Obstructive Sleep Apnoea Modulates Airway Inflammation and Remodelling in Severe Asthma

Background

Obstructive sleep apnoea (OSA) is frequently observed in severe asthma but the causal link between the 2 diseases remains hypothetical. The role of OSA-related systemic and airway neutrophilic inflammation in asthma bronchial inflammation or remodelling has been rarely investigated. The aim of this study was to compare hallmarks of inflammation in induced sputum and features of airway remodelling in bronchial biopsies from adult patients with severe asthma with and without OSA.

Materials and Methods

An overnight polygraphy was performed in 55 patients referred for difficult-to-treat asthma, who complained of nocturnal respiratory symptoms, poor sleep quality or fatigue. We compared sputum analysis, reticular basement membrane (RBM) thickness, smooth muscle area, vascular density and inflammatory cell infiltration in bronchial biopsies.

Results

In total, 27/55 patients (49%) had OSA diagnosed by overnight polygraphy. Despite a moderate increase in apnoea-hypopnoea index (AHI; 14.2±1.6 event/h [5–35]), the proportion of sputum neutrophils was higher and that of macrophages lower in OSA than non-OSA patients, with higher levels of interleukin 8 and matrix metalloproteinase 9. The RBM was significantly thinner in OSA than non-OSA patients (5.8±0.4 vs. 7.8±0.4 μm, p<0.05). RBM thickness and OSA severity assessed by the AHI were negatively correlated (rho = -0.65, p<0.05). OSA and non-OSA patients did not differ in age, sex, BMI, lung function, asthma control findings or treatment.

Conclusion

Mild OSA in patients with severe asthma is associated with increased proportion of neutrophils in sputum and changes in airway remodelling.     

Treatment Outcomes of Multidrug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis

Background

Treatment outcomes for multidrug-resistant Mycobacterium Tuberculosis (MDRTB) are generally poor compared to drug sensitive disease. We sought to estimate treatment outcomes and identify risk factors associated with poor outcomes in patients with MDRTB.

Methodology/Principal Findings

We performed a systematic search (to December 2008) to identify trials describing outcomes of patients treated for MDRTB. We pooled appropriate data to estimate WHO-defined outcomes at the end of treatment and follow-up. Where appropriate, pooled covariates were analyzed to identify factors associated with worse outcomes. Among articles identified, 36 met our inclusion criteria, representing 31 treatment programmes from 21 countries. In a pooled analysis, 62% [95% CI 57–67] of patients had successful outcomes, while 13% [9]–[17] defaulted, 11% [9]–[13] died, and 2% [1]–[4] were transferred out. Factors associated with worse outcome included male gender 0.61 (OR for successful outcome) [0.46–0.82], alcohol abuse 0.49 [0.39–0.63], low BMI 0.41[0.23–0.72], smear positivity at diagnosis 0.53 [0.31–0.91], fluoroquinolone resistance 0.45 [0.22–0.91] and the presence of an XDR resistance pattern 0.57 [0.41–0.80]. Factors associated with successful outcome were surgical intervention 1.91 [1.44–2.53], no previous treatment 1.42 [1.05–1.94], and fluoroquinolone use 2.20 [1.19–4.09].

Conclusions/Significance

We have identified several factors associated with poor outcomes where interventions may be targeted. In addition, we have identified high rates of default, which likely contributes to the development and spread of MDRTB.     

Incidence of Rotavirus and Circulating Genotypes in Northeast Brazil during 7 Years of National Rotavirus Vaccination

Background and Aims

Rotavirus causes severe diarrhoea and Brazil introduced the Rotarix G1P[8] vaccine in 2006. We aimed to describe changes in rotavirus incidence and diarrhoea epidemiology before and after vaccine introduction.

Methods

Design: (i) hospital-based survey of children with diarrhoea (2006–2012); (ii) diarrhea-mortality and hospitalization surveillance (1999–2012).

Setting

(i) Aracaju and (ii) state and national level.

Results

1841 children were enrolled and 231 (12.5%) had rotavirus. Rotavirus was less frequent from January-June than from July-December (9.4% versus 20.9%, p<0.01), but the seasonal variation was less defined after 2009. Very few rotavirus cases (8–3.9%) were detected in 2011, with an increase in 2012 (13–18.5%). In 2006, unvaccinated children were more likely to have rotavirus, but thereafter unvaccinated and vaccinated children had equally low incidence. Older children and those with rotavirus were more likely to have severe diarrhea episodes. The most frequent genotype from 2006 to 2010 was G2P[4]; except in 2009, when most cases were G1P[8]. Very few G2P[4] were detected from 2011 and 50% cases in 2012 were G8P[4]. Diarrhoea-hospitalizations decreased nationally from 89,934 (2003) to 53,705 (2012; 40.3% reduction) and in the state from 1729 to 748 (56.7% reduction). Diarrhoea-deaths decreased nationally from 4368 in 1999 to 697 in 2012 (84% reduction, p<0.001) and in the state from 132 to 18 (86% reduction). These changes were much larger after vaccine introduction.

