Integration of Family Medicine into University Teaching Hospital in Israel: A Pilot Project

In accordance with the recommendation of the Mann Committee established by the Israel Medical Association a centre for family medicine serving 11 villages was established at Beit Shemesh, Israel, in 1970; this was affiliated with the department of internal medicine at Hadassah University Hospital. The centre''s doctors have become fully-fledged members of the department, and have full access to its resources and participate actively in its service, teaching, and research activities. They teach family medicine to students at the Hebrew University-Hadassah Medical School and have the same academic responsibilities and privileges as all other faculty members. This affiliation has raised the standard of the health service provided.     

Hydrolysis of Pork Muscle Sarcoplasmic Proteins by Lactobacillus curvatus and Lactobacillus sake

Lactobacillus curvatus CECT 904 and Lactobacillus sake CECT 4808 were selected on the basis of their proteolytic activities against synthetic substrates. Further, the effects of whole cells, cell extracts, and a combination of both enzymatic sources on muscle sarcoplasmic proteins were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and reverse-phase high-performance liquid chromatography analyses. Strains of both species displayed proteinase activities on five sarcoplasmic proteins. The inoculation of whole cells caused a degradation of peptides, whereas the addition of cell extracts resulted in the generation of both hydrophilic and hydrophobic peptides. This phenomenon was remarkably more pronounced when L. curvatus was involved. Whole cells also consumed a great amount of free amino acids, while the addition of intracellular enzymes contributed to their generation. L. sake accounted for a greater release of free amino acids. In general, cell viability and also proteolytic events were promoted when cell suspensions were provided with cell extracts as an extra source of enzymes.     

The P. falciparum CSP repeat region contains three distinct epitopes required for protection by antibodies in vivo

Rare and potent monoclonal antibodies (mAbs) against the Plasmodium falciparum (Pf) circumsporozoite protein (CSP) on infective sporozoites (SPZ) preferentially bind the PfCSP junctional tetrapeptide NPDP or NVDP minor repeats while cross-reacting with NANP central repeats in vitro. The extent to which each of these epitopes is required for protection in vivo is unknown. Here, we assessed whether junction-, minor repeat- and central repeat-preferring human mAbs (CIS43, L9 and 317 respectively) bound and protected against in vivo challenge with transgenic P. berghei (Pb) SPZ expressing either PfCSP with the junction and minor repeats knocked out (KO), or PbCSP with the junction and minor repeats knocked in (KI). In vivo protection studies showed that the junction and minor repeats are necessary and sufficient for CIS43 and L9 to neutralize KO and KI SPZ, respectively. In contrast, 317 required major repeats for in vivo protection. These data establish that human mAbs can prevent malaria infection by targeting three different protective epitopes (NPDP, NVDP, NANP) in the PfCSP repeat region. This report will inform vaccine development and the use of mAbs to passively prevent malaria.     

Genome-wide analysis of human disease alleles reveals that their locations are correlated in paralogous proteins

The millions of mutations and polymorphisms that occur in human populations are potential predictors of disease, of our reactions to drugs, of predisposition to microbial infections, and of age-related conditions such as impaired brain and cardiovascular functions. However, predicting the phenotypic consequences and eventual clinical significance of a sequence variant is not an easy task. Computational approaches have found perturbation of conserved amino acids to be a useful criterion for identifying variants likely to have phenotypic consequences. To our knowledge, however, no study to date has explored the potential of variants that occur at homologous positions within paralogous human proteins as a means of identifying polymorphisms with likely phenotypic consequences. In order to investigate the potential of this approach, we have assembled a unique collection of known disease-causing variants from OMIM and the Human Genome Mutation Database (HGMD) and used them to identify and characterize pairs of sequence variants that occur at homologous positions within paralogous human proteins. Our analyses demonstrate that the locations of variants are correlated in paralogous proteins. Moreover, if one member of a variant-pair is disease-causing, its partner is likely to be disease-causing as well. Thus, information about variant-pairs can be used to identify potentially disease-causing variants, extend existing procedures for polymorphism prioritization, and provide a suite of candidates for further diagnostic and therapeutic purposes.     

