Mycobacterium tuberculosis Responds to Chloride and pH as Synergistic Cues to the Immune Status of its Host Cell

PubMed ID: 23592993This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

The role of union leader-member relationship capital within trade union for mental health

Objective – There are three main objectives of this study. First, this study is to examine the influence of union effectiveness and perceived union support on union relationship capital to achieve positive mental health in the workplace. Next, this study is to investigate the interdependency of the dimensions of union relationship capital: communication, trust and commitment between the union leader and union members in improving and strengthening the relationship within the union. Lastly, this study is to investigate the role of relationship capital as the mediator between union effectiveness, perceived union support and mental health. Methodology/Technique – A total of 600 questionnaires completed by trade union leaders and members in manufacturing sector based in Peninsular Malaysia were analysed using SEM (AMOS) and SPSS. The relationship between union effectiveness, perceived union support, union relationship capital and mental health were analysed using SEM. But the interaction between communication, trust and commitment were analysed using SPSS. Findings – The results demonstrated that union effectiveness and perceived union support are determinants for union relationship capital. The finding showed that communication, trust and commitment are interdependent. Furthermore, the finding also shows a significant relationship between union relationship capital and mental health. Novelty – It is said that good communication, trust and commitment within the trade union can increase cohesiveness and strengthen the trade union. A strong union can lead to positive mental health in the workplace. Type of Paper: Empirical

Optimising use of electronic health records to describe the presentation of rheumatoid arthritis in primary care: a strategy for developing code lists

Background Research using electronic health records (EHRs) relies heavily on coded clinical data. Due to variation in coding practices, it can be difficult to aggregate the codes for a condition in order to define cases. This paper describes a methodology to develop ‘indicator markers’ found in patients with early rheumatoid arthritis (RA); these are a broader range of codes which may allow a probabilistic case definition to use in cases where no diagnostic code is yet recorded. Methods We examined EHRs of 5,843 patients in the General Practice Research Database, aged ≥30y, with a first coded diagnosis of RA between 2005 and 2008. Lists of indicator markers for RA were developed initially by panels of clinicians drawing up code-lists and then modified based on scrutiny of available data. The prevalence of indicator markers, and their temporal relationship to RA codes, was examined in patients from 3y before to 14d after recorded RA diagnosis. Findings Indicator markers were common throughout EHRs of RA patients, with 83.5% having 2 or more markers. 34% of patients received a disease-specific prescription before RA was coded; 42% had a referral to rheumatology, and 63% had a test for rheumatoid factor. 65% had at least one joint symptom or sign recorded and in 44% this was at least 6-months before recorded RA diagnosis. Conclusion Indicator markers of RA may be valuable for case definition in cases which do not yet have a diagnostic code. The clinical diagnosis of RA is likely to occur some months before it is coded, shown by markers frequently occurring ≥6 months before recorded diagnosis. It is difficult to differentiate delay in diagnosis from delay in recording. Information concealed in free text may be required for the accurate identification of patients and to assess the quality of care in general practice

Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: An economic evaluation alongside a randomised controlled trial

Objective: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS') and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. Methods: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov) model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY) estimated using both EQ-5D and SF-6D. Results: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100) and generated 0.002 more QALYs. Conclusion: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most costeffective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial. Copyright: © 2014 Sanghera et al

Probing host pathogen cross-talk by transcriptional profiling of both Mycobacterium tuberculosis and infected human dendritic cells and macrophages

This study provides the proof of principle that probing the host and the microbe transcriptomes simultaneously is a valuable means to accessing unique information on host pathogen interactions. Our results also underline the extraordinary plasticity of host cell and pathogen responses to infection, and provide a solid framework to further understand the complex mechanisms involved in immunity to M. tuberculosis and in mycobacterial adaptation to different intracellular environments

Grain silo location-allocation problem with dwell time for optimization of food grain supply chain network

In the last few decades, production and procurement of food grain in India have steadily increased, however, storage capacity has not increased proportionally. The government of India (GOI) is establishing the various capacitated silos across the country to bridge this storage capacity gap. This paper presents a novel integrated multi-objective, multi-modal and multiperiod mathematical model for grain silo location-allocation problem with Dwell time to support the decision-making process of GOI. Two conflicting objectives- minimization of total supply chain network cost and total lead time (transit and dwell time) are simultaneously optimized using two Pareto based multi-objective algorithms with calibrated parameters

Selection at a single locus leads to widespread expansion of toxoplasma gondii lineages that are virulent in mice

The determinants of virulence are rarely defined for eukaryotic parasites such as T. gondii, a widespread parasite of mammals that also infects humans, sometimes with serious consequences. Recent laboratory studies have established that variation in a single secreted protein, a serine/threonine kinase known as ROPO18, controls whether or not mice survive infection. Here, we establish the extent and nature of variation in ROP18among a collection of parasite strains from geographically diverse regions. Compared to other genes, ROP18 showed extremely high levels of diversification and changes in expression level, which correlated with severity of infection in mice. Comparison with an out-group demonstrated that changes in the upstream region that regulates expression of ROP18 led to an historical increase in the expression and exposed the protein to diversifying selective pressure. Surprisingly, only three atypically distinct protein variants exist despite marked genetic divergence elsewhere in the genome. These three forms of ROP18 are likely adaptations for different niches in nature, and they confer markedly different virulence to mice. The widespread distribution of a single mouse-virulent allele among geographically and genetically disparate parasites may have consequences for transmission and disease in other hosts, including humans

Knowledge of UK Dental Undergraduates and Dentists in Treating Dentine Hypersensitivity

Aim: The purpose of the present questionnaire-based study was to evaluate the knowledge and understanding of UK based dental undergraduates and qualified dentists in treating Dentine Hypersensitivity (DH). Methods: 120 questionnaires were handed out to 4th and 5th year dental students and Staff at the Dental Hospital in London UK as part of a collaborative study with the Faculdade de Odontologia de Bauru, University of Sao Paulo, Brazil. The questionnaire consisted of 22 questions, which included both open and closed questions. Results: 91 questionnaires (75.8% response rate) were returned; of the 91 respondents (38M; 52F, 1 missing value) 53 were dentists (61%) and 34 were dental students (39%) (4 missing values). 37.5% of students indicated that 10% of patients suffered from DH whereas 18.9% of dentists indicated that 25% of patients suffered from DH. Both dentists (22.6%) and 27.5% of students indicated that DH lasted >12 weeks. 18.9% of dentists considered that DH was a serious problem for patients although 32.5% of students were not sure. Dentists (66%) and students (62.5%) indicated that DH had a major impact on the quality of life (QOL) with 51.1% (dentists) and 56.3% (students) indicating that it was moderate in nature. Conclusion: The results of the present pilot study would suggest that in terms of knowledge and understanding of DH (e.g., hydrodynamic theory) both dentists (90.5%) and students (76.9%) were comparable although in the assessment and subsequent management of DH the results indicated that dentists were more confident than the student