Conclusions

The vaccine was associated with substantial reductions in rotavirus incidence and diarrhoea-hospitalizations and deaths. The G2P[4] genotype predominance disappeared over time and may be replaced by other heterotypic genotypes.     

Apamin Does Not Inhibit Human Cardiac Na+ Current,L-type Ca2+ Current or Other Major K+ Currents

Background

Apamin is commonly used as a small-conductance Ca²⁺-activated K⁺ (SK) current inhibitor. However, the specificity of apamin in cardiac tissues remains unclear.

Objective

To test the hypothesis that apamin does not inhibit any major cardiac ion currents.

Methods

We studied human embryonic kidney (HEK) 293 cells that expressed human voltage-gated Na⁺, K⁺ and Ca²⁺ currents and isolated rabbit ventricular myocytes. Whole-cell patch clamp techniques were used to determine ionic current densities before and after apamin administration.

Results

Ca²⁺ currents (CACNA1c+CACNB2b) were not affected by apamin (500 nM) (data are presented as median [25^th percentile;75^th percentile] (from –16 [–20;–10] to –17 [–19;–13] pA/pF, P = NS), but were reduced by nifedipine to –1.6 [–3.2;–1.3] pA/pF (p = 0.008). Na⁺ currents (SCN5A) were not affected by apamin (from –261 [–282;–145] to –268 [–379;–132] pA/pF, P = NS), but were reduced by flecainide to –57 [–70;–47] pA/pF (p = 0.018). None of the major K⁺ currents (I _Ks, I _Kr, I _K1 and I _to) were inhibited by 500 nM of apamin (KCNQ1+KCNE1, from 28 [20]; [37] to 23 [18]; [32] pA/pF; KCNH2+KCNE2, from 28 [24]; [30] to 27 [24]; [29] pA/pF; KCNJ2, from –46 [–48;–40] to –46 [–51;–35] pA/pF; KCND3, from 608 [505;748] to 606 [454;684]). Apamin did not inhibit the I _Na or I _CaL in isolated rabbit ventricular myocytes (I _Na, from –67 [–75;–59] to –68 [–71;–59] pA/pF; I _CaL, from –16 [–17;–14] to –14 [–15;–13] pA/pF, P = NS for both).

Conclusions

Apamin does not inhibit human cardiac Na⁺ currents, L-type Ca²⁺ currents or other major K⁺ currents. These findings indicate that apamin is a specific SK current inhibitor in hearts as well as in other organs.     

What Is a Group? Young Children’s Perceptions of Different Types of Groups and Group Entitativity

