Trauma rates and patterns in specific pathogen free (SPF) rhesus macaque (Macaca mulatta) groups.

There are some predictable patterns of trauma in captive rhesus macaque (Macaca mulatta) social groups. Several factors have been documented to contribute to these patterns, including group formation of unrelated animals, and the establishment of dominance ranks. Here, we report on how socially induced trauma in groups of rhesus monkeys is influenced by the breeding season, numbers of matrilines per group and matriline size. We analyzed 3 years of data collected from veterinary admittance logs for four groups in our specific pathogen free (SPF) breeding colony. Since the groups differed in time from formation, both the numbers of matrilines and the composition of those matrilines were different. Across the four groups, trauma rates were significantly higher during the fall breeding season than the spring and summer months when births occur. The group that was formed most recently, comprised of the greatest number of matrilines but fewest related animals, showed significantly higher rates of trauma than the older social groups. Further, the middle and lowest ranking families received signifincantly higher rates of trauma than the highest ranking families, suggesting a rank-related phenomenon. Additionally, there was a significant negative correlation between numbers of adult females in a matriline and rates of trauma observed in each matriline, but the numbers of adult females are significantly higher in the top ranked families compared to all of the other matrilines. These findings suggest that trauma rates increase during the breeding season and may be exacerbated in recently formed breeding groups that have smaller matrilines and reduced opportunities for social support to mitigate rank-related aggression. Management practices should be devised to ensure adequate matrilineal size to decrease rates of trauma in captive rhesus macaque groups.

Eu(2+) luminescence in strontium aluminates.

The luminescence properties of Eu(2+) doped strontium aluminates are reported and reviewed for a variety of aluminates, viz. SrAl12O19, SrAl4O7, Sr4Al14O25, SrAl2O4 and Sr3Al2O6. The aim of the research is to investigate the role of local coordination and covalency of the aluminate host lattice, related to the Sr/Al ratio, on the optical properties of the Eu(2+) ion. The UV and VUV excited luminescence spectra as well as luminescence decay curves were recorded to characterize the luminescence properties of the investigated aluminates. The emission of Eu(2+) ions varies over a wide spectral range, from ultraviolet (UV) to red, for the series of aluminates. The variation in emission color can be related to the crystal-field splitting of the 5d levels and the covalent interaction with the surrounding oxygen anions. In the least covalent material, viz. SrAl12O19:Eu(2+), narrow line emission due to the (6)P7/2-(8)S7/2 transition occurs at 4 K, indicating that the 4f(6)5d excited state is situated above the (6)P7/2(4f(7)) excited state around 360 nm. The most alkaline material, viz. Sr3Al2O6:Eu(2+) is the most covalent host and exhibits several d-f emission bands in the yellow to red spectral range due to the Eu(2+) ions located on different crystallographic Sr(2+) sites. The Eu(2+) emission spectra in the other aluminates confirm the trend that with increasing Sr/Al ratio the Eu(2+) emission shifts to longer wavelengths. Interesting differences are observed for the Eu(2+) from different crystallographic sites which cannot always be related with apparent differences in the first oxygen coordination sphere. The discussion gives insight into how in a similar class of materials, strontium aluminates, the emission color of Eu(2+) can be tuned over a wide spectral region.

Adult caregivers in the United States: characteristics and differences in well-being, by caregiver age and caregiving status.

We examined the characteristics of adults providing regular care or assistance to friends or family members who have health problems, long-term illnesses, or disabilities (ie, caregivers). We used data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to examine caregiver characteristics, by age and caregiving status, and compare these characteristics with those of noncaregivers. Approximately 24.7% (95% confidence interval, 24.4%-25.0%) of respondents were caregivers. Compared with younger caregivers, older caregivers reported more fair or poor health and physical distress but more satisfaction with life and lower mental distress. Understanding the characteristics of caregivers can help enhance strategies that support their role in providing long-term care.

Stimulatory adrenocortical effects of a selective estrogen receptor modulator in ovariectomized female macaques.

