The Support for Smoke Free Policy and How It Is Influenced by Tolerance to Smoking – Experience of a Developing Country

This cross sectional survey was conducted to determine the support in making Penang UNESCO World Heritage Site (GTWHS) smoke free and to determine the influence of tolerance towards smoking on this support. This is the first phase in making Penang, Malaysia a smoke free state. A multistage sampling process was done to select a sample of respondents to represent the population of GTWHS. Attitude towards smoking was assessed using tolerance as a proxy. A total of 3,268 members of the community participated in the survey. A big majority (n = 2969; 90.9%) of the respondents supported the initiative. Support was lowest among the owners and residents/tenants, higher age groups, the Chinese, men, respondents who had poor knowledge of the places gazetted as smoke free, and respondents with poor knowledge of the health effects on smokers and on passive smokers. The odds (both adjusted and unadjusted) of not supporting the initiative was high among those tolerant to smoking in public areas. Tolerance towards smoking was associated with 80.3% risk of non-support in the respondents who were tolerant to smoking and a 57.2% risk in the population. Health promotion and education concerning the harm of tobacco smoke in Malaysia, which has mainly targeted smokers, must change. Health education concerning the risks of second hand smoke must also be given to non-smokers and efforts should be made to denormalize smoking.     

HYPERTHYROIDISM—Diagnosis by Failure of Triiodothyronine to Suppress Uptake of Iodine131

Sixty patients with abnormally high I¹³¹ uptake were treated with liothyronine (L-triiodothyronine) for seven or eight days and then tested again. Fifty-five patients showed a suppression of iodine uptake sufficient to eliminate the possibility of hyperthyroidism. Also the therapeutic trial of liothyronine indicated whether they were euthyroid, or hypothyroid with iodine deficiency. Six of the patients showed insignificant change in the I¹³¹ uptake after treatment with thyroid hormone—that is, the change from the original uptake was less than 30 per cent. These six patients were later confirmed to be hyperthyroid. In four patients the uptake at the second test was less by between 35 and 52 per cent than at the first. These four patients, like the remainder with even greater suppression in thyroid uptake, remained clinically euthyroid.The repeat I¹³¹ uptake test was thus seen to be considerably more accurate than the single test and well worth the time required to perform it.     

Suppression of an invasive legume by a native grass — High impact of priority effects

Nitrogen-limited ecosystems are threatened by extensive spread of broom (Cytisus scoparius (L.) Link), a European leguminous shrub that is invasive in several countries. The establishment of invading species may, however, be suppressed by competition from native vegetation. The neighbor impact of the grass Festuca rubra subsp. commutata Gaudin on the performance of C. scoparius was studied in a greenhouse experiment with different arrival order, under low and high nitrogen supply, and with or without inoculation of nitrogen-fixing bacteria. Aboveground biomass of both species was measured after a six-months establishment period, and after a five-months regrowth period. In both periods, presence of F. rubra reduced the performance of C. scoparius as indicated by negative neighbor-effect intensity indices (NInt_A).During the establishment period the competitive impact of F. rubra was highest, when planted before C. scoparius, followed by synchronous and late planting. Inoculation with rhizobia and low fertilization decreased the competitive impact of F. rubra. After cutting and regrowth priority effects of F. rubra were still visible. Interaction between the two study species was not affected anymore by inoculation, but strongly by fertilization, with highest competitive impact of F. rubra on C. scoparius under high nitrogen fertilization. In both study periods biomass of C. scoparius was negatively correlated with biomass of F. rubra. Our study provides knowledge about competition processes, which help to improve conservation and restoration measures regarding the spread of C. scoparius. Early sowing of a native grass can help to suppress the invasive species at an early stage. Competitive impact of the grass might be strengthened by high nitrogen availability.     

Teaching to Relax: Development of a Program to Potentiate Stress—Results of a Feasibility Study with Medical Undergraduate Students

Medical students are a population at risk for the development of stress-related risk states (e.g. burnout) and manifest mental disorders (e.g. depression). Still the learning of coping mechanisms against stress is not an integral part of the medical curriculum. In a pilot study we developed an elective course for learning relaxation techniques (Relacs) which was geared to the clinical practice of autogenic training (AT) with psychiatric patients. The course focussed on an innovative and mostly communicative transfer of knowledge about AT, progressive muscle relaxation and medical hypnosis and stressed the principle of repeated and supervised exercises in small student groups alongside self-administered exercise. 42 students took part in this course and showed a very high acceptance for the topic and positive evaluation. Moreover, we found a distinct improvement of the participants’ mental parameters (burnout, anxiety) and a good knowledge about the course’s contents within the final exams at the end of the semester. The structure and realisation of the course is easily adaptable and very effective regarding the improvement of the students’ mental health. Due to our results and the commonly known prevalence of stress-related disorders in medical students we postulate the integration of courses on relaxation strategies in the medical curriculum.     

