Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type 1 [ISRCTN84121379]

Background  

Complex Regional Pain Syndrome type one (CRPS I) or formerly Reflex Sympathetic Dystrophy (RSD) is a disabling syndrome, in which a painful limb is accompanied by varying symptoms. Neuropathic pain is a prominent feature of CRPS I, and is often refractory to treatment. Since gabapentin is an anticonvulsant with a proven analgesic effect in various neuropathic pain syndromes, we sought to study the efficacy of the anticonvulsant gabapentin as treatment for pain in patients with CRPS I.     

Recent shoreline changes in the Volta River delta,West Africa: the roles of natural processes and human impacts§

The Volta River delta developed as an asymmetric lobe in a tectonic offset on the coast of Ghana. The delta comprises a large curvilinear spit that widens in its central portion due to the adjunction of successive sandy beach ridges. The appearance of a distinct spit, in lieu of a continuous barrier from the present mouth of the Volta River to the Bight of Benin coast, may be an outgrowth of a natural change in the location of the mouth of the Volta. The spit marks a segmentation of the unique sand drift cell that hitherto prevailed on this bight coast. Spit growth has been accompanied by a wave of erosion over the last century of the immediate downdrift sector of the bight coast, endangering the town of Keta. Erosion since the 1960s may have been aggravated by the construction of the Akosombo hydropower dam. The tip of the spit has recently welded to the shoreline, thus assuring resumption of sand supply from the Volta towards the rest of this formerly sand-starved sector of the bight coast. Blocking of sediment by the Akosombo Dam is, in due course, likely to become the overarching factor in delta shoreline stability.     

Milling Red SWB: A Textile Dye for Staining Epithelial Intercellular Bridges

Fourteen textile dyes were evaluated as histological stains for benign and malignant tissues. An acid dye, Milling red SWB (Acid Red 114, C.I. 23635) was found to possess great affinity for epithelial intercellular bridges. The intercellular bridges were demonstrated clearly when the Milling red SWB was used as a 1% solution in 1% potassium alum after hematoxylin and, also, when methylene blue ZX (Basic Blue 9, C.I. 52015) was used as a counter-stain, without hematoxylin. The intercellular bridges could not be demonstrated in pleomorphic cells which invaded the subepithelial connective tissue.     

Waist Circumference as a Screening Tool for Cardiovascular Risk Factors: Evaluation of Receiver Operating Characteristics (ROC)

To evaluate the receiver operating characteristics (ROC) to determine the cutoffs of waist circumference as a potential population directed screening tool for hypercholesterolaemia (≥6.5 mmol/L), low high density lipoprotein cholesterol (<0.9 mmol/L), and hypertension (treated and/or systolic ≥160 and/or diastolic blood pressure ≥95 mmHg), in 2183 men and 2698 women aged 20 to 59 years selected at random from Dutch civil registries. Main outcome measures: Height, weight, body mass index (BMI), waist circumference, total plasma cholesterol and high density lipoprotein cholesterol concentrations, and blood pressure. Results: ROC curves showed that sensitivity equalled specificity at waist circumferences between 93–95 cm in men and 81–84 cm in women for identifying individual risk factors, and 92 cm in men and 81 cm in women for identifying those with at least one risk factor. Sensitivity and specificity were equal at levels between 61% to 69% for identifying individual risk factors, with positive predictions (56.8% in men and 37.8% in women) within 2% of those using previously defined ‘Action Level 1’ of waist circumference 94 cm in men and 80 cm in women (58.8% in men and 37.4% in women). Risk prediction by anthropometric methods was relatively low: ROC areas for identifying each risk factor by waist varied from 55% to 60%, and reached about 65% for identifying at least one risk factor. Height accounted for less than 03% of variance in waist circumference. Using BMI at 25 kg/m² gave similar prediction to waist, but its combination with waist did not improve predictive values. Conclusions: Measurement of waist circumference ‘Action Level 1’ at 94 cm (37 inches) in men and 80 cm (32 inches) in women could be adopted as a simpler valid alternative to BMI for health promotion, to alert those at risk of cardiovascular disease, and as a guide to risk avoidance by self-weight management     

Cathepsin L is responsible for processing and activation of proheparanase through multiple cleavages of a linker segment

Heparanase is an endo-beta-d-glucuronidase that degrades heparan sulfate in the extracellular matrix and on the cell surface. Human proheparanase is produced as a latent protein of 543 amino acids whose activation involves excision of an internal linker segment (Ser(110)-Gln(157)), yielding the active heterodimer composed of 8- and 50-kDa subunits. Applying cathepsin L knock-out tissues and cultured fibroblasts, as well as cathepsin L gene silencing and overexpression strategies, we demonstrate, for the first time, that removal of the linker peptide and conversion of proheparanase into its active 8 + 50-kDa form is brought about predominantly by cathepsin L. Excision of a 10-amino acid peptide located at the C terminus of the linker segment between two functional cathepsin L cleavage sites (Y156Q and Y146Q) was critical for activation of proheparanase. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry demonstrates that the entire linker segment is susceptible to multiple endocleavages by cathepsin L, generating small peptides. Mass spectrometry demonstrated further that an active 8-kDa subunit can be generated by several alternative adjacent endocleavages, yielding the precise 8-kDa subunit and/or slightly elongated forms. Altogether, the mode of action presented here demonstrates that processing and activation of proheparanase can be brought about solely by cathepsin L. The critical involvement of cathepsin L in proheparanase processing and activation offers new strategies for inhibiting the prometastatic, proangiogenic, and proinflammatory activities of heparanase.     

Peatland vascular plant functional types affect dissolved organic matter chemistry

Aims

The readily available global rock phosphate (P) reserves may be depleted within the next 50–130 years warranting careful use of this finite resource. We develop a model that allows us to assess a range of P fertiliser and soil management strategies for Barley in order to find which one maximises plant P uptake under certain climate conditions.

Methods

Our model describes the development of the P and water profiles within the soil. Current cultivation techniques such as ploughing and reduced till gradient are simulated along with fertiliser options to feed the top soil or the soil right below the seed.

Results

Our model was able to fit data from two barley field trials, achieving a good fit at early growth stages but a poor fit at late growth stages, where the model underestimated plant P uptake. A well-mixed soil (inverted and 25 cm ploughing) is important for optimal plant P uptake and provides the best environment for the root system.

Conclusions

The model is sensitive to the initial state of P and its distribution within the soil profile; experimental parameters which are sparsely measured. The combination of modelling and experimental data provides useful agricultural predictions for site specific locations.

     

Herd-level risk factors associated with the presence of Phage type 21/28 E. coli O157 on Scottish cattle farms

Background  

E. coli O157 is a bacterial pathogen that is shed by cattle and can cause severe disease in humans. Phage type (PT) 21/28 is a subtype of E. coli O157 that is found across Scotland and is associated with particularly severe human morbidity.