Astrocytic uptake of posttranslationally modified amyloid-ß leads to endolysosomal system disruption and induction of pro-inflammatory signaling.

The disruption of astrocytic catabolic processes contributes to the impairment of amyloid-ß (Aß) clearance, neuroinflammatory signaling, and the loss of synaptic contacts in late-onset Alzheimer's disease (AD). While it is known that the posttranslational modifications of Aß have significant implications on biophysical properties of the peptides, their consequences for clearance impairment are not well understood. It was previously shown that N-terminally pyroglutamylated Aß3(pE)-42, a significant constituent of amyloid plaques, is efficiently taken up by astrocytes, leading to the release of pro-inflammatory cytokine tumor necrosis factor α and synapse loss. Here we report that Aß3(pE)-42, but not Aß1-42, gradually accumulates within the astrocytic endolysosomal system, disrupting this catabolic pathway and inducing the formation of heteromorphous vacuoles. This accumulation alters lysosomal kinetics, lysosome-dependent calcium signaling, and upregulates the lysosomal stress response. These changes correlate with the upregulation of glial fibrillary acidic protein (GFAP) and increased activity of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB). Treatment with a lysosomal protease inhibitor, E-64, rescues GFAP upregulation, NF-κB activation, and synapse loss, indicating that abnormal lysosomal protease activity is upstream of pro-inflammatory signaling and related synapse loss. Collectively, our data suggest that Aß3(pE)-42-induced disruption of the astrocytic endolysosomal system leads to cytoplasmic leakage of lysosomal proteases, promoting pro-inflammatory signaling and synapse loss, hallmarks of AD-pathology.

14-3-3 [Formula: see text]-reported early synaptic injury in Alzheimer's disease is independently mediated by sTREM2.

INTRODUCTION: Synaptic loss is closely associated with tau aggregation and microglia activation in later stages of Alzheimer's disease (AD). However, synaptic damage happens early in AD at the very early stages of tau accumulation. It remains unclear whether microglia activation independently causes synaptic cleavage before tau aggregation appears. METHODS: We investigated 104 participants across the AD continuum by measuring 14-3-3 zeta/delta ([Formula: see text]) as a cerebrospinal fluid biomarker for synaptic degradation, and fluid and imaging biomarkers of tau, amyloidosis, astrogliosis, neurodegeneration, and inflammation. We performed correlation analyses in cognitively unimpaired and impaired participants and used structural equation models to estimate the impact of microglia activation on synaptic injury in different disease stages. RESULTS: 14-3-3 [Formula: see text] was increased in participants with amyloid pathology at the early stages of tau aggregation before hippocampal volume loss was detectable. 14-3-3 [Formula: see text] correlated with amyloidosis and tau load in all participants but only with biomarkers of neurodegeneration and memory deficits in cognitively unimpaired participants. This early synaptic damage was independently mediated by sTREM2. At later disease stages, tau and astrogliosis additionally mediated synaptic loss. CONCLUSIONS: Our results advertise that sTREM2 is mediating synaptic injury at the early stages of tau accumulation, underlining the importance of microglia activation for AD disease propagation.

Calcium channel ß3 subunit regulates ATP-dependent migration of dendritic cells.

Migratory dendritic cells (migDCs) continuously patrol tissues and are activated by injury and inflammation. Extracellular adenosine triphosphate (ATP) is released by damaged cells or actively secreted during inflammation and increases migDC motility. However, the underlying molecular mechanisms by which ATP accelerates migDC migration is not understood. Here, we show that migDCs can be distinguished from other DC subsets and immune cells by their expression of the voltage-gated calcium channel subunit ß3 (Cavß3; CACNB3), which exclusively facilitates ATP-dependent migration in vitro and during tissue damage in vivo. By contrast, CACNB3 does not regulate lipopolysaccharide-dependent migration. Mechanistically, CACNB3 regulates ATP-dependent inositol 1,4,5-trisphophate receptor-controlled calcium release from the endoplasmic reticulum. This, in turn, is required for ATP-mediated suppression of adhesion molecules, their detachment, and initiation of migDC migration. Thus, Cacnb3-deficient migDCs have an impaired migration after ATP exposure. In summary, we identified CACNB3 as a master regulator of ATP-dependent migDC migration that controls tissue-specific immunological responses during injury and inflammation.