High Incidence Is Not High Exposure: What Proportion of Prevention Trial Participants Are Exposed to HIV?

Objective

Randomized clinical trials of HIV prevention in high-risk populations of women often assume that all participants have similar exposure to HIV. However, a substantial fraction of women enrolled in the trial may have no or low exposure to HIV. Our objective was to estimate the proportion of women exposed to HIV throughout a hypothetical high-risk study population.

Methods

A stochastic individual-based model was developed to simulate the sexual behavior and the risk of HIV acquisition for a cohort of sexually active HIV-uninfected women in high HIV prevalence settings. Key behavior and epidemic assumptions in the model were based on published studies on HIV transmission in South Africa. The prevalence of exposure, defined as the proportion of women who have sex with HIV-infected partner, and HIV incidence were evaluated.

Results

Our model projects that in communities with HIV incidence rate of 1 per 100 person years, only 5-6% of women are exposed to HIV annually while in communities with an HIV incidence of 5 per 100 person years 20-25% of women are exposed to HIV. Approximately 70% of the new infections are acquired from partners with asymptomatic HIV.

Conclusions

Mathematical models suggest that a high proportion of women enrolled in HIV prevention trials may be unexposed to HIV even when incidence rates are high. The relationship between HIV exposure and other risk factors should be carefully analyzed when future clinical trials are planned.     

Empathy and Effortful Control Effects on Early Adolescents’ Aggression: When Do Students’ Perceptions of Their School Climate Matter?

Guided by the social emotional learning framework, this study examined whether early adolescents’ social awareness (empathic concern, perspective taking) and self-management (effortful control) would uniquely contribute to early adolescents’ subsequent forms of aggression, and whether perceptions of their school climate (friction, cohesion, competition, satisfaction with classes) would moderate those associations. Participants were 479 10- to 14-year old students (54% female; 78% European American) who completed the first wave of a survey in sixth and seventh grades and the second wave 1 year later. Hierarchical regression analyses indicated that across gender, empathic concern was the only competency to reduce subsequent overt and relational aggression. None of the school climate perceptions made unique contributions to aggression, nor did they show protective functions. Rather, several instances of cumulative advantage were observed, whereby positive school climate perceptions only reduced aggression for students with high levels of empathic concern. Unexpectedly, boys’ perceived cohesion contributed to overt aggression if they reported high levels of effortful control.     

Leading Students to Investigate Diffusion as a Model of Brine Shrimp Movement

Integrating experimental biology laboratory exercises with mathematical modeling can be an effective tool to enhance mathematical relevance for biologists and to emphasize biological realism for mathematicians. This paper describes a lab project designed for and tested in an undergraduate biomathematics course. In the lab, students follow and track the paths of individual brine shrimp confined in shallow salt water in a Petri dish. Students investigate the question, “Is the movement well characterized as a 2-dimensional random walk?” Through open, but directed discussions, students derive the corresponding partial differential equation, gain an understanding of the solution behavior, and model brine shrimp dispersal under the experimental conditions developed in class. Students use data they collect to estimate a diffusion coefficient, and perform additional experiments of their own design tracking shrimp migration for model validation. We present our teaching philosophy, lecture notes, instructional and lab procedures, and the results of our class-tested experiments so that others can implement this exercise in their classes. Our own experience has led us to appreciate the pedagogical value of allowing students and faculty to grapple with open-ended questions, imperfect data, and the various issues of modeling biological phenomena.     

Split Personality of a Potyvirus: To Specialize or Not to Specialize?

