Early tissue migration of and host response to Brugia pahangi in gerbils

The host-parasite interaction during early filarial nematode migration is poorly understood. The objective of this study was to develop a model of early cutaneous filarid migration using Brugia pahangi in the jird (gerbil) host and measure the histologic and cytokine responses during this period. Male gerbils were intradermally inoculated in the left hindlimb with 100 B. pahangi L3 then necropsied at 3 hours, 24 hours, 3 days, 7 days, and 28 days post-infection. Larvae were recovered and tissues collected for histology and cytokine measurement. At 3 hours, most larvae (96.3%) were recovered from tissues associated with the infection site. Migration away from the infection site occurred within 24 hours. By 7 days, larvae were dispersed throughout the lymphatic system, including the spermatic cord lymphatics. Larvae were identified on histologic exam at all time points and were located in the dermis, muscle, lymphatic vessels, and lymph nodes. Predominantly neutrophilic inflammation was frequently present around larvae in the dermis and muscle at 3 and 24 hours. Levels of the cytokines IL-6, TNF, IFN-gamma, and IL-4 were measured in the spleen and popliteal and renal lymph nodes. IL-6 and TNF both showed a peak at 3 hours followed by consistent decline in all tissues. No clear increase in expression was appreciated for IFN-gamma. IL-4 remained low through 7 days and rose by 28 days in all tissues. These results indicate the ability of filarid L3 to rapidly migrate through host tissue and they support intradermal gerbil infection as a model for early filariasis. Cytokine analysis and histology indicated an acute host inflammatory response following initial infection, with Th2 polarization occurring later in the course of infection

Numerical simulation of aerofoil and bluff body flows by vortex dynamics

PhD ThesisThe computer simulation of flow separation from bluff bodies is achieved by a method which solves the two dimensional incompressible Navier-Stokes equations using clouds of point vortices. The vortices convect each other, and have an additional random motion to represent viscosity, as originally proposed by A. J. Chorin. Some justifications for the introduction of randomness as the agent of entropy production are presented. The method is applied to some simple boundary layer simulations, and then in combination with an integral equation method due to E. Martensen , the flow around bluff bodies of arbitrary shape is simulated in order to predict lift and drag. The stalling characteristics of aerofoil NACA 0012 are reproduced from first principles by computer simulation, and the results compared to experiment. The dependency of the Strouhal number against Reynolds number for the von Karman vortex street behind a circular cylinder is also investigated by simulation. An attempt is made to simulate the phenomenon of rotating stall which appears in curpressors as the first sign of aerodynamic overloading

Evaluation of a stack: A concrete chimney with brick liner

A 200 ft. tall stack, consisting of a concrete chimney with an independent acid proof brick liner built in the 1950`s, serving the Separations facility at the Savannah River Site (SRS), was evaluated for the performance category 3 (PC3) level of Natural Phenomena Hazards (NPH) effects. The inelastic energy absorption capacity of the concrete chimney was considered in the evaluation of the earthquake resistance, in particular, to compute the F{sub {mu}} factor. The calculated value of F{sub {mu}} exceeded 3.0, while the seismic demand for the PC3 level, using an F{sub {mu}} value of 1.5, was found to be less than the capacity of the concrete chimney. The capacity formulation of ACI 307 was modified to incorporate the effect of an after design opening on the tension side. There are considerable uncertainties in determining the earthquake resistance of the independent brick liner. The critical liner section, located at the bottom of the breeching opening, does not meet the current recommendations. A discussion is provided for the possible acceptable values for the ``Moment Reduction Factor``, R{sub w} or F{sub {mu}} for the liner. Comments are provided on the comparison of stack demands using response spectra (RS) versus time history (TH) analysis, with and without soil structure interaction (SSI) effects

A randomised controlled trial to assess the effectiveness of offering study results as an incentive to increase response rates to postal questionnaires [ISRCTN26118436]

BACKGROUND: Postal questionnaires are widely used to collect outcome data on participants. However, a poor response to questionnaires will reduce the statistical power of the study and may introduce bias. A meta analysis of ten trials offering study results, largely in the fields of education and marketing, was shown to be ineffective, with the odds ratio for response with offering research findings is 0.92 (95% CI 0.75 to 1.11). However uncertainty still exists as it is uncertain whether results from such trials can be extrapolated to that of a health care setting. The aim of this study was to assess whether offering participants study results increases the response rates to postal questionnaires. METHODS: 1038 women aged over 70 years were remotely randomised by computer in a 3:1 ratio. 250 participants did not receive the offer of knowing the results of the trial and 788 participants were offered the results of the trial in a postal questionnaire. The main outcome measure was response rate. Chi square test was used to evaluate the overall differences in response rate between the two groups. An adjusted analysis, adjusting for whether the participant was taking calcium and age was also undertaken. RESULTS: The response rates were not significantly different Odds Ratio 0.88 (95% confidence intervals 0.48 to 1.63) p = 0.69. CONCLUSION: Offering study results to women living in the community aged over 70 does not increase response rates to postal questionnaires. Although researchers have an ethical obligation to offer participants study results, since 10% of women did not wish to receive the results, investigators should give participants the option to opt out of receiving the study's results

The impact of vitamin D status on changes in bone mineral density during treatment with bisphosphonates and after discontinuation following long-term use in post-menopausal osteoporosis