To date, developmental research on groups has focused mainly on in-group biases and intergroup relations. However, little is known about children’s general understanding of social groups and their perceptions of different forms of group. In this study, 5- to 6-year-old children were asked to evaluate prototypes of four key types of groups: an intimacy group (friends), a task group (people who are collaborating), a social category (people who look alike), and a loose association (people who coincidently meet at a tram stop). In line with previous work with adults, the vast majority of children perceived the intimacy group, task group, and social category, but not the loose association, to possess entitativity, that is, to be a ‘real group.’ In addition, children evaluated group member properties, social relations, and social obligations differently in each type of group, demonstrating that young children are able to distinguish between different types of in-group relations. The origins of the general group typology used by adults thus appear early in development. These findings contribute to our knowledge about children''s intuitive understanding of groups and group members'' behavior.Young children grow up in a complex social world in which they are constantly flooded with social information. Our social world is composed not only of individuals but of an array of different relationships and social groupings. One challenge for children is to decipher which of these social groupings are meaningful. People can appear to be a group from the outside, for example simply because they are in close proximity to each other, but they can be connected with each other at different levels: they can be kin or friends, be on the same sports or work team, be part of the same national or language group, or they can be associated with each other only briefly and loosely when, for instance, they take the same bus to get to the airport, or line up at a counter at the same time. Determining the type of group to which an association of people belongs is not only crucial for being able to understand individual group members’ behavior but can also be a short-cut to predicting how group members will relate to each other. For example, one can expect kin or friends to be loyal to each other, but one might not expect this about people who happen to be lining up at a counter at the same time. Another important form of predictions that can be drawn from social groupings, but which has been understudied in previous research (see also [1]), regards the grouping as a whole. For example, a friendship is supposed to be a longer-lasting, more coherent entity than a gathering in front of a counter.When it comes to the perception of social groupings, Lickel and colleagues [2] have argued that adults apply a folk typology, in which they intuitively distinguish between four qualitatively different types of groups. In support of this idea, Lickel at el. [3] investigated how adult participants sorted 40 examples of real-life groups, and how they rated each of these groups on a set of eight group characteristics such as shared goals, similarity of group members, interaction among group members, and group size. They found that participants distinguished four basic types of groups: intimacy groups (such as families and friends), task groups (such as work or sports teams), social categories (such as women or U.S. citizens), and loose associations (such as people waiting in line at a counter). Participants associated different group characteristics with each group type, for example a long duration and high levels of interaction for intimacy groups, common goals and interaction in task groups, large size and member similarity for social categories, and short duration and low levels of similarity and common goals for loose associations (for an overview, see [2]). Related research has shown that adults treat some social groupings as entities [4–6]. The extent to which a group appears to be a coherent entity and therefore possesses a quality of “groupness” has been referred to as “entitativity” [2–5, 7]. Lickel and colleagues showed that the four types of groups were perceived by adults to have different levels of entitativity, with the highest level for intimacy groups, followed by task groups, social categories, and loose associations.This group typology has received further support and validation from work in anthropology [8, 9]. Interdisciplinary work has linked these different types of groups to different relational models that are more or less prominent within each group type [10]. For example, communal sharing, a relationship in which I see “what is mine as yours” is more pronounced in intimacy groups than in other types of groups. It has been argued that children do not develop a fully-fledged concept of these different relational models before nine or ten years of age [8, 9].Despite the theoretical importance of this group typology, very little research has investigated its origins in childhood. Instead, developmental research on group cognition in young children has focused mainly on children’s in-group biases, that is, their preference for members of their own group over members of other groups. Research in this tradition has shown that children prefer members of their own group on a variety of implicit and explicit measures [11–14]. Another line of research focuses on the inferences children draw about individuals based on their group membership. For example, 4- to 6-year-old children predict what a person will do, like, or intend on the basis of that person’s gender, race, or ethnicity [15–17]. Children also use information about group membership to make inferences about social interactions: Knowing that two individuals are either from the same or from two different groups influences their prediction about whether those individuals will harm each other (around 4 years; [18]), help each other (from 6 years; [18]), or be friends with each other (from 7 years; [19]).However, this body of research leaves at least three significant gaps in our knowledge about children’s understanding of groups. First, previous research has focused primarily on just one type of group: the one Lickel and colleagues refer to as social categories, thus limiting what we can conclude about children’s understanding of group relations more generally (although see, e.g., [7, 20, 21], for work on preferential behavior towards intimacy and task group members). Second, the main focus of this previous research has been on children’s attitudes and expectations about in-group as compared with out-group members. However, as illustrated in our introductory examples, relationships among members of an in-group may differ in systematic ways depending on the type of in-group to which they belong. Finally, previous work has focused mainly on children’s perceptions of and expectations about individual group members rather than on their perceptions of and expectations about the group as a whole. It is thus important for our understanding of the development of group psychology to ask whether children distinguish different types of social groups and whether they expect relationships within and characteristics of these types of groups to differ from each other.One exception to this general trend is a study conducted by Svirydzenka and colleagues [7]. They found that 10-year-old children intuitively distinguish the same four main types of groups as adults: intimacy groups, task groups, social categories, and loose associations. They also judged the level of entitativity of different group types in similar ways as adults, but their assessments seemed to rely on group characteristics that were more perceptually salient (for example the level of interaction) than adults, who focused on more abstract features such as the importance of the group for its members [22].Inspired by this study and Lickel and colleagues’ work [3], we investigated whether the origins of this folk theory of groups could be seen even in children as young as 5 to 6 years of age. This is an important age in the development of group cognition as 5 to 6 years appears to be just at the border of explicit group understanding. It is at this age that children first show a more general preference for in-group members, even in more abstract and novel groups (in the minimal group paradigm; [21, 23]). Furthermore, it is also at this age that children first become able to predict intergroup relations in third party contexts at least for social categories (e.g., [16, 18]).Thus our objective was to investigate whether, in addition to these preferences and expectations, children of this age also have a more general understanding of groups and different types of group–in other words, an early folk typology of groups. Several prominent theoretical accounts of the origins of intergroup psychology postulate substantial development between the age group in our study and the youngest age, so far, at which a group typology has been found, 10 years [24–26]. However, given their relatively sophisticated abilities in other areas of group cognition, we predicted that already by 5 to 6 years of age, children would be able to make subtle distinctions between different types of groups and use this understanding in order to make inferences about group members’ behaviors within different group types.As a first step, we measured children’s spontaneous definition of a group. We did this to investigate children’s naïve, spontaneous ideas about groups, before presenting them with different group types. We predicted that children would be able to give some appropriate examples of groups and were especially interested in whether they would focus on one particular example or definition when thinking about groups (e.g., mention just one group type), or whether they would be able to give a more abstract definition (covering all group types, such as “a collection of people”). Second, because recent work has shown that 5-year-old children have comparable preferences for two types of group members–task group members and social category members [21]–we investigated which of these two examples (operationalized as people who work together vs. people who are similar to each other) children thought was most representative of a group. Third, we investigated whether preschool children would see an intimacy group, a task group, a social category, and a loose association as qualitatively different.It was impossible, given the young age of our participants, to adopt the exact methods of previous studies, which used complex tasks such as sorting of examples of groups and rating multiple group characteristics for each example. To simplify the procedure so that young children would understand it, we thus created a prototype for each of the four types of groups and asked children to judge these prototypes on entitativity and 12 other group characteristics. These group characteristics were generally inspired by the characteristics Lickel et al. [3] and Svirydzenka et al. [7] chose. However, in addition, we asked about several further characteristics that are important topics in recent work on the developmental origins of group psychology (e.g., [20, 27–29]) and anthropology [8, 9]. There were four main sets of group characteristics. The first three involved judgments and predictions about individual group members and group member relationships (see, e.g., [27]). The first set involved judgments about social obligations and prosocial behaviors among group members (helping, sharing, and loyalty; e.g., [18, 20, 28, 30]). The second involved the quality of group members’ social relationships (liking, familiarity, interdependence, and joint goals; [7, 31]). The third involved properties marking fundamental similarities among group members (group member similarity, shared preferences, and common knowledge; [29, 32, 33]). The fourth set, in contrast, involved traits of the group itself, concerning characteristics that apply to the group as a whole, rather than to individual members (permeability, continuance, and entitativity; [3]). We predicted generally that children’s perceptions of and expectations about groups would be contingent upon the type of group they were presented with and that they would recognize that a loose association was not a real group.     