Bean yellow mosaic virus (BYMV), genus Potyvirus, has an extensive natural host range encompassing both dicots and monocots. Its phylogenetic groups were considered to consist of an ancestral generalist group and six specialist groups derived from this generalist group during plant domestication. Recombination was suggested to be playing a role in BYMV''s evolution towards host specialization. However, in subsequent phylogenetic analysis of whole genomes, group names based on the original hosts of isolates within each of them were no longer supported. Also, nine groups were found and designated I-IX. Recombination analysis was conducted on the complete coding regions of 33 BYMV genomes and two genomes of the related Clover yellow vein virus (CYVV). This analysis found evidence for 12 firm recombination events within BYMV phylogenetic groups I–VI, but none within groups VII–IX or CYVV. The greatest numbers of recombination events within a sequence (two or three each) occurred in four groups, three which formerly constituted the single ancestral generalist group (I, II and IV), and group VI. The individual sequences in groups III and V had one event each. These findings with whole genomes are consistent with recombination being associated with expanding host ranges, and call into question the proposed role of recombination in the evolution of BYMV, where it was previously suggested to play a role in host specialization. Instead, they (i) indicate that recombination explains the very broad natural host ranges of the three BYMV groups which infect both monocots and dicots (I, II, IV), and (ii) suggest that the three groups with narrow natural host ranges (III, V, VI) which also showed recombination now have the potential to reduce host specificity and broaden their natural host ranges.     

Degradation of wheat straw by a microbial community —stimulation by a polysaccharidase complex

Laboratory-scale reactors were used to watch aspects of biodegradation of wheat straw when supplemented with polysaccharidases (Czym) to increase the enzyme production of microorganisms involved during a composting process for mushroom production. Biochemical and biological parameters were tested both under aerobic and O₂-limited conditions to assess degradability. These were measurement of released CO₂ and NH₃, determination of neutral detergent fibre content and cellulase activities from compost extract. The addition of Czym to decomposing straw had three consequences: (i) it supplied and released low quantities of readily available sugars; (ii) it increased the cellulase activities in the substrates; (iii) it increased the number of bacteria under aerobic conditions. The three effects were linked and the small quantity of sugars released by the addition of Czym may have acted as an activator of bacterial activities through an inductive mechanism. Correspondence to: S. Libmond     

Application of a High Throughput Method of Biomarker Discovery to Improvement of the EarlyCDT?-Lung Test

Background

The National Lung Screening Trial showed that CT screening for lung cancer led to a 20% reduction in mortality. However, CT screening has a number of disadvantages including low specificity. A validated autoantibody assay is available commercially (EarlyCDT®-Lung) to aid in the early detection of lung cancer and risk stratification in patients with pulmonary nodules detected by CT.Recent advances in high throughput (HTP) cloning and expression methods have been developed into a discovery pipeline to identify biomarkers that detect autoantibodies. The aim of this study was to demonstrate the successful clinical application of this strategy to add to the EarlyCDT-Lung panel in order to improve its sensitivity and specificity (and hence positive predictive value, (PPV)).

Methods and Findings

Serum from two matched independent cohorts of lung cancer patients were used (n = 100 and n = 165). Sixty nine proteins were initially screened on an abridged HTP version of the autoantibody ELISA using protein prepared on small scale by a HTP expression and purification screen. Promising leads were produced in shake flask culture and tested on the full assay. These results were analyzed in combination with those from the EarlyCDT-Lung panel in order to provide a set of re-optimized cut-offs. Five proteins that still displayed cancer/normal differentiation were tested for reproducibility and validation on a second batch of protein and a separate patient cohort. Addition of these proteins resulted in an improvement in the sensitivity and specificity of the test from 38% and 86% to 49% and 93% respectively (PPV improvement from 1 in 16 to 1 in 7).

Conclusion

This is a practical example of the value of investing resources to develop a HTP technology. Such technology may lead to improvement in the clinical utility of the EarlyCDT­-Lung test, and so further aid the early detection of lung cancer.     

INFANTILE DIARRHEA—Tolerance to Solutions of Electrolytes by Mouth

Since Darrow''s recommendation of electrolyte administration by mouth to infants with diarrhea, the constituting of a palatable liquid has been in the minds of all persons concerned with the treatment of diarrhea. Owing to the frequent association of gastric distress with oral administration of electrolyte solution, presumably because of increased osmolarity, a study was made at Kern County General Hospital to determine what osmolarity of solution was tolerated by most infants. For this purpose a commercially prepared oral electrolyte solution was used. When this new solution was given undiluted—that is, at an osmolarity of 20 times that of physiologic solution—only one of 29 patients, who were acutely ill and dehydrated, refused it or vomited it, probably due to irritation of the gastric mucosa. However, at a dilution of 1:3 with 5 per cent glucose and an osmolarity of six times physiological, only one of the 29 infants vomited and two others occasionally refused it.The length of hospital stay was not shortened by the substitution of the commercial preparation in either dilution. However, since the babies readily drank this electrolyte solution, it was possible to stop parenteral administration of electrolytes once fluid replacement had been carried out when the patient was first admitted.     

