Prognostic Value of a Quantitative Analysis of Lipoarabinomannan in Urine from Patients with HIV-Associated Tuberculosis

Background

Detection of the mycobacterial cell wall antigen lipoarabinomannan (LAM) in urine can be used to diagnose HIV-associated tuberculosis (TB) using a qualitative (positive/negative) read-out. However, it is not known whether the quantity of LAM present in urine provides additional prognostic information.

Methods/Findings

Consecutively recruited adult outpatients initiating antiretroviral therapy (ART) in South Africa were investigated for TB regardless of clinical symptoms using sputum smear microscopy and liquid culture (reference standard). Urine samples were tested using the Clearview TB-ELISA for LAM and the Xpert MTB/RIF assay. The ELISA optical densities (OD) were used as a quantitative assessment of urine LAM. Among 514 patients with complete sputum and urine LAM OD results, culture-confirmed TB was diagnosed in 84 patients. Twenty-three (27.3%) were LAM-positive with a median LAM OD of 0.68 (IQR 0.16–2.43; range, 0.10–3.29) and 61 (72.6%) were LAM negative (LAM OD <0.1 above background). Higher LAM ODs were associated with a range of prognostic indices, including lower CD4 cell counts, lower haemoglobin levels, higher blood neutrophil counts and higher mycobacterial load as assessed using both sputum and urine samples. The median LAM OD among patients who died was more than 6.8-fold higher than that of patients who remained alive at 3 months (P<0.001). The small number of deaths, however, precluded adequate assessment of mortality risk stratified according to urine LAM OD.

Conclusions

In patients with HIV-associated TB, concentrations of LAM in urine were strongly associated with a range of poor prognostic characteristics known to be associated with mortality risk. Urine LAM assays with a semi-quantitative (negative vs. low-positive vs. high-positive) read-out may have improved clinical utility over assays with a simple binary result.     

Radiologically Defined Ecological Dynamics and Clinical Outcomes in Glioblastoma Multiforme: Preliminary Results

MATERIALS AND METHODS: We examined pretreatment magnetic resonance imaging (MRI) examinations from 32 patients with glioblastoma multiforme (GBM) enrolled in The Cancer Genome Atlas (TCGA). Spatial variations in T1 post-gadolinium and either T2-weighted or fluid attenuated inversion recovery sequences from each tumor MRI study were used to characterize each small region of the tumor by its local contrast enhancement and edema/cellularity (“habitat”). The patient cohort was divided into group 1 (survival < 400 days, n = 16) and group 2 (survival > 400 days, n = 16). RESULTS: Histograms of relative values in each sequence demonstrated that the tumor regions were consistently divided into high and low blood contrast enhancement, each of which could be subdivided into regions of high, low, and intermediate cell density/interstitial edema. Group 1 tumors contained greater volumes of habitats with low contrast enhancement but intermediate and high cell density (not fully necrotic) than group 2. Both leave-one-out and 10-fold cross-validation schemes demonstrated that individual patients could be correctly assigned to the short or long survival group with 81.25% accuracy. CONCLUSION: We demonstrate that novel image analytic techniques can characterize regional habitat variations in GBMs using combinations of MRI sequences. A preliminary study of 32 patients from the TCGA database found that the distribution of MRI-defined habitats varied significantly among the different survival groups. Radiologically defined ecological tumor analysis may provide valuable prognostic and predictive biomarkers in GBM and other tumors.     

The design and function of birds' nests

All birds construct nests in which to lay eggs and/or raise offspring. Traditionally, it was thought that natural selection and the requirement to minimize the risk of predation determined the design of completed nests. However, it is becoming increasingly apparent that sexual selection also influences nest design. This is an important development as while species such as bowerbirds build structures that are extended phenotypic signals whose sole purpose is to attract a mate, nests contain eggs and/or offspring, thereby suggesting a direct trade‐off between the conflicting requirements of natural and sexual selection. Nest design also varies adaptively in order to both minimize the detrimental effects of parasites and to create a suitable microclimate for parents and developing offspring in relation to predictable variation in environmental conditions. Our understanding of the design and function of birds' nests has increased considerably in recent years, and the evidence suggests that nests have four nonmutually exclusive functions. Consequently, we conclude that the design of birds' nests is far more sophisticated than previously realized and that nests are multifunctional structures that have important fitness consequences for the builder/s.     

Diversity of honey stores and their impact on pathogenic bacteria of the honeybee,Apis mellifera

Honeybee colonies offer an excellent environment for microbial pathogen development. The highest virulent, colony killing, bacterial agents are Paenibacillus larvae causing American foulbrood (AFB), and European foulbrood (EFB) associated bacteria. Besides the innate immune defense, honeybees evolved behavioral defenses to combat infections. Foraging of antimicrobial plant compounds plays a key role for this “social immunity” behavior. Secondary plant metabolites in floral nectar are known for their antimicrobial effects. Yet, these compounds are highly plant specific, and the effects on bee health will depend on the floral origin of the honey produced. As worker bees not only feed themselves, but also the larvae and other colony members, honey is a prime candidate acting as self‐medication agent in honeybee colonies to prevent or decrease infections. Here, we test eight AFB and EFB bacterial strains and the growth inhibitory activity of three honey types. Using a high‐throughput cell growth assay, we show that all honeys have high growth inhibitory activity and the two monofloral honeys appeared to be strain specific. The specificity of the monofloral honeys and the strong antimicrobial potential of the polyfloral honey suggest that the diversity of honeys in the honey stores of a colony may be highly adaptive for its “social immunity” against the highly diverse suite of pathogens encountered in nature. This ecological diversity may therefore operate similar to the well‐known effects of host genetic variance in the arms race between host and parasite.     