Inhibition of mTOR by Rapamycin Abolishes Cognitive Deficits and Reduces Amyloid-β Levels in a Mouse Model of Alzheimer's Disease

Background

Reduced TOR signaling has been shown to significantly increase lifespan in a variety of organisms [1], [2], [3], [4]. It was recently demonstrated that long-term treatment with rapamycin, an inhibitor of the mTOR pathway[5], or ablation of the mTOR target p70S6K[6] extends lifespan in mice, possibly by delaying aging. Whether inhibition of the mTOR pathway would delay or prevent age-associated disease such as AD remained to be determined.

Methodology/Principal Findings

We used rapamycin administration and behavioral tools in a mouse model of AD as well as standard biochemical and immunohistochemical measures in brain tissue to provide answers for this question. Here we show that long-term inhibition of mTOR by rapamycin prevented AD-like cognitive deficits and lowered levels of Aβ₄₂, a major toxic species in AD[7], in the PDAPP transgenic mouse model. These data indicate that inhibition of the mTOR pathway can reduce Aβ₄₂ levels in vivo and block or delay AD in mice. As expected from the inhibition of mTOR, autophagy was increased in neurons of rapamycin-treated transgenic, but not in non-transgenic, PDAPP mice, suggesting that the reduction in Aβ and the improvement in cognitive function are due in part to increased autophagy, possibly as a response to high levels of Aβ.

Conclusions/Significance

Our data suggest that inhibition of mTOR by rapamycin, an intervention that extends lifespan in mice, can slow or block AD progression in a transgenic mouse model of the disease. Rapamycin, already used in clinical settings, may be a potentially effective therapeutic agent for the treatment of AD.     

Community Based Case-Control Study of Rotavirus Gastroenteritis among Young Children during 2008-2010 Reveals Vast Genetic Diversity and Increased Prevalence of G9 Strains in Kolkata

Background

Group A Rotaviruses are a major etiologic agent of gastroenteritis in infants and young children (<5 years) worldwide. Although rotavirus vaccines have been successfully administered in many countries, in India the introduction of rotavirus vaccine in national immunization program was approved in 2014. Since high disease burden and large number of genetic variants have been reported from low income countries including India, monitoring of rotavirus was initiated prior to implementation of the vaccine in the region.

Methods

A total number of 3,582 stool samples were collected from an urban slum community in Kolkata, among which 1,568 samples were obtained from children of ≤5 years of age, with moderate to severe diarrhoea and 2,014 samples were collected from age-sex matched healthy neighbourhood controls. Rotavirus positive samples were typed by multiplex semi-nested PCR and nucleotide sequencing. Circulating strains were phylogenetically analyzed.