Animal models of mucosal Candida infection

Rodent models of oral, vaginal and gastrointestinal Candida infection are described and discussed in terms of their scientific merits. The common feature of all experimental mucosal Candida infections is the need for some level of host immunocompromise or exogenous treatment to ensure quantitatively reproducible disease. A growing literature describes the contributions of such candidiasis models to our understanding of certain aspects of fungal virulence and host response to mucosal Candida albicans challenge. Evidence to date shows that T-lymphocyte responses dominate host immune defences to oral and gastrointestinal challenge, while other, highly compartmentalized responses defend vaginal surfaces. By contrast the study of C. albicans virulence factors in mucosal infection models has only begun to unravel the complex of attributes required to define the difference between strongly and weakly muco-invasive strains.     

Solar Drinking Water Disinfection (SODIS) to Reduce Childhood Diarrhoea in Rural Bolivia: A Cluster-Randomized,Controlled Trial

Background

Solar drinking water disinfection (SODIS) is a low-cost, point-of-use water purification method that has been disseminated globally. Laboratory studies suggest that SODIS is highly efficacious in inactivating waterborne pathogens. Previous field studies provided limited evidence for its effectiveness in reducing diarrhoea.

Methods and Findings

We conducted a cluster-randomized controlled trial in 22 rural communities in Bolivia to evaluate the effect of SODIS in reducing diarrhoea among children under the age of 5 y. A local nongovernmental organisation conducted a standardised interactive SODIS-promotion campaign in 11 communities targeting households, communities, and primary schools. Mothers completed a daily child health diary for 1 y. Within the intervention arm 225 households (376 children) were trained to expose water-filled polyethyleneteraphtalate bottles to sunlight. Eleven communities (200 households, 349 children) served as a control. We recorded 166,971 person-days of observation during the trial representing 79.9% and 78.9% of the total possible person-days of child observation in intervention and control arms, respectively. Mean compliance with SODIS was 32.1%. The reported incidence rate of gastrointestinal illness in children in the intervention arm was 3.6 compared to 4.3 episodes/year at risk in the control arm. The relative rate of diarrhoea adjusted for intracluster correlation was 0.81 (95% confidence interval 0.59–1.12). The median length of diarrhoea was 3 d in both groups.

Conclusions

Despite an extensive SODIS promotion campaign we found only moderate compliance with the intervention and no strong evidence for a substantive reduction in diarrhoea among children. These results suggest that there is a need for better evidence of how the well-established laboratory efficacy of this home-based water treatment method translates into field effectiveness under various cultural settings and intervention intensities. Further global promotion of SODIS for general use should be undertaken with care until such evidence is available.

Trial Registration

www.ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00731497","term_id":"NCT00731497"}}NCT00731497 Please see later in the article for Editors'' Summary     

Immobility response elicited by clamping the neck induces antinociception in a "tonic pain" test in mice

Clamping the neck followed by body inversion to a supine position in mice elicits an immobility response called immobility by clamping the neck (ICN). The noxious pinch to the scruff of the neck produces antinociception in "phasic pain" models (e.g. tail-flick test). Here, a "tonic pain" model was used to test the antinociception associated with the ICN, and naloxone was used to determine the role of opioids in such antinociception. Mice were injected intraperitoneally with 0.3 mL of 0.4% acetic acid to produce writhing responses that were measured for one hour. ICN was induced every five minutes for one hour. Naloxone (5 mg/kg ip) was injected 10 min before acetic acid administration. There was a control group, sham clamping (SCLA). These mice were handled and restricted every five minutes as in the ICN but without real clamping. The repetitive inductions of ICN were able to reduce the writhing behavior; this antinociception was blocked by the naloxone pretreatment. In the SCLA group antinociception was not observed. These findings indicate that as in the "phasic pain" model, ICN also was able to elicit antinociception in this "tonic pain" model, and such antinociception seems to be mediated by opioids.     