Isolation and Quantification of Epstein-Barr Virus from the P3HR1 Cell Line.

The Epstein-Barr virus (EBV), formally designated as Human herpesvirus 4 (HHV-4), is the first isolated human tumor virus. Nearly 90-95% of the world's adult population is infected by EBV. With the recent advancements in molecular biology and immunology, the application of both in vitro and in vivo experimental models has provided deep and meaningful insight into the pathogenesis of EBV in many diseases as well as into EBV-associated tumorigenesis. The aim of this visualized experiment paper is to provide an overview of the isolation of EBV viral particles from cells of the P3HR1 cell line, followed by quantification of the viral preparation. P3HR1 cells, originally isolated from a human Burkitt lymphoma, can produce a P3HR1 virus, which is a type 2 EBV strain. The EBV lytic cycle can be induced in these P3HR1 cells by treatment with phorbol 12-myristate 13-acetate (PMA), yielding EBV viral particles. Using this protocol for the isolation of EBV particles, P3HR1 cells are cultured for 5 days at 37 °C and 5% CO2 in complete RPMI-1640 medium containing 35 ng/mL PMA. Subsequently, the culture medium is centrifuged at a speed of 120 x g for 8 min to pellet the cells. The virus-containing supernatant is then collected and spun down at a speed of 16,000 x g for 90 min to pellet the EBV particles. The viral pellet is then resuspended in a complete RPMI-1640 medium. This is followed by DNA extraction and quantitative real-time PCR to assess the concentration of EBV particles in the preparation.

Covalent bonding of 4-methylcatechol to ß-lactoglobulin results in the release of cysteine-4-methylcatechol adducts after in vitro digestion.

Protein-polyphenol adducts are formed upon covalent bonding between oxidized polyphenols and proteins. 4-Methylcatechol (4MC) is a polyphenol with origin in coffee and is oxidized to 4-methylbenzoquinone (4MBQ) under conditions used during food processing. The present study characterizes 4MBQ-induced covalent modifications on ß-lactoglobulin (ß-LG) from bovine milk, (henceforth ß-LQ) and the effect on protein digestibility. Significant thiol and amine loss was found in ß-LQ compared to ß-LG. Site-specific 4MBQ-induced modifications were identified on Cys, Lys, Arg, His and Trp in ß-LQ. No significant differences between ß-LG and ß-LQ on in vitro digestibility were observed by assessment with SDS-PAGE, degree of hydrolysis and LC-MS/MS unmodified peptide intensities. Cys-4MC adduct (1.7 ± 0.1 µmol/g) was released from ß-LQ after in vitro digestion. Thus, it is relevant to investigate how released Cys-4MC adducts are absorbed in vivo in future studies.

Cofilin1 oxidation links oxidative distress to mitochondrial demise and neuronal cell death.

Many cell death pathways, including apoptosis, regulated necrosis, and ferroptosis, are relevant for neuronal cell death and share common mechanisms such as the formation of reactive oxygen species (ROS) and mitochondrial damage. Here, we present the role of the actin-regulating protein cofilin1 in regulating mitochondrial pathways in oxidative neuronal death. Cofilin1 deletion in neuronal HT22 cells exerted increased mitochondrial resilience, assessed by quantification of mitochondrial ROS production, mitochondrial membrane potential, and ATP levels. Further, cofilin1-deficient cells met their energy demand through enhanced glycolysis, whereas control cells were metabolically impaired when challenged by ferroptosis. Further, cofilin1 was confirmed as a key player in glutamate-mediated excitotoxicity and associated mitochondrial damage in primary cortical neurons. Using isolated mitochondria and recombinant cofilin1, we provide a further link to toxicity-related mitochondrial impairment mediated by oxidized cofilin1. Our data revealed that the detrimental impact of cofilin1 on mitochondria depends on the oxidation of cysteine residues at positions 139 and 147. Overall, our findings show that cofilin1 acts as a redox sensor in oxidative cell death pathways of ferroptosis, and also promotes glutamate excitotoxicity. Protective effects by cofilin1 inhibition are particularly attributed to preserved mitochondrial integrity and function. Thus, interfering with the oxidation and pathological activation of cofilin1 may offer an effective therapeutic strategy in neurodegenerative diseases.