Results

Among 1,568 children with diarrhoea, 395 (25.2%), and among 2,014 asymptomatic children, 42 (2%) were rotavirus positive. G1P[8] was identified as the most common strain (32%) followed by G9P[8] (16.9%), G2P[4] (13.5%) and G9P[4] (10.75%). G12 strains with combinations of P[4], P[6] and P[8] comprised 11.9% of total positive strains. The rest (<10%) were rare and uncommon strains like G1P[4], G1P[6], G2P[8] and animal-like strains G4P[6], G6P[14] and G11P[25]. The 42 rotavirus positive samples from asymptomatic children revealed common genotypes like G1, G2 and G9.

Conclusion

This community based case-control study showed increased predominance of genotype G9 in Kolkata. It also confirmed co-circulation of a large number of genetic variants in the community. Asymptomatic rotavirus positive children though low in number can also be a source of dispersal of infection in the community. This study provides background information to the policy makers for implementation of rotavirus vaccines in this region.     

Effects of Physical Activity Training in Patients with Alzheimer’s Dementia: Results of a Pilot RCT Study

Background

There is evidence that physical activity (PA) is of cognitive benefit to the ageing brain, but little is known on the effect in patients with Alzheimer’s disease (AD). The present pilot study assessed the effect of a home-based PA training on clinical symptoms, functional abilities, and caregiver burden after 12 and 24 weeks.

Methods

In an RCT thirty patients (aged 72.4±4.3 years) with AD (MMSE: 20.6±6.5 points) and their family caregivers were allocated to a home-based 12-week PA intervention program or the usual care group. The program changed between passive, motor-assisted or active resistive leg training and changes in direction on a movement trainer in order to combine physical and cognitive stimuli.

Results

Analysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01–10.51). The control group experienced decreases in ADL performance at week 12 and 24 whereas patients in the intervention group remained stable. Analyses of executive function and language ability revealed considerable effects for semantic word fluency with a group × time interaction (95% CI of the difference between both groups at T2: 0.18–4.02). Patients in the intervention group improved during the intervention and returned to initial performance at week 12 whereas the controls revealed continuous worsening. Analyses of reaction time, hand-eye quickness and attention revealed improvement only in the intervention group. Caregiver burden remained stable in the intervention group but worsened in the control group.

Conclusions

This study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden. The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.

Trial Registration

ClinicalTrials.gov NCT02196545     

A Vertebrate-Specific Chp-PAK-PIX Pathway Maintains E-Cadherin at Adherens Junctions during Zebrafish Epiboly

Background

In early vertebrate development, embryonic tissues modulate cell adhesiveness and acto-myosin contractility to correctly orchestrate the complex processes of gastrulation. E-cadherin (E-cadh) is the earliest expressed cadherin and is needed in the mesendodermal progenitors for efficient migration [1], [2]. Regulatory mechanisms involving directed E-cadh trafficking have been invoked downstream of Wnt11/5 signaling [3]. This non-canonical Wnt pathway regulates RhoA-ROK/DAAM1 to control the acto-myosin network. However, in this context nothing is known of the intracellular signals that participate in the correct localization of E-cadh, other than a need for Rab5c signaling [3].

Methodology/Principal Findings

By studying loss of Chp induced by morpholino-oligonucleotide injection in zebrafish, we find that the vertebrate atypical Rho-GTPase Chp is essential for the proper disposition of cells in the early embryo. The underlying defect is not leading edge F-actin assembly (prominent in the cells of the envelope layer), but rather the failure to localize E-cadh and β-catenin at the adherens junctions. Loss of Chp results in delayed epiboly that can be rescued by mRNA co-injection, and phenocopies zebrafish E-cadh mutants [4], [5]. This new signaling pathway involves activation of an effector kinase PAK, and involvement of the adaptor PAK-interacting exchange factor PIX. Loss of signaling by any of the three components results in similar underlying defects, which is most prominent in the epithelial-like envelope layer.

Conclusions/Significance

Our current study uncovers a developmental pathway involving Chp/PAK/PIX signaling, which helps co-ordinate E-cadh disposition to promote proper cell adhesiveness, and coordinate movements of the three major cell layers in epiboly. Our data shows that without Chp signaling, E-cadh shifts to intracellular vesicles rather than the adhesive contacts needed for directed cell movement. These events may mirror the requirement for PAK2 signaling essential for the proper formation of the blood-brain barrier [6], [7].     

A Global Analysis of the Effectiveness of Marine Protected Areas in Preventing Coral Loss

Background

A variety of human activities have led to the recent global decline of reef-building corals [1], [2]. The ecological, social, and economic value of coral reefs has made them an international conservation priority [2], [3]. The success of Marine Protected Areas (MPAs) in restoring fish populations [4] has led to optimism that they could also benefit corals by indirectly reducing threats like overfishing, which cause coral degradation and mortality [2], [5]. However, the general efficacy of MPAs in increasing coral reef resilience has never been tested.

