma; extremely high in Nelson's syndrome; and elevated in a patient with bronchogenic carcinoma before, but undetectable after tumor resection. In subjects with intact hypothalamic-pituitary-adrenal axis, ..beta..-EP was undectectable after dexamethasone and increased after metyrapone administration andmore » insulin-induced hypoglycemia. ..beta..-EP concentration was considerably lower in serum than in simultaneously collected plasma, but increased in serum left unfrozen for several hours after clot removal. Thus, ..beta..-EP behaves like a hormone responding to the same stimuli as ACTH and ..beta..-LPH and blood appears to contain enzymes both generating and destroying immunoreactive ..beta..-EP.« less

The Selenylation Modification of Epimedium Polysaccharide and Isatis Root Polysaccharide and the Immune-enhancing Activity Comparison of Their Modifiers.

PubMed

Li, Xiuping; Hou, Ranran; Yue, Chanjuan; Liu, Jie; Gao, Zhenzhen; Chen, Jin; Lu, Yu; Wang, Deyun; Liu, Cui; Hu, Yuanliang

2016-05-01

Epimedium polysaccharide (EPS) and isatis root polysaccharide (IRPS) were extracted, purified, and selenizingly modified by nitric acid-sodium selenite method to obtain nine selenizing EPSs (sEPSs), sEPS1-sEPS9 and nine selenizing IRPSs (sIRPSs), sIRPS1-sIRPS9, respectively. Their effects on chicken peripheral lymphocyte proliferation in vitro were compared by MTT assay. The results showed that selenium polysaccharides at appropriate concentration could promote lymphocyte proliferation more significantly than unmodified polysaccharides, sEPS5 and sIRPS5 with stronger actions were picked out and injected into the chickens vaccinated with Newcastle disease vaccine in vivo tests. The peripheral lymphocyte proliferation and serum antibody titer were determined. The results showed that sEPS5 and sIRPS5 could elevate serum antibody titer and promote lymphocyte proliferation more significantly than unmodified polysaccharides, sEPS5 possessed the strongest efficacy. These results indicate that selenylation modification can significantly enhance the immune-enhancing activity of EPS and IRPS, and sEPS5 can be as a new-type immunopotentiator of chickens.

Characterization of Extracellular Polymeric Substances Produced by Pseudomonas fragi Under Air and Modified Atmosphere Packaging.

PubMed

Wang, Guang-Yu; Ma, Fang; Wang, Hu-Hu; Xu, Xing-Lian; Zhou, Guang-Hong

2017-09-01

Extracellular polymeric substances (EPS) play an important role in bacterial biochemical properties. The characteristics of EPS from 2 strains of Pseudomonas fragi cultured in meat aerobically (control) and in modified atmosphere packaging (MAP) were studied. The amount and components of EPS, the surface properties, and the effect on biofilm formation of several spoilage organisms were evaluated. The results showed that MAP inhibited the growth of the P. fragi strains. Compared with the control, more loose and less bound EPS (containing protein and carbohydrate) were produced by P. fragi in MAP samples. MAP also caused increased cell autoaggregation and surface hydrophobicity. After the removal of the EPS, the surface property changes were strain-dependent, suggesting that membrane compositions were also changed. In addition, the EPS displayed significant antibiofilm activity on Pseudomonas fluorescens and Serratia liquefaciens. In conclusion, P. fragi strains not only modified the amount, components, and surface properties of EPS but also changed the cell membrane compositions to adapt to MAP stress. Moreover, EPS may play an important role in microbial community competitions. © 2017 Institute of Food Technologists®.

Comorbidity between lifetime eating problems and mood and anxiety disorders: results from the Canadian Community Health Survey of Mental Health and Well-being.

PubMed

Meng, Xiangfei; D'Arcy, Carl

2015-03-01

This study was to examine profiles of eating problems (EPs), mood and anxiety disorders and their comorbidities; explore risk patterns for these disorders; and document differences in health service utilization in a national population. Data were from the Canadian Community Health Survey of Mental Health and Well-being. The lifetime prevalence of EPs was 1.70% among Canadians, compared with 13.25% for mood disorder, 11.27% for anxiety disorder and 20.16% for any mood or anxiety disorder. Almost half of those with EPs also suffered with mood or anxiety disorders. A similar pattern in depressive symptoms was found among individuals with major depression and EPs, but individuals with EPs reported fewer symptoms. Factors associated with the comorbidity of EPs and mood and anxiety disorders were identified. Individuals with EPs reported more unmet needs. Patients with EPs should be concomitantly investigated for mood and anxiety disorders, as similar interventions may be effective for both. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations.

PubMed

Galea, J T; Kinsler, J J; Salazar, X; Lee, S-J; Giron, M; Sayles, J N; Cáceres, C; Cunningham, W E

2011-05-01

This study examined pre-exposure prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, P < 0.001), followed by efficacy (21.4, P < 0.001) and potential side-effects (14.7, P < 0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health-care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out.

Studies on the mechanism of endogenous pyrogen production. II. Role of cell products in the regulation of pyrogen release from blood leukocytes.

PubMed

Bodel, P

1974-09-01

Some characteristics of the process by which endogenous pyrogen (EP), the mediator of fever, is released from cells were examined by using human blood leukocytes incubated in vitro. Studies were designed to examine a possible role for leukocyte products, including EP, in the induction, augmentation, or suppression of pyrogen release by blood leukocytes. Products of stimulated leukocytes, including a partially purified preparation of EP, did not induce significant activation of nonstimulated cells. Also, no evidence was obtained that stimulated cell products either augment or inhibit pyrogen production by other stimulated cells. A feedback control of EP production was thus not observed. A crude preparation of EP, containing other products of activated cells, maintained its pyrogenicity when incubated at pH 7.4 but not at pH 5.0. These studies thus provide no support for hypothesized control mechanisms regulating production of EP by blood leukocytes. By contrast, local inactivation of EP at inflammatory sites may modify the amount of EP entering the blood, and hence fever.

Studies on the Mechanism of Endogenous Pyrogen Production II. Role of Cell Products in the Regulation of Pyrogen Release from Blood Leukocytes

PubMed Central

Bodel, Phyllis

1974-01-01

Some characteristics of the process by which endogenous pyrogen (EP), the mediator of fever, is released from cells were examined by using human blood leukocytes incubated in vitro. Studies were designed to examine a possible role for leukocyte products, including EP, in the induction, augmentation, or suppression of pyrogen release by blood leukocytes. Products of stimulated leukocytes, including a partially purified preparation of EP, did not induce significant activation of nonstimulated cells. Also, no evidence was obtained that stimulated cell products either augment or inhibit pyrogen production by other stimulated cells. A feedback control of EP production was thus not observed. A crude preparation of EP, containing other products of activated cells, maintained its pyrogenicity when incubated at pH 7.4 but not at pH 5.0. These studies thus provide no support for hypothesized control mechanisms regulating production of EP by blood leukocytes. By contrast, local inactivation of EP at inflammatory sites may modify the amount of EP entering the blood, and hence fever. PMID:4426696

Awareness and Willingness to Use Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men and Transgender Women in Brazil.

PubMed

Hoagland, Brenda; De Boni, Raquel B; Moreira, Ronaldo I; Madruga, José Valdez; Kallas, Esper G; Goulart, Silvia Pereira; Cerqueira, Natalia; Torres, Thiago S; Luz, Paula M; Fernandes, Nilo Martinez; Liu, Albert Y; Grinsztejn, Beatriz; Veloso, Valdilea G

2017-05-01

Antiretroviral pre-exposure prophylaxis (PrEP) is recommended to prevent HIV infection among high-risk men who have sex with men (MSM) though not available in Brazil where the HIV epidemic persists unabated in this group. This cross-sectional study describes PrEP awareness and willingness and associated factors among MSM and transvestite/transgender women (trans women) pre-screened for the PrEP Brasil study. Awareness was reported by 61.3 % of the participants and was associated with age, education, site, study period and prior HIV testing. Most participants (82.1 %) were willing to use PrEP, which was associated with site, study period, number of male condomless anal sexual partners and anal sex with HIV positive/unknown partners. PrEP information is need among young and less educated individuals. Willingness to use PrEP was high and future studies should be conducted to confirm PrEP acceptability and the characteristics of the population who chose to adopt this intervention.

Knowledge of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men in Denver, Colorado

PubMed Central

Al-Tayyib, Alia A.; Thrun, Mark W.; Haukoos, Jason S.; Walls, N. Eugene

2014-01-01

As part of the National HIV Behavioral Surveillance System among men who have sex with men (MSM) in Denver, Colorado, we assessed knowledge of pre-exposure prophylaxis (PrEP); willingness to use PrEP; and potential changes in risk behaviors among HIV-negative participants reporting sexual activity with a male partner in the preceding 12 months. We examined knowledge of PrEP before (2008) and after (2011) results of the iPrEx trial were available. Of the 425 participants in the 2008 sample, 91 (21 %) were aware of PrEP compared to 131 (28 %) of the 461 participants in the 2011 sample (adjusted prevalence ratio: 1.43, 95 % confidence interval: 1.18, 1.72). Despite the increase in 2011, few MSM in Denver were aware of PrEP. Educating high-risk MSM about the potential utility of PrEP as an adjunct to other effective prevention methods is needed when considering the addition of PrEP to the HIV prevention arsenal. PMID:23824227

Primary Care Physicians' Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs.

PubMed

Edelman, E Jennifer; Moore, Brent A; Calabrese, Sarah K; Berkenblit, Gail; Cunningham, Chinazo; Patel, Viraj; Phillips, Karran; Tetrault, Jeanette M; Shah, Minesh; Fiellin, David A; Blackstock, Oni

2017-04-01

Pre-exposure prophylaxis for HIV (PrEP) is recommended for people who inject drugs (PWID). Despite their central role in disease prevention, willingness to prescribe PrEP to PWID among primary care physicians (PCPs) is largely understudied. We conducted an online survey (April-May 2015) of members of a society for academic general internists regarding PrEP. Among 250 respondents, 74% (n = 185) of PCPs reported high willingness to prescribe PrEP to PWID. PCPs were more likely to report high willingness to prescribe PrEP to all other HIV risk groups (p's < 0.03 for all pair comparisons). Compared with PCPs delivering care to more HIV-infected clinic patients, PCPs delivering care to fewer HIV-infected patients were more likely to report low willingness to prescribe PrEP to PWID (Odds Ratio [95% CI] = 6.38 [1.48-27.47]). PCP and practice characteristics were not otherwise associated with low willingness to prescribe PrEP to PWID. Interventions to improve PCPs' willingness to prescribe PrEP to PWID are needed.

Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067/ADAPT Study.

PubMed

Franks, Julie; Hirsch-Moverman, Yael; Loquere, Avelino S; Amico, K Rivet; Grant, Robert M; Dye, Bonnie J; Rivera, Yan; Gamboa, Robert; Mannheimer, Sharon B

2018-04-01

The HPTN 067/Alternative Dosing to Augment Pre-Exposure Prophylaxis Pill Taking (ADAPT) study evaluated daily and non-daily dosing schedules for oral pre-exposure prophylaxis (PrEP) to prevent HIV. A qualitative sub-study including focus groups and in-depth interviews was conducted among men who have sex with men participating in New York City to understand their experience with PrEP and study dosing schedules. The 37 sub-study participants were 68% black, 11% white, and 8% Asian; 27% were of Hispanic/Latino ethnicity. Mean age was 34 years. Themes resulting from qualitative analysis include: PrEP is a significant advance for HIV prevention; non-daily dosing of PrEP is congruent with HIV risk; and pervasive stigma connected to HIV and risk behavior is a barrier to PrEP adherence, especially for non-daily dosing schedules. The findings underscore how PrEP intersects with other HIV prevention practices and highlight the need to understand and address multidimensional stigma related to PrEP use.

Investigation on extracellular polymeric substances, sludge flocs morphology, bound water release and dewatering performance of sewage sludge under pretreatment with modified phosphogypsum.