Novel, provable algorithms for efficient ensemble-based computational protein design and their application to the redesign of the c-Raf-RBD:KRas protein-protein interface.

The K* algorithm provably approximates partition functions for a set of states (e.g., protein, ligand, and protein-ligand complex) to a user-specified accuracy ε. Often, reaching an ε-approximation for a particular set of partition functions takes a prohibitive amount of time and space. To alleviate some of this cost, we introduce two new algorithms into the osprey suite for protein design: fries, a Fast Removal of Inadequately Energied Sequences, and EWAK*, an Energy Window Approximation to K*. fries pre-processes the sequence space to limit a design to only the most stable, energetically favorable sequence possibilities. EWAK* then takes this pruned sequence space as input and, using a user-specified energy window, calculates K* scores using the lowest energy conformations. We expect fries/EWAK* to be most useful in cases where there are many unstable sequences in the design sequence space and when users are satisfied with enumerating the low-energy ensemble of conformations. In combination, these algorithms provably retain calculational accuracy while limiting the input sequence space and the conformations included in each partition function calculation to only the most energetically favorable, effectively reducing runtime while still enriching for desirable sequences. This combined approach led to significant speed-ups compared to the previous state-of-the-art multi-sequence algorithm, BBK*, while maintaining its efficiency and accuracy, which we show across 40 different protein systems and a total of 2,826 protein design problems. Additionally, as a proof of concept, we used these new algorithms to redesign the protein-protein interface (PPI) of the c-Raf-RBD:KRas complex. The Ras-binding domain of the protein kinase c-Raf (c-Raf-RBD) is the tightest known binder of KRas, a protein implicated in difficult-to-treat cancers. fries/EWAK* accurately retrospectively predicted the effect of 41 different sets of mutations in the PPI of the c-Raf-RBD:KRas complex. Notably, these mutations include mutations whose effect had previously been incorrectly predicted using other computational methods. Next, we used fries/EWAK* for prospective design and discovered a novel point mutation that improves binding of c-Raf-RBD to KRas in its active, GTP-bound state (KRasGTP). We combined this new mutation with two previously reported mutations (which were highly-ranked by osprey) to create a new variant of c-Raf-RBD, c-Raf-RBD(RKY). fries/EWAK* in osprey computationally predicted that this new variant binds even more tightly than the previous best-binding variant, c-Raf-RBD(RK). We measured the binding affinity of c-Raf-RBD(RKY) using a bio-layer interferometry (BLI) assay, and found that this new variant exhibits single-digit nanomolar affinity for KRasGTP, confirming the computational predictions made with fries/EWAK*. This new variant binds roughly five times more tightly than the previous best known binder and roughly 36 times more tightly than the design starting point (wild-type c-Raf-RBD). This study steps through the advancement and development of computational protein design by presenting theory, new algorithms, accurate retrospective designs, new prospective designs, and biochemical validation.

Gender and neglected tropical disease front-line workers: Data from 16 countries.

BACKGROUND: Delivery of preventive chemotherapy (PC) through mass drug administration (MDA) is used to control or eliminate five of the most common neglected tropical diseases (NTDs). The success of an MDA campaign relies on the ability of drug distributors and their supervisors-the NTD front-line workers-to reach populations at risk of NTDs. In the past, our understanding of the demographics of these workers has been limited, but with increased access to sex-disaggregated data, we begin to explore the implications of gender and sex for the success of NTD front-line workers. METHODOLOGY/PRINCIPAL FINDINGS: We reviewed data collected by USAID-supported NTD projects from national NTD programs from fiscal years (FY) 2012-2017 to assess availability of sex-disaggregated data on the workforce. What we found was sex-disaggregated data on 2,984,908 trainees trained with financial support from the project. We then analyzed the percentage of males and females trained by job category, country, and fiscal year. During FY12, 59% of these data were disaggregated by sex, which increased to nearly 100% by FY15 and was sustained through FY17. In FY17, 43% of trainees were female, with just four countries reporting more females than males trained as drug distributors and three countries reporting more females than males trained as trainers/supervisors. Except for two countries, there were no clear trends over time in changes to the percent of females trained. CONCLUSIONS/SIGNIFICANCE: There has been a rapid increase in availability of sex-disaggregated data, but little increase in recruitment of female workers in countries included in this study. Women continue to be under-represented in the NTD workforce, and while there are often valid reasons for this distribution, we need to test this norm and better understand gender dynamics within NTD programs to increase equity.

