Thrombocytopenia in bacteraemia and association with bacterial species.

Thrombocytopenia is common in patients with invasive bacterial infections. Bacteria can activate platelets, but it is unclear if this affects platelet count. The aim of this study was to examine whether bacteraemia with Staphylococcus aureus, which readily activate human platelets, was more likely to be complicated by thrombocytopenia than bacteraemia with Escherichia coli or Streptococcus pneumoniae with different abilities to activate platelets.We compared information from 600 adult patients with community-acquired bacteraemia with S. aureus (n = 140), E. coli (n = 420) and S. pneumoniae (n = 40) in Southern Sweden, 2012, linking information on positive blood cultures from microbiological databases and medical charts. The proportion of patients with thrombocytopenia (platelet count <150 × 109/ml) was calculated. Logistic regression was used to estimate the odds ratios (OR) for thrombocytopenia according to bacterial species adjusted for confounders.The proportion of thrombocytopenia was 29% in S. aureus, 28% in E. coli and 20% in S. pneumonia bacteraemia (P = 0.50), corresponding to an OR of 1.2 (95% confidence interval 0.7-1.9) for thrombocytopenia for S. aureus as compared with E. coli or S. pneumoniae, adjusted for confounders.This study indicates that platelet activation by bacteria is not a major causative mechanism in sepsis-associated thrombocytopenia.

Wearables in epilepsy and Parkinson's disease-A focus group study.

OBJECTIVES: Wearable sensors that measure movement and physiological variables are attractive for clinical evaluation of neurological diseases such as epilepsy and Parkinson's disease (PD). The aim of this study was to explore perceptions regarding the use of wearable technology in disease monitoring and management as reported by individuals with epilepsy and Parkinson's disease as well as health professionals working with these patient groups. MATERIALS AND METHODS: Six patient groups (n=25) and two groups with health professionals (n=15) participated in this qualitative, descriptive study with focus group interviews. A manifest qualitative content analysis was used. RESULTS: Four categories and nine subcategories emerged from the analysis. Participants saw possible benefits for improved treatment effect and valued this benefit more than possible inconvenience of wearing the sensors. Discrete design and simplicity were considered as facilitators for improved usability. They emphasized the importance of interactive information between patients and health professionals. However, they were concerned about unclear information and inconclusive recordings and some fears about personal integrity were at odds with the expectations on interactivity. CONCLUSIONS: Patients need to feel well informed and find an added value in using wearables. Wearables need to be user-friendly, have an attractive design, and show clinical efficacy in improving disease management. Variations in perceptions regarding integrity, benefits, and effectiveness of monitoring indicate possible conflicts of expectations among participants. The engagement of end users, patients, and health professionals, in the design and implementation process, is crucial for the development of wearable devices that enhance and facilitate neurological rehabilitation practice.

Neutral processes forming large clones during colonization of new areas.

In species reproducing both sexually and asexually clones are often more common in recently established populations. Earlier studies have suggested that this pattern arises due to natural selection favouring generally or locally successful genotypes in new environments. Alternatively, as we show here, this pattern may result from neutral processes during species' range expansions. We model a dioecious species expanding into a new area in which all individuals are capable of both sexual and asexual reproduction, and all individuals have equal survival rates and dispersal distances. Even under conditions that favour sexual recruitment in the long run, colonization starts with an asexual wave. After colonization is completed, a sexual wave erodes clonal dominance. If individuals reproduce more than one season, and with only local dispersal, a few large clones typically dominate for thousands of reproductive seasons. Adding occasional long-distance dispersal, more dominant clones emerge, but they persist for a shorter period of time. The general mechanism involved is simple: edge effects at the expansion front favour asexual (uniparental) recruitment where potential mates are rare. Specifically, our model shows that neutral processes (with respect to genotype fitness) during the population expansion, such as random dispersal and demographic stochasticity, produce genotype patterns that differ from the patterns arising in a selection model. The comparison with empirical data from a post-glacially established seaweed species (Fucus radicans) shows that in this case, a neutral mechanism is strongly supported.

Parallel speciation or long-distance dispersal? Lessons from seaweeds (Fucus) in the Baltic Sea.