PubMed

Dai, Quxiu; Ma, Liping; Ren, Nanqi; Ning, Ping; Guo, Zhiying; Xie, Longgui; Gao, Haijun

2018-06-06

Modified phosphogypsum (MPG) was developed to improve dewaterability of sewage sludge, and dewatering performance, properties of treated sludge, composition and morphology distribution of EPS, dynamic analysis and multiple regression model on bound water release were investigated. The results showed that addition of MPG caused extracellular polymeric substances (EPS) disintegration through charge neutralization. Destruction of EPS promoted the formation of larger sludge flocs and the release of bound water into supernatant. Simultaneously, content of organics with molecular weight between 1000 and 7000 Da in soluble EPS (SB-EPS) increased with increasing of EPS dissolved into the liquid phase. Besides, about 8.8 kg•kg -1 DS of bound water was released after pretreatment with 40%DS MPG dosage. Additionally, a multiple linear regression model for bound water release was established, showing that lower loosely bond EPS (LB-EPS) content and specific resistance of filtration (SRF) may improve dehydration performance, and larger sludge flocs may be beneficial for sludge dewatering. Copyright © 2018 Elsevier Ltd. All rights reserved.

Extrapyramidal side effects of antipsychotic treatment: scope of problem and impact on outcome.

PubMed

Tandon, Rajiv; Jibson, Michael D

2002-06-01

Previously, clinicians worked with antipsychotic drugs (conventional or typical) that almost invariably caused extrapyramidal symptoms (EPS) at clinically effective doses. This led to the false impression that all antipsychotics were the same, and that EPS were an unavoidable consequence of effective antipsychotic therapy. EPS adversely impact several aspects of antipsychotic efficacy and tolerability, thereby worsening outcome of afflicted individuals. EPS reduce beneficial effects of antipsychotic treatment on the negative, cognitive, and mood symptom domains, while increasing the risk of tardive dyskinesia and reducing compliance. By definition, the newer generation of "atypical" antipsychotic agents are significantly better than conventional agents with regard to EPS (i.e., they are clinically effective at doses at which they do not cause EPS). Pharmacologically, this difference is expressed in the greater degree of separation between respective dose response curves for antipsychotic and EPS effects observed for "atypical" in contrast to conventional agents. Clinically, this EPS advantage of atypical antipsychotics translates into several important benefits, including better negative symptom efficacy, less dysphoria, less impaired cognition, a lower risk of TD, and better overall outcome.

Reinforced carbon fiber laminates with oriented carbon nanotube epoxy nanocomposites: Magnetic field assisted alignment and cryogenic temperature mechanical properties.

PubMed

He, Yuxin; Yang, Song; Liu, Hu; Shao, Qian; Chen, Qiuyu; Lu, Chang; Jiang, Yuanli; Liu, Chuntai; Guo, Zhanhu

2018-05-01

The epoxy nanocomposites with ordered multi-walled carbon nanotubes (MWCNTs) were used to influence the micro-cracks resistance of carbon fiber reinforced epoxy (CF/EP) laminate at 77 K, Oxidized MWCNTs functionalized with Fe 3 O 4 (Fe 3 O 4 /O-MWCNTs) with good magnetic properties were prepared by co-precipitation method and used to modify epoxy (EP) for cryogenic applications. Fe 3 O 4 /O-MWCNTs reinforced carbon fiber epoxy composites were also prepared through vacuum-assisted resin transfer molding (VARTM). The ordered Fe 3 O 4 /O-MWCNTs were observed to have effectively improved the mechanical properties of epoxy (EP) matrix at 77 K and reduce the coefficient of thermal expansion (CTE) of EP matrix. The ordered Fe 3 O 4 /O-MWCNTs also obviously improved the micro-cracks resistance of CF/EP composites at 77 K. Compared to neat EP, the CTE of ordered Fe 3 O 4 /O-MWCNTs modified CF/EP composites was decreased 37.6%. Compared to CF/EP composites, the micro-cracks density of ordered Fe 3 O 4 /O-MWCNTs modified CF/EP composites at 77 K was decreased 37.2%. Copyright © 2018 Elsevier Inc. All rights reserved.

Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes.

PubMed

Carlo Hojilla, J; Koester, Kimberly A; Cohen, Stephanie E; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y

2016-07-01

Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP demonstration project to assess how men who have sex with men used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was 'seasonal' and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts.

Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men.

PubMed

Greene, George J; Swann, Greg; Fought, Angela J; Carballo-Diéguez, Alex; Hope, Thomas J; Kiser, Patrick F; Mustanski, Brian; D'Aquila, Richard T

2017-05-01

HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90 % consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8 %), followed by non-visible implants (21.5 %), and oral PrEP (17.0 %); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5 and 34.3 %, respectively), followed by injections (25.2 %) and visible implants (4.3 %). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention.

Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes

PubMed Central

Hojilla, J. Carlo; Koester, Kimberly A.; Cohen, Stephanie E.; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y

2015-01-01

Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP Demonstration Project to assess how men who have sex with men (MSM) used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was ‘seasonal’ and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts. PMID:25835463

'I am not a man': Trans-specific barriers and facilitators to PrEP acceptability among transgender women.

PubMed

Sevelius, Jae M; Keatley, JoAnne; Calma, Nikki; Arnold, Emily

2016-01-01

The frequent conflation of transgender ('trans') women with 'men who have sex with men (MSM)' in HIV prevention obscures trans women's unique gender identities, social and behavioural vulnerabilities, and their disproportionately high rates of HIV infection. Pre-exposure prophylaxis (PrEP) is an efficacious biomedical HIV prevention approach. However, trans women are underrepresented in PrEP research, and are often aggregated with MSM without consideration for their unique positions within sociocultural contexts. This study examined PrEP acceptability among trans women via three focus groups and nine individual interviews (total N = 30) in San Francisco. While knowledge of PrEP was low, interest was relatively high once participants were informed. Due to past negative healthcare experiences, ability to obtain PrEP from a trans-competent provider was cited as essential to PrEP uptake and adherence. Participants noted that PrEP could address situations in which trans women experience reduced power to negotiate safer sex, including sex work. Trans-specific barriers included lack of trans-inclusive marketing of PrEP, prioritisation of hormone use, and medical mistrust due to transphobia. Findings underscore the importance of disaggregating trans women from MSM in HIV prevention strategies to mitigate disparate risk among this highly vulnerable population.

The Ep152R ORF of African swine fever virus strain Georgia encodes for an essential gene that interacts with host protein BAG6.

PubMed

Borca, Manuel V; O'Donnell, Vivian; Holinka, Lauren G; Rai, Devendra K; Sanford, Brenton; Alfano, Marialexia; Carlson, Jolene; Azzinaro, Paul A; Alonso, Covadonga; Gladue, Douglas P

2016-09-02

African swine fever virus (ASFV) is the etiological agent of a contagious and often lethal disease of domestic pigs that has significant economic consequences for the swine industry. The viral genome encodes for more than 150 genes, and only a select few of these genes have been studied in some detail. Here we report the characterization of open reading frame Ep152R that has a predicted complement control module/SCR domain. This domain is found in Vaccinia virus proteins that are involved in blocking the immune response during viral infection. A recombinant ASFV harboring a HA tagged version of the Ep152R protein was developed (ASFV-G-Ep152R-HA) and used to demonstrate that Ep152R is an early virus protein. Attempts to construct recombinant viruses having a deleted Ep152R gene were consistently unsuccessful indicating that Ep152R is an essential gene. Interestingly, analysis of host-protein interactions for Ep152R using a yeast two-hybrid screen, identified BAG6, a protein previously identified as being required for ASFV replication. Furthermore, fluorescent microscopy analysis confirms that Ep152R-BAG6 interaction actually occurs in cells infected with ASFV. Published by Elsevier B.V.

The role of exopolymeric substances in the bioaccumulation and toxicity of Ag nanoparticles to algae

NASA Astrophysics Data System (ADS)

Zhou, Kaijun; Hu, Yi; Zhang, Luqing; Yang, Kun; Lin, Daohui

2016-09-01

Exopolymeric substances (EPS) have an important role in bioaccumulation and toxicity of nanoparticles (NPs) to algae, which warrants specific studies. The interaction of EPS with citrate and polyvinyl pyrrolidone (PVP) coated AgNPs (C-AgNPs and P-AgNPs, respectively) and its roles in bioaccumulation and toxicity of the AgNPs to Chlorella pyrenoidosa were investigated. The amino and aromatic carboxylic groups in the EPS were involved in the EPS-AgNP interactions. Compared with Ag+, C-AgNPs had comparable total bioaccumulation but greater absorption by intact algae with EPS; P-AgNPs had the smallest total bioaccumulation and were mainly adsorbed on algal surfaces. With EPS removed, the total bioaccumulations and surface adsorptions for the three Ag species decreased but the cell internalizations increased; the 96 h half growth inhibition concentrations decreased, indicating EPS alleviated the algal toxicity of Ag. The cell-internalized but not the adsorbed AgNPs could contribute to the nanotoxicity. The EPS could bind both AgNPs and Ag+, and thus inhibited the cell internalization and the nanotoxicity. However, the EPS-bound Ag on the cell surfaces would migrate along with the algae and be biologically amplified in the aquatic food chains, presenting ecological risks. These results are helpful for understanding the fate and ecological effects of NPs.

[Effects of asphyxia on endocochlear direct-current potential in guinea pig].

PubMed

Liu, Xiuli; Ren, Zhong; Lü, Mei; Nakashima, Tsutomu

2006-04-01

To investigate the mechanism of auditory function disturbance due to asphyxiants. Guinea pigs with nice auricle reflex were selected in the experiment. The changes of endocochlear direct-current potential (EP) were detected when apnea and after artificial respiration, using the stria vascularis method. (1) The original EP of experimental group was (76.4+/-8.4) mV, and the original EP of control group was (80.8+/-8.4) mV, there was no significant difference between them. (2) During apnea, the EP of all the guinea pigs decreased precipitously after incubation period of 8 to 34 seconds. The decreasing rate of EP was positively correlated to the incubation period (P=0.008). (3) After 3 minutes of apnea, the mean minimum of EP was (-17.5+/-4.4) mV, which was positively correlated with decreasing rate and incubation period (P was 0.0002, 0.000 separately). (4) After artificial respiration, it needed the average time of (85.0+/-16.0) s to return original EP, and 7 cases got an overrun. The EP of all the guinea pigs decreased when apnea, which showed the abnormal living circumstance of acoustic hair cells. After 3 minutes of apnea, the EP of all the guinea pigs decreased to negative value, which demonstrated that the functions of acoustic hair cells had not lost within 3 minutes of apnea. After artificial respiration, all the guinea pigs' EP returned to original value, which indicated that the functions of the stria vascularis had not failed irreversibly.

Can we afford to offer pre-exposure prophylaxis to MSM in Catalonia? Cost-effectiveness analysis and budget impact assessment.

PubMed

Reyes-Urueña, J; Campbell, C; Diez, E; Ortún, V; Casabona, J

2018-06-01

Pre-exposure prophylaxis (PrEP) effectiveness has been well established. This study aims to assess the cost-effectiveness of providing PrEP, estimate the number of eligible MSM, and its budget impact in Catalonia. Cost-effectiveness analysis compared costs of on daily basis and "on demand" PrEP to prevent one infection with lifetime costs of one HIV infection. We estimated the total cost of providing PrEP by estimating number of eligible MSM, and included in the budget impact assessment antiretroviral and laboratory costs. Costs were lower for the on-demand PrEP group by €64015.1 and the incremental benefit was nearly 15 life-years and 17 quality-adjusted life-years gained. The incremental cost-effectiveness ratio (ICER) was cost-effective at €6281.62 when undiscounted PrEP was given daily. On-demand PrEP can be considered cost-saving in 20 years if the price is reduced by 90%. The number of eligible MSM in Catalonia ranges from 5,989 to 10,972. At current antiretroviral costs, the annual cost would range between €25.3-46.7 million/year (on demand PrEP), and €42.9-78.7 million/year (daily basis PrEP). PrEP is most cost-effective if targeted towards groups with high incidence rates of over 3%/year. Beneficial ICER depends on reducing the current price of Truvada® and ensuring that effectiveness is maintained at high levels.