Comparative evaluation of the quality of Papanicolaou staining at different intervals of fixation times using 96% ethyl alcohol / Avaliação comparativa da qualidade da coloração de Papanicolaou em diferentes tempos de fixação em álcool etílico a 96%

ABSTRACT Introduction: Fixation of cytological smears consists of immediate immersion in appropriate fixative, in order to preserve cellular morphological characteristics, it is essential for the microscopic examination and diagnostic interpretation. Objective: To evaluate the influence of fixation times on the morphological and staining characteristics of samples fixed in ethanol and stained by the Papanicolaou method. Method: Experimental, quantitative and qualitative research was carried out on 99 samples of the jugal mucosa scrapings from 33 participants, fixed in 96% ethyl alcohol in three different times. Group A: 15 minutes; group B: 30 minutes; group C: seven days. The quality of staining was categorized in Optimal, Good, Regular and Poor, with subsequent recategorization at optimal and non-optimal. To verify the association among the groups and the categories, Fisher's exact test was performed, with significance level of 0.05. Results: From the 99 stained slides, 19 were discarded due to acellularity, remaining 80 slides. From these, 28 in group A, 26 in group B and 26 in group C were evaluated. In Group A, optimal quality was found in 60.7% (n = 17), good in 28.6% (n = 8), regular in 10.7% (n = 3) and poor in 0% (n = 0). In group B optimal was found in 61.5% (n = 16), good in 30.8% (n = 8), regular in 7.7% (n = 2) and poor in 0% (n = 0). In group C, optimal was found in 92.3% (n = 24), good in 7.7% (n = 2), regular in 0% (n = 0) and poor in 0% (n = 0). In the three groups, there was no representation of the Poor category. Conclusion: The results suggest that there is a significant difference in the staining quality (p-value = 0.01) according to the fixation time.

RESUMEN Introducción: La fijación de extensiones citológicas consiste en la inmersión inmediata en fijador adecuado para preservar la morfología celular, siendo esencial para el análisis microscópico y la interpretación diagnóstica. Objetivo: Evaluar la influencia de los tiempos de fijación en las características morfológicasy de tinción de muestras fijadas con metanoly tenidas con el método de Papanicolaou. Método: Se realizó una investigación experimental, cuantitativa y cualitativa de 99 muestras de raspado de la mucosa yugal de 33 participantes, fijadas con etanol al 96% en tres tiempos distintos. Grupo A: 15 minutos; grupo B: 30 minutos; grupo C: 7 días. La calidad de la tinción fue categorizada en óptima, buena, regular y mala, con posterior reclasificación en óptima y no óptima. Para determinar la asociación entre los grupos y las categorias, se realizó la prueba exacta de Fisher, con un nivel de significación del 0,05. Resultado: De las 99 muestras tenidas, 19 fueron desechadas por acelularidad, quedando 80 para ser analizadas. De estas muestras, 28 fueron evaluadas en el grupo A, 26 en el grupo B y 26 en el grupo C. En el grupo A, hemos encontrado calidad óptima - 60,7% (n =17); buena - 28,6% (n = 8); regular -10,7% (n = 3) y mala - 0% (n = 0). En el grupo B, óptima - 61,5% (n = 16); buena - 30,8% (n = 8); regular - 7,7% (n = 2); y mala - 0% (n = 0). En el grupo C, óptima - 92,3% (n = 24); buena - 7,7% (n = 2); regular - 0% (n = 0) y mala - 0% (n = 0). En los tres grupos no hubo representación en la categoria mala. Conclusión: Los resultados sugieren que hay diferencia significativa en la calidad de la tinción (p = 0,01) de acuerdo con el tiempo de fijación.

