One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations

Proposes a framework for meeting patients' cultural and linguistic needs: policies and procedures that support cultural competence, data collection, population-tailored services, and internal and external collaborations. Includes a self-assessment tool

The African Lungfish (\u3cem\u3eProtopterus dolloi\u3c/em\u3e): Ionoregulation and Osmoregulation in a Fish out of Water

Although urea production and metabolism in lungish have been thoroughly studied, we have little knowledge of how internal osmotic and electrolyte balance are controlled during estivation or in water. We tested the hypothesis that, compared with the body surface of teleosts, the slender African lungfish (Protopterus dolloi) body surface was relatively impermeable to water, Na+ and Cl- due to its greatly reduced gills. Accordingly, we measured the tritiated water (3H-H2O) flux in P. dolloi in water and during air exposure. In water, 3H-H2O efflux was comparable with the lowest measurements reported in freshwater teleosts, with a rate constant (K) of 17.6% body water h-1. Unidirectional ion fluxes, measured using 22Na+ and 36Cl-, indicated that Na+ and Cl- influx was more than 90% lower than values reported in most freshwater teleosts. During air exposure, a cocoon formed within 1 wk that completely covered the dorsolateral body surface. However, there were no disturbances to blood osmotic or ion (Na+, Cl-) balance, despite seven- to eightfold increases in plasma urea after 20 wk. Up to 13-fold increases in muscle urea (on a dry-weight basis) were the likely explanation for the 56% increase in muscle water content observed after 20 wk of air exposure. The possibility that muscle acted as a “water reservoir” during air exposure was supported by the 20% decline in body mass observed during subsequent reimmersion in water. This decline in body mass was equivalent to 28 mL water in a 100-g animal and was very close to the calculated net water gain (approximately 32 mL) observed during the 20-wk period of air exposure. Tritiated water and unidirectional ion fluxes on air-exposed lungfish revealed that the majority of water and ion exchange was via the ventral body surface at rates that were initially similar to aquatic rates. The 3H-H2O flux declined over time but increased upon reimmersion. We conclude that the slender lungfish body surface, including the gills, has relatively low permeability to water and ions but that the ventral surface is an important site of osmoregulation and ionoregulation. We further propose that an amphibian-like combination of ventral skin water and ion permeability, plus internal urea accumulation during air exposure, allows P. dolloi to extract water from its surroundings and to store water in the muscle when the water supply becomes limited

Intracellular pH regulation in isolated trout gill mitochondrion-rich (MR) cell subtypes: Evidence for Na\u3csup\u3e+\u3c/sup\u3e/H\u3csup\u3e+\u3c/sup\u3e activity

We have studied intracellular pH (pHi) recovery in isolated trout gill mitochondrion-rich (MR) cells following acidification by the NH4Cl pre-pulse technique. Within a mixed MR cell population, one cell type displayed Na+-independent pHi recovery while the other cell type lacked a Na+-independent pHi recovery. Cells displaying Na+ independent recovery exhibited a significantly higher buffering capacity compared to cells lacking Na+-independent pHi recovery. Cells displaying Na+ independent recovery were identified as PNA+ (peanut lectin agluttinin binding) MR cells while those unable to recover were identified as PNA- (non-peanut lectin agluttinin binding) MR cells. Therefore, recovery from acidification in the absence of Na+ provides a direct functional marker for PNA+ and PNA- MR cells. Re-addition of Na+ to acidified cells resulted in a transient pHi recovery in both cell types. This event was abolished by amiloride (500 μM) but it was insensitive to phenamil (50 μM). The phorbol ester PMA (1 μM) potentiated the Na+ induced pHi recovery suggesting that activation by PKC is required for continuous Na+/H+ exchanger activity in trout gill MR cells. This study is the first functional description of pHi recovery in lectin-identified trout gill MR cells and provides insight into a putative cellular signaling mechanism that may control pHi regulation in the gill epithelium. © 2009 Elsevier Inc. All rights reserved

Increased gene expression of a facilitated diffusion urea transporter in the skin of the African lungfish (Protopterus annectens) during massively elevated post-terrestrialization urea excretion

The full-length cDNA sequence of a putative urea transporter (IfUl) of the facilitated diffusion UT-A type has been cloned from the African lungfish Protopterus annectens. The IFUTcDNA is 1990bp in length and its open reading frame encodes a 409 amino acid long protein, with a calculated molecular mass of 44,723 Da. The sequence is closest to those of amphibians (∼65% amino acid homology), followed by mammals and elasmobranchs (∼60%), and then teleosts (∼50%). IfUT was clearly expressed in gill, kidney, liver, skeletal muscle and skin. Upon re-immersion in water after 33days of air exposure (\u27terrestrialization\u27), lungfish exhibited a massive rise in urea-N excretion which peaked at 12-30h with rates of 2000-5000μmol-N kg-1 h -1 (versus normal aquatic rates of \u3c130μmol-Nkg -1h-1) and persisted until 70h. This appears to occur mainly through the skin. Total \u27excess\u27 urea-N excretion amounted to ∼81,000-91,000 μmol-N kg-1 over 3 days. By real-time PCR, there was no difference in IfUT expression in the ventral abdominal skin between aquatic ammoniotelic controls and terrestrialized lungfish immediately after return to water (0h), and no elevation of urea-N excretion at this time. However, skin biopsies revealed a significant 2.55-fold elevation of IfUT expression at 14h, coincident with peak urea-N excretion. At 48h, there was no longer any significant difference in IFUT mRNA levels from those at 0 and 14h, or from aquatic fed controls. In accordance with earlier studies, which identified elevated urea-N excretion w\u27athe skin of P. dolloi with pharmacology typical of UT-A carriers, these results argue that transcriptional activation of a facilitated diffusion type urea transporter (IfUT) occurs in the skin during re-immersion. This serves to clear the body burden of urea-N accumulated during terrestrialization