Boron efficiency in oilseed rape: I. Genotypic variation demonstrated in field and pot grown Brassica napus L. and Brassica juncea L.

Boron (B) efficiency of oilseed rape (Brassica napus) and mustard (B. juncea) genotypes was determined on a low B soil at Mt. Compass, South Australia. B efficiency was observed in oilseed rape genotypes, Zhongyou 821, Dunkeld and Zheyou 2, and in mustard genotypes Pusa Bold and CSIRO 6. Genotypes grown in the field were also grown under glass-house conditions, in pots filled with pre-washed sand extracted from the Mt. Compass field site. Two B treatments, one B adequate (0.25 mg B kg⁻¹ soil) and one B deficient (imposed by omission) were used to indicate whether vegetative response to B could predict final yield response and provide a more convenient selection criterion for identifying B-efficient germplasm. Vegetative response of 35 d old (D35) genotypes grown in pot culture closely reflected field response, indicating the expression of B efficiency traits in early growth, and its potential use in selection. This revised version was published online in June 2006 with corrections to the Cover Date.     

Morphology and ontogeny of Cretaceous ostracods with preserved appendages from Brazil

The Lower Cretaceous ostracod Pattersoncypris micropapillosa Bate is redescribed, and Reconcavona sp. indet. with appendages preserved is described for the first time. The morphology of the carapace and especially of the appendages of P. micropapillosa is compared in detail with that of the Recent Cyprididae Eucypris virens , which demonstrates that there are substantial similarities. In addition to the adults of P. micropapillosa , a number of juveniles have also been recovered and described, and these are compared with the juveniles of E. virens . The ontogenetic development of P. micropapillosa is shown to be very similar to that of Recent Cyprididae. This has highlighted that this group of ostracods has changed very little over the last 100 My. P. micropapillosa is tentatively placed in the subfamily Cyprinotinae, based on features of the upper lip. As the morphology of the appendages and the ontogeny of P. micropapillosa are very similar to those of Recent forms, it is postulated that the function of the limbs and lifestyle were also similar, i.e. it was nektobenthic and an opportunistic detritus feeder.     

Microbial Dynamics during Bioremediation of a Crude Oil-Contaminated Coastal Wetland

In 1996, a controlled crude oil application was conducted at a Texas intertidal, coastal wetland to determine the effectiveness of two biostimulation treatments in these sensitive areas. An inorganic nutrient treatment and inorganic nutrient plus a potential electron acceptor (nitrate) treatment were examined. As part of this research, polycyclic aromatic hydrocarbon (PAH)-degrading, aliphatic-degrading, and total heterotrophic microbial numbers were monitored. Using a randomized, complete block design consisting of 21 plots, microbial data from biostimulation treatment plots were statistically compared to oiled control plots to assess treatment differences. Sediment samples from all plots receiving oil showed exponential increases in the numbers of aliphatic (n-alkane) and PAH-degrading microorganisms. This increase was observed at both 0 to 5 cm and 5 to 10 cm sample depths. Statistical analysis, however, revealed no significant differences in the numbers of aliphatic-degrading or PAH-degrading microorganisms between treatment plots and oiled control plots or between treatments on any sample day. The numbers of PAH- and aliphatic-degrading microorganisms returned to near pre-application levels by the end of the monitoring period. Ratios of hydrocarbon-degrading microbes to total heterotrophs also increased as a result of the oil application and returned to pre-application levels by the end of the monitoring period. Overall, the populations of hydrocarbon-degrading microorganisms illustrated a well-documented response to crude oil. However, the addition of the biostimulation treatments did not significantly increase the numbers of aliphatic-degrading, PAH-degrading, or total heterotrophic microorganisms over populations on control plots.     

Central Exendin‐4 Infusion Reduces Body Weight without Altering Plasma Leptin in (fa/fa) Zucker Rats

Objective: To investigate whether chronic administration of the long‐acting glucagon‐like peptide‐1 receptor agonist exendin‐4 can elicit sustained reductions in food intake and body weight and whether its actions require an intact leptin system. Research Methods and Procedures: Male lean and obese Zucker (fa/fa) rats were infused intracerebroventricularly with exendin‐4 using osmotic minipumps for 8 days. Results: Exendin‐4 reduced body weight in both lean and obese Zucker rats, maximum suppression being reached on Day 5 in obese (8%) and Day 7 in lean (16%) rats. However, epididymal white adipose tissue weight was not reduced, and only in lean rats was there a reduction in plasma leptin concentration. Food intake was maximally suppressed (by 81%) on Day 3 in obese rats but was reduced by only 18% on Day 8. Similarly, in lean rats food intake was maximally reduced (by 93%) on Day 4 of treatment and by 45% on Day 8. Brown adipose tissue temperature was reduced from Days 2 to 4. Plasma corticosterone was elevated by 76% in lean but by only 28% in obese rats. Discussion: Chronic exendin‐4 treatment reduced body weight in both obese and lean Zucker rats by reducing food intake: metabolic rate was apparently suppressed. These effects did not require an intact leptin system. Neither does the absence of an intact leptin system sensitize animals to exendin‐4. Partial tolerance to the anorectic effect of exendin‐4 in lean rats may have been due to elevated plasma corticosterone and depressed plasma leptin levels, but other counter‐regulatory mechanisms seem to play a role in obese Zucker rats.