Defective Chylomicron Synthesis as a Cause of Delayed Particle Clearance in Diabetes?

Chylomicron metabolism is abnormal in diabetes and the chylomicron particle may play a very important role in atherosclerosis. The aim of this study was to examine the effect of diabetes on the metabolism of chylomicrons in cholesterol-fed alloxan diabetic and nondiabetic rabbits. Five diabetic rabbits and 5 control rabbits were given [14C]linoleic acid and [3H]cholesterol by gavage. Lymph was collected following cannulation of the lymph duct and radiolabelled chylomicrons were isolated by ultracentrifugation. The chylomicrons from each animal were injected into paired control and diabetic recipients. Lymph apolipoprotein (apo) B48, apo B100, and apo E were measured using sodium dodecyl sulfate–polyacrylamide gradient gel electrophoresis. Mean blood sugar of the diabetic donors and diabetic recipients were 19.7 ± 2.3 and 17.2 ± 3.2 mmol/L. Diabetic rabbits had significantly raised plasma triglyceride (10.8 ± 13.9 versus 0.8 ± 0.5 mmol/L, P < 0.02). There was a large increase in apo B48 in lymph chylomicrons in the diabetic donor animals (0.19 ± 0.10 versus 0.04 ± 0.02 mg/h, P < 0.01) and apo B100 (0.22 ± 0.15 versus 0.07 ± 0.07 mg/h, P < 0.05) and a reduction in apo E on the lymph chylomicron particle (0.27 ± 0.01 versus 0.62 ± 0.07 mg/mg apo B, P < 0.001). Diabetic recipients cleared both control and diabetic chylomicron triglyceride significantly more slowly than control recipients (P < 0.05). Clearance of control chylomicron cholesterol was delayed when injected into diabetic recipients compared to when these chylomicrons were injected into control recipients (P < 0.005). Clearance of diabetic chylomicron cholesterol was significantly slower when injected into control animals compared to control chylomicron injected into control animals (P < 0.02). In this animal model of atherosclerosis, we have demonstrated that diabetes leads to the production of an increased number of lipid and apo E–deficient chylomicron particles. Chylomicron particles from the control animals were cleared more slowly by the diabetic recipient (both triglyceride and cholesterol). The chylomicron particles obtained from the diabetic animals were cleared even more slowly when injected into the diabetic recipient. Although there was an initial delay in clearance of chylomicron triglyceride from the diabetic particle when injected into the control animals, the clearance over the first 15 minutes was not significantly different when compared to the control chylomicron injected into the control animal. On the other hand, the cholesterol clearance was significantly delayed. Thus, diabetes resulted in the production of an increased number of lipid- and apo E–deficient chylomicron particles. These alterations account, in part, for the delay in clearance of these particles

Effects of Housing System on Dairy Heifer Replacement Cost from Birth to Calving: Evaluating Costs of Confinement, Dry-Lot, and Pasture-Based Systems and Their Impact on Total Rearing Investment

Replacement heifer rearing is critical for the future of dairy operations, to improve genetic merit and maintain herd size. A myriad of options exist on how to manage, feed, and ultimately raise replacement heifers. Pasture is perceived to offer optimal welfare and an economical housing system for replacement animals, but confinement systems are gaining popularity. This study investigates the costs associated with replacement heifer management decisions from birth to calving, considering the factors of housing systems, labor, feed, and health. The objective of this study was to develop an economic model to determine the cost of raising a replacement heifer managed in confinement, dry-lot, and pasture-based scenarios post-weaning. We accounted for variation in feed, labor, and health inputs and quantified the impact of these individual management decisions. An economic simulation with 10,000 iterations were completed for each situation using @Risk and PrecisionTree add-ons (Palisade Corporation, Ithaca, NY) where health incidence, commodity prices, and management variables were made stochastic. Published literature or sample farm data created parameters used in Pert distributions. Costs and biological responses were reflective of published surveys, literature, and market conditions. Management decision inputs had 3 main factors: housing type, ration composition, and labor utilization. Housing systems were calculated separately for confinement, dry-lot, and pasture scenarios. The mean total cost (min, max) to raise a replacement heifer from birth to calving, assuming the same pre-weaning strategy of group housing with an automatic calf feeder, was found to be $1,919.02 ($1,777.25, $2,100.57),$1,593.57 ($1,490.30,$1,737.26), and $1,335.84 ($1,266.69, $1,423.94) for confinement, dry-lot, and pasture, respectively. Total housing cost per replacement heifer was$423.05, $117.96, and$207.96 for confinement, dry-lot, and pasture management systems, respectively. When compared to total cost, housing contributed 21% for confinement, 7% for dry-lot, and 15% for pasture. Upon analysis of all scenarios, utilizing pasture to raise heifers resulted in a lower overall cost when compared to confinement housing options. Percentage breakdowns of feed, labor, housing, and fixed and variable costs provided more information on efficiency rather than total cost, which makes each situation different in relation to on-farm cost. This cost analysis is critical to assisting farms in making decisions in the utilization of their resources for replacement dairy heifers