Methodology/Principal Findings

We compiled a global database of 8534 live coral cover surveys from 1969–2006 to compare annual changes in coral cover inside 310 MPAs to unprotected areas. We found that on average, coral cover within MPAs remained constant, while coral cover on unprotected reefs declined. Although the short-term differences between unprotected and protected reefs are modest, they could be significant over the long-term if the effects are temporally consistent. Our results also suggest that older MPAs were generally more effective in preventing coral loss. Initially, coral cover continued to decrease after MPA establishment. Several years later, however, rates of coral cover decline slowed and then stabilized so that further losses stopped.

Conclusions/Significance

These findings suggest that MPAs can be a useful tool not only for fisheries management, but also for maintaining coral cover. Furthermore, the benefits of MPAs appear to increase with the number of years since MPA establishment. Given the time needed to maximize MPA benefits, there should be increased emphasis on implementing new MPAs and strengthening the enforcement of existing MPAs.     

Generation and Initial Characterization of FDD Knock In Mice

Background

Mutations in the integral membrane protein 2B [1], also known as BRI₂ [2], a type II trans-membrane domain protein cause two autosomal dominant neurodegenerative diseases, Familial British and Danish Dementia [3]. In these conditions, accumulation of a C-terminal peptide (ABri and ADan) cleaved off from the mutated precursor protein by the pro-protein convertase furin [4], leads to amyloid deposition in the walls of blood vessels and parenchyma of the brain. Recent advances in the understanding of the generation of amyloid in Alzheimer''s disease has lead to the finding that BRI₂ interacts with the Amyloid Precursor Protein (APP), decreasing the efficiency of APP processing to generate Aβ [5], [6], [7]. The interaction between the two precursors, APP and BRI₂, and possibly between Aβ and ABri or ADan, could be important in influencing the rate of amyloid production or the tendency of these peptides to aggregate.

Methodology/Principal Findings

We have generated the first BRI₂ Danish Knock-In (FDD_KI) murine model of FDD, expressing the pathogenic decamer duplication in exon 6 of the BRI₂ gene. FDD_KI mice do not show any evident abnormal phenotype, with normal brain histology and no detectable amyloid deposition in blood vessel walls or parenchyma.

Conclusions/Significance

This new murine mouse model will be important to further understand the interaction between APP and BRI₂, and to provide insights into the molecular basis of FDD.     

Culture-Independent Microbiological Analysis of Foley Urinary Catheter Biofilms

Background

Prevention of catheter-associated urinary tract infection (CAUTI), a leading cause of nosocomial disease, is complicated by the propensity of bacteria to form biofilms on indwelling medical devices [1], [2], [3], [4], [5].

Methodology/Principal Findings

To better understand the microbial diversity of these communities, we report the results of a culture-independent bacterial survey of Foley urinary catheters obtained from patients following total prostatectomy. Two patient subsets were analyzed, based on treatment or no treatment with systemic fluoroquinolone antibiotics during convalescence. Results indicate the presence of diverse polymicrobial assemblages that were most commonly observed in patients who did not receive systemic antibiotics. The communities typically contained both Gram-positive and Gram-negative microorganisms that included multiple potential pathogens.

Conclusion/Significance

Prevention and treatment of CAUTI must take into consideration the possible polymicrobial nature of any particular infection.     

Genetic Diversity of Circulating Rotavirus Strains in Tanzania Prior to the Introduction of Vaccination

Background

Tanzania currently rolls out vaccination against rotavirus-diarrhea, a major cause of child illness and death. As the vaccine covers a limited number of rotavirus variants, this study describes the molecular epidemiology of rotavirus among children under two years in Dar es Salaam, Tanzania, prior to implementation of vaccination.

Methods

Stool specimens, demographic and clinical information, were collected from 690 children admitted to hospital due to diarrhea (cases) and 545 children without diarrhea (controls) during one year. Controls were inpatient or children attending child health clinics. Rotavirus antigen was detected using ELISA and positive samples were typed by multiplex semi-nested PCR and sequencing.

Results

The prevalence of rotavirus was higher in cases (32.5%) than in controls (7.7%, P<0.001). The most common G genotypes were G1 followed by G8, G12, and G4 in cases and G1, G12 and G8 in controls. The Tanzanian G1 variants displayed 94% similarity with the Rotarix vaccine G1 variant. The commonest P genotypes were P[8], P[4] and P[6], and the commonest G/P combination G1 P[8] (n = 123), G8 P[4] and G12 P[6]. Overall, rotavirus prevalence was higher in cool (23.9%) than hot months (17.1%) of the year (P = 0.012). We also observed significant seasonal variation of G genotypes. Rotavirus was most frequently found in the age group of four to six months. The prevalence of rotavirus in cases was lower in stunted children (28.9%) than in non-stunted children (40.1%, P = 0.003) and lower in HIV-infected (15.4%, 4/26) than in HIV-uninfected children (55.3%, 42/76, P<0.001).