Lessons learned from the experiences of informal PrEP users in France: results from the ANRS-PrEPage study.

PubMed

Rivierez, I; Quatremere, G; Spire, B; Ghosn, J; Rojas Castro, D

2018-05-30

Before January 2016, Pre-Exposure Prophylaxis (PrEP), a new biomedical HIV-prevention tool, was only available in France via ANRS-Ipergay clinical study but informal use was reported outside this setting. PrEPage qualitative study reports profiles and experiences of participants who used PrEP outside of a biomedical trial before this prevention method was authorized. Between March 2015 and February 2016, a cross-section of twenty-four informal PrEP users, mostly MSM, was recruited to complete in-depth semi-structured interviews. While ANRS-Ipergay was still ongoing (2012-2016), participants described their initiation to PrEP, the way they used it and the difficulties they faced to acquire antiretroviral drugs in an environment where PrEP was still not widely known and often criticized . Through the testimonies, different user profiles and motivation toward informal PrEP use emerged: (a) participants who have increasing difficulties using condoms, (b) "opportunists" who tried PrEP without the intention of using it regularly and (c) participants with a risk aversion who sought additional protection against HIV. Participants chose to use PrEP and/or their usual prevention strategies depending on available supplies, type of partners and individual attitudes toward risk. The feeling of living a safer sex life helped participants to outweigh the fear of possible toxicity and drug resistance. Participants' needs and expectations about PrEP implementation in France were also presented.

HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report.

PubMed

Adams, Leah M; Balderson, Benjamin H

2016-09-01

Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers for Disease Control (CDC) have released detailed guidelines to aid providers in prescribing PrEP for their high-risk patients, including men who have sex with men (MSM), high-risk heterosexuals, and injection drug users (IDUs). Given that much attention in PrEP has focused on MSM patients, the present study used an online survey to assess factors involved in HIV care providers' (n = 363) decisions about prescribing PrEP, along with their willingness to prescribe PrEP to patients from various risk populations (e.g., MSM, heterosexuals, IDUs). The efficacy of PrEP was an important factor in providers' decisions about prescribing PrEP, as were considerations about patients' adherence to the regimen, regular follow-up for care, and medication costs. This survey's findings also suggest that providers' willingness to prescribe PrEP varies by patient group, with providers most willing to initiate the regimen with MSM who have an HIV-positive partner, and least willing to prescribe to high-risk heterosexuals or IDUs. In the context of the current CDC recommendations for PrEP that include MSM, heterosexuals, and IDUs, examining providers' rationales for and barriers against supporting this HIV prevention strategy across patient groups merits further attention.

Antiretroviral Therapy and Pre-exposure Prophylaxis: Combined Impact on HIV Transmission and Drug Resistance in South Africa

PubMed Central

Abbas, Ume L.; Glaubius, Robert; Mubayi, Anuj; Hood, Gregory; Mellors, John W.

2013-01-01

Background. The potential impact of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) with overlapping and nonoverlapping antiretrovirals (ARVs) on human immunodeficiency virus (HIV) transmission and drug resistance is unknown. Methods. A detailed mathematical model was used to simulate the epidemiological impact of ART alone, PrEP alone, and combined ART + PrEP in South Africa. Results. ART alone initiated at a CD4 lymphocyte cell count <200 cells/µL (80% coverage and 96% effectiveness) prevents 20% of HIV infections over 10 years but increases drug resistance prevalence to 6.6%. PrEP alone (30% coverage and 75% effectiveness) also prevents 21% of infections but with lower resistance prevalence of 0.5%. The ratio of cumulative infections prevented to prevalent drug-resistant cases after 10 years is 7-fold higher for PrEP than for ART. Combined ART + PrEP with overlapping ARVs prevents 35% of infections but increases resistance prevalence to 8.2%, whereas ART + PrEP with nonoverlapping ARVs prevents slightly more infections (37%) and reduces resistance prevalence to 7.2%. Conclusions. Combined ART + PrEP is likely to prevent more HIV infections than either strategy alone, but with higher prevalence of drug resistance. ART is predicted to contribute more to resistance than is PrEP. Optimizing both ART and PrEP effectiveness and delivery are the keys to preventing HIV transmission and drug resistance. PMID:23570850

Development of a Sensitive and Specific Polyclonal Antibody for Serological Detection of Clavibacter michiganensis subsp. sepedonicus

PubMed Central

Przewodowska, Agnieszka

2017-01-01

The quarantine bacterium Clavibacter michiganensis subsp. sepedonicus (Cms) causes bacterial ring rot (BRR) in potato but is difficult to detect, hampering the diagnosis of this disease. ELISA immunoassays have not been widely used to detect Cms because commercially available anti-Cms antibodies detect mainly EPS-producing bacteria and can fail to detect strains that do not produce EPS. In the current study, we developed a new type of polyclonal antibody that specifically detects Clavibacter michiganensis subsp. sepedonicus bacteria irrespective of their EPS level. We first found that the presence of bacterial EPS precluded quantitative measurement of bacteria by currently available immunoenzymatic methods, but that washing Cms cells with acidic and basic buffers to remove EPS before analysis successfully standardized ELISA results. We used a mix of three strains of Cms with diverse EPS levels to generate antigen for production of antibodies recognizing Cms cells with and without an EPS layer (IgG-EPS and IgG-N-EPS, respectively). The resulting IgG-N-EPS recognized almost all Cms strains tested in this work regardless of their mucoidal level. The availability of this new antibody renders immunological diagnostics of Cms more sensitive and reliable, as our newly developed antibodies can be used in many type of immunoassays. This work represents an important step forward in efforts to diagnose and prevent the spread of BRR, and the methods and solutions developed in this work are covered by six Polish, one European and one US patents. PMID:28068400

Study of interactions between anionic exopolysaccharides produced by newly isolated probiotic bacteria and sodium caseinate.

PubMed

Abid, Yousra; Joulak, Ichrak; Ben Amara, Chedia; Casillo, Angela; Attia, Hamadi; Gharsallaoui, Adem; Azabou, Samia

2018-07-01

The present study aims to evaluate the interactions between four exopolysaccharides (EPS) produced by probiotic bacteria and sodium caseinate (Cas) in order to simulate their behavior in dairy products. Complexation between the produced EPS samples and Cas was investigated as a function of polysaccharide to protein ratio. The highest turbidity and average size of complexes were formed at an EPS/Cas ratio of 3 (corresponding to 1 g/L of EPS and 0.33 g/L of Cas) as a result of the combination of individual complexes to form aggregates. Zeta potential measurements and Cas surface hydrophobicity results suggested that complex formation occurred essentially through electrostatic attractions with a possible contribution of hydrophobic interaction for EPS-GM which was produced by Bacillus tequilensis-GM. Afterwards, the effect of pH on the complexation between biopolymers was studied when EPS and Cas concentrations were maintained constant at 1 and 0.33 g/L, respectively. pH was adjusted to 3.0 and 3.5, respectively. Results showed that the highest amount and sizes of EPS/Cas complexes were formed at pH 3.5 and that EPS-GM enabled to obtain the biggest and highest amount of aggregates. Therefore, the obtained results support the fact that the simultaneous presence of EPS and Cas in dairy products results in complexes formation via electrostatic interactions depending on EPS/Cas ratio and pH of the medium. Copyright © 2018 Elsevier B.V. All rights reserved.

Differences between emergency patients and their doctors in the perception of physician empathy: implications for medical education.

PubMed

Lin, C-S; Hsu, M-Y F; Chong, C-F

2008-07-01

Conveying empathy is a multi-phase process involving an inner resonation phase, communication phase, and reception phase. Previous investigations on physician empathy have focused on a physician's inner resonation phase or communication phase and not on the patient's reception phase. The purpose of this study was to investigate the differences in the perception of physicians' empathy between emergency physicians (EPs) and their patients. The answer to this question will allow us to more fully understand all phases of empathy and will help guide the teaching of how to effectively communicate empathy in the clinical setting. From 2004 to 2005, we conducted in-depth, semi-structured interviews with 7 each of EPs, patients, patients' family members and nurses. A phenomenological approach was used to analyze the data. Four themes emerged from the analysis: (1) When patients expressed their feelings, EPs usually did not resonate with their concerns; (2) Patients needed EPs to provide psychological comfort, but EPs focused only on patients' physical discomfort; (3) Patients needed appropriate feedback from EPs, but EPs did not reflect on whether their patients had received empathy from them; (4) EPs' ability to empathize was affected by environmental factors, which EPs found difficult to overcome. EPs and their patients perceive the physicians' empathy differently. These findings provide insights into patients' perceptions of their physicians' empathic expressions and provide a framework for teaching physicians how to convey empathy in the emergency department setting.

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan.

PubMed

Hashmi, Furqan K; Hassali, Mohamed Azmi; Khalid, Adnan; Saleem, Fahad; Aljadhey, Hisham; Babar, Zaheer Ud Din; Bashaar, Mohammad

2017-07-19

In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

Chemical and rheological properties of an extracellular polysaccharide produced by the cyanobacterium Anabaena sp. ATCC 33047.

PubMed

Moreno, J; Vargas, M A; Madiedo, J M; Muñoz, J; Rivas, J; Guerrero, M G

2000-02-05

The cyanobacterium (blue-green alga) Anabaena sp. ATCC 33047 produces an exopolysaccharide (EPS) during the stationary growth phase in batch culture. Chemical analysis of EPS revealed a heteropolysaccharidic nature, with xylose, glucose, galactose, and mannose the main neutral sugars found. The infrared (IR) spectrum of EPS showed absorption bands of carboxylate groups. The average molecular mass of the polymer was 1.35 MDa. Aqueous dispersions at EPS concentrations ranging from 0.2% to 0.6% (w/w) showed marked shear-thinning properties (power-law behavior). Linear dynamic viscoelastic properties showed that the elastic component was always higher than the viscous component. Viscous and viscoelastic properties demonstrated the absence of conformational changes within the concentration range studied. Stress-growth experiments revealed that 0.4% and 0.6% (w/w) EPS dispersions showed thixotropic properties. A detailed comparison of the linear dynamic viscoelasticity, transient flow, and decreasing shear rate flow curve properties was made for 0.4% (w/w) dispersions of xanthan gum (XG), Alkemir 110 (AG), and EPS. Viscoelastic spectra demonstrated that the EPS dispersion turned out to be more "fluidlike" than the AG and XG dispersions. The flow indexes indicated that the EPS dispersion was less shear-sensitive than that of XG, showing essentially the same viscosity, that is, >50 s(-1). The fact that viscosities of EPS and AG dispersions were not substantially different within the shear-rate range covered must be emphasized, in relation to EPS potential applications. The rheological behavior of EPS dispersions indicates the formation of an intermediate structure between a random-coil polysaccharide and a weak gel. Copyright 2000 John Wiley & Sons, Inc.