Identifying barriers to help seeking for non-motor symptoms in people with Parkinson’s disease

Non-motor Symptoms (NMS) of Parkinson’s disease (PD) have a significant impact on quality of life. Despite this many NMS remain unreported by patients and consequently untreated. The present study explored barriers to help-seeking using two theoretical frameworks, the Common Sense Model of illness and Theoretical Domains Framework. 20 Participants completed semi-structured interviews to explore symptom beliefs and help-seeking behaviour. Uncertainty about the relationship of NMS to PD and lack of clarity around treatments were common. Embarrassment and communication difficulties were common for potentially sensitive symptoms such as sexual dysfunction. Symptom perceptions and beliefs about help-seeking acted as barriers to reporting NMS

Oceanids C2: An Integrated Command, Control, and Data Infrastructure for the Over-the-Horizon Operation of Marine Autonomous Systems

Long-range Marine Autonomous Systems (MAS), operating beyond the visual line-of-sight of a human pilot or research ship, are creating unprecedented opportunities for oceanographic data collection. Able to operate for up to months at a time, periodically communicating with a remote pilot via satellite, long-range MAS vehicles significantly reduce the need for an expensive research ship presence within the operating area. Heterogeneous fleets of MAS vehicles, operating simultaneously in an area for an extended period of time, are becoming increasingly popular due to their ability to provide an improved composite picture of the marine environment. However, at present, the expansion of the size and complexity of these multi-vehicle operations is limited by a number of factors: (1) custom control-interfaces require pilots to be trained in the use of each individual vehicle, with limited cross-platform standardization; (2) the data produced by each vehicle are typically in a custom vehicle-specific format, making the automated ingestion of observational data for near-real-time analysis and assimilation into operational ocean models very difficult; (3) the majority of MAS vehicles do not provide machine-to-machine interfaces, limiting the development and usage of common piloting tools, multi-vehicle operating strategies, autonomous control algorithms and automated data delivery. In this paper, we describe a novel piloting and data management system (C2) which provides a unified web-based infrastructure for the operation of long-range MAS vehicles within the UK's National Marine Equipment Pool. The system automates the archiving, standardization and delivery of near-real-time science data and associated metadata from the vehicles to end-users and Global Data Assembly Centers mid-mission. Through the use and promotion of standard data formats and machine interfaces throughout the C2 system, we seek to enable future opportunities to collaborate with both the marine science and robotics communities to maximize the delivery of high-quality oceanographic data for world-leading science

Cognitive ability in early adulthood is associated with systemic inflammation in middle age: The Vietnam experience study

We examined the prospective association between cognitive ability in early adulthood and erythrocyte sedimentation rate, a marker of inflammation, in middle age. Participants were 4256 male Vietnam era US veterans. Data on cognitive ability, assessed by the Army General Technical Test, ethnicity, and place of service were extracted from enlistment files. Smoking behaviour, alcohol consumption, basic socio-demographics, and whether participants suffered from a physician diagnosed chronic disease were determined by telephone interview in middle-age in 1985. Erythrocyte sedimentation rate, cholesterol, blood pressure, height, and weight were measured at a 3-day medical examination in 1986. In linear regression models that adjusted for age and then additionally for circumstantial, socio-demographic, lifestyle, and health factors, poor cognitive ability in early adulthood was associated with greater erythrocyte sedimentation rate in middle age, β = -.09. Thus, it would appear that not only does systemic inflammation affect cognition, but also that poor cognitive ability earlier in life increases the risk of developing inflammation

Malaria impairs T cell clustering and immune priming despite normal signal 1 from dendritic cells

Interactions between antigen-presenting dendritic cells (DCs) and T cells are essential for the induction of an immune response. However, during malaria infection, DC function is compromised and immune responses against parasite and heterologous antigens are reduced. Here, we demonstrate that malaria infection or the parasite pigment hemozoin inhibits T cell and DC interactions both in vitro and in vivo, while signal 1 intensity remains unaltered. This altered cellular behaviour is associated with the suppression of DC costimulatory activity and functional T cell responses, potentially explaining why immunity is reduced during malaria infection

Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility

Background: The causes of female infertility are multifactorial and necessitate comprehensive evaluation including physical examination, hormonal testing, and imaging. Given the associated psychological and financial stress that imaging can cause, infertility patients benefit from a structured and streamlined evaluation. The goal of such a work up is to evaluate the uterus, endometrium, and fallopian tubes for anomalies or abnormalities potentially preventing normal conception. To date, the standard method for assessing these structures typically involves some combination of transvaginal sonography (TVS), hysterosalpingography (HSG), and hysteroscopy (HSC). The goal of this review is to compare the diagnostic accuracy of TVS, HSG, and HSC for diagnosing abnormalities in infertility patients to determine if all studies are necessary for pre-treatment evaluation. Results: We identified infertility patients prior to initiation of assisted reproductive technology who had baseline TVS, HSG, and HSC within 180 days of each other. From medical record review, we compared frequencies of each finding between modalities. Of the 1274 patients who received a baseline TVS over 2 years, 327 had TVS and HSG within 180 days and 55 patients had TVS, HSG and HSC. Of the 327, TVS detected fibroids more often than HSG (74 vs. 5, p < .0001), and adenomyosis more often than HSG (7 vs. 2, p = .02). HSG detected tubal obstruction more often than TVS (56 vs. 8, p = .002). Four (1.2 %) patients had endometrial polyps on both HSG and TVS. In the 55 patients with HSG, TVS, and HSC, HSC identified endometrial polyps more often than TVS (10 vs. 1, p = .0001) and HSG (10 vs. 2, p = .0007). TVS detected more fibroids than HSC (17 vs. 5, p < .0001). Tubal obstruction was identified more often by HSG than HSC (19 vs. 5, p < .0001). Conclusions: TVS is superior for evaluation of myometrial pathology. HSG is superior for evaluation of tubal pathologies. Endometrial pathologies are best identified with HSC

Radio-Excess IRAS Galaxies: PMN/FSC Sample Selection

A sample of 178 extragalactic objects is defined by correlating the 60 micron IRAS FSC with the 5 GHz PMN catalog. Of these, 98 objects lie above the radio/far-infrared relation for radio-quiet objects. These radio-excess galaxies and quasars have a uniform distribution of radio excesses and appear to be a new population of active galaxies not present in previous radio/far-infrared samples. The radio-excess objects extend over the full range of far-infrared luminosities seen in extragalactic objects. Objects with small radio excesses are more likely to have far-infrared colors similar to starbursts, while objects with large radio excesses have far-infrared colors typical of pure AGN. Some of the most far-infrared luminous radio-excess objects have the highest far-infrared optical depths. These are good candidates to search for hidden broad line regions in polarized light or via near-infrared spectroscopy. Some low far-infrared luminosity radio-excess objects appear to derive a dominant fraction of their far-infrared emission from star formation, despite the dominance of the AGN at radio wavelengths. Many of the radio-excess objects have sizes likely to be smaller than the optical host, but show optically thin radio emission. We draw parallels between these objects and high radio luminosity Compact Steep-Spectrum (CSS) and GigaHertz Peaked-Spectrum (GPS) objects. Radio sources with these characteristics may be young AGN in which the radio activity has begun only recently. Alternatively, high central densities in the host galaxies may be confining the radio sources to compact sizes. We discuss future observations required to distinguish between these possibilities and determine the nature of radio-excess objects.Comment: Submitted to AJ. 44 pages, 11 figures. A version of the paper with higher quality figures is available from http://www.mso.anu.edu.au/~cdrake/PMNFSC/paperI

The impact of behavioral and mental health risk assessments on goal setting in primary care

Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p < 0.001), set goals for six risks (range of differences 3.8-16.6 %, p < 0.01), and improve five risks (range of differences 5.4-13.6 %, p < 0.01). Compared to controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.Trial RegistrationClinicaltrials.gov identifier: NCT01825746

Universal access: the benefits and challenges in bringing integrated HIV care to isolated and conflict affected populations in the Republic of Congo

The Pool region of the Republic of Congo is an isolated, conflict-affected area with under-resourced and poorly functioning health care services. Despite significant AIDS-related mortality and morbidity in this area, and a national level commitment to universal HIV care, HIV has been largely neglected. In 2005 Médecins Sans Frontières decided to introduce HIV care activities. However, in this setting of high basic health care needs, limited medical resources and competing medical priorities, a vertical HIV programme was not suitable. This paper describes the process of integrating HIV care and treatment into basic health services, the clinical outcomes of 222 patients started on antiretroviral treatment (ART), and the benefits to communities and health care systems. Key lessons learned include the use of multi-skilled human resources, the step-wise implementation of HIV activities, the initial engagement of an HIV experienced staff member, the use of simplified and adapted testing, clinical and monitoring protocols and drug regimens, the introduction of more complex monitoring tools to simplify clinical management decisions and intensive staff education regarding the benefits of HIV integration. This project in a rural and remote conflict-affected setting demonstrates that integrated HIV programs can save lives and play a key role in helping to achieve universal access to ART in Africa