An orthologue of bacteroides fragilis NanH is the principal sialidase in tannerella forsythia

Sialidase activity is a putative virulence factor of the anaerobic periodontal pathogen Tannerella forsythia, but it is uncertain which genes encode this activity. Characterization of a putative sialidase, SiaHI, by others, indicated that this protein alone may not be responsible for all of the sialidase activity. We describe a second sialidase in T. forsythia (TF0035), an orthologue of Bacteroides fragilis NanH, and its expression in Escherichia coli. Sialidase activity of the expressed NanH was confirmed by using 2′-(4-methylumbelliferyl)-α-d-N-acetylneuraminic acid as a substrate. Biochemical characterization of the recombinant T. forsythia NanH indicated that it was active over a broad pH range, with optimum activity at pH 5.5. This enzyme has high affinity for 2′-(4-methylumbelliferyl)-α-d-N-acetylneuraminic acid (Km of 32.9 ± 10.3 μM) and rapidly releases 4-methylumbelliferone (Vmax of 170.8 ± 11.8 nmol of 4-methylumbelliferone min−1 mg of protein−1). E. coli lysates containing recombinant T. forsythia NanH cleave sialic acid from a range of substrates, with a preference for α2-3 glycosidic linkages. The genes adjacent to nanH encode proteins apparently involved in the metabolism of sialic acid, indicating that the NanH sialidase is likely to be involved in nutrient acquisition

Follow-up after treatment for head and neck cancer: United Kingdom National Multidisciplinary Guidelines

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. In the absence of high-level evidence base for follow-up practices, the duration and frequency are often at the discretion of local centres. By reviewing the existing literature and collating experience from varying practices across the UK, this paper provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition

Expectations of bariatric surgery: myths and reality

Introduction: Obesity is a chronic condition. Demand for surgical weight loss procedures funded by the NHS is increasing. Surgery is a recommended cost effective treatment and is often viewed ‘as a quick fix’. However through surgery alone, commissioners and clinicians are struggling to resolve the complex behavioural, social and metabolic problems linked to obesity. The literature on bariatric surgery is mainly quantitative in nature, focussing on clinical and quality of life outcome measures. The social narratives, experiences and influences of an obese person undergoing weight-loss surgery are rarely investigated. Existing qualitative research is mainly non-UK based and uses conventional methodologies to capture experiences. This study seeks to highlight the myths and realities of patient experience to inform clinical and commissioning professionals and future surgical pathways. This paper presents findings from the first stage of a longitudinal study. Methods: A qualitative longitudinal study using in-depth semi-structured interviews, Photovoice and framework analysis techniques. 15 patients interviewed pre and post bariatric surgery. Results: Themes focus on the negative impacts weight has on the quality of life for the participant and close family. Behaviours, life events and lack of self-control were suggested causes of obesity. The anticipated health benefits are the main motivation for undergoing bariatric surgery. Levels of knowledge and expectation vary between participants. Photovoice methodology is proving to have a unique role in capturing insight into the lived experiences of participants. Conclusion: Findings will provide insight to inform the implementation of NCEPOD recommendations and NICE Guidance for weight loss surgery. Conflict of Interest: None Funding: Research relating to this abstract was funded by Collaboration and Leadership for Applied Health Research and Care – South Yorkshire</p

Individual 17-Hydroxyprogesterone Responses to hCG Are Not Correlated With Follicle Size in Polycystic Ovary Syndrome.

Context:In women with polycystic ovary syndrome (PCOS), 17-hydroxyprogesterone (17-OHP) responses to gonadotropin stimulation vary from increased to indistinguishable compared with normal controls. Objective:To determine whether 17-OHP responses to recombinant-human chorionic gonadotropin (r-hCG) are individually correlated to the size of antral follicles among women with PCOS. Design Setting and Participants:A prospective study conducted in 19 women with PCOS and 20 normal controls at an academic medical center. Interventions:Blood samples were obtained before and 24 hours after administration of 25 μg of r-hCG. Ovarian imaging was conducted with three-dimensional pelvic ultrasonography. Each subject underwent a 2-hour oral glucose tolerance test. Main Outcome Measures:Basal and stimulated levels of 17-OHP, androgens, estradiol, progesterone, anti-Mullerian hormone (AMH), insulin, glucose, follicle number, and size. Results:In women with PCOS, mean antral follicle count (AFC) was greater than that of controls, although the size of cohort follicles within individual subjects was not correlated to 17-OHP responses. The numbers of 2- to 3-mm and 3- to 4-mm follicles in PCOS were significantly greater than in controls, whereas differences between larger follicles were not observed. Increased AMH in PCOS was correlated to AFC, but not 17-OHP responses. Insulin sensitivity did not correlate to r-hCG‒stimulated 17-OHP after adjustment for body mass index. Conclusions:17-OHP responses to hCG in individuals with PCOS were not correlated to the distribution of antral follicles. Greater numbers of small antral follicles in women with PCOS than in controls suggest an extension of accelerated growth from the preantral stage

Boosting clinical performance: The impact of enhanced final year placements.