RESUMO Introdução: A fixação dos esfregaços citológicos consiste na imersão imediata em fixador adequado para preservar as características morfológicas celulares, sendo essencial para a análise microscópica e a interpretação diagnóstica. Objetivo: Avaliar a influência dos tempos de fixação nas características morfológicas e tintoriais de amostras fixadas em álcool etílico e coradas pelo método de Papanicolaou. Método: Realizou-se pesquisa experimental, quantitativa e qualitativa de 99 amostras de raspado da mucosa jugal de 33participantes, fixadas em álcool etílico 96% em três tempos diferentes. Grupo A: 15 minutos; grupo B: 30 minutos; grupo C: sete dias. A qualidade da coloração foi categorizada em ótima, boa, regular e ruim, com posterior recategorização em ótimo e não ótimo. Para verificar a associação entre os grupos e as categorias, realizou-se teste exato de Fisher, com nível de significância de 0,05. Resultado: Das 99 lâminas coradas, 19 foram desprezadas por acelularidade, restando 80 lâminas para serem analisadas. Destas, foram avaliadas 28 no grupo A, 26 no grupo B e 26 no grupo C. No grupo A, foi encontrada qualidade ótima - 60,7% (n = 17); boa - 28,6% (n = 8); regular - 10,7% (n = 3) e ruim - 0% (n = 0). No grupo B, ótima - 61,5% (n = 16); boa - 30,8% (n = 8); regular - 7,7% (n = 2); e ruim - 0% (n = 0). E no Grupo C, ótima - 92,3% (n = 24); boa - 7,7% (n = 2); regular - 0% (n = 0); e ruim - 0% (n = 0). Nos três grupos não houve representação na categoria ruim. Conclusão: Os resultados sugerem que há diferença significativa na qualidade da coloração (p = 0,01) de acordo com o tempo de fixação.

Quality of life and associated factors in patients with chronic Chagas disease.

OBJECTIVES: To evaluate the quality of life (QoL) of patients with Chagas disease (CD) and the association between QoL domains and several clinical, socioeconomic and lifestyle characteristics of this population. METHODS: Cross-sectional observational study conducted from March 2014 to March 2017 including a total of 361 outpatients followed at Evandro Chagas National Institute of Infectious Disease, Brazil. QoL was assessed using the Portuguese shorter version of the original WHO Quality of Life questionnaire (WHOQOL-BREF). Information about clinical CD presentation, presence of comorbidities, functional class, previous benznidazole treatment, socioeconomic profile and lifestyle was also obtained. RESULTS: Environment and physical domains presented the worst QoL scores, while the social relationship domain presented the highest score. Multivariate regression analysis demonstrated that variables independently associated with QoL were functional class, sex, clinical presentation of CD, sleep duration, schooling, physical activity level, smoking, income per capita and residents by domicile. CONCLUSIONS: The low socioeconomic status and the physical limitations imposed by the disease presented an important impact on the QoL reduction among CD patients, especially on environment and physical domains. Strategies to improve QoL among CD patients should be tailored and consider many different variables to maximise improvements not only of patients' physical but also of their mental health.

Galling Insects of the Brazilian Páramos: Species Richness and Composition Along High-Altitude Grasslands.

In this work, we investigated the factors that determine the distribution of galling insects in high-altitude grasslands, locally called 'campos de altitude' of Mantiqueira Range and tested whether 1) richness of galling insects decreases with altitude, 2) galling insect richness increases with plant richness, 3) variation in galling insect diversity is predominantly a consequence of its ß component, and 4) turnover is the main mechanism driving the beta diversity of both galling insects and plants. Galling insect richness did not exhibit a negative relationship with altitude, but it did increase with plant richness. The additive partition of regional richness (γ) into its local and beta components showed that local diversity (α) of galling insects and plants was relatively low in relation to regional diversity; the ß component incorporated most of the regional diversity. This pattern was also found in the multiscale analysis of the additive partition for galling insects and plants. The beta diversity of galling insects and plants was driven predominantly by the process of turnover and minimally by nesting. The results reported here point out that the spatial distribution of galling insects is best explained by historical factors, such as the distribution of genera and species of key host plants, as well as their relation to habitat, than ecological effects such as hygrothermal stress - here represented by altitude.

Mortality in HIV-infected women, heterosexual men, and men who have sex with men in Rio de Janeiro, Brazil: an observational cohort study.