Here, we report the effects of estrogen and the selective estrogen receptor modulator (SERM) levormeloxifene on adrenocortical measures in ovariectomized female cynomolgus monkeys (Macaca fascicularis). Animals were randomized into one of five treatment groups, each containing 23 to 26 animals: (1) placebo, (2) 0.016 mg/kg 17ß-estradiol (E(2)), (3) 0.5 mg/kg levormeloxifene (L(1)), (4) 1.0 mg/kg levormeloxifene (L(2)), and (5) 5.0 mg/kg levormeloxifene (L(3)). Treatments were administered orally each day for 18 mo. All doses of levormeloxifene resulted in adrenal weights at least 50% greater than placebo (p < .0001 for all). The target dose of levormeloxifene (L(2)) resulted in higher serum concentrations of cortisol (+63%), dehydroepiandrosterone-sulfate (+73%), and androstenedione (+37%) compared with the placebo group (p < .05 for all). In contrast, E(2) resulted in no significant differences in adrenal weight or adrenocortical steroids. Oral E(2) and all SERM doses resulted in similar reductions in serum gonadotropins and at least threefold greater uterine weight versus placebo (p < .0001 for all). Results indicate that the SERM levormeloxifene, in contrast to E(2), may have robust stimulatory effects on adrenocortical hormones in a postmenopausal model. These findings warrant further investigation into long-term SERM effects on adrenocortical function.

Roles of organizers and champions in building campus-community prevention partnerships.

OBJECTIVE: A campus-community partnership can be an effective vehicle for launching environmental strategies to prevent college alcohol-related problems. In this study, the authors' primary aim was identifying key factors that facilitate or impede colleges' efforts to build campus-community partnerships. PARTICIPANTS AND METHODS: From fall 2004 to summer 2006, administrators at five 4-year colleges participated in a multisite case study. Level of partnership development was the primary outcome. RESULTS: Three interrelated factors facilitated higher-developed partnerships: college staff assigned to facilitate the partnerships who worked as community organizers, higher-level college administrators who served as aggressive champions, and community initiation of the partnership. The authors did not observe this trio of factors among the less-developed partnerships. A lack of administrative support made it more difficult for a champion to emerge, a college administrator who staunchly advocated for a campus-community partnership, and for those assigned to facilitate the partnership to carry out their work. CONCLUSIONS: Colleges should appoint higher-level administrators to serve as champions, while also ensuring that those assigned to facilitate a partnership can apply community organizing skills.

Adherence of glucan-positive and glucan-negative streptococcal strains to normal and damaged heart valves.

The adherence of 18 strains of streptococci to sections of normal canine and human aortic, mitral, and tricuspid valves and to canine interatrial septum was compared in an in vitro system. Quantitative measurements of adherence ratios were performed by two independent methods. Adherence ratios for Streptococcus mutans, S. sanguis, S. bovis, and Group D streptococci were higher (0.0058-0.0101) than for the other streptococcal strains studied (0.0025-0.0041). With the exception of Group D streptococci, adherence ratios for each bacterial strain were similar with the aortic, mitral, and tricuspid valve sections. Adherence ratios with normal human and canine valve leaflets were similar, but adherence ratios with interatrial septum were lower than with normal valve sections. Adherence ratios for glucan-positive and glucan-negative strains of streptococci with normal and with damaged aortic valve leaflets were also compared. The adherence ratios of the glucan-positive streptococci (S. mutans, S. sanguis, and S. bovis) and one glucan-negative enterococcal strain (KG-3) were approximately five times higher with damaged aortic valves (0.039-0.051) than with normal aortic valves (0.009-0.010). For glucan-positive strains, adherence ratios with normal aortic leaflets were similar when bacteria were grown in media which contains or lacks sucrose. In striking contrast, growth of the glucan-positive strains in medium which lacks sucrose, with resultant deficiency of glucan production, decreased the adherence ratios with damaged aortic valve leaflets to those found with normal aortic leaflets. Treatment of glucan-positive strains with dextranase resulted in a decrease in their adherence ratios to levels seen with bacteria grown in medium lacking sucrose, but the higher adherence ratios could be restored in the presence of exogenous dextran.It is concluded that glucan production is one quantitatively important factor that contributes to the greater adherence of glucan-positive streptococci to damaged rather than to normal aortic heart valve leaflets. However, glucan production is not the only factor that determines preferential adherence of streptococci to damaged heart valves, because glucan-negative strains may also show some degree of increased adherence to damaged valves. Thus, bacterial glucan production is one of the factors that could contribute to the pathogenesis of bacterial endocarditis.

Adherence of bacteria to heart valves in vitro.