Parallel evolution has been invoked as a forceful mechanism of ecotype and species formation in many animal taxa. However, parallelism may be difficult to separate from recently monophyletically diverged species that are likely to show complex genetic relationships as a result of considerable shared ancestral variation and secondary hybridization in local areas. Thus, species' degrees of reproductive isolation, barriers to dispersal and, in particular, limited capacities for long-distance dispersal will affect demographical structures underlying mechanisms of divergent evolution. Here, we used nine microsatellite DNA markers to study intra- and interspecific genetic diversity of two recently diverged species of brown macroalgae, Fucus radicans (L. Bergström & L. Kautsky) and F. vesiculosus (Linnaeus), in the Baltic Sea. We further performed biophysical modelling to identify likely connectivity patterns influencing the species' genetic structures. For each species, we found intraspecific contrasting patterns of clonality incidence and population structure. In addition, strong genetic differentiation between the two species within each locality supported the existence of two distinct evolutionary lineages (FST  = 0.15-0.41). However, overall genetic clustering analyses across both species' populations revealed that all populations from one region (Estonia) were more genetically similar to each other than to their own taxon from the other two regions (Sweden and Finland). Our data support a hypothesis of parallel speciation. Alternatively, Estonia may be the ancestral source of both species, but is presently isolated by oceanographic barriers to dispersal. Thus, a limited gene flow in combination with genetic drift could have shaped the seemingly parallel structure.

Surface evolution of aluminosilicate glass fibers during dissolution: Influence of pH, solid-to-solution ratio and organic treatment.

Materials made of synthetic vitreous mineral fibers, such as stone wool, are widely used in construction, in functional composites and as thermal and acoustic insulation. Chemical stability is an important parameter in assessing long term durability of the products. Stability is determined by fiber resistivity to dissolution, where the controlling parameters are solid surface area to solution volume ratio (S/V), pH and composition of the fibers and organic compounds used as binders. We investigated stone wool dissolution under flow through conditions, far from equilibrium, at pH range of 2 to 13, as well as under batch conditions, close to equilibrium, for up to 28 days, where S/V ranged from 100 to 10000 m-1. The dissolution rate of stone wool shows minimum at pH 8.5 and increases significantly at pH < 4.5 and pH > 12. In close to equilibrium conditions, S/V defines the steady state concentration for the leached components. Decreased dissolution rate could result from evolution of a surface leached layer or the formation of secondary surface phases or both. We suggested three dissolution rate controlling mechanisms, which depend on pH. That is, dissolution is controlled by: a SiO2 rich surface layer at pH < 4.5; by adsorption of an Al and Al-Si mixed surface layer at 5 < pH < 11 and by divalent cation adsorption and formation of secondary phases (silicates, hydroxides) at pH âˆ¼ 13. The organic compounds, used to treat the stone wool fibers during manufacture, had no influence on their dissolution properties.

Use of real-time, label-free analysis in revealing low-affinity binding to blood group antigens by Helicobacter pylori.

Infectious diseases are often initiated by microbial adherence that is mediated by the binding of attachment molecules, termed adhesins, to cell surface receptors on host cells. We present an experimental system, oblique-incidence reflectivity difference (OI-RD) microscopy, which allows the detection of novel, low-affinity microbial attachment mechanisms that may be essential for infectious processes. OI-RD microscopy was used to analyze direct binding of the oncopathogen, Helicobacter pylori ( H. pylori ) to immobilized glycoconjugates in real time with no need for labeling tags. The results suggest the presence of additional Lewis b blood group antigen (Le(b)) binding adhesins that have not been detected previously. OI-RD microscopy also confirmed the high-affinity binding of H. pylori outer-membrane protein BabA to Le(b). The OI-RD microscopy method is broadly applicable to real-time characterization of intact microbial binding to host receptors and offers new strategies to elucidate the molecular interactions of infectious agents with human host cells.

Cisplatin-induced expression of Gb3 enables verotoxin-1 treatment of cisplatin resistance in malignant pleural mesothelioma cells.