Sry HMG Box Protein 9-positive (Sox9+) Epithelial Cell Adhesion Molecule-negative (EpCAM−) Biphenotypic Cells Derived from Hepatocytes Are Involved in Mouse Liver Regeneration*

PubMed Central

Tanimizu, Naoki; Nishikawa, Yuji; Ichinohe, Norihisa; Akiyama, Haruhiko; Mitaka, Toshihiro

2014-01-01

It has been shown that mature hepatocytes compensate tissue damages not only by proliferation and/or hypertrophy but also by conversion into cholangiocyte-like cells. We found that Sry HMG box protein 9-positive (Sox9+) epithelial cell adhesion molecule-negative (EpCAM−) hepatocyte nuclear factor 4α-positive (HNF4α+) biphenotypic cells showing hepatocytic morphology appeared near EpCAM+ ductular structures in the livers of mice fed 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC)-containing diet. When Mx1-Cre:ROSA mice, which were injected with poly(I:C) to label mature hepatocytes, were fed with the DDC diet, we found LacZ+Sox9+ cells near ductular structures. Although Sox9+EpCAM− cells adjacent to expanding ducts likely further converted into ductular cells, the incidence was rare. To know the cellular characteristics of Sox9+EpCAM− cells, we isolated them as GFP+EpCAM− cells from DDC-injured livers of Sox9-EGFP mice. Sox9+EpCAM− cells proliferated and could differentiate to functional hepatocytes in vitro. In addition, Sox9+EpCAM− cells formed cysts with a small central lumen in collagen gels containing Matrigel® without expressing EpCAM. These results suggest that Sox9+EpCAM− cells maintaining biphenotypic status can establish cholangiocyte-type polarity. Interestingly, we found that some of the Sox9+ cells surrounded luminal spaces in DDC-injured liver while they expressed HNF4α. Taken together, we consider that in addition to converting to cholangiocyte-like cells, Sox9+EpCAM− cells provide luminal space near expanded ductular structures to prevent deterioration of the injuries and potentially supply new hepatocytes to repair damaged tissues. PMID:24482234

Fungal extracellular polysaccharides in house dust as a marker for exposure to fungi: relations with culturable fungi, reported home dampness, and respiratory symptoms.

PubMed

Douwes, J; van der Sluis, B; Doekes, G; van Leusden, F; Wijnands, L; van Strien, R; Verhoeff, A; Brunekreef, B

1999-03-01

Epidemiologic studies have demonstrated an association between indoor fungal growth and respiratory symptoms. However, in only a few studies was fungal exposure actually measured. The purpose of this study was to evaluate the measurement by enzyme immunoassay of extracellular polysaccharides of Aspergillus and Penicillium species (EPS-Asp/Pen ) in house dust as a marker for fungal exposure and to study the relations between EPS-Asp/Pen levels and home dampness and respiratory symptoms in children. Extracts of house dust samples from bedroom and living room floors and mattresses from homes of 31 children with chronic respiratory symptoms and 29 children with no chronic respiratory symptoms were analyzed for EPS-Asp/Pen. EPS-Asp/Pen were readily detectable (40 to 46,513 nanogram equivalent/g dust) in 161 house dust extracts, with highest concentrations in living room floor dust. EPS-Asp/Pen levels were 2 to 3 times higher on carpeted floors than on smooth floors. EPS-Asp/Pen were significantly correlated with total culturable fungi (r = 0.3 to 0.5) and with house dust mite allergens (r = 0.3 to 0.5). EPS-Asp/Pen levels in living room floor dust were positively associated with occupant-reported home dampness. This was not observed for EPS-Asp/Pen in bedroom floor and mattress dust. EPS-Asp/Pen levels in living room floor dust were positively associated with respiratory symptoms. EPS-Asp/Pen in bedroom floor and mattress dust showed a reversed association with respiratory symptoms, possibly because of allergen-avoidance measures taken in the bedroom. The enzyme immunoassay for fungal EPS-Asp/Pen may be a useful method for exposure assessment of indoor fungi.

Acceptability of microbicidal vaginal rings and oral pre-exposure prophylaxis for HIV prevention among female sex workers in a high-prevalence US city.

PubMed

Peitzmeier, Sarah M; Tomko, Catherine; Wingo, Erin; Sawyer, Anne; Sherman, Susan G; Glass, Nancy; Beyrer, Chris; Decker, Michele R

2017-11-01

Biomedical HIV prevention tools including oral pre-exposure prophylaxis (PrEP) and vaginal microbicidal rings hold unique value for high-risk women who may have limited capacity for condom negotiation, including the key populations of sex workers and drug users. Commercial sex is a PrEP indicator in CDC guidelines, yet little is known about female sex workers' (FSWs) knowledge of and attitudes toward PrEP or the recently developed monthly vaginal microbicide rings. We describe knowledge and attitudes toward PrEP and microbicide rings in a sample of 60 mostly drug-using FSWs in Baltimore, Maryland, a high HIV-prevalence US city. Just 33% had heard of PrEP, but 65% were interested in taking daily oral PrEP and 76% were interested in a microbicide vaginal ring; 87% were interested in at least one of the two methods. Results suggest method mix will be important as biomedical tools for HIV prophylaxis are implemented and scaled up in this population, as 12% were interested in PrEP but not vaginal rings, while 19% were interested in vaginal rings but not in PrEP. Self-efficacy for daily oral adherence was high (79%) and 78% were interested in using PrEP even if condoms were still necessary. Women who had experienced recent client-perpetrated violence were significantly more interested in PrEP (86% vs 53%, p = 0.009) and microbicidal rings (91% vs 65%, p = 0.028) than women who had not recently experienced violence. No differences were observed by demographics nor HIV risk behaviors, suggesting broad potential interest in daily PrEP and monthly-use vaginal microbicides in this high-risk population.

Assessing the need for a pre-exposure prophylaxis programme using the social media app Grindr®.

PubMed

Hampel, B; Kusejko, K; Braun, D L; Harrison-Quintana, J; Kouyos, R; Fehr, J

2017-11-01

HIV pre-exposure prophylaxis (PrEP) is not approved in Switzerland and therefore must be paid for by the users themselves. We conducted a survey to find out whether men who have sex with men (MSM) in Switzerland are already taking PrEP, or are considering using it, and whether it is being taken under medical supervision or not. Grindr® is a geosocial networking app for MSM. Between 5 and 24 January 2017, users of the app who were located in Switzerland by a global positioning system (GPS) were asked to participate in a ten-question survey on PrEP use. Of the 2455 people who took part in the survey, 1893 were included in the analysis. Eighty-two participants (4.3%) reported that they were currently taking PrEP, 64 of whom (78%) said that they were under medical supervision. Seven PrEP users (9%) declared that they had not taken an HIV test within the previous 12 months. Nine hundred and forty-four (49.9%) were considering taking PrEP in the next 6 months, and 1474 (77.9%) were considering taking it at some point in the future. In an online survey carried out among sexually active MSM in Switzerland, only a minority of the individuals approached responded that they were currently using PrEP. However, the majority of participants were considering taking PrEP in the future. We identified a substantial proportion of PrEP users taking PrEP outside a medical setting. Hence, a national programme facilitating access to medical care and providing PrEP is urgently needed. © 2017 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

Differing Experiences with Pre-Exposure Prophylaxis in Boston Among Lesbian, Gay, Bisexual, and Transgender Specialists and Generalists in Primary Care: Implications for Scale-Up.

PubMed

Krakower, Douglas S; Ware, Norma C; Maloney, Kevin M; Wilson, Ira B; Wong, John B; Mayer, Kenneth H

2017-07-01

The Centers for Disease Control and Prevention estimates that one in four sexually active men who have sex with men (MSM) could decrease their HIV risk by using HIV pre-exposure prophylaxis (PrEP). Because many MSM access healthcare from primary care providers (PCPs), these clinicians could play an important role in providing access to PrEP. Semistructured qualitative interviews were conducted with 31 PCPs in Boston, MA, to explore how they approach decisions about prescribing PrEP to MSM and their experiences with PrEP provision. Purposive sampling included 12 PCPs from an urban community health center specializing in the care of lesbian, gay, bisexual, and transgender persons ("LGBT specialists") and 19 PCPs from a general academic medical center ("generalists"). Analyses utilized an inductive approach to identify emergent themes. Both groups of PCPs approached prescribing decisions about PrEP as a process of informed decision-making with patients. Providers would defer to patients' preferences if they were unsure about the appropriateness of PrEP. LGBT specialists and generalists were at vastly different stages of adopting PrEP into practice. For LGBT specialists, PrEP was a disruptive innovation that rapidly became normative in practice. Generalists had limited experience with PrEP; however, they desired succinct decision-support tools to help them achieve proficiency, because they considered preventive medicine to be central to their professional role. As generalists vastly outnumber LGBT specialists in the United States, interventions to support PrEP provision by generalists could accelerate the scale-up of PrEP for MSM nationally, which could in turn decrease HIV incidence for this priority population.

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.

PubMed

Koechlin, Florence M; Fonner, Virginia A; Dalglish, Sarah L; O'Reilly, Kevin R; Baggaley, Rachel; Grant, Robert M; Rodolph, Michelle; Hodges-Mameletzis, Ioannis; Kennedy, Caitlin E

2017-05-01

Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

The Vaginal Microbiome and its Potential to Impact Efficacy of HIV Pre-exposure Prophylaxis for Women.

PubMed

Velloza, Jennifer; Heffron, Renee

2017-10-01

This review describes existing evidence addressing the potential modulation of pre-exposure prophylaxis (PrEP) products, specifically 1% tenofovir (TFV) gel and oral tenofovir-based PrEP, by vaginal dysbiosis and discusses future considerations for delivering novel, long-acting PrEP products to women at high risk for vaginal dysbiosis and HIV. We describe results from analyses investigating the modification of PrEP efficacy by vaginal dysbiosis and studies of biological mechanisms that could render PrEP ineffective in the presence of specific microbiota. A secondary analysis from the CAPRISA-004 cohort demonstrated that there is no effect of the 1% TFV gel in the presence of non-Lactobacillus dominant microbiota. Another recent analysis comparing oral tenofovir-based PrEP efficacy among women with and without bacterial vaginosis in the Partners PrEP Study found that oral PrEP efficacy is not modified by bacterial vaginosis. Gardnerella vaginalis, commonly present in women with vaginal dysbiosis, can rapidly metabolize TFV particularly when it is locally applied and thereby prevent TFV integration into cells. Given that vaginal dysbiosis appears to modulate efficacy for 1% TFV gel but not for oral tenofovir-based PrEP, vaginal dysbiosis is potentially less consequential to HIV protection from TFV in the context of systemic drug delivery and high product adherence. Vaginal dysbiosis may undermine the efficacy of 1% TFV gel to protect women from HIV but not the efficacy of oral PrEP. Ongoing development of novel ring, injectable, and film-based PrEP products should investigate whether vaginal dysbiosis can reduce efficacy of these products, even in the presence of high adherence.

Towards preparedness for PrEP: PrEP awareness and acceptability among MSM at high risk of HIV transmission who use sociosexual media in four Celtic nations: Scotland, Wales, Northern Ireland and The Republic of Ireland: an online survey.

PubMed

Frankis, Jamie S; Young, Ingrid; Lorimer, Karen; Davis, Mark; Flowers, Paul

2016-06-01

To assess the awareness and acceptability of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) and use sociosexual media at high risk of HIV infection in four Celtic nations. Cross-sectional study. Online self-complete survey of 386 HIV-negative/status unknown MSM who reported condomless anal intercourse (CAI) with ≥2 men in the last year, recruited from gay sociosexual media. One-third (34.5%, 132/386) of the participants were aware of PrEP but over half (58.5%, 226/356) reported that they would be willing to use PrEP if it were available to them. Only men who regularly tested for HIV every 6 months (adjusted OR 2.89, 95% CI 1.54 to 5.42) were more likely to be aware of PrEP. PrEP acceptability was only associated with reporting ≥5 CAI partners (OR 2.04, 95% CI 1.2 to 3.46) in the last year. Low levels of PrEP awareness were reported across these Celtic nations. Only one-third of high-risk MSM had heard of PrEP but over one-half would be willing to take a daily pill to prevent HIV infection. Sociodemographic factors, commercial gay scene proximity and social network use were unrelated to considering PrEP use. However, those reporting most CAI partners were more likely to consider PrEP use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Does Pre-exposure prophylaxis (PrEP) for HIV prevention in men who have sex with men (MSM) change risk behavior? A systematic review.