BACKGROUND: This study follows on from a study that investigated how to develop effective final year medical student assistantship placements, using multidisciplinary clinical teams in planning and delivery. AIMS: This study assessed the effects on objective structured clinical examination (OSCE) performance of the in-course enhanced "super-assistantship" placement introduced to a randomly selected sample of 2013-14 final year medical students at Leeds medical school. METHODS: Quantitative data analysis was used to compare the global grades of OSCE stations between students who undertook this placement against those who did not. RESULTS: There was a small overall improvement in the "super-assistantship" student scores across the whole assessment (effect size = 0.085). "Pre-op Capacity", "Admissions Prescribing" and "Hip Pain" stations had small-medium effect sizes (0.226, 0.215, and 0.214) in favor of the intervention group. Other stations had small effect sizes (0.107-0.191), mostly in favor of the intervention group. CONCLUSIONS: The "super-assistantship" experience characterized by increasing student responsibility on placement can help to improve competence and confidence in clinical decision-making "in a simulated environment". The clinical environment and multidisciplinary team must be ready and supported to provide these opportunities effectively. Further in-course opportunities for increasing final year student responsibility should be developed

The biochemical, physiological, and metabolic evaluation of human subjects in a life support systems evaluator and on a liquid food diet Final report, 12 Jun. 1964 - 23 Feb. 1965

Biochemical, physiological, and metabolic analysis of subjects in life support system on liquid food diets during space environment simulatio

Spectrophotometric Studies of Dilute Aqueous Periodate Solutions

The solubility behavior of various sparingly soluble periodates was found to be anomalous as interpreted through the equilibrium constants for the dilute aqueous periodate system as reported in the literature. Thus it was necessary to investigate these equilibria as a possible reason for the anomaly. Reinterpretation of this solubility behavior in light of the results of this investigation will be reported at a later date

Simultaneous X-ray and Ultraviolet Observations of the SW Sextantis Star DW Ursae Majoris

We present the first pointed X-ray observation of DW Ursae Majoris, a novalike cataclysmic variable (CV) and one of the archetype members of the SW Sextantis class, obtained with the XMM-Newton satellite. These data provide the first detailed look at an SW Sex star in the X-ray regime (with previous X-ray knowledge of the SW Sex stars limited primarily to weak or non-detections in the ROSAT All Sky Survey). It is also one of only a few XMM-Newton observations (to date) of any high mass transfer rate novalike CV, and the only one in the evolutionarily important 3-4 hr orbital period range. The observed X-ray spectrum of DW UMa is very soft, with ~95% of the detected X-ray photons at energies <2 keV. The spectrum can be fit equally well by a one-component cooling flow model, with a temperature range of 0.2-3.5 keV, or a two-component, two-temperature thermal plasma model, containing hard (~5-6 keV) and soft (~0.8 keV) components. The X-ray light curve of DW UMa shows a likely partial eclipse, implying X-ray reprocessing in a vertically extended region, and an orbital modulation, implying a structural asymmetry in the X-ray reprocessing site (e.g., it cannot be a uniform corona). We also obtained a simultaneous near-ultraviolet light curve of DW UMa using the Optical Monitor on XMM-Newton. This light curve is similar in appearance to published optical-UV light curves of DW UMa and shows a prominent deep eclipse. Regardless of the exact nature of the X-ray reprocessing site in DW UMa, the lack of a prominent hard X-ray total eclipse and very low fraction of high energy X-rays point to the presence of an optically and geometrically thick accretion disk that obscures the boundary layer and modifies the X-ray spectrum emitted near the white dwarf

Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy.

Background In March 2020, COVID-19 was declared to be a pandemic. While data suggests that COVID-19 is not associated with significant adverse health outcomes for pregnant women and newborns, the psychological impact on pregnant women is likely to be high. Aim The aim was to explore the psychological impact of the COVID-19 pandemic on Italian pregnant women, especially regarding concerns and birth expectations. Methods A cross-sectional online survey of pregnant women in Italy was conducted. Responses were analysed for all women and segregated into two groups depending on previous experience of pregnancy loss. Analysis of open text responses examined expectations and concerns before and after the onset of the pandemic. Findings Two hundred pregnant women responded to the first wave of the survey. Most (n = 157, 78.5%) had other children and 100 (50.0%) had a previous history of perinatal loss. ‘Joy’ was the most prevalent emotion expressed before COVID-19 (126, 63.0% before vs 34, 17.0% after; p < 0.05); fear was the most prevalent after (15, 7.5% before vs 98, 49.0% after; p < 0.05). Positive constructs were prevalent before COVID-19, while negative ones were dominant after (p < 0.05). Across the country, women were concerned about COVID-19 and a history of psychological disorders was significantly associated with higher concerns (p < 0.05). A previous pregnancy loss did not influence women’s concerns. Conclusions Women’s expectations and concerns regarding childbirth changed significantly as a result of the COVID-19 pandemic in Italy. Women with a history of psychological disorders need particular attention as they seem to experience higher levels of concern