The abilities of 14 strains of aerobic gram-positive cocci and gram-negative bacilli to adhere in vitro to human or canine aortic valve leaflets were compared. 2-mm sections of excised valve leaflets were obtained by punch biopsy and were incubated under standardized conditions in suspensions of bacteria. Valve sections were subsequently washed and homogenized, and quantitative techniques were used to determine the proportions of bacteria from the initial suspensions that had adhered to the valve sections. Comparable results were obtained when these adherence ratios were determined by two independent methods based either on measurements of bacterial viability or of radioactivity in 51Cr-labeled bacteria. For each bacterial strain, the adherence ratio was constant over a wide range of concentrations of bacteria in the incubation medium. Strains of enterococci, viridans streptococci, coagulase-positive and coagulase-negative staphylococci and Pseudomonas aeruginosa (adherence ratios 0.003-0.017) were found to adhere more readily to valve sections than strains of Escherichia coli and Klebsiella pneumoniae (adherence ratios 0.00002-0.00004). The organisms that most frequently cause bacterial endocarditis were found to adhere best to heart valves in vitro, suggesting that the ability to adhere to valvular endothelium may be an important or essential charcteristic of bacteria that cause endocarditis in man.

Framing the public health of caregiving.

Caregiving has only recently been acknowledged by the nation as an important topic for millions of Americans. A psychological or sociological approach to care-giving services has been most often applied, with little attention to the population-based public health outcomes of caregivers. We conceptualize caregiving as an emerging public health issue involving complex and fluctuating roles. We contend that caregiving must be considered in the context of life span needs that vary according to the ages, developmental levels, mental health needs, and physical health demands of both caregivers and care recipients.

Supportive care needs of Americans: a major issue for women as both recipients and providers.

In 2004, there were approximately 44 million men and women in the United States who were providing unpaid care to a family member, friend, or neighbor; these caregivers represented an estimated 22.9 million households (21% of all U.S. households). The 1-year economic value of this unpaid labor force was recently estimated to be 306 billion dollars. Caregiving is an important issue for women, as they represent 61% of those providing care and 65% of those receiving care. Women caregivers tend to fare worse than men, reporting higher levels of symptoms tied to depression and anxiety and lower levels of subjective well-being, life satisfaction, and physical health. In addition, the care that women provide is not without cost to them in terms of their financial future. Still, despite the burden, most caregivers consider providing care to family and friends a rewarding experience.

What coalition factors foster community capacity? Lessons learned from the Fighting Back Initiative.

Coalitions build community capacity by encouraging local organizations to expand services, programs, or policies (i.e., organizational capacity). The aim of the study was to identify coalition factors--resources, lead agency, governance, and leadership--that foster organizational capacity. Thirteen coalitions funded by Robert Wood Johnson Foundation's Fighting Back (FB) Initiative were examined in a multiple-site case study where coalition served as the unit of analysis. Organizational capacity was measured by creating a scale for each community based on changes in programs, services, or policies among eight types of organizations. Both qualitative and quantitative analyses were conducted to identify relationships among organizational capacity and coalition factors. FB sites with greater organizational capacity shared seven characteristics: received more funds for coalition building; delayed establishing new lead agencies; were housed in agencies supportive of FB; maintained stable, participatory decision-making bodies; cultivated active involvement of local government; practiced collaborative leadership; and had effective, long-serving project directors.

What explains community coalition effectiveness?: a review of the literature.

Community coalitions have become popular vehicles for promoting health. Which factors make coalitions effective, however, is unclear. The study's aim was to identify coalition-building factors related to indicators of coalition effectiveness through a review of the empirical literature. Published articles from 1980 to 2004 that empirically examined the relationships among coalition-building factors and indicators of coalition effectiveness were reviewed. Two indicators of coalition effectiveness were examined: coalition functioning and community-wide changes. A two-phase strategy was employed to identify articles by reviewing citations from previous literature reviews and then searching electronic reference databases. A total of 1168 non-mutually exclusive citations were identified, their abstracts reviewed, and 145 unique full articles were retrieved. The review yielded 26 studies that met the selection criteria. Collectively, these studies assessed 26 indicators of coalition effectiveness, with 19 indicators (73%) measuring coalition functioning, and only two indicators (7%) measuring changes in rates of community-wide health behaviors. The 26 studies identified 55 coalition-building factors that were associated with indicators of coalition effectiveness. Six coalition-building factors were found to be associated with indicators of effectiveness in five or more studies: formalization of rules/procedures, leadership style, member participation, membership diversity, agency collaboration, and group cohesion. However, caution is warranted when drawing conclusions about these associations due to the wide variations in indicators of coalition effectiveness and coalition-building factors examined across relatively few studies, discrepancies in how these variables were measured, and the studies' reliance on cross-sectional designs.

Melatonin enhances the in vitro and in vivo repair of severed rat sciatic axons.