Transgenic expression of lactoferrin imparts enhanced resistance to head blight of wheat caused by Fusarium graminearum

<p>Abstract</p> <p>Background</p> <p>The development of plant gene transfer systems has allowed for the introgression of alien genes into plant genomes for novel disease control strategies, thus providing a mechanism for broadening the genetic resources available to plant breeders. Using the tools of plant genetic engineering, a broad-spectrum antimicrobial gene was tested for resistance against head blight caused by <it>Fusarium graminearum </it>Schwabe, a devastating disease of wheat (<it>Triticum </it><it>aestivum </it>L.) and barley (<it>Hordeum vulgare </it>L.) that reduces both grain yield and quality.</p> <p>Results</p> <p>A construct containing a bovine lactoferrin cDNA was used to transform wheat using an <it>Agrobacterium</it>-mediated DNA transfer system to express this antimicrobial protein in transgenic wheat. Transformants were analyzed by Northern and Western blots to determine lactoferrin gene expression levels and were inoculated with the head blight disease fungus <it>F</it>. <it>graminearum</it>. Transgenic wheat showed a significant reduction of disease incidence caused by <it>F. graminearum </it>compared to control wheat plants. The level of resistance in the highly susceptible wheat cultivar Bobwhite was significantly higher in transgenic plants compared to control Bobwhite and two untransformed commercial wheat cultivars, susceptible Wheaton and tolerant ND 2710. Quantification of the expressed lactoferrin protein by ELISA in transgenic wheat indicated a positive correlation between the lactoferrin gene expression levels and the levels of disease resistance.</p> <p>Conclusions</p> <p>Introgression of the lactoferrin gene into elite commercial wheat, barley and other susceptible cereals may enhance resistance to <it>F. graminearum</it>.</p

Estimating the Quality of Electroconvulsive Therapy Induced Seizures Using Decision Tree and Fuzzy Inference System Classifiers

© 2018 IEEE. Electroconvulsive therapy (ECT) is an effective and widely used treatment for major depressive disorder, in which a brief electric current is passed through the brain to trigger a brief seizure. This study aims to identify seizure quality rating by utilizing a set of seizure parameters. We used 750 ECT EEG recordings in this experiment. Four seizure related parameters, (time of slowing, regularity, stereotypy and post-ictal suppression) are used as inputs to two classifiers, decision tree and fuzzy inference system (FIS), to predict seizure quality ratings. The two classifiers produced encouraging results with error rate of 0.31 and 0.25 for FIS and decision tree, respectively. The classification results show that the four seizure parameters provide relevant information about the rating of seizure quality. Automatic scoring of seizure quality may be beneficial to clinicians working in this field

Estimating the Quality of Electroconvulsive Therapy Induced Seizures Using Decision Tree and Fuzzy Inference System Classifiers

Electroconvulsive therapy (ECT) is an effective and widely used treatment for major depressive disorder, in which a brief electric current is passed through the brain to trigger a brief seizure. This study aims to identify seizure quality rating by utilizing a set of seizure parameters. We used 750 ECT EEG recordings in this experiment. Four seizure related parameters, (time of slowing, regularity, stereotypy and post-ictal suppression) are used as inputs to two classifiers, decision tree and fuzzy inference system (FIS), to predict seizure quality ratings. The two classifiers produced encouraging results with error rate of 0.31 and 0.25 for FIS and decision tree, respectively. The classification results show that the four seizure parameters provide relevant information about the rating of seizure quality. Automatic scoring of seizure quality may be beneficial to clinicians working in this field

The effect of parallel static and microwave electric fields on excited hydrogen atoms

Motivated by recent experiments we analyse the classical dynamics of a hydrogen atom in parallel static and microwave electric fields. Using an appropriate representation and averaging approximations we show that resonant ionisation is controlled by a separatrix, and provide necessary conditions for a dynamical resonance to affect the ionisation probability. The position of the dynamical resonance is computed using a high-order perturbation series, and estimate its radius of convergence. We show that the position of the dynamical resonance does not coincide precisely with the ionisation maxima, and that the field switch-on time can dramatically affect the ionisation signal which, for long switch times, reflects the shape of an incipient homoclinic. Similarly, the resonance ionisation time can reflect the time-scale of the separatrix motion, which is therefore longer than conventional static field Stark ionisation. We explain why these effects should be observed in the quantum dynamics. PACs: 32.80.Rm, 33.40.+f, 34.10.+x, 05.45.Ac, 05.45.MtComment: 47 pages, 20 figure