Prolonged Adaptation to a Low or High Protein Diet Does Not Modulate Basal Muscle Protein Synthesis Rates – A Substudy

Background

Based on controlled 36 h experiments a higher dietary protein intake causes a positive protein balance and a negative fat balance. A positive net protein balance may support fat free mass accrual. However, few data are available on the impact of more prolonged changes in habitual protein intake on whole-body protein metabolism and basal muscle protein synthesis rates.

Objective

To assess changes in whole-body protein turnover and basal muscle protein synthesis rates following 12 weeks of adaptation to a low versus high dietary protein intake.

Methods

A randomized parallel study was performed in 40 subjects who followed either a high protein (2.4 g protein/kg/d) or low protein (0.4 g protein/kg/d) energy-balanced diet (30/35/35% or 5/60/35% energy from protein/carbohydrate/fat) for a period of 12 weeks. A subgroup of 7 men and 8 women (body mass index: 22.8±2.3 kg/m², age: 24.3±4.9 y) were selected to evaluate the impact of prolonged adaptation to either a high or low protein intake on whole body protein metabolism and basal muscle protein synthesis rates. After the diet, subjects received continuous infusions with L-[ring-²H₅]phenylalanine and L-[ring-²H₂]tyrosine in an overnight fasted state, with blood samples and muscle biopsies being collected to assess post-absorptive whole-body protein turnover and muscle protein synthesis rates in vivo in humans.

Results

After 12 weeks of intervention, whole-body protein balance in the fasted state was more negative in the high protein treatment when compared with the low protein treatment (-4.1±0.5 vs -2.7±0.6 μmol phenylalanine/kg/h;P<0.001). Whole-body protein breakdown (43.0±4.4 vs 37.8±3.8 μmol phenylalanine/kg/h;P<0.03), synthesis (38.9±4.2 vs 35.1±3.6 μmol phenylalanine/kg/h;P<0.01) and phenylalanine hydroxylation rates (4.1±0.6 vs 2.7±0.6 μmol phenylalanine/kg/h;P<0.001) were significantly higher in the high vs low protein group. Basal muscle protein synthesis rates were maintained on a low vs high protein diet (0.042±0.01 vs 0.045±0.01%/h;P = 0.620).

Conclusions

In the overnight fasted state, adaptation to a low-protein intake (0.4 g/kg/d) does not result in a more negative whole-body protein balance and does not lower basal muscle protein synthesis rates when compared to a high-protein intake.

Trial Registration

Clinicaltrials.gov NCT01551238.     

Adding depth to line artwork by digital stippling—a step-by-step guide to the method

Vector-based software has revolutionized scientific illustrating and is well established in taxonomy. However, simple line drawings lack depth information. Shading techniques, such as stippling—the application of dots to generate shade—are the methods of choice for simulating shade, structure, shape, and texture. In this paper, a step-by-step guide for digital stippling is presented. Manual stippling offers great flexibility to achieve highly realistic results. A round brush is applied to the line art by tapping. To drastically reduce time consumption and generate homogeneous tinges, a semiautomation was developed: the smallest units of symmetric stippling patterns are stored in a brush library. Using macroinstructions (macros), such stored raw patterns are converted into symmetric repetitive patterns. This way, stippling can be applied quickly and evenly across large areas of the underlying line drawing. These methods come with all the advantages of vector illustrations, such as high scalability, reproducibility and easy correction of strokes that have turned out imperfect.     

Generation of Rodent Malaria Parasites with a High Mutation Rate by Destructing Proofreading Activity of DNA Polymerase δ

Plasmodium falciparum malaria imposes a serious public health concern throughout the tropics. Although genetic tools are principally important to fully investigate malaria parasites, currently available forward and reverse tools are fairly limited. It is expected that parasites with a high mutation rate can readily acquire novel phenotypes/traits; however, they remain an untapped tool for malaria biology. Here, we generated a mutator malaria parasite (hereinafter called a ‘malaria mutator’), using site-directed mutagenesis and gene transfection techniques. A mutator Plasmodium berghei line with a defective proofreading 3′ → 5′ exonuclease activity in DNA polymerase δ (referred to as PbMut) and a control P. berghei line with wild-type DNA polymerase δ (referred to as PbCtl) were maintained by weekly passage in ddY mice for 122 weeks. High-throughput genome sequencing analysis revealed that two PbMut lines had 175–178 mutations and a 86- to 90-fold higher mutation rate than that of a PbCtl line. PbMut, PbCtl, and their parent strain, PbWT, showed similar course of infection. Interestingly, PbMut lost the ability to form gametocytes during serial passages. We believe that the malaria mutator system could provide a novel and useful tool to investigate malaria biology.