BACKGROUND: A major problem with cisplatin treatment is the development of acquired-drug resistance of the tumour cells. Verotoxin-1 (VT-1) exerts its cytotoxicity by targeting the membrane glycolipid globotriasosylceramide (Gb3), a molecule associated with drug resistance. Cisplatin- and VT-1-induced apoptosis involves mitogen-activated protein kinase (MAPK) activation, and deactivation of MAPKs is associated with cisplatin resistance. This study aimed to investigate whether a sub-toxic concentration of VT-1 could enhance cisplatin-induced apoptosis and overcome acquired-cisplatin resistance in cultured cancer cell lines. METHOD: P31 and H1299 cells with corresponding cisplatin-resistant sub-lines (P31res/H1299res) were incubated with VT-1 and/or cisplatin followed by determination of Gb3 expression, cell viability, apoptosis, and signalling pathways. RESULTS: Cells from the resistant sub-lines had elevated Gb3 expression compared with the parental cell lines, and cisplatin further increased Gb3 expression, whereas VT-1 reduced the percentage of Gb3-expressing cells. Combination of cisplatin and sub-toxic concentrations of VT-1 led to a super-additive increase of cytotoxicity and TUNEL staining, especially in the cisplatin-resistant sub-lines. Blockade of Gb3 synthesis by a Gb3 synthesis inhibitor not only led to eradicated TUNEL staining of P31 cells, but also sensitised P31res cells to the induction of apoptosis by cisplatin alone. Cisplatin- and VT-1-induced apoptosis involved the MAPK pathways with increased C-Jun N-terminal kinase and MAPK kinase-3 and -6 phosphorylation. CONCLUSIONS: We show the presence of Gb3 in acquired-cisplatin resistance in P31res and H1299res cells. Cisplatin up-regulated Gb3 expression in all cells and thus sensitised the cells to VT-1-induced cytotoxicity. A strong super-additive effect of combined cisplatin and a sub-toxic concentration of VT-1 in cisplatin-resistant malignant pleural mesothelioma cells were observed, indicating a new potential clinical-treatment approach.

Surface Reactivity and Dissolution Properties of Alumina-Silica Glasses and Fibers.

The ability of bulk glass and fibers to react in aqueous solution, with organic polymers and coupling agents, depends on the surface charge, reactivity, and adsorption properties of the glass surface, i.e. the character and density of surface -OH groups, whereas glass and fiber chemical stability and biosolubility depend on the resistance to dissolution. If glass dissolution products are accumulated in a media, they can change the surface properties by specific adsorption. We determined the -OH surface concentration, reactivity, adsorption, and dissolution properties of aluminosilicate glasses containing various modifiers and compared the results with the behavior of complex mineral wool fibers. Using proton consumption and element release from batch surface titration experiments, over the range 5 < pH < 10, surface -OH adsorption properties were modeled with the FITEQL program. During titration, network modifiers in the glass subsurface are preferentially replaced by protons, resulting in cation accumulation in the solution and formation of a leached layer enriched with Si on the solid. The behavior of Al was different. At 5 < pH < 9, only very small amounts of Al were found in the leachates, which can be explained by almost complete Al adsorption as stable surface complexes, i.e. >XOAl(OH)2 (where X = Si or Al and > represents the surface). At pH > 9, divalent cations adsorbed specifically, as >XOMe+ complexes (Me = Ca or Mg). This deeper understanding of the surface behavior of glasses and fibers is important for the design of composite materials, for applications in biology and medicine and in materials production in general, as well as for understanding natural processes, such as global uptake estimates of CO2 during rock weathering.

alpha-Toxin of Staphylococcus aureus overcomes acquired cisplatin-resistance in malignant mesothelioma cells.

alpha-Toxin (alpha-hemolysin) of Staphylococcus aureus is a pore-forming bacterial toxin which after caveolin-1-dependent assembly induces apoptosis in eukaryotic cells. We investigated if a sub-toxic concentration of staphylococcal alpha-toxin could enhance cisplatin-induced apoptosis and overcome acquired cisplatin-resistance in cultured malignant pleural mesothelioma (MPM) cells. MPM cells (P31wt) and a cisplatin-resistant sub-line (P31res) was incubated with alpha-toxin and/or cisplatin followed by determination of cell viability, apoptosis, and signaling pathways. P31res cells were more sensitive to alpha-toxin than P31 wt cells due to induction of apoptosis. A low-toxic concentration of alpha-toxin re-sensitized cisplatin P31res cytotoxicity by apoptosis-induced through the mitochondrial pathway without detectable activation of common up-stream apoptosis signaling proteins. The toxin/drug combination should be tested for cisplatin-resistant mesothelioma treatment.