Conclusion

This pre-vaccination study shows predominance of genotype G1 in Tanzania, which is phylogenetically distantly related to the vaccine strains. We confirm the emergence of genotype G8 and G12. Rotavirus infection and circulating genotypes showed seasonal variation. This study also suggests that rotavirus may not be an opportunistic pathogen in children infected with HIV.     

Physical Activity Patterns of the Spanish Population Are Mostly Determined by Sex and Age: Findings in the ANIBES Study

Background

Representative data for the Spanish population regarding physical activity (PA) behaviors are scarce and seldom comparable due to methodological inconsistencies.

Aim

Our objectives were to describe the PA behavior by means of the standardized self-reported International Physical Activity Questionnaire (IPAQ) and to know the proportion of the Spanish population meeting and not meeting international PA recommendations.

Material and Methods

PA was assessed using the IPAQ in a representative sample of 2285 individuals (males, 50.4%) aged 9–75 years and living in municipalities of at least 2,000 inhabitants. Data were analyzed according to: age groups 9–12, 13–17, 18–64, and 65–75 years; sex; geographical distribution; locality size and educational levels.

Results

Mean total PA was 868.8±660.9 min/wk, mean vigorous PA 146.4±254.1 min/wk, and mean moderate PA 398.1±408.0 min/wk, showing significant differences between sexes (p<0.05). Children performed higher moderate-vigorous PA than adolescents and seniors (p<0.05), and adults than adolescents and seniors (p<0.05). Compared to recommendations, 36.2% of adults performed <150 min/week of moderate PA, 65.4% <75 min/week of vigorous PA and 27.0% did not perform any PA at all, presenting significant differences between sexes (p<0.05). A total of 55.4% of children and adolescents performed less than 420 min/week of MVPA, being higher in the later (62.6%) than in the former (48.4%). Highest non-compliance was observed in adolescent females (86.5%).

Conclusion

Sex and age are the main influencing factors on PA in the Spanish population. Males engage in more vigorous and light PA overall, whereas females perform more moderate PA. PA behavior differs between age groups and no clear lineal increase with age could be observed. Twenty-seven percent of adults and 55.4% of children and adolescents do not meet international PA recommendations. Identified target groups should be addressed to increase PA in the Spanish population.     

Physical Education: The Effect of Epoch Lengths on Children’s Physical Activity in a Structured Context

Background

Despite a consensus emerging that affirms that shorter epochs should be used in youth to correctly register physical activity levels in free-living conditions, little is known about its effect on children’s physical activity conducted in structured periods of time. This study analyzed the effect that epoch length (1, 2, 3, 5, 10, 15, 30 and 60s) may have on different physical activity intensities in physical education lessons.

Methods

A sample of 1912 individual measures of physical education lessons were measured with a GT3X accelerometer. Data were collected from 1227 Swiss Elementary school students recruited in 17 elementary schools. PE lessons lasted from 45 minutes to one and a half hours. Data, originally collected in 1-s epoch, were then reintegrated into 2s, – 3s – 5s – 10s – 15s – 30s –60s epochs.

Results

Longer epochs were associated with higher levels of light (F = 8197.6, p < .001), moderate (F = 2708.17, p < .001), and moderate-to-vigorous physical activity (F = 888.08, p < .001). However, longer epochs showed lower levels of sedentary activity (F = 31714.33, p < .001) and vigorous physical activity (F = 1910.97, p < .001). Bias increased in all PA intensities when shorter epochs were compared with longer epochs. There were statistically significant differences in compliance with physical education guidelines (χ2 = 989.27, p<.001), showing higher levels with longer epochs.

Conclusion

PA context may have some influence on the effects that epoch length have on PA estimates, more specifically on MVPA. Nevertheless, the use of a high-frequency sampling interval should be used to more accurately assess children’s PA.     

Stability-Based Comparison of Class Discovery Methods for DNA Copy Number Profiles

Motivation

Array-CGH can be used to determine DNA copy number, imbalances in which are a fundamental factor in the genesis and progression of tumors. The discovery of classes with similar patterns of array-CGH profiles therefore adds to our understanding of cancer and the treatment of patients. Various input data representations for array-CGH, dissimilarity measures between tumor samples and clustering algorithms may be used for this purpose. The choice between procedures is often difficult. An evaluation procedure is therefore required to select the best class discovery method (combination of one input data representation, one dissimilarity measure and one clustering algorithm) for array-CGH. Robustness of the resulting classes is a common requirement, but no stability-based comparison of class discovery methods for array-CGH profiles has ever been reported.

