Chlamydia trachomatis Infection of Endocervical Epithelial Cells Enhances Early HIV Transmission Events

Chlamydia trachomatis causes a predominantly asymptomatic, but generally inflammatory, genital infection that is associated with an increased risk for HIV acquisition. Endocervical epithelial cells provide the major niche for this obligate intracellular bacterium in women, and the endocervix is also a tissue in which HIV transmission can occur. The mechanism by which CT infection enhances HIV susceptibility at this site, however, is not well understood. Utilizing the A2EN immortalized endocervical epithelial cell line grown on cell culture inserts, we evaluated the direct role that CT-infected epithelial cells play in facilitating HIV transmission events. We determined that CT infection significantly enhanced the apical-to-basolateral migration of cell-associated, but not cell-free, HIV_BaL, a CCR5-tropic strain of virus, across the endocervical epithelial barrier. We also established that basolateral supernatants from CT-infected A2EN cells significantly enhanced HIV replication in peripheral mononuclear cells and a CCR5+ T cell line. These results suggest that CT infection of endocervical epithelial cells could facilitate both HIV crossing the mucosal barrier and subsequent infection or replication in underlying target cells. Our studies provide a mechanism by which this common STI could potentially promote the establishment of founder virus populations and the maintenance of local HIV reservoirs in the endocervix. Development of an HIV/STI co-infection model also provides a tool to further explore the role of other sexually transmitted infections in enhancing HIV acquisition.     

Staff Nurses’ Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study

The aim of the study reported in this article was to investigate staff nurses’ perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses’ involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.     

The molecular mechanism of the bicarbonate effect at the plastoquinone reductase site of photosynthesis

It has been known for some time that bicarbonate reverses the inhibition, by formate under HCO₃ ^--depletion conditions, of electron transport in thylakoid membranes. It has been shown that the major effect is on the electron acceptor side of photosystem II, at the site of plastoquinone reduction. After presenting a historical introduction, and a minireview of the bicarbonate effect, we present a hypothesis on how HCO₃ ^- functions in vivo as (a) a proton donor to the plastoquinone reductase site in the D1-D2 protein; and (b) a ligand to Fe²⁺ in the Q_A-Fe-Q_B complex that keeps the D1-D2 proteins in their proper functional conformation. They key points of the hypothesis are: (1) HCO₃ ^- forms a salt bridge between Fe²⁺ and the D2 protein. The carboxyl group of HCO₃ ^- is a bidentate ligand to Fe²⁺, while the hydroxyl group H-bonds to a protein residue. (2) A second HCO₃ ^- is involved in protonating a histidine near the Q_B site to stabilize the negative charge on Q_B. HCO₃ ^- provides a rapidly available source of H⁺ for this purpose. (3) After donation of a H⁺, CO₃ ^2- is replaced by another HCO₃ ^-. The high pKa of CO₃ ^2- ensures rapid reprotonation from the bulk phase. (4) An intramembrane pool of HCO₃ ^- is in equilibrium with a large number of low affinity sites. This pool is a H⁺ buffering domain functionally connecting the external bulk phase with the quinones. The low affinity sites buffer the intrathylakoid [HCO₃ ^-] against fluctuations in the intracellular CO₂. (5) Low pH and high ionic strength are suggested to disrupt the HCO₃ ^- salt bridge between Fe²⁺ and D₂. The resulting conformational change exposes the intramembrane HCO₃ ^- pool and low affinity sites to the bulk phase.Two contrasting hypotheses for the action of formate are: (a) it functions to remove bicarbonate, and the low electron transport left in such samples is due to the left-over (or endogenous) bicarbonate in the system; or (b) bicarbonate is less of an inhibitor and so appears to relieve the inhibition by formate. Hypothesis (a) implies that HCO₃ ^- is an essential requirement for electron transport through the plastoquinones (bound plastoquinones Q_A and Q_B and the plastoquinone pool) of photosystem II. Hypothesis (b) implies that HCO₃ ^- does not play any significant role in vivo. Our conclusion is that hypothesis (a) is correct and HCO₃ ^- is an essential requirement for electron transport on the electron acceptor side of PS II. This is based on several observations: (i) since HCO₃ ^-, not CO₂, is the active species involved (Blubaugh and Govindjee 1986), the calculated concentration of this species (220 M at pH 8, pH of the stroma) is much higher than the calculated dissociation constant (Kd) of 35–60 M; thus, the likelihood of bound HCO₃ ^- in ambient air is high; (ii) studies on HCO₃ ^- effect in thylakoid samples with different chlorophyll concentrations suggest that the left-over (or endogenous) electron flow in bicarbonate-depleted chloroplasts is due to left-over (or endogenous) HCO₃ ^- remaining bound to the system (Blubaugh 1987).Abbreviations DCMU 3-(3,4-dichlorophenyl)-1, 1-dimethylurea (common name: diuron) - PSII photosystem II - Q_A first plastoquinone electron acceptor of PSII - Q_B second plastoquinone acceptor of PS II     

