Candidate vaccine construction against tick-born encephalitis based on hybrid recombinant flagG-protE-protein

The present work describes the construction of the gene encoding the recombinant protein flagG­protE, its synthesis, purification and study. The recombinant flagG­protE protein is a promising molecule for developing a candidate recombinant vaccine against tickborne encephalitis by the ability to bind to monoclonal antibodies (MCA) against native protein E of tick­borne encephalitis virus. The antigenic determinants of two recombinant proteins were studied: protE and flagG­protE using a panel of 8 MCA. The recombinant protein protE comprises the tick­borne encephalitis virus envelope protein and the flagGprotE recombinant protein has an additional flagG domain encoding flagellin G of Salmonella typhi. It was found that the MCA tested revealed epitopes on the recombinant protein protE. This indicates that the investigated recombinant protein has an antigenic structure similar to the antigenic structure of the native tick­borne encephalitis virus protein E. In the study of the recombinant protein flagG­protE by the ability to bind a panel of 8 MCA, only five of them react with epitopes of the tested protein. MCA 4F6, 7F10, and 6B9 did not recognize the corresponding epitope in the recombinant flagG­protE protein, while in the recombinant protein protE, these epitopes were detected successfully. Our data indicate that the antigenic structure of recombinant protE­protein can be changed under the influence of the flagellin domain, which in turn can lead to the unavailability of some antigenic determinants. This fact must be taken into account when constructing recombinant molecules with antigenic properties. Nevertheless, the fundamentally important regions in the region of the fusion peptide and III domain are antigenically present on the surface of the recombinant protein. This should ensure the formation of neutralizing antibodies, and the presence of a complete amino acid sequence of protein E in the recombinant protein induces the formation of a T­cell immune response. The emergence of a new generation of vaccines against tick­borne encephalitis with a higher level of safety and immunogenicity will improve the vaccine prevention of the population from tick­borne encephalitis

Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

Background: Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smokefree Hospitals before and after a comprehensive national smoking ban. Methods: We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two crosssectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results: The mean of the implementation score of tobacco control policies was 52.4 (95% CI:45.4-59.5) in 2005 and 71.6 (95% CI: 67.0-76.2) in 2007 with an increase of 36.7% (p 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35-39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion: The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network

A systematic review of tests of empathy in medicine

Abstract Background Empathy is frequently cited as an important attribute in physicians and some groups have expressed a desire to measure empathy either at selection for medical school or during medical (or postgraduate) training. In order to do this, a reliable and valid test of empathy is required. The purpose of this systematic review is to determine the reliability and validity of existing tests for the assessment of medical empathy. Methods A systematic review of research papers relating to the reliability and validity of tests of empathy in medical students and doctors. Journal databases (Medline, EMBASE, and PsycINFO) were searched for English-language articles relating to the assessment of empathy and related constructs in applicants to medical school, medical students, and doctors. Results From 1147 citations, we identified 50 relevant papers describing 36 different instruments of empathy measurement. As some papers assessed more than one instrument, there were 59 instrument assessments. 20 of these involved only medical students, 30 involved only practising clinicians, and three involved only medical school applicants. Four assessments involved both medical students and practising clinicians, and two studies involved both medical school applicants and students. Eight instruments demonstrated evidence of reliability, internal consistency, and validity. Of these, six were self-rated measures, one was a patient-rated measure, and one was an observer-rated measure. Conclusion A number of empathy measures available have been psychometrically assessed for research use among medical students and practising medical doctors. No empathy measures were found with sufficient evidence of predictive validity for use as selection measures for medical school. However, measures with a sufficient evidential base to support their use as tools for investigating the role of empathy in medical training and clinical care are available.</p

Treating tobacco addiction as a chronic medical condition.

Tobacco consumption remains the leading preventable cause of death, disease and disability. Nicotine is the chemical compound sustaining tobacco addiction, a lethal chronic disease, and the major cause of other prevalent chronic diseases. The downward trend of prevalence rates in Canada appears to have levelled with smoking rates hovering at 18%. Of those individuals who currently smoke, 70% would like to stop and half will try to quit at least once this year. But unless provided with evidence-based and multimodal treatment, only 3-5% of individuals who try will be abstinent six months later. International standards recommend treatment that includes offering combinations of counselling and pharmacotherapy for every individual wanting to quit. But unlike other chronic diseases, most individuals with tobacco addiction are often precluded from treatment because prevailing ideologies frame their disease as a “lifestyle choice”. This profound misinterpretation of a chronic disease poses a significant barrier to effective tobacco control and a major contributor to unsustainable growth in excess health spending across Canada. Our existing tobacco control paradigm will likely not yield the desired health outcomes and costs savings until policy and clinical practice are aligned with scientific evidence. Furthermore, an urgent need is identified to incorporate an increased level of vigilance for depression and other neuropsychiatric issues has been identified. This manuscript outlines the health professional’s legal duty to treat and introduces a single algorithmic approach to achieve such. This integrated and unified approach is aimed at defragmenting current approaches by crossing disciplines and levels of care. This guide for safe and effective treatment delivery may be particularly appropriate to resource- scarce settings

Detoxification: treatment of the "other" tobacco

Geneeskunde en GesondheidswetenskappePsigiatriePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Candidate vaccine construction against tick-born encephalitis based on hybrid recombinant flagG-protE-protein

The present work describes the construction of the gene encoding the recombinant protein flagG­protE, its synthesis, purification and study. The recombinant flagG­protE protein is a promising molecule for developing a candidate recombinant vaccine against tickborne encephalitis by the ability to bind to monoclonal antibodies (MCA) against native protein E of tick­borne encephalitis virus. The antigenic determinants of two recombinant proteins were studied: protE and flagG­protE using a panel of 8 MCA. The recombinant protein protE comprises the tick­borne encephalitis virus envelope protein and the flagGprotE recombinant protein has an additional flagG domain encoding flagellin G of Salmonella typhi. It was found that the MCA tested revealed epitopes on the recombinant protein protE. This indicates that the investigated recombinant protein has an antigenic structure similar to the antigenic structure of the native tick­borne encephalitis virus protein E. In the study of the recombinant protein flagG­protE by the ability to bind a panel of 8 MCA, only five of them react with epitopes of the tested protein. MCA 4F6, 7F10, and 6B9 did not recognize the corresponding epitope in the recombinant flagG­protE protein, while in the recombinant protein protE, these epitopes were detected successfully. Our data indicate that the antigenic structure of recombinant protE­protein can be changed under the influence of the flagellin domain, which in turn can lead to the unavailability of some antigenic determinants. This fact must be taken into account when constructing recombinant molecules with antigenic properties. Nevertheless, the fundamentally important regions in the region of the fusion peptide and III domain are antigenically present on the surface of the recombinant protein. This should ensure the formation of neutralizing antibodies, and the presence of a complete amino acid sequence of protein E in the recombinant protein induces the formation of a T­cell immune response. The emergence of a new generation of vaccines against tick­borne encephalitis with a higher level of safety and immunogenicity will improve the vaccine prevention of the population from tick­borne encephalitis