This study examines the effects of several experimental compounds [melatonin (MEL), cyclosporin A (CsA), glial-derived neurotrophic factor (GDNF), and methylprednisolone (MP)] on polyethylene glycol (PEG)-induced repair in vitro and/or in vivo by plasmalemmal fusion (PEG-fusion) of sciatic axons severed by crushing. As measured by conduction of compound action potentials (CAPs) through the lesion site, a significantly (p<0.025) higher percentage (75%) of crushed rat sciatic axons can be repaired in vitro by PEG-fusion following exposure to MEL compared to PEG-fusion of severed sciatic axons in control Krebs saline that contains calcium (CTL=20%). In contrast, no other experimental compound (GDNF: 45%; MP: 42%; CsA: 24%) produces a significant improvement in PEG-fusion success compared to CTL. Further, MEL produces significantly (p<0.001) larger peak CAP amplitudes conducted through the lesion site following PEG-fusion compared to CTL or any other experimental compound in vitro. Additionally, MEL significantly (p<0.025) increases the ability to PEG-fuse sciatic axons in vivo, compared to CTL. Finally, PEG-fusion success in vivo is significantly (p<0.01) greater in calcium-free CTL (CTL-Ca) compared to CTL.

Pharyngeal flora in ambulatory alcoholic patients: prevalence of gram-negative bacilli.

The pharyngeal flora of a group of ambulatory alcoholic patients was studied and compared with the pharyngeal flora of a control group. Sixty-eight patients were studied, 34 alcoholics and 28 controls. Of the alcoholic patients, 59% had Gram-negative bacilli in their pharyngeal flora, while 14% of the control group had the same organisms. There were no differences in Gram-positive cocci colonization between the groups. Klebsiella pneumoniae was the most frequent isolate (40%) and the Klebsiella-Enterobacter group accounted for 76% of the isolates. Colonization rates of greater than 10 colony forming units/ml were found in 43% of the alcoholic patients. The high prevalence and higher colonization rates of Gram-negative bacilli in alcoholic patients might explain the higher incidence of Gram-negative bacillary pneumonia among alcoholics.

Increased pharyngeal bacterial colonization during viral illness.

The oropharyngeal colonization by Staphylococcus aureus and Gram-negative bacilli (GNB) and its duration were studied in 89 house staff officers, with biweekly quantitative cultures for 11 months. Eighty-two episodes of upper respiratory tract infection were documented during the study period. The oropharyngeal colonization during illness-free periods ranged from 12% to 18% for GNB and from 5% to 14% for S aureus. During an episode of upper respiratory tract infection, the oropharyngeal colonization of GNB increased to 60%; S aureus colonization increased to 43%. The colonization with both GNB and S aureus was transient and lasted for approximately two weeks. The increased colonization by S aureus and GNB during a viral respiratory tract infection may be a factor contributing to the increased risk of pneumonia in patients with this condition.

Oral ciprofloxacin vs parenteral cefotaxime in the treatment of difficult skin and skin structure infections. A multicenter trial.

A prospective, randomized, double-blind, multicenter study was conducted of hospitalized patients to compare the efficacy and safety of oral ciprofloxacin (dosage, 750 mg every 12 hours) with intravenous cefotaxime (dosage, 2.0 g every 8 hours) as monotherapy for difficult skin and skin structure infections requiring hospitalization. Five hundred seventy patients were assessed for an analysis of safety and 461 patients were assessed for an analysis of efficacy. The most common infections were infected ulcers and abscesses. At the end of therapy, there was a higher incidence of recurrent or persistent organisms in the cefotaxime group compared with ciprofloxacin. Adverse reactions related to either therapy were rare. By pathogens, there were no differences in activity, except the higher rate of recurrent or persistent Pseudomonas aeruginosa infection in the cefotaxime group. By diagnosis, the two drugs had comparable efficacy, except for the higher incidence of bacteriologic failure in patients with polymicrobial infected ulcers in the cefotaxime group. Larger studies are needed to evaluate emergence of resistance to ciprofloxacin. Oral ciprofloxacin therapy is as safe and effective as parenteral cefotaxime in the treatment of difficult infections of the skin and skin structure, and affords the prospect of early discharge from the hospital and significant cost savings.

Cortisol response to relocation stress in Garnett's bushbaby (Otolemur garnettii).