PubMed

Freeborn, Kellie; Portillo, Carmen J

2017-08-03

Pre-exposure prophylaxis (PrEP) for HIV has been available since 2012. Even so, PrEP has not been widely accepted among healthcare providers and MSM some of whom are convinced that PrEP decreases condom use, and increases sexually transmitted infections (STIs). A systematic review of the state of the evidence regarding the association of PrEP with condom use, STI incidence and change in sexual risk behaviors in MSM. A structured search of databases resulted in 142 potential citations, but only ten publications met inclusion criteria and underwent data abstraction and critical appraisal. An adapted Cochrane Collaboration domain based assessment tool was used to critically appraise the methodological components of each quantitative study, and the Mixed Methods Appraisal Tool (MMAT) was used to critically appraise qualitative and mixed-methods studies. Condom use in MSM utilizing PrEP is influenced by multiple factors. Studies indicate rates of STIs in treatment and placebo groups were high. PrEP did not significantly change STI rates between baseline and follow-up. Reporting of sexual risk improved when questionnaires were completed in private by clients. Our review found that PrEP may provide an opportunity for MSM to access sexual health care, testing, treatment and counselling services. We did not find any conclusive evidence that PrEP users increase sexual risk behaviors. The perception among healthcare providers that PrEP leads to increased sexual risk behaviors has yet to be confirmed. In order to provide effective sexual health services, clinicians need to be knowledgeable about PrEP as an HIV prevention tool. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Pre-Exposure Prophylaxis-Stigma Paradox: Learning from Canada's First Wave of PrEP Users.

PubMed

Grace, Daniel; Jollimore, Jody; MacPherson, Paul; Strang, Matthew J P; Tan, Darrell H S

2018-01-01

With the emergence of daily oral tenofovir disoproxil fumarate and emtricitabine-based pre-exposure prophylaxis (PrEP) use in Canada, questions have emerged concerning the impacts of this HIV prevention tool on gay men's social and sexual lives. We conducted small focus groups and individual qualitative interviews with 16 gay men in Toronto who were part of the 'first wave' of Canadian PrEP users. Participants were on PrEP for at least one year as part of a demonstration project (November 2014-June 2016). These participants accessed PrEP before regulatory approval by Health Canada in February 2016. The mean age of participants was 37.6 years (SD 11.02); 94% completed secondary education, and 69% were white. Sex-stigma emerged as a complex theme in men's accounts of PrEP use across three overlapping domains: (1) PrEP-related stigma, including discussions of concealment and stigma from friends, family, and sexual partners, (2) PrEP as a perceived tool for combating HIV-related stigma, where some men said that they no longer discussed HIV status with sexual partners, and (3) PrEP as illuminating structural stigma, where it was attributed to unmasking stigma related to sex and sexuality. For some participants, PrEP has allowed for liberating sex and a self-described return to normalcy-normal, exciting, pleasurable sex that was no longer reliant on condom use. Paradoxically, some men said that PrEP use both led them to experience stigmatizing reactions within their social and sexual networks, while also helping to remove stigma, shame, and fear related to HIV, sexuality, and sex with gay men living with HIV.

HIV pre-exposure prophylaxis: Exploring the potential for expanding the role of pharmacists in public health.

PubMed

Okoro, Olihe; Hillman, Lisa

2018-05-19

The study objectives were to a) assess knowledge and experience; b) describe perceptions and attitudes; and c) identify training needs of community-based pharmacists regarding HIV pre-exposure prophylaxis (PrEP). This was a cross-sectional survey study. The survey was administered online to pharmacists practicing in a community setting in the state of Minnesota. Measures included knowledge of and experience with HIV PrEP, perceptions and attitudes towards pharmacists' involvement, and HIV PrEP-specific training needs for pharmacists. With a survey response rate of approximately 13% (n = 347), most respondents (76.4%) agreed that HIV PrEP can be beneficial in high-risk populations. Forty-six percent of respondents were not aware of U.S. Food and Drug Administration approval of emtricitabine and tenofovir disoproxil fumarate for PrEP. Most respondents (71.1%) were "not at all familiar" with Centers for Disease Control and Prevention guidelines for PrEP. Twenty-one percent of respondents had sufficient knowledge to counsel patients on PrEP. Experience with counseling on PrEP (21.8%), having dispensed PrEP in the last 2 years (33.1%), fewer years in practice (≤10 years), location of practice site (urban or suburban), and having received HIV continuing education in the last 2 years (33.0%) were associated with more knowledge of HIV PrEP. Top concerns with counseling were knowledge about the medication and behavior modification. The most frequently indicated primary concerns with implementing PrEP initiatives were identifying appropriate candidates and patient adherence. As pharmacists' roles continue to expand, relevant content in pharmacy education and requisite training (including continuing education) are critical to addressing knowledge gaps and competencies that will enable pharmacists engage more effectively in public health efforts such as HIV prevention. Published by Elsevier Inc.

Potentiation of epidural lidocaine by co-administering tramadol by either intramuscular or epidural route in cats

PubMed Central

Hermeto, Larissa C.; DeRossi, Rafael; Marques, Beatriz C.; Jardim, Paulo H.A.

2015-01-01

This study investigated the analgesic and systemic effects of intramuscular (IM) versus epidural (EP) administration of tramadol as an adjunct to EP injection of lidocaine in cats. Six healthy, domestic, shorthair female cats underwent general anesthesia. A prospective, randomized, crossover trial was then conducted with each cat receiving the following 3 treatments: EP injection of 2% lidocaine [LEP; 3.0 mg/kg body weight (BW)]; EP injection of a combination of lidocaine and 5% tramadol (LTEP; 3.0 and 2.0 mg/kg BW, respectively); or EP injection of lidocaine and IM injection of tramadol (LEPTIM; 3.0 and 2.0 mg/kg BW, respectively). Systemic effects, spread and duration of analgesia, behavior, and motor blockade were determined before treatment and at predetermined intervals afterwards. The duration of analgesia was 120 ± 31 min for LTEP, 71 ± 17 min for LEPTIM, and 53 ± 6 min for LEP (P < 0.05; mean ± SD). The cranial spread of analgesia obtained with LTEP was similar to that with LEP or LEPTIM, extending to dermatomic region T13–L1. Complete motor blockade was similar for the 3 treatments. It was concluded that tramadol produces similar side effects in cats after either EP or IM administration. Our findings indicate that EP and IM tramadol (2 mg/kg BW) with EP lidocaine produce satisfactory analgesia in cats. As an adjunct to lidocaine, EP tramadol provides a longer duration of analgesia than IM administration. The adverse effects produced by EP and IM administration of tramadol were not different. Further studies are needed to determine whether EP administration of tramadol could play a role in managing postoperative pain in cats when co-administered with lidocaine after painful surgical procedures. PMID:26130854

Effects of the probiotic Bifidobacterium animalis subsp. lactis on the non-surgical treatment of periodontitis. A histomorphometric, microtomographic and immunohistochemical study in rats

PubMed Central

Ricoldi, Milla S. T.; Furlaneto, Flávia A. C.; Oliveira, Luiz F. F.; Teixeira, Gustavo C.; Pischiotini, Jéssica P.; Moreira, André L. G.; Ervolino, Edilson; de Oliveira, Maricê N.; Bogsan, Cristina S. B.; Salvador, Sérgio L.

2017-01-01

Lactobacillus probiotics have been investigated in periodontitis. However, the effects of the genus Bifidobacterium on periodontitis are hardly known. This study evaluated the effects of the probiotic (PROB) Bifidobacterium animalis subsp. lactis (B. lactis) HN019 as an adjunct to scaling and root planing (SRP) in rats with experimental periodontitis (EP). At baseline, 32 rats were assigned to 4 groups: C (control), PROB, EP-SRP and EP-SRP-PROB. In groups EP-SRP and EP-SRP-PROB, the mandibular first molars of the animals received a ligature. At day 14, the ligatures were removed and SRP was performed. Animals of groups PROB and EP-SRP-PROB were orally administered with 10 mL/day of 109 colony forming units of B. lactis HN019 for 15 days, starting at day 14. Animals were euthanized at day 29. Histomorphometric, microtomographic and immunohistochemical analyses were performed. Microbiological effects of B. lactis on biofilm were also evaluated. Data were statistically analyzed (ANOVA, Tukey; Kruskal-Wallis, Dunn’s; Two-tailed t-test; p<0.05). Group EP-SRP-PROB presented reduced alveolar bone resorption and attachment loss when compared with Group EP-SRP (p<0.05). Group EP-SRP-PROB showed significantly fewer osteoclasts, increased expression of anti-inflammatory cytokines and reduced expression of proinflammatory cytokines compared with Group EP-SRP (p<0.05). B. lactis promoted a higher ratio between aerobic and anaerobic bacteria in biofilm samples (p<0.05). B. lactis HN019 may have a role in the treatment of EP in rats, as an adjunct to SRP. PMID:28662142

SciDAC GSEP: Gyrokinetic Simulation of Energetic Particle Turbulence and Transport

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, Zhihong

Energetic particle (EP) confinement is a key physics issue for burning plasma experiment ITER, the crucial next step in the quest for clean and abundant energy, since ignition relies on self-heating by energetic fusion products (α-particles). Due to the strong coupling of EP with burning thermal plasmas, plasma confinement property in the ignition regime is one of the most uncertain factors when extrapolating from existing fusion devices to the ITER tokamak. EP population in current tokamaks are mostly produced by auxiliary heating such as neutral beam injection (NBI) and radio frequency (RF) heating. Remarkable progress in developing comprehensive EP simulationmore » codes and understanding basic EP physics has been made by two concurrent SciDAC EP projects GSEP funded by the Department of Energy (DOE) Office of Fusion Energy Science (OFES), which have successfully established gyrokinetic turbulence simulation as a necessary paradigm shift for studying the EP confinement in burning plasmas. Verification and validation have rapidly advanced through close collaborations between simulation, theory, and experiment. Furthermore, productive collaborations with computational scientists have enabled EP simulation codes to effectively utilize current petascale computers and emerging exascale computers. We review here key physics progress in the GSEP projects regarding verification and validation of gyrokinetic simulations, nonlinear EP physics, EP coupling with thermal plasmas, and reduced EP transport models. Advances in high performance computing through collaborations with computational scientists that enable these large scale electromagnetic simulations are also highlighted. These results have been widely disseminated in numerous peer-reviewed publications including many Phys. Rev. Lett. papers and many invited presentations at prominent fusion conferences such as the biennial International Atomic Energy Agency (IAEA) Fusion Energy Conference and the annual meeting of the American Physics Society, Division of Plasma Physics (APS-DPP).« less

Vascular Smooth Muscle-Specific EP4 Receptor Deletion in Mice Exacerbates Angiotensin II-Induced Renal Injury.

PubMed

Thibodeau, Jean-Francois; Holterman, Chet E; He, Ying; Carter, Anthony; Cron, Gregory O; Boisvert, Naomi C; Abd-Elrahman, Khaled S; Hsu, Karolynn J; Ferguson, Stephen S G; Kennedy, Christopher R J

2016-10-20

Cyclooxygenase inhibition by non-steroidal anti-inflammatory drugs is contraindicated in hypertension, as it may reduce glomerular filtration rate (GFR) and renal blood flow. However, the identity of the specific eicosanoid and receptor underlying these effects is not known. We hypothesized that vascular smooth muscle prostaglandin E2 (PGE2) E-prostanoid 4 (EP4) receptor deletion predisposes to renal injury via unchecked vasoconstrictive actions of angiotensin II (AngII) in a hypertension model. Mice with inducible vascular smooth muscle cell (VSMC)-specific EP4 receptor deletion were generated and subjected to AngII-induced hypertension. EP4 deletion was verified by PCR of aorta and renal vessels, as well as functionally by loss of PGE2-mediated mesenteric artery relaxation. Both AngII-treated groups became similarly hypertensive, whereas albuminuria, foot process effacement, and renal hypertrophy were exacerbated in AngII-treated EP4 VSMC-/- but not in EP4 VSMC+/+ mice and were associated with glomerular scarring, tubulointerstitial injury, and reduced GFR. AngII-treated EP4 VSMC-/- mice exhibited capillary damage and reduced renal perfusion as measured by fluorescent bead microangiography and magnetic resonance imaging, respectively. NADPH oxidase 2 (Nox2) expression was significantly elevated in AngII-treated EP4 -/- mice. EP4-receptor silencing in primary VSMCs abolished PGE2 inhibition of AngII-induced Nox2 mRNA and superoxide production. These data suggest that vascular EP4 receptors buffer the actions of AngII on renal hemodynamics and oxidative injury. EP4 agonists may, therefore, protect against hypertension-associated kidney damage. Antioxid. Redox Signal. 25, 642-656.