Untargeted screening for novel autoantibodies with prognostic value in first-episode psychosis.

Immunological and inflammatory reactions have been suggested to have a role in the development of schizophrenia, a hypothesis that has recently been supported by genetic data. The aim of our study was to perform an unbiased search for autoantibodies in patients with a first psychotic episode, and to explore the association between any seroreactivity and the development of a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder characterized by chronic or relapsing psychotic symptoms. We collected plasma samples from 53 patients when they were treated for their first-episode psychosis, and 41 non-psychotic controls, after which the patients were followed for a mean duration of 7 years. Thirty patients were diagnosed with schizophrenia, delusional disorder, schizoaffective disorder, bipolar disorder or a long-term unspecified nonorganic psychosis during follow-up, whereas 23 patients achieved complete remission. At the end of follow-up, plasma samples were analyzed for IgG reactivity to 2304 fragments of human proteins using a multiplexed affinity proteomic technique. Eight patient samples showed autoreactivity to the N-terminal fragment of the PAGE (P antigen) protein family (PAGE2B/PAGE2/PAGE5), whereas no such autoreactivity was seen among the controls. PAGE autoreactivity was associated with a significantly increased risk of being diagnosed with schizophrenia during follow-up (odds ratio 6.7, relative risk 4.6). An immunohistochemistry analysis using antisera raised against the N-terminal fragment stained an unknown extracellular target in human cortical brain tissue. Our findings suggest that autoreactivity to the N-terminal portion of the PAGE protein family is associated with schizophrenia in a subset of patients with first-episode psychosis.

Evidence for a common Spinocerebellar ataxia type 7 (SCA7) founder mutation in Scandinavia.

Spinocerebellar ataxia type 7 (SCA7) is a neuro-degenerative disorder characterised by progressive cerebellar ataxia and macular degeneration. SCA7 is one of the least common genetically verified autosomal dominant cerebellar ataxias (ADCAs) in the world (4.5 to 11.6%), but in Sweden and Finland SCA7 is the most commonly identified form of ADCA. In an inventory of hereditary ataxias in Scandinavia (Sweden, Norway, Denmark and Finland) we identified 15 SCA7 families, eight in Sweden and seven in Finland, while no cases of SCA7 could be found in Norway or Denmark. We examined whether the relatively high frequency of SCA7 families in Sweden and Finland was the result of a common founder effect. Only two out of 15 families could be connected genealogically. However, an extensive haplotype analysis over a 10.2 cM region surrounding the SCA7 gene locus showed that all 15 families studied shared a common haplotype over at least 1.9 cM. This strongly suggests that all Scandinavian SCA7 families originate from a common founder pre-mutation.

Activation of sexual behaviour in castrated rats: the role of oestradiol.

Sexual behaviour was induced in castrated male rats with oestradiol-17 beta- or testosterone-filled constant-release implants. Testosterone-induced sexual behaviour was unaffected by treatment with the 5 alpha-reductase inhibitor 17 beta-N,N-diethylcarbamoyl-4-aza-5 alpha-androstan-3-one (4-MA; 16.7 mg/day) but treatment with the aromatization inhibitor 1,4,6-androstatriene-3,17-dione (ATD; 10 mg/day) prevented testosterone from inducing the behaviour. Sexual behaviour could be activated in castrated rats treated with testosterone plus ATD by treatment with 4-MA or with implants filled with a low dose of oestradiol. Lordosis behaviour induced in ovariectomized rats with testosterone-filled implants and progesterone was blocked by ATD treatment and could not be activated with 4-MA but oestradiol implants restored the display of lordosis in the testosterone plus ATD-treated females. 4-MA inhibited the in-vitro formation of [14C]5 alpha-dihydrotestosterone from [14C]testosterone by combined preoptic and hypothalamic tissue at all doses tested and a high dose of oestradiol exerted a similar effect. The results suggest that androgen aromatization is required for testosterone-activated female sexual behaviour but not for testosterone-activated male sexual behaviour. It is suggested that oestradiol normally acts to control the sexual behaviour of male rats by modifying neural androgen metabolism.