BACKGROUND: It is still unclear whether addition of calcium/vitamin D supplements leads to an incremental benefit in patients taking bisphosphonates and whether achievement of serum level of 25 (OH) vitamin D of at least 70 nmol/L has an impact on the skeletal response to bisphosphonates. Moreover the maintenance of BMD after bisphosphonates withdrawal with the continuation of calcium/vitamin D supplements only, remains uncertain. The aims were to assess the impact of vitamin D status on changes in bone mineral density (BMD) in firstly patients with post-menopausal osteoporosis on bisphosphonates and secondly following discontinuation of bisphosphonates after long-term use. METHODS: Two patient groups were recruited. The first study population comprised of 112 women treated with a bisphosphonate. The second study population consisted of 35 women who had been on bisphosphonates for > 5 years in whom the treatment agent was discontinued. Baseline BMD, changes in BMD following treatment, duration of treatment, serum 25 (OH) vitamin D, parathyroid hormone (PTH), urine C-terminal telopeptides of type 1 collagen (CTX) were obtained on the study participants. RESULTS: In the first study group, subjects with serum vitamin D concentrations (> 70 nmol/L) had a significantly lower serum PTH level (mean [SEM] 41 [2] ng/L). PTH concentrations of 41 ng/L or less was associated with a significantly higher increase in BMD at the hip following treatment with bisphosphonates compared to patients with PTH > 41 ng/L (2.5% [0.9] v/s -0.2% [0.9], P = 0.04). In the second study group, discontinuation of bisphosphonate for 15 months after long-term treatment did not result in significant bone loss at the lumbar spine and total hip, although a trend towards gradual decline in BMD at the femoral neck was observed. CONCLUSION: the data suggest that optimal serum 25 (OH) vitamin D concentration may lead to further reduction in bone loss at the hip in patients on bisphosphonates. A prospective controlled trial is needed to evaluate whether the response to bisphosphonates is influenced by vitamin D status. BMD is preserved at the lumbar spine and total hip following discontinuation of bisphosphonate for a short period following long-term treatment, although a gradual loss occurs at the femoral neck

Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents

Summary: The effect of equivalent oral doses of vitamin D3 600 IU/day, 4200 IU/week and 18,000 IU/month on vitamin D status was compared in a randomized clinical trial in nursing home residents. A daily dose was more effective than a weekly dose, and a monthly dose was the least effective. Introduction: It is assumed that equivalent daily, weekly or monthly doses of vitamin D3 equally influence vitamin D status. This was investigated in a randomized clinical trial in nursing home residents. Methods: The study was performed in ten nursing homes including 338 subjects (76 male and 262 female), with a mean age of 84 (± SD 6.3 years). They received oral vitamin D3 either 600 IU/day, or 4200 IU/week, or 18,000 IU/month or placebo. After 4 months, calcium was added during 2 weeks, 320 mg/day or 640 mg/day or placebo. Outcome: serum levels of 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone turnover markers. Statistical approach: linear multilevel analysis. Results: At baseline, mean serum 25(OH)D was 25.0 nmol/L (SD 10.9), and in 98%, it was lower than 50 nmol/L. After 4 months, mean serum 25(OH)D levels increased to 62.5 nmol/L (after daily vitamin D3 69.9 nmol/L, weekly 67.2 nmol/L and monthly 53.1 nmol/L, P<0.001 between groups). Median serum PTH levels decreased by 23% (p<0.001). Bone turnover markers did not decrease. Calcium supplementation had no effect on serum PTH and bone turnover. Conclusion: Daily vitamin D was more effective than weekly, and monthly administration was the least effective. © 2007 International Osteoporosis Foundation and National Osteoporosis Foundation

Attempts to Image the Early Inflammatory Response during Infection with the Lymphatic Filarial Nematode Brugia pahangi in a Mouse Model

Helminth parasites remain a major constraint upon human health and well-being in many parts of the world. Treatment of these infections relies upon a very small number of therapeutics, most of which were originally developed for use in animal health. A lack of high throughput screening systems, together with limitations of available animal models, has restricted the development of novel chemotherapeutics. This is particularly so for filarial nematodes, which are long-lived parasites with a complex cycle of development. In this paper, we describe attempts to visualise the immune response elicited by filarial parasites in infected mice using a non-invasive bioluminescence imaging reagent, luminol, our aim being to determine whether such a model could be developed to discriminate between live and dead worms for in vivo compound screening. We show that while imaging can detect the immune response elicited by early stages of infection with L3, it was unable to detect the presence of adult worms or, indeed, later stages of infection with L3, despite the presence of worms within the lymphatic system of infected animals. In the future, more specific reagents that detect secreted products of adult worms may be required for developing screens based upon live imaging of infected animals

Clinical Value of Prognostic Instruments to Identify Patients with an Increased Risk for Osteoporotic Fractures: Systematic Review

There is a plethora of evidence available studying the association of risk profiles and the development of osteoporotic fractures. The small number of out-of-sample validations, the large variety of study characteristics, outcomes and follow-up periods impedes from deriving robust summaries and from conclusions regarding the clinical performance of many tools. First and foremost, future activity in this field should aim at reaching a consensus among clinical experts in respect to the existing instruments. Then we call for careful validations and expedient adaptations for local circumstances of the most promising candidates