Signaling of Prostaglandin E Receptors, EP3 and EP4 Facilitates Wound Healing and Lymphangiogenesis with Enhanced Recruitment of M2 Macrophages in Mice.

PubMed

Hosono, Kanako; Isonaka, Risa; Kawakami, Tadashi; Narumiya, Shuh; Majima, Masataka

2016-01-01

Lymphangiogenesis plays an important role in homeostasis, metabolism, and immunity, and also occurs during wound-healing. Here, we examined the roles of prostaglandin E2 (PGE2) receptor (EP) signaling in enhancement of lymphangiogenesis in wound healing processes. The hole-punch was made in the ears of male C57BL/6 mice using a metal ear punch. Healing process and lymphangiogenesis together with macrophage recruitment were analyzed in EP knockout mice. Lymphangiogenesis was up-regulated in the granulation tissues at the margins of punched-hole wounds in mouse ears, and this increase was accompanied by increased expression levels of COX-2 and microsomal prostaglandin E synthase-1. Administration of celecoxib, a COX-2 inhibitor, suppressed lymphangiogenesis in the granulation tissues and reduced the induction of the pro-lymphangiogenic factors, vascular endothelial growth factor (VEGF) -C and VEGF-D. Topical applications of selective EP receptor agonists enhanced the expressions of lymphatic vessel endothelial hyaluronan receptor-1 and VEGF receptor-3. The wound-healing processes and recruitment of CD11b-positive macrophages, which produced VEGF-C and VEGF-D, were suppressed under COX-2 inhibition. Mice lacking either EP3 or EP4 exhibited reduced wound-healing, lymphangiogenesis and recruitment of M2 macrophages, compared with wild type mice. Proliferation of cultured human lymphatic endothelial cells was not detected under PGE2 stimulation. Lymphangiogenesis and recruitment of M2 macrophages that produced VEGF-C/D were suppressed in mice treated with a COX-2 inhibitor or lacking either EP3 or EP4 during wound healing. COX-2 and EP3/EP4 signaling may be novel targets to control lymphangiogenesis in vivo.

Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department: a systematic review.

PubMed

Joshi, Nikita; Lira, Alena; Mehta, Ninfa; Paladino, Lorenzo; Sinert, Richard

2013-01-01

Understanding history, physical examination, and ultrasonography (US) to diagnose extremity fractures compared with radiography has potential benefits of decreasing radiation exposure, costs, and pain and improving emergency department (ED) resource management and triage time. The authors performed two electronic searches using PubMed and EMBASE databases for studies published between 1965 to 2012 using a strategy based on the inclusion of any patient presenting with extremity injuries suspicious for fracture who had history and physical examination and a separate search for US performed by an emergency physician (EP) with subsequent radiography. The primary outcome was operating characteristics of ED history, physical examination, and US in diagnosing radiologically proven extremity fractures. The methodologic quality of the studies was assessed using the quality assessment of studies of diagnostic accuracy tool (QUADAS-2). Nine studies met the inclusion criteria for history and physical examination, while eight studies met the inclusion criteria for US. There was significant heterogeneity in the studies that prevented data pooling. Data were organized into subgroups based on anatomic fracture locations, but heterogeneity within the subgroups also prevented data pooling. The prevalence of fracture varied among the studies from 22% to 70%. Upper extremity physical examination tests have positive likelihood ratios (LRs) ranging from 1.2 to infinity and negative LRs ranging from 0 to 0.8. US sensitivities varied between 85% and 100%, specificities varied between 73% and 100%, positive LRs varied between 3.2 and 56.1, and negative LRs varied between 0 and 0.2. Compared with radiography, EP US is an accurate diagnostic test to rule in or rule out extremity fractures. The diagnostic accuracy for history and physical examination are inconclusive. Future research is needed to understand the accuracy of ED US when combined with history and physical examination for upper and lower extremity fractures. © 2013 by the Society for Academic Emergency Medicine.

EpCAM overexpression prolongs proliferative capacity of primary human breast epithelial cells and supports hyperplastic growth

PubMed Central

2013-01-01

Introduction The Epithelial Cell Adhesion Molecule (EpCAM) has been shown to be strongly expressed in human breast cancer and cancer stem cells and its overexpression has been supposed to support tumor progression and metastasis. However, effects of EpCAM overexpression on normal breast epithelial cells have never been studied before. Therefore, we analyzed effects of transient adenoviral overexpression of EpCAM on proliferation, migration and differentiation of primary human mammary epithelial cells (HMECs). Methods HMECs were transfected by an adenoviral system for transient overexpression of EpCAM. Thereafter, changes in cell proliferation and migration were studied using a real time measurement system. Target gene expression was evaluated by transcriptome analysis in proliferating and polarized HMEC cultures. A Chicken Chorioallantoic Membrane (CAM) xenograft model was used to study effects on in vivo growth of HMECs. Results EpCAM overexpression in HMECs did not significantly alter gene expression profile of proliferating or growth arrested cells. Proliferating HMECs displayed predominantly glycosylated EpCAM isoforms and were inhibited in cell proliferation and migration by upregulation of p27KIP1 and p53. HMECs with overexpression of EpCAM showed a down regulation of E-cadherin. Moreover, cells were more resistant to TGF-β1 induced growth arrest and maintained longer capacities to proliferate in vitro. EpCAM overexpressing HMECs xenografts in chicken embryos showed hyperplastic growth, lack of lumen formation and increased infiltrates of the chicken leukocytes. Conclusions EpCAM revealed oncogenic features in normal human breast cells by inducing resistance to TGF-β1-mediated growth arrest and supporting a cell phenotype with longer proliferative capacities in vitro. EpCAM overexpression resulted in hyperplastic growth in vivo. Thus, we suggest that EpCAM acts as a prosurvival factor counteracting terminal differentiation processes in normal mammary glands. PMID:23758908

Enhancement of therapeutic drug and DNA delivery into cells by electroporation* Enhancement of therapeutic drug and DNA delivery into cells by electroporation

NASA Astrophysics Data System (ADS)

Rabussay, Dietmar; Dev, Nagendu B.; Fewell, Jason; Smith, Louis C.; Widera, Georg; Zhang, Lei

2003-02-01

The effectiveness of potentially powerful therapeutics, including DNA, is often limited by their inability to permeate the cell membrane efficiently. Electroporation (EP) also referred to as `electropermeabilization' of the outer cell membrane renders this barrier temporarily permeable by inducing `pores' across the lipid bilayer. For in vivo EP, the drug or DNA is delivered into the interstitial space of the target tissue by conventional means, followed by local EP. EP pulses of micro- to millisecond duration and field strengths of 100-1500 V cm-1 generally enhance the delivery of certain chemotherapeutic drugs by three to four orders of magnitude and intracellular delivery of DNA several hundred-fold. We have used EP in clinical studies for human cancer therapy and in animals for gene therapy and DNA vaccination. Late stage squamous cell carcinomas of the head and neck were treated with intratumoural injection of bleomycin and subsequent EP. Of the 69 tumours treated, 25% disappeared completely and another 32% were reduced in volume by more than half. Residence time of bleomycin in electroporated tumours was significantly greater than in non-electroporated lesions. Histological findings and gene expression patterns after bleomycin-EP treatment indicated rapid apoptosis of the majority of tumour cells. In animals, we demonstrated the usefulness of EP for enhanced DNA delivery by achieving normalization of blood clotting times in haemophilic dogs, and by substantially increasing transgene expression in smooth muscle cells of arterial walls using a novel porous balloon EP catheter. Finally, we have found in animal experiments that the immune response to DNA vaccines can be dramatically enhanced and accelerated by EP and co-injection of micron-sized particles. We conclude that EP represents an effective, economical and safe approach to enhance the intracellular delivery, and thus potency, of important drugs and genes for therapeutic purposes. The safety and pharmaco-economic profile of EP compares favourably with other drug and DNA delivery methods.

1-Ethynylpyrene, a suicide inhibitor of cytochrome P-450 dependent benzo(a)pyrene hydroxylase activity in liver microsomes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gan, L.S.L.; Acebo, A.L.; Alworth, W.L.

The preparation of 1-ethynylpyrene (EP) by incubation of EP with liver microsomes in the presence of NADPH yields fluorescent products briefly. Addition of microsomes restores the original rate. The metabolism of EP is initially more rapid in microsomes from 5,6-benzoflavone- (BF) pretreated rats than in those from phenobarbital (PB) pretreated rats or controls. Ep inhibits the hydroxylation of benzo(a)pyrene (BP) by liver microsomes. Ep more effectively inhibits the oxidation of BP in liver microsomes from BF rats than from PB rats or from controls. The inhibition of BP hydroxylation activity due to EP is dependent upon NADPH and is apparentlymore » irreversible. Kinetic analyses show that the inhibition of BP hydroxylation is due to loss of the activity by a process that is first order in EP and that reaches a limiting value at infinite EP concentrations. A self-catalyzed inhibition of the cytochrome P-450 dependent BP hydroxylation may occur in the presence of EP. Incubation with EP under conditions that result in loss of BP hydroxylase activity in microsomes from BF rats and 66% of the activity from PB rats causes the loss of 6 and 12% of the cytochrome P-450, respectively. Thus the loss of P-450 content is an insensitive measure of the effect of this inhibitor upon this cytochrome P-450 dependent enzyme activity. Selectivity of the loss of P-450 due to the incubation of the different microsomal preparations with EP is observed to be different than the selectivity for loss of BP hydroxylase activity. It is proposed that the inhibition of cytochrome P-450 dependent enzymes by alkynes need not involve heme alkylation and a resulting loss of P-450 content. In vivo EP does not cause a significant change in the cytochrome P-450 content in the microsomes isolated, or result in the change in BP hydroxylation.« less

Selected engineering properties and applications of EPS geofoam

NASA Astrophysics Data System (ADS)

Elragi, Ahmed Fouad

Expanded polystyrene (EPS) geofoam is a lightweight material that has been used in engineering applications since at least the 1950s. Its density is about a hundredth of that of soil. It has good thermal insulation properties with stiffness and compression strength comparable to medium clay. It is utilized in reducing settlement below embankments, sound and vibration damping, reducing lateral pressure on substructures, reducing stresses on rigid buried conduits and related applications. This study starts with an overview on EPS geofoam. EPS manufacturing processes are described followed by a review of engineering properties found in previous research work done so far. Standards and design manuals applicable to EPS are presented. Selected EPS geofoam-engineering applications are discussed with examples. State-of-the-art of experimental work is done on different sizes of EPS specimens under different loading rates for better understanding of the behavior of the material. The effects of creep, sample size, strain rate and cyclic loading on the stress strain response are studied. Equations for the initial modulus and the strength of the material under compression for different strain rates are presented. The initial modulus and Poisson's ratio are discussed in detail. Sample size effect on creep behavior is examined. Three EPS projects are shown in this study. The creep behavior of the largest EPS geofoam embankment fill is shown. Results from laboratory tests, mathematical modeling and field records are compared to each other. Field records of a geofoam-stabilized slope are compared to finite difference analysis results. Lateral stress reduction on an EPS backfill retaining structure is analyzed. The study ends with a discussion on two promising properties of EPS geofoam. These are the damping ability and the compressibility of this material. Finite element analysis, finite difference analysis and lab results are included in this discussion. The discussion with the rest of the study points towards the main conclusion that EPS geofoam is the future material of promise in various civil engineering applications.

Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.

PubMed

Walters, Suzan M; Reilly, Kathleen H; Neaigus, Alan; Braunstein, Sarah

2017-06-29

Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

Exploring strategies for PrEP adherence and dosing preferences in the context of sexualized recreational drug use among MSM: a qualitative study.