BACKGROUND: Mortality in HIV-infected individuals might differ by sex and mode of HIV acquisition. We aimed to study mortality in HIV-infected women, heterosexual men, and men who have sex with men (MSM) in a cohort from Rio de Janeiro, Brazil. METHODS: In this observational cohort study, we included HIV-infected women, heterosexual men, and MSM (aged ≥18 years) from the Instituto Nacional de Infectologia Evandro Chagas database who were enrolled between Jan 1, 2000, and Oct 30, 2011, and who had at least 60 days of follow-up. Causes of deaths, defined with the Coding of Death in HIV protocol, were documented. Cox proportional hazards models accounting for competing risks were used to explore risk factors for AIDS-related and non-AIDS-related deaths. FINDINGS: We had 10 142 person-years of follow-up from 2224 individuals: 817 (37%) women, 554 (25%) heterosexual men, and 853 (38%) MSM. Of 103 deaths occurred, 64 were AIDS related, 31 were non-AIDS related, and eight were of unknown causes. In unadjusted analyses, compared with women, the hazard of AIDS-related deaths was higher for heterosexual men (hazard ratio [HR] 3·52, 95% CI 1·30-9·08; p=0·009) and for MSM (2·30, 0·89-5·94; p=0·084). After adjustment for age, CD4 cell counts, last HIV viral load, antiretroviral therapy use, and AIDS-defining infection, AIDS-defining malignant disease, and hospital admission during follow-up, the excess risk of AIDS-related death decreased for heterosexual men (adjusted HR 1·99, 0·75-5·25; p=0·163) but was unchanged for MSM (2·24, 0·82-6·11; p=0·114). Non-AIDS-related mortality did not differ by group. INTERPRETATION: Compared with women, increased risk of AIDS-related death in heterosexual men was partly mitigated by risk factors for AIDS mortality, whereas the excess risk in MSM was unchanged. Further study of reasons for disparity in AIDS-related mortality by mode of transmission is needed. FUNDING: US National Institutes of Health, Brazilian National Council of Technological and Scientific Development (CNPq), and Research Funding Agency of the State of Rio de Janeiro (FAPERJ).

PEEK Cages in Lumbar Fusion: Mid-term Clinical Outcome and Radiologic Fusion.

STUDY DESIGN: Historical cohort analysis. OBJECTIVE: Evaluation of mid-term clinical outcome and radiologic fusion in patients treated with a polyetheretherketone (PEEK) cage. SUMMARY OF BACKGROUND DATA: Anterior lumbar interbody fusion can be a good alternative in chronic low back pain when conservative treatment fails. Although titanium alloy cages give good fusion rates, disadvantages are the subsidence of the cage in the adjacent vertebrae and problematic radiologic evaluation of fusion. PEEK cages such as the Synfix-LR cage (Synthes, Switzerland) should overcome this. METHODS: From December 2004 until August 2007, 95 patients (21 double-level and 74 single-level) with degenerative disk disease from L3-S1 were operated by a single surgeon. The number of reoperations was counted. Radiologic fusion on computed tomography scan was scored with a new scoring system by an independent skeletal radiologist and orthopedic surgeon. Intraobserver agreement and specificity were assessed. Clinical improvement was measured by the Oswestry Disability Index score. The median duration of clinical follow-up was 47.7 months (range 29.9-61.6). RESULTS: In total, 26 patients were reoperated after a median period of 17.6 months (range 6.7-46.9) of the initial surgery. Of the 26 patients, 23 patients (18 single-level and 5 double-level) were reoperated for symptomatic pseudarthrosis. A moderate agreement (κ=0.36) and a specificity of 70% and 37% for the radiologist and orthopedic surgeon, respectively, were found for scoring bony bridging. The Oswestry Disability Index score improved after initial surgery; however, reoperated patients reported a significantly lower improvement. CONCLUSIONS: A high number of reoperations after an anterior lumbar interbody fusion procedure with the Synfix-LR cage were found, mainly because of symptomatic pseudarthrosis. The absence of posterior fixation in combination with lower stiffness and the hydrophobic characteristics of PEEK probably lead to insufficient initial stability, creating suboptimal conditions for bony bridging, and thus solid fusion. The proposed ease of the evaluation of radiologic fusion could not be supported. Clinicians should be alert on pseudarthrosis when patients treated with the Synfix-LR cage presented with persisted or aggravated complaints.

Automated screening for high-frequency hearing loss.