Relocation of research animals, either within a facility or from one facility to another, is assumed to be stressful. Development of appropriate research methodologies may be facilitated by understanding the extent and duration of the physiological response to relocation stress and whether the stress can be buffered by environmental or social factors, such as the presence of a cagemate. To characterize the response to relocation stress in Garnett's bushbaby, we assessed cortisol concentrations in nine female and six male bushbabies during relocation to a different facility; six of the animals were pair-housed at the time of the move and were moved with their respective cagemates. Fecal cortisol was assessed at three time points: 1) baseline (1 day prior to moving); 2) relocation (the day the animals were relocated); and 3) post-relocation (7 days after relocation). Cortisol concentrations were higher at the relocation time point than at baseline and post-relocation, which did not differ. Cortisol concentration did not differ as a function of having a cagemate during relocation. Although relocation resulted in a significant (P < 0.05) increase in cortisol excretion concentration, the levels returned to baseline within 7 days after the stressor.

Comparative studies of two-times-daily versus three-times-daily indinavir in combination with zidovudine and lamivudine.

OBJECTIVES: To compare the efficacy and safety of two-times-daily versus three-times-daily indinavir in combination with zidovudine and lamivudine. DESIGN: Two multicenter, open-label, randomized 24-week studies. METHODS: Adults HIV-1 infection, HIV-1 RNA greater than 10000 copies/ml, and no prior lamivudine or protease inhibitor therapy were eligible. In a pilot study (Study A), patients received indinavir at 800 mg every 8 h, 1000 mg every 12 h, or 1200 mg every 12 h. In a subsequent study (Study B), patients received indinavir at 800 mg every 8 h or 1200 mg every 12 h. All subjects received zidovudine (300 mg) and lamivudine (150 mg) every 12 h. An intent-to-treat analysis was used. RESULTS: In Study A, which enrolled 88 patients, neither HIV-1 RNA nor CD4 cell responses differed significantly between treatment groups at 24 weeks when corrected for multiple comparisons. Study B enrolled 433 patients, but was prematurely discontinued when interim analysis suggested greater efficacy of three-times-daily indinavir. Of the first 87 patients reaching week 24, HIV-1 RNA was less than 400 copies/ml in 91% receiving three-times-daily versus 64% receiving two-times-daily indinavir (P < 0.01). CONCLUSION: Three-times-daily indinavir appears more efficacious than two-times-daily dosing when administered with zidovudine and lamivudine. Two-times-daily indinavir dosing should only be considered in situations characterized by favorable pharmacokinetic drug-drug interactions.

Role of the C-terminal domain of the lysozyme of Clostridium acetobutylicum ATCC 824 in a chimeric pneumococcal-clostridial cell wall lytic enzyme.

An active chimeric cell wall lytic enzyme has been constructed by domain substitution between the major autolysins of Clostridium acetobutylicum ATCC 824 and Streptococcus pneumoniae. The chimeric enzyme, built up by the fusion of the N-terminal domain of the pneumococcal LYTA amidase and the C-terminal domain of the clostridial LYC lysozyme, exhibited an amidase activity capable of hydrolyzing choline-containing clostridial cell walls with an efficiency 250-times higher than when tested on pneumococcal cell walls. This experimental approach demonstrates the basic role of the C-terminal domain of the LYC lysozyme in substrate recognition and provides additional support to our hypothesis of modular evolution of these lytic enzymes. Moreover, the construction described here confirmed the role of the C-terminal domains of the modular cell wall lytic enzymes on the optimal pH for catalytic activity. To our knowledge, this is the first example of the construction of an active chimeric lytic enzyme by fusing genes that lack nucleotide homology and are derived from different bacterial genera.

Dengue and hepatic failure.

Dengue hemorrhagic fever/dengue shock syndrome is a serious manifestation of dengue fever, which is observed predominantly in the tropical regions of the West Pacific and in Southeast Asia and is associated with secondary infections, mainly in children under age 15. A concomitant microangiopathic coagulopathy has been described; moreover, encephalopathy and even Reye's syndrome have been rarely reported. This report describes a 51-year-old man with secondary dengue infection who presented with clinical evidence of severe hepatitis, encephalopathy, cranial nerve palsy, and microangiopathic coagulopathy and who had a favorable outcome. A careful surveillance for the occurrence of secondary dengue in the Western Hemisphere is proposed, and dengue is suggested as a diagnostic possibility in obscure febrile illnesses presenting as either hepatitis, encephalopathy, or coagulopathy in places in which the mosquito vector, Aedes aegypti, is present.

Efficacy and safety of aztreonam versus tobramycin for aerobic gram-negative bacilli lower respiratory tract infections.

Aztreonam therapy was evaluated for the management of 80 patients with gram-negative bacilli lower respiratory tract infections. Study results confirmed its efficacy and safety for this indication.