Expression and Distribution of Dopamine Transporter in Cardiac Tissues of the Guinea Pig

Dopamine transporter (DAT) is a membrane protein that it is a marker for dopaminergic neurons. In the present work, throught Western blot and autoradiographic studies with a selective ligand for DAT ([³H] WIN-35428) and noradrenaline transporter (NET) ([³H] Nisoxetine), we search the expression and distribution of DAT in comparison with NET, in cardiac tissue of guinea pig in order to support the presence of dopaminergic nerve cells into the heart. Expression of DAT, and NET were evidenced by a bands of 75 and 54 kDa, respectively in the heart. Binding for DAT and NET were found in the four cardiac chambers. However, DAT show heterogeneous distribution with binding in right atria and in both ventricles, whereas NET show homogenous distribution in the four cardiac chambers. The results show the expression of DAT in cardiac tissues with a different distribution compared with NET, being an evidence for the presence of dopaminergic nerve cells into the heart.     

Simulating northern bobwhite population responses to nest predation,nesting habitat,and weather in south Texas

Nest predation is thought to be one of the major factors limiting northern bobwhite (Colinus virginianus) populations. We examined the relative impact of altering nest-predation rate, nesting habitat, and weather (i.e., temp and precipitation) on northern bobwhite population dynamics in a hypothetical 15,000-ha subtropical-rangeland ecosystem in south Texas using a simulation model. The systems model consisted of a 3-stage (i.e., eggs, juv, and ad) bobwhite population with dynamics influenced by variables affecting production, recruitment, nest predation, and mortality. We based model parameters on data collected from a 3-yr nest-predator study employing infrared-camera technology, from ongoing field research using a radio-marked population of wild bobwhites, and from the literature. The baseline simulated bobwhite population dynamics corresponded closely to empirical data, with no difference between medians of simulated (n = 30 yr) and observed bobwhite age ratios over a 28-yr period. Similarly, a time-series comparison of simulated and observed age ratios showed most (89%) observed values fell within the 5th and 95th percentiles of the simulated data over the 28-yr period. We created simulated population scenarios representing 1) baseline historical conditions, 2) predator control, 3) low precipitation, 4) low precipitation with predator control, 5) high temperature, 6) high temperature with predator control, 7) reduced nest-clump availability, and 8) reduced nest-clump availability with predator control that resulted in considerably different median bobwhite densities over 10 yr. For example, under simulated predator control, populations increased by about 55% from the baseline scenario, whereas under simulated reduced nest-clump availability, populations decreased by about 75% from the baseline scenario. Comparisons of time-series for each scenario showed that reduced nest-clump availability, low precipitation, and high temperature reduced bobwhite densities to a larger degree compared to a natural nest predation rate. Reduced nest-clump availability resulted in the most substantial decline of simulated bobwhite densities. Simulations suggested that management efforts should focus on maintaining adequate nest-clump availability and then possibly consider nest predator control as a secondary priority. © 2010 The Wildlife Society     

LIMP-2 links late phagosomal trafficking with the onset of the innate immune response to Listeria monocytogenes: a role in macrophage activation

The innate immune response to Listeria monocytogenes depends on phagosomal bacterial degradation by macrophages. Here, we describe the role of LIMP-2, a lysosomal type III transmembrane glycoprotein and scavenger-like protein, in Listeria phagocytosis. LIMP-2-deficient mice display a macrophage-related defect in Listeria innate immunity. They produce less acute phase pro-inflammatory cytokines/chemokines, MCP-1, TNF-α, and IL-6 but normal levels of IL-12, IL-10, and IFN-γ and a 25-fold increase in susceptibility to Listeria infection. This macrophage defect results in a low listericidal potential, poor response to TNF-α activation signals, impaired phago-lysosome transformation into antigen-processing compartments, and uncontrolled LM cytosolic growth that fails to induce normal levels of acute phase pro-inflammatory cytokines. LIMP-2 transfection of CHO cells confirmed that LIMP-2 participates in the degradation of Listeria within phagosomes, controls the late endosomal/lysosomal fusion machinery, and is linked to the activation of Rab5a. Therefore, the role of LIMP-2 appears to be connected to the TNF-α-dependent and early activation of Listeria macrophages through internal signals linking the regulation of late trafficking events with the onset of the innate Listeria immune response.