Results

We applied several class discovery methods and evaluated the stability of their solutions, with a modified version of Bertoni''s -based test [1]. Our version relaxes the assumption of independency required by original Bertoni''s -based test. We conclude that Minimal Regions of alteration (a concept introduced by [2]) for input data representation, sim [3] or agree [4] for dissimilarity measure and the use of average group distance in the clustering algorithm produce the most robust classes of array-CGH profiles.

Availability

The software is available from http://bioinfo.curie.fr/projects/cgh-clustering. It has also been partly integrated into "Visualization and analysis of array-CGH"(VAMP)[5]. The data sets used are publicly available from ACTuDB [6].     

Medication Monitoring in a Nurse-Led Respiratory Outpatient Clinic: Pragmatic Randomised Trial of the West Wales Adverse Drug Reaction Profile

Objective

To assess the clinical effect of medication monitoring using the West Wales Adverse Drug Reaction (ADR) Profile for Respiratory Medicine.

Design

Single-site parallel-arm pragmatic trial using stratified randomisation.

Setting

Nurse-led respiratory outpatient clinic in general hospital in South Wales.

Participants

54 patients with chronic respiratory disease receiving bronchodilators, corticosteroids or leukotriene receptor antagonists.

Intervention

Following initial observation of usual nursing care, we allocated participants at random to receive at follow up: either the West Wales ADR Profile for Respiratory Medicine in addition to usual care (‘intervention arm’ with 26 participants); or usual care alone (‘control arm’ with 28 participants).

Main Outcome Measures

Problems reported and actions taken.

Results

We followed up all randomised participants, and analysed data in accordance with treatment allocated. The increase in numbers of problems per participant identified at follow up was significantly higher in the intervention arm, where the median increase was 20.5 [inter-quartile range (IQR) 13–26], while that in the control arm was −1 [−3 to +2] [Mann-Whitney U test: z = 6.28, p<0.001]. The increase in numbers of actions per participant taken at follow up was also significantly higher in the intervention arm, where the median increase was 2.5 [1]–[4] while that in the control arm was 0 [−1.75 to +1] [Mann-Whitney U test: z = 4.40, p<0.001].

Conclusion

When added to usual nursing care, the West Wales ADR Profile identified more problems and prompted more nursing actions. Our ADR Profile warrants further investigation as a strategy to optimise medication management.

Trial Registration

Controlled-trials.com ISRCTN10386209     

Objectively Measured Physical Activity in European Adults: Cross-Sectional Findings from the Food4Me Study

Background

Comparisons of objectively measured physical activity (PA) between residents of European countries measured concurrently with the same protocol are lacking. We aimed to compare PA between the seven European countries involved in the Food4Me Study, using accelerometer data collected remotely via the Internet.

Methods

Of the 1607 participants recruited, 1287 (539 men and 748 women) provided at least 3 weekdays and 2 weekend days of valid accelerometer data (TracmorD) at baseline and were included in the present analyses.

Results

Men were significantly more active than women (physical activity level = 1.74 vs. 1.70, p < 0.001). Time spent in light PA and moderate PA differed significantly between countries but only for women. Adherence to the World Health Organization recommendation to accumulate at least 150 min of moderate-equivalent PA weekly was similar between countries for men (range: 54–65%) but differed significantly between countries for women (range: 26–49%). Prevalence estimates decreased substantially for men and women in all seven countries when PA guidelines were defined as achieving 30 min of moderate and vigorous PA per day.

Conclusions

We were able to obtain valid accelerometer data in real time via the Internet from 80% of participants. Although our estimates are higher compared with data from Sweden, Norway, Portugal and the US, there is room for improvement in PA for all countries involved in the Food4Me Study.     

Fear Inhibition in High Trait Anxiety

Trait anxiety is recognized as an individual risk factor for the development of anxiety disorders but the neurobiological mechanisms remain unknown. Here we test whether trait anxiety is associated with impaired fear inhibition utilizing the AX+/BX- conditional discrimination procedure that allows for the independent evaluation of startle fear potentiation and inhibition of fear [1]. Sixty undergraduate students participated in the study - High Trait Anxious: n = 28 and Low Trait Anxious: n = 32. We replicated earlier findings that a transfer of conditioned inhibition for startle responses requires contingency awareness. However, contrary to the fear inhibition hypothesis, our data suggest that high trait anxious individuals show a normal fear inhibition of conditioned startle responding. Only at the cognitive level the high trait anxious individuals showed evidence for impaired inhibitory learning of the threat cue. Together with other findings where impaired fear inhibition was only observed in those PTSD patients who were either high on hyperarousal symptoms [2] or with current anxiety symptoms [3], we question whether impaired fear inhibition is a biomarker for the development of anxiety disorders.