Receptor-mediated uptake of starch and mannan microparticles by macrophages: relative contribution of receptors for complement, immunoglobulins and carbohydrates.

The contribution of different macrophage receptors to the uptake of polyacryl starch and polyacryl mannan microparticles by macrophages was studied. Both types of microparticle were taken up to a larger and similar extent when they had been pre-incubated with serum, indicating the importance of serum factors in the uptake process. These results were supported by organ distribution studies in mice, showing that the two microparticles were rapidly targeted to the liver and spleen after i.v. injection. The carbohydrate-specific mannose/fucose receptor was found to contribute significantly to the uptake of non-opsonized but not opsonized mannan microparticles. The two different microparticles were found to activate the alternative complement pathway and to adsorb immunoglobulin G, human serum albumin and fibronectin to their surface. Inhibition experiments provided evidence for the involvement of a complement receptor (CR3) and an Fc-receptor (FCR) for IgG in the uptake of opsonized microparticles.

Roles of energy status, KATP channels and channel arrest in fish brain K+ gradient dissipation during anoxia

The crucian carp (Carassius carassius L.) is one of the most anoxia-tolerant vertebrates known, being able to maintain ion homeostasis in its brain for many hours of anoxia. This study aims to clarify the importance of glycolysis during anoxia and also to investigate whether the extreme tolerance to anoxia could be due to down-regulation of K+ permeability ('channel arrest') and/or activation of ATP-sensitive K+ (KATP) channels. The latter was also tested in rainbow trout (Oncorhynchus mykiss). The results suggest that, during anoxia, the crucian carp brain is completely dependent on glycolysis, since blocking glycolysis with iodoacetic acid (IAA) rapidly caused an increase in [K+]o that coincided with a drastic drop in ATP level and energy charge. Testing the channel arrest hypothesis by measuring the K+ efflux rate after Na+/K+-ATPase had been blocked by ouabain revealed no change in K+ permeability in crucian carp brain in response to anoxia. Furthermore, superfusing the brain of anoxic crucian carp with the KATP channel blocker glibenclamide did not alter the efflux rate of K+ after glycolysis had been inhibited with IAA. Glibenclamide had no effect on K+ efflux rate in rainbow trout brain during anoxia.

Effects of anoxia on energy metabolism in crucian carp brain slices studied with microcalorimetry

Crucian carp (Carassius carassius L.) is an exceptionally anoxia-tolerant vertebrate. To determine whether isolated crucian carp brain tissue survives anoxia and whether it displays anoxic metabolic depression, heat production (using microcalorimetry), lactate production, ethanol production and the maintenance of ATP, ADP and AMP levels and energy charge were measured in telencephalic brain slices during anoxia. In response to anoxia, heat output decreased by 37 %, corresponding to a 31 % fall in ATP turnover rate. Adenylate phosphates and energy charge were well maintained and no ethanol was produced during anoxia. It is concluded that crucian carp brain tissue has an intrinsic capacity to tolerate anoxia and that it responds to anoxia by depressing metabolic rate and elevating the glycolytic rate, thereby maintaining ATP levels.

Anoxic depression of light-evoked potentials in retina and optic tectum of crucian carp.

The crucian carp is an exceptionally anoxia-tolerant vertebrate. For the brain, with its very high rate of ATP use, depression of energy use is likely to be an important strategy for anoxic survival. This study shows that the light-evoked response of the retina and the corresponding evoked potential in optic tectum decrease in amplitude by 69 and 75%, respectively, during 38 min of anoxia, and by about 90% after 1 h in anoxia. Both responses were restored upon reoxygenation. The length of light exposure (5 s or 100 ms) did not affect the degree of anoxic depression. These results are the first to show an anoxia-induced depression of central nervous system (CNS) activity in vivo in this species, and indicate that the crucian carp temporarily turns off its visual sense in order to reduce neural energy use during anoxic condition.