PubMed

Closson, Elizabeth F; Mitty, Jennifer A; Malone, Jowanna; Mayer, Kenneth H; Mimiaga, Matthew J

2018-02-01

The use of recreational drugs while having sex is associated with increased HIV incidence among men who have sex with men (MSM). Taking a daily antiretroviral pill, or pre-exposure prophylaxis (PrEP) is a biomedical intervention to prevent HIV. However, the efficacy of PrEP is closely tied with high levels of adherence. While PrEP has the potential to reduce HIV acquisition, the use of recreational drugs may impede adherence. We explored perceptions of PrEP utilization and regimen preferences among 40 HIV-negative, MSM who reported concurrent recreational drug use and condomless anal sex with a man. Semi-structured qualitative interviews were conducted and the data were analyzed using a qualitative descriptive approach. Participants perceived that it would be challenging to take PrEP while high on crystal meth, crack, powder cocaine, ecstasy and/or GHB. However, men identified strategies for using PrEP when they were not high on these drugs, including taking the pill when they started their day and integrating PrEP into an established routine, such as when taking other medications or preparing for sex. PrEP regimen preferences seemed to be shaped by the frequency in which participants used drugs and their ability to plan for sex. Taking PrEP everyday was appealing for those who regularly engaged in sexualized recreational drug use. Accounts depict these sexual interactions as frequent but unpredictable. A daily regimen would allow them to be prepared for sex without having to plan. An event-driven regimen was acceptable to men who occasionally used recreational drugs in the context of sex. For this group, sex usually occurred was generally prearranged. Patterns of sex and recreational drug use figured largely into participants' framings of how they would use PrEP. These behaviors will likely play a role in the uptake of and adherence to PrEP among this population.

Piracy of PGE2/EP receptor mediated signaling by Kaposi’s sarcoma associated herpes virus (KSHV/HHV-8) for latency gene expression: Strategy of a successful pathogen

PubMed Central

Paul, Arun George; Sharma-Walia, Neelam; Kerur, Nagaraj; White, Carl; Chandran, Bala

2010-01-01

KSHV is implicated in the pathogenesis of KS, a chronic inflammation associated malignancy. COX-2 and its metabolite PGE2, two pivotal proinflammatory/oncogeneic molecules, are proposed to play roles in the expression of major KSHV latency associated nuclear antigen-1 (LANA-1). Microsomal prostaglandin E2 synthase (mPGES), PGE2 and its receptors (EP1, EP2, EP3, and EP4) were detected in KS lesions with the distinct staining of EP2/EP4 in KS lesions. In latently infected endothelial TIVE-LTC cells, EP receptor antagonists down-regulated LANA-1 expression as well as Ca2+, p-Src, p-PI3K, p-PKCζ/λ, and p-NF-κB, which are also some of the signal molecules proposed to be important in KS pathogenesis. Exogenous PGE2 and EP receptor agonists induced the LANA-1 promoter in 293 cells, and YY1, Sp1, Oct-1, Oct-6, C/EBP and c-Jun transcription factors appear to be involved in this induction. PGE2/EP receptor induced LANA-1 promoter activity was down-regulated significantly by the inhibition of Ca2+, p-Src, p-PI3K, p-PKCζ/λ, and p-NF-κB. These findings implicate the inflammatory PGE2/EP receptors and the associated signal molecules in herpes virus latency and uncover a novel paradigm that demonstrates the evolution of KSHV genome plasticity to utilize inflammatory response for its survival advantage of maintaining latent gene expression. This data also suggests that potential use of anti-COX-2 and anti-EP receptor therapy may not only ameliorate the chronic inflammation associated with KS but could also lead to elimination of the KSHV latent infection and the associated KS lesions. PMID:20388794

Molecular cloning and characterization of chicken prostaglandin E receptor subtypes 2 and 4 (EP2 and EP4).

PubMed

Kwok, Amy Ho Yan; Wang, Yajun; Wang, Crystal Ying; Leung, Frederick C

2008-06-01

Prostaglandin E(2) (PGE(2)) is an important chemical mediator responsible for regulation of many vital physiological processes. Four receptor subtypes have been identified to mediate its biological actions. Among these subtypes, prostaglandin E receptor subtypes 2 and 4 (EP(2) and EP(4)), both coupled to cAMP-protein kinase A (cAMP-PKA) signaling pathway, are proposed to play crucial roles under both physiological and pathological conditions. Though both receptors were extensively studied in mammals, little is known about their functionality and expression in non-mammalian species including chicken. In present study, the full-length cDNAs for chicken EP(2) and EP(4) receptors were first cloned from adult chicken ovary and testis, respectively. Chicken EP(2) is 356 amino acids in length and shows high amino acid identity to that of human (61%), mouse (63%), and rat (61%). On the other hand, the full-length cDNA of EP(4) gene encodes a precursor of 475 amino acids with a high degree of amino acid identity to that of mammals, including human (87%), mouse (86%), rat (84%), dog (85%), and cattle (83%), and a comparatively lower sequence identity to zebrafish (52%). RT-PCR assays revealed that EP(2) mRNA was expressed in all tissues examined including the oviduct, while EP(4) expression was detected only in a few tissues. Using the pGL3-CRE-luciferase reporter system, we also demonstrated that PGE(2) could induce luciferase activity in DF-1 cells expressing EP(2) and EP(4) in dose-dependent manners (EC(50): <1 nM), confirming that both receptors could be activated by PGE(2) and functionally coupled to the cAMP-PKA signaling pathway. Together, our study establishes a molecular basis to understand the physiological roles of PGE(2) in target tissues of chicken.

The influence of pharmacy and pharmacist characteristics on the secondary prevention of cardiovascular disease.

PubMed

Puspitasari, Hanni Prihhastuti; Aslani, Parisa; Krass, Ines

2015-10-01

A range of extended/enhanced pharmacy services (EPS) are increasingly being offered in community pharmacies following a global paradigm shift in professional pharmacy practice from a product-oriented focus to a patient-centered approach. A number of pharmacy/pharmacist characteristics have been reported to influence EPS provision. To investigate the association between EPS provision and community pharmacists' support in CVD secondary prevention and to identify pharmacy/pharmacist characteristics which predict EPS provision and CVD support. Setting Australian community pharmacies. Mail surveys to 1350 randomly selected pharmacies, stratified by state/territory, exploring professional activities provided to clients with CVD, characteristics of pharmacies (including EPS provision), and pharmacist characteristics. The survey data were analyzed using univariate analyses and multiple linear regression analysis. The level of community pharmacists' CVD support, determined by summing respondents' score for seven CVD support-related activities, and the pharmacies' level of involvement in EPS provision, determined by summing respondents' score for four types of EPS. EPS provision was then used as an independent variable in the regression analysis of CVD support. A response rate of 15.8% (209/1320) was obtained after three waves of the survey. Pharmacy documentation, a private area, Quality Care Pharmacy Program accreditation, number of pharmacists, and pharmacists' resource adequacy were predictors of EPS provision (adjusted R2 = 0.299, p < 0.001). The provision of CVD support was predicted by EPS provision (β = 0.290, p < 0.001), pharmacists' frequent contacts with general practitioners (β = 0.298, p < 0.001), and pharmacy documentation (β = 0.134, p = 0.033). The regression model of CVD support explained 34.2% of the variation (p < 0.001). Community pharmacists could contribute to CVD secondary prevention if they had frequent contacts with general practitioners and worked in pharmacies with a higher level of involvement in EPS provision. Of all influencing factors, documentation was a predictor of both EPS provision and CVD support, indicating the importance of documentation in supporting the management of chronic conditions.

PrEP in Italy: The time may be ripe but who's paying the bill? A nationwide survey on physicians' attitudes towards using antiretrovirals to prevent HIV infection

PubMed Central

Di Biagio, Antonio; Signori, Alessio; Maserati, Renato; Nozza, Silvia; Gori, Andrea; Bonora, Stefano; Borderi, Marco; Ripamonti, Diego; Rossi, Maria Cristina; Orofino, Giancarlo; Quirino, Tiziana; Nunnari, Giuseppe; Celesia, Benedetto Maurizio; Martini, Salvatore; Sagnelli, Caterina; Mazzola, Giovanni; Colletti, Pietro; Bartolozzi, Dario; Bini, Teresa; Ladisa, Nicoletta; Castelnuovo, Filippo; Saracino, Annalisa; Lo Caputo, Sergio

2017-01-01

Several studies have demonstrated the efficacy of the oral pre-exposure prophylaxis (PrEP) with tenofovir (with or without emtricitabine) on preventing HIV-negative partners of HIV infected patients to become infected through sexual contacts. PrEP is already available in the United States and now is approved by European Medicine Agency. In this setting we would like to gauge physicians’ knowledge, acquaintance with and attitude to include PrEP in their clinical practice. A cross sectional survey was conducted among Italian physicians expert on antiretroviral therapy. Out of 146 physicians, 35% of participants declared to be familiar with PrEP but only 46% of them believed that, currently, there are not enough reasons to make it available in Italy. 51% of physicians have already been attracted to prescribe it and 63.4% have been openly asked about PrEP. The main concerns noticed were: the risk of acquire other sexual transmitted diseases (STDs) (70% of physicians feared that PrEP could favor STDs spread), the potential harmful of PrEP if not adequately implemented and, especially the risk of possible side effects if not properly used. Nevertheless, 55.9% of participants believed that Health Authorities face an ethical obligation to make PrEP available as part of the strategies to protect from HIV transmission and half of the respondents asked for further researches to better define the role for PrEP. Attitudes regarding PrEP impact on Italian National Health Organization were also very interesting: 57.5% of participants did not believe that investing in PrEP would be an appropriate use of healthcare resources, while 70.6% affirmed that PrEP’s financial coverage should not be funded by the Italian National System of Health (SSN). This survey showed a high awareness of PrEP potential among Italian physicians coupled with a great deal of skepticism about how and if implementing it in clinical practice. PMID:28727818

Willingness to use and have sex with men taking HIV pre-exposure prophylaxis (PrEP): results of online surveys of Australian gay and bisexual men, 2011-2015.

PubMed

Holt, Martin; Lea, Toby; Schmidt, Heather-Marie; Kolstee, Johann; Ellard, Jeanne; Murphy, Dean; Truong, Hong-Ha; de Wit, John

2017-09-01

Assess willingness to use HIV pre-exposure prophylaxis (PrEP), support for others using it and willingness to have sex with partners using PrEP among Australian gay and bisexual men (GBM). National, online cross-sectional surveys of Australian GBM were conducted in 2011, 2013 and 2015. Scales measuring support for and willingness to have sex with men using PrEP were developed in 2015 using factor analysis. Trends and associations with key measures were analysed using multivariate logistic regression. During 2011-2015, 3850 surveys were completed by GBM. Willingness to use PrEP among HIV-negative and untested men did not change between 2011 (28.2%) and 2015 (31.7%, p=0.13). In 2015, willingness to use PrEP was independently associated with younger age, having an HIV-positive regular partner, recent condomless anal intercourse with casual male partners (CAIC), more than 10 male sex partners in the previous 6 months, ever having taken postexposure prophylaxis and having fewer concerns about using PrEP. In 2015, 54.5% of GBM supported other GBM taking PrEP and 39% were willing to have sex with men using PrEP. Support for and willingness to have sex with PrEP users were both associated with being HIV-positive, having a university degree and having two or more male partners in the previous 6 months. Willingness to have sex with men on PrEP was also associated with recent CAIC and using party drugs for sex, but was less likely among men who consistently used or had a positive experience using condoms. Interest in and support for using PrEP are concentrated among men who engage in higher risk practices and who know more about living with HIV. This is consistent with the targeting of PrEP in Australia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Comparison of Expansive Pedicle Screw and Polymethylmethacrylate-Augmented Pedicle Screw in Osteoporotic Sheep Lumbar Vertebrae: Biomechanical and Interfacial Evaluations

PubMed Central

Zhang, Bo; Xie, Qing-yun; Wang, Cai-ru; Liu, Jin-biao; Liao, Dong-fa; Jiang, Kai; Lei, Wei; Pan, Xian-ming

2013-01-01

Background It was reported that expansive pedicle screw (EPS) and polymethylmethacrylate-augmented pedicle screw (PMMA-PS) could be used to increase screw stability in osteoporosis. However, there are no studies comparing the two kinds of screws in vivo. Thus, we aimed to compare biomechanical and interfacial performances of EPS and PMMA-PS in osteoporotic sheep spine. Methodology/Principal Findings After successful induction of osteoporotic sheep, lumbar vertebrae in each sheep were randomly divided into three groups. The conventional pedicle screw (CPS) was inserted directly into vertebrae in CPS group; PMMA was injected prior to insertion of CPS in PMMA-PS group; and the EPS was inserted in EPS group. Sheep were killed and biomechanical tests, micro-CT analysis and histological observation were performed at both 6 and 12 weeks post-operation. At 6-week and 12-week, screw stabilities in EPS and PMMA-PS groups were significantly higher than that in CPS group, but there were no significant differences between EPS and PMMA-PS groups at two study periods. The screw stability in EPS group at 12-week was significantly higher than that at 6-week. The bone trabeculae around the expanding anterior part of EPS were more and denser than that in CPS group at 6-week and 12-week. PMMA was found without any degradation and absorption forming non-biological “screw-PMMA-bone” interface in PMMA-PS group, however, more and more bone trabeculae surrounded anterior part of EPS improving local bone quality and formed biological “screw-bone” interface. Conclusions/Significance EPS can markedly enhance screw stability with a similar effect to the traditional method of screw augmentation with PMMA in initial surgery in osteoporosis. EPS can form better biological interface between screw and bone than PMMA-PS. In addition, EPS have no risk of thermal injury, leakage and compression caused by PMMA. We propose EPS has a great application potential in augmentation of screw stability in osteoporosis in clinic. PMID:24086381

Pre-exposure Prophylaxis (PrEP) Use, Seroadaptation, and Sexual Behavior Among Men Who Have Sex with Men, San Francisco, 2004-2014.