Circadian and Ultradian Rhythms in Blood Glucose and Plasma Insulin of Healthy Adults

The circadian and ultradian variations of blood glucose and plasma insulin have been characterized individually and as a group phenomenon in five healthy young adults studied while adhering as closely as possible to their usual routine of sleep, activity, meal content and timing. Three complementary methods were used to analyze the data: displaying raw data as a function of time; cosinor method according to Nelson and Halberg; and time series analyses as proposed by De Prins and Malbecq. The subjects were studied in the laboratory and their life routine were controlled, but very close to that of their habitual routine. They had mainly ultradian rhythms of blood glucose (mainly about 6 hr) and circadian rhythms of immunoreactive insulin (I.R.I.). Blood glucose ultradian rhythms seem to be mainly but not exclusively mealtime dependent, while I.R.I, circadian rhythms appear to be primarily endogenous in origin. Therefore, the role played by insulin in the control of blood glucose levels seems to be programmed on a circadian basis rather than by a time independent feedback phenomenon as postulated by the conventional homeostatic hypothesis. The advantage of this chronophysiologic approach is to consider circadian rhythms of both I.R.I. and insulin effectiveness as an adaptive phenomenon able to maintain blood sugar changes in the ultradian domain of rhythms.     

Circadian rhythm in total pulmonary resistance of asthmatic children. Effects of a beta-agonist agent

Six children (boys and girls, 8 to 13 years old) with allergic asthma (AA) had their total pulmonary resistance (R1) measured at four fixed times (0730, 1130, 1630 and 2230 hr), before and again 10 min after a 2 mg orciprenaline (beta-agonist) aerosol inhalation. R1 was measured by means of the esophageal balloon technique. Subjects were socially synchronized in May with a diurnal activity from 0700 to 2100 and a nocturnal rest. Patients had had no asthma attacks and had received no medication for 8-15 days. Time series were analyzed according to conventional (t-tested mean time point differences) ANOVA, and cosinor methods. The 24 hr adjusted means (cm H2O.l/s +/- SEM) were 5.7 +- 0.4 in seven previously documented healthy children. 7.4 +/- 1.2 in AA before orciprenaline, and 4.9 +/- 0.2 in healthy children, 5.2 +/- 0.8 in AA after beta-agonist inhalation. Circadian rhythms were detected in both groups before but not after treatment. The treatment had its maximal effect on R1 around 0730 (when bronchial patency is close to its trough) and had no effect around 1630 (peak time of airway patency) in both groups (P less than 0.01; ANOVA). Thus, inhaled orciprenaline was mainly effective around 0730 and to a lesser extent around 2230 whereas there was no detectable effect during the day (1230 and 1630).     

Circadian Rhythms in Competitive Sabre Fencers: Internal Desynchronization and Performance

During a 7-10 day span, circadian rhythms of sleep-wake, self-rated fatigue and mood, oral temperature, eye-hand skill and right and left hand grip strength were investigated in eight subjects: five males (21-28 years of age), members of the French sabre fencing team selected for the 1984 Olympic Games in Los Angeles, and three females (19-26 years of age) practicing fleuret (foil) fencing as a sports activity. On the average six measurements/day/variable/subject were performed. The single cosinor method showed that a circadian rhythm was detectable for only 26 out of the 56 time series (46.4%). Power spectrum analysis gave almost the same figure (19 out of 48: 39.5%) with regard to rhythms with τ=24hr indicating that with one exception (subject JFL) rhythms were internally desynchronized including differences τ between right and left hand grip strength rhythms for three subjects. Results suggest: (a) a physiologic synchronization of circadian rhythms may be a predictor of good performance; (b) however, internal desynchronization as shown previously may be a trivial phenomenon and thus does not imply in itself alterations of either health or performance; (c) chronobiologic methods should be recommended for a better understanding of changes in performance by those participating in competitive and other sports.