A study of the possible association between adenosine A2A receptor gene polymorphisms and attention-deficit hyperactivity disorder traits.

The adenosine A2A receptor (ADORA2A) is linked to the dopamine neurotransmitter system and is also implicated in the regulation of alertness, suggesting a potential association with attention-deficit hyperactivity disorder (ADHD) traits. Furthermore, animal studies suggest that the ADORA2A may influence ADHD-like behavior. For that reason, the ADORA2A gene emerges as a promising candidate for studying the etiology of ADHD traits. The aim of this study was to examine the relationship between ADORA2A gene polymorphisms and ADHD traits in a large population-based sample. This study was based on the Child and Adolescent Twin Study in Sweden (CATSS), and included 1747 twins. Attention-deficit hyperactivity disorder traits were assessed through parental reports, and samples of DNA were collected. Associations between six single nucleotide polymorphisms (SNPs) and ADHD traits were examined, and results suggested a nominal association between ADHD traits and three of these SNPs: rs3761422, rs5751876 and rs35320474. For one of the SNPs, rs35320474, results remained significant after correction for multiple comparisons. These results indicate the possibility that the ADORA2A gene may be involved in ADHD traits. However, more studies replicating the present results are warranted before this association can be confirmed.

Invited article: millimeter-wave bolometer array receiver for the Atacama pathfinder experiment Sunyaev-Zel'dovich (APEX-SZ) instrument.

The Atacama pathfinder experiment Sunyaev-Zel'dovich (APEX-SZ) instrument is a millimeter-wave cryogenic receiver designed to observe galaxy clusters via the Sunyaev-Zel'dovich effect from the 12 m APEX telescope on the Atacama plateau in Chile. The receiver contains a focal plane of 280 superconducting transition-edge sensor (TES) bolometers instrumented with a frequency-domain multiplexed readout system. The bolometers are cooled to 280 mK via a three-stage helium sorption refrigerator and a mechanical pulse-tube cooler. Three warm mirrors, two 4 K lenses, and a horn array couple the TES bolometers to the telescope. APEX-SZ observes in a single frequency band at 150 GHz with 1' angular resolution and a 22' field-of-view, all well suited for cluster mapping. The APEX-SZ receiver has played a key role in the introduction of several new technologies including TES bolometers, the frequency-domain multiplexed readout, and the use of a pulse-tube cooler with bolometers. As a result of these new technologies, the instrument has a higher instantaneous sensitivity and covers a larger field-of-view than earlier generations of Sunyaev-Zel'dovich instruments. The TES bolometers have a median sensitivity of 890 µK(CMB)√s (NEy of 3.5 × 10(-4) √s). We have also demonstrated upgraded detectors with improved sensitivity of 530 µK(CMB)√s (NEy of 2.2 × 10(-4) √s). Since its commissioning in April 2007, APEX-SZ has been used to map 48 clusters. We describe the design of the receiver and its performance when installed on the APEX telescope.

Assessment of placental function by estimation of testosterone in plasma after an intravenous injection of dehydroepiandrosterone sulphate (DHAS).

The response of plasma testosterone to an intravenous injection of 50 mg dehydroepiandrosterone sulphate (DHAS) was measured in 22 pregnant women. In 15 women with uncomplicated pregnancies a rapid and steep increase of plasma testosterone was observed, most women having their maximum testosterone value recorded as soon as 5 minutes after the injection. Three women with preeclampsia had delayed maximum values. They delivered infants of low birth-weight or with low Apgar scores. One woman with pre-eclampsia had a normal response and gave birth to a healthy infant of normal birth-weight. Out of 3 women with intrauterine growth retardation (IUGR) 2 had an abnormal and 1 a normal response. It is concluded that the plasma response of testosterone to an injection of DHAS is a reflection of placental function.