PubMed

Chen, Yea-Hung; Snowden, Jonathan M; McFarland, Willi; Raymond, H Fisher

2016-12-01

The Food and Drug Administration approved pre-exposure prophylaxis (PrEP) to prevent HIV infection, and the Centers for Disease Control and Prevention has presented PrEP as a prevention option for groups at high risk such as men who have sex with men (MSM). Intervention data provide some information on how PrEP affects sexual behavior of MSM in trials, open label extensions, or clinics. However, it is unclear whether sexual risk and preventive behavioral patterns are changing in the population as a whole as PrEP becomes more widely available, whether due to PrEP use or other factors. We examined trends in PrEP use, numbers of condomless anal sex partners, consistent condom use, and seroadaptive strategies in San Francisco-a city which has actively promoted PrEP-using data from National HIV Behavioral Surveillance (NHBS). NHBS recruited 1211, 383, 373, and 268 HIV-negative MSM in 2004, 2008, 2011, and 2014, respectively. PrEP use increased from zero in 2004, 2008, and 2011 to 9.6 % in 2014. The proportion of men with no condomless anal sex partners dropped from 60.6 % in 2004, to 58.2 % in 2008, to 54.2 % in 2011, to 40.2 % in 2014. Consistent condom use decreased from 36.8 % in 2004, and 30.5 % in 2008 and 2011, to 18.3 % in 2014. PrEP's introduction and scale-up enters in a pre-existing trend of decreasing condom use and increasing sexually transmitted infections among MSM which may be accelerating in recent years. While PrEP use should be scaled up as a prevention option among those who would benefit most, we believe that public health officials need to be realistic about the possibility that condom use could very well continue to decline as PrEP use increases, and to an extent that may not be directly or indirectly offset by PrEP.

Willingness to use pre-exposure prophylaxis for HIV prevention among female sex workers: a cross-sectional study in China

PubMed Central

Peng, Bin; Yang, Xiaowei; Zhang, Yan; Dai, Jianghong; Liang, Hao; Zou, Yunfeng; Luo, Jinkun; Peng, Hongbin; Zhong, Xiaoni; Huang, Ailong

2012-01-01

Background Pre-exposure prophylaxis (PrEP) is a strategy developed to prevent individuals who are human immunodeficiency virus (HIV)-negative from developing HIV infection. In China, while conducting a clinical trial to investigate the effectiveness and safety of PrEP, we performed this survey to assess the willingness of female sex workers to use PrEP, and identify predictors of this willingness. Methods From July 2009 to April 2010, a cross-sectional study was carried out in four provinces of China. We recruited 1611 female sex workers who completed a self-administered survey to assess their awareness of and intention to use PrEP. The survey also canvassed demographic, behavioral, and psychosocial variables. Bivariate and multivariable logistic regression models were fitted to identify predictors of intent to use PrEP. Results In total, 69% of the women (95% confidence interval [CI] 66.7–71.3) reported intent to use PrEP, and 12% (95% CI 10.5–13.7) had used drugs in the past to prevent a sexually transmitted infection. Further, 16.5% (95% CI 14.7–18.4) had previously heard of PrEP, and 1.4% (95% CI 0.9–2.1) had used PrEP previously to prevent HIV infection. Multivariate analysis indicated the following significant predictors of intent to use PrEP: Han ethnicity (adjusted odds ratio [AOR] 1.446; P = 0.011), urban residence (AOR 1.302; P = 0.027), knowledge about transmission of HIV/acquired immune deficiency virus syndrome (AIDS, AOR 1.817; P = 0.0007), a history of sexually transmitted infection (AOR 1.830; P < 0.0001), a history of using medication to prevent a sexually transmitted disease (AOR 2.547; P < 0.0001), and willingness to access knowledge about HIV/AIDS (AOR 2.153; P < 0.0001). Conclusion The majority of female sex workers reported intent to use PrEP if it is safe and effective. Given that most of the participants had never heard of PrEP before, we strongly recommend that educational materials be developed with detailed introduction of PrEP. The risks and benefits of PrEP use should be fully explained to potential users when promoting PrEP in the future. PMID:23055781

Hydrodynamic impacts on biogenic stabilisation and the fate of extracellular polymeric substances (EPS) in mixed sediment bedforms.

NASA Astrophysics Data System (ADS)

Hope, J. A.; Aspden, R.; Schindler, R.; Parsons, D. R.; Ye, L.; Baas, J.; Paterson, D. M.

2014-12-01

The stability and morphology of bedforms have traditionally been treated as a function of mean flow velocity/non-dimensional bed shear stress and sediment particle size, despite the known influence of key biological components such as extracellular polymeric substances (EPS). EPS is produced by microbial communities and can increase erosion thresholds by more than 300%. However, the mechanisms behind the influence of EPS on sediment transport and bedform dynamics is poorly understood, as is the fate of EPS and exchange of EPS between the sediment bed and water column during ripple formation. The exchange of EPS between the sediment bed and water column is dynamic, with important implications for a range of physical and geochemical processes, with the spatio-temporal variation in EPS content, from source to eventual fate, being extremely important for determining the behaviour and natural variability of sedimentary systems. This paper reports on a series of flume experiments where a tripartite mixture of sand, clay and model EPS (xanthan gum) was used to create a sediment substrate, which was subject to a unidirectional current (0.8 ms-1 for 10.5 hrs, n=6). For each run the spatio-temporal changes in concentration, distribution, and effect of EPS, on the evolving bed of mixed sediment was monitored throughout, with complete 3D bed morphology scans also acquired at ~360 s intervals. The various substrate mixtures produced bedforms varying from ripples to dunes and biochemical analysis of EPS concentration across the formed bedforms, suggest EPS is winnowed from the sediment - water interface, particularly at the bedform crests. The depth of winnowing in each run was found to be related to the bedform size, with variation in the stoss, crest and trough of the bedforms identified. The loss of EPS was also significantly correlated with the depth to which clay was winnowed, presumably due to a close association between the clay mineral and EPS fractions. The paper will discuss how sediment processes and flow are linked by migration of dissolved and particulate substances into and out of the bed and how this exchange is affected by the topography of the sediment bed and advective pore water transfers. Finally, the implications for natural systems and larger scale sediment-biota linkages will also be discussed.

"Why should I take drugs for your infection?": outcomes of formative research on the use of HIV pre-exposure prophylaxis in Nigeria.

PubMed

Idoko, John; Folayan, Morenike Oluwatoyin; Dadem, Nancin Yusufu; Kolawole, Grace Oluwatosin; Anenih, James; Alhassan, Emmanuel

2015-04-10

Nigeria has the second highest number of new HIV infections annually. Therefore, it is important to explore new strategies for preventing new infections. The introduction of pre-exposure prophylaxis (PrEP) for use by persons at high risk of HIV infection has new potential in preventing new HIV infections. The aim of this study is to explore the public opinion, community interest, and perceptions about the use and access to PrEP in Nigeria. This formative study used a mixed method approach to collect data on public opinions and perceptions on appropriate target groups for PrEP access, community interest, perceptions about the use of PrEP as an HIV-prevention tool, how best to communicate with participants about PrEP, concerns about PrEP use by serodiscordant couples, and suggestions for the design and implementation of a PrEP demonstration project. Telephone and in-depth interviews were conducted, and focus group discussions and consultative meetings were held with critical stakeholders engaged in HIV-prevention, treatment, care, and support programmes in Nigeria. An online survey was also conducted. HIV serodiscordant couples were identified as the appropriate target group for PrEP use. Most respondents felt that PrEP use by key affected populations would help reduce the HIV incidence. Stigma was identified as a major concern and a potential barrier for the acceptance and use of PrEP by HIV serodiscordant couples. Electronic and print media were identified as important means for massive public education to prevent stigma and create awareness about PrEP. In a male dominated society such as Nigeria, HIV-negative male partners in serodiscordant relationships may resist enrolment in PrEP programmes. This may be complicated by the fact that the identified index partner in most serodiscordant relationships in Nigeria is an HIV-positive woman, who is often diagnosed during pregnancy. PrEP uptake and use by HIV serodiscordant couples in Nigeria may face notable but surmountable challenges. Much depends on the appropriateness of actions taken by multiple players. Motivation of HIV-negative male partners to use PrEP and establishment of effective public education programmes in addressing stigma are essential.

Willingness of community-recruited men who have sex with men in Washington, DC to use long-acting injectable HIV pre-exposure prophylaxis

PubMed Central

Patrick, Rudy; Gamble, Jonjelyn; Rawls, Anthony; Opoku, Jenevieve; Magnus, Manya; Kharfen, Michael; Greenberg, Alan E.; Kuo, Irene

2017-01-01

Objectives Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI) agents as HIV pre-exposure prophylaxis (PrEP). Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM) to use LAI PrEP and their preference for LAI versus daily oral PrEP. Methods In 2014, venue-based sampling was used to recruit MSM aged ≥18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being “very likely” to use LAI PrEP and preferring it to daily oral PrEP were identified using multivariable logistic regression. Results Of 314 participants who self-reported negative/unknown HIV status, 50% were <30 years old, 41% were non-Hispanic Black, 37% were non-Hispanic White, and 14% were Hispanic. If LAI PrEP were offered for free or covered by health insurance, 62% were very likely, 25% were somewhat likely, and 12% were unlikely to use it. Regarding preferred PrEP modality, 67% chose LAI PrEP, 24% chose oral PrEP, and 9% chose neither. Correlates of being very likely versus somewhat likely/unlikely to use LAI PrEP included age <30 years (aOR 1.64; 95% CI 1.00–2.68), reporting ≥6 (vs. 1) sex partners in the last year (aOR 2.60; 95% CI 1.22–5.53), previous oral PrEP use (aOR 3.67; 95% CI 1.20–11.24), and being newly identified as HIV-infected during study testing (aOR 4.83; 95% CI 1.03–22.67). Black (vs. White) men (aOR 0.48; 95% CI 0.24–0.96) and men with an income of <$20,000 (vs. ≥$75,000; aOR 0.37; 95% CI 0.15–0.93) were less likely to prefer LAI to oral PrEP. Conclusions If LAI PrEP were found to be efficacious, its addition to the HIV prevention toolkit could facilitate more complete PrEP coverage among MSM at risk for HIV. PMID:28827821