OBJECTIVE: Hearing loss at high frequencies produces perceptual difficulties and is often an early sign of a more general hearing loss. This study reports the development and validation of two new speech-based hearing screening tests in English that focus on detecting hearing loss at frequencies above 2000 Hz. DESIGN: The Internet-delivered, speech-in noise tests used closed target-word sets of digit triplets or consonant-vowel-consonant (CVC) words presented against a speech-shaped noise masker. The digit triplet test uses the digits 0 to 9 (excluding the disyllabic 7), grouped in quasi-random triplets. The CVC test uses simple words (e.g., "cat") selected for the high-frequency spectral content of the consonants. During testing, triplets or CVC words were identified in an adaptive procedure to obtain the speech reception threshold (SRT) in noise. For these new, high-frequency (HF) tests, the noise was low-pass filtered to produce greater masking of the low-frequency speech components, increasing the sensitivity of the test for HF hearing loss. Individual test tokens (digits, CVCs) were first homogenized using a group of 10 normal-hearing (NH) listeners by equalizing intelligibility across tokens at several speech-in-noise levels. Both tests were then validated and standardized using groups of 24 NH listeners and 50 listeners with hearing impairment. Performance on the new high frequency digit triplet (HF-triplet) and CVC (HF-CVC) tests was compared with audiometric hearing loss, and with that on the unfiltered, broadband digit triplet test (BB-triplet) test, and the ASL (Adaptive Sentence Lists) speech-in-noise test. RESULTS: The HF-triplet and HF-CVC test results (SRT) both correlated positively and highly with high-frequency audiometric hearing loss and with the ASL test. SRT for both tests as a function of high-frequency hearing loss increased at nearly three times the rate as that of the BB-triplet test. The intraindividual variability (SD) on the tests was about 2.1 (HF-triplet) and 1.7 (HF-CVC) times less than that for the BB-triplet test. The effect on the HF-triplet test of varying presentation method (professional or cheap headphones and loudspeakers) was small for the NH group and somewhat larger, but nonsignificant for the hearing-impaired group. Test repetition produced a moderate, significant learning effect for the first and second retests, but was small and nonsignificant for further retesting. The learning effect was about two times larger for the HF-CVC test than for the HF-triplet test. The sensitivity of both new tests for high-frequency hearing loss was similar, with an 87% true-positive and 7% false-positive ratio for detecting an average high-frequency hearing loss of 20 dB or more. CONCLUSIONS: The new HF-triplet and HF-CVC tests provide a sensitive and accurate method for detecting high-frequency hearing loss. The tests may signal developing hearing impairment at an early stage. The HF-triplet is preferred over the HF-CVC test because of its smaller learning effect, smaller error rate, greater simplicity, and lower cultural dependency.

The role of cigarette smoking and liver enzymes polymorphisms in anti-tuberculosis drug-induced hepatotoxicity in Brazilian patients.

Tuberculosis (TB) is still a major health concern and side-effects related to the treatment, especially drug-induced hepatotoxicity (DIH), should be better investigated. In the present study, a possible association between anti-TB DIH and cigarette smoking, N-acetyltransferase 2 (NAT2), Cytochrome P450 2E1 (CYP2E1) and Cytochrome P450 3A4 (CYP3A4) genotypes was studied in 131 TB Brazilian patients. The NAT2 and CYP3A4 genetic polymorphisms were determined using a polymerase chain reaction (PCR) direct sequencing approach and genetic polymorphisms of CYP2E1 gene were determined by restriction fragment length polymorphism (RFLP). The risk of anti-TB DIH was lower in rapid/intermediate acetylators when compared to slow acetylators (OR: 0.34, CI 95: 0.16-0.71; p < 0.01). A decreased risk of developing anti-TB DIH was also observed in active smokers when compared to non-smokers (OR: 0.28, 95 CI: 0.11-0.64; p < 0.01). Significant association between CYP3A4 genotypes and hepatotoxicity was not observed, as well as between CYP2E1 genotype and hepatotoxicity, whose frequency of patients with wild homozygous was more prevalent. The anti-TB drugs interactions with smoking on hepatotoxicity, as well as the NAT2 phenotype, may require to adjust therapeutic regimen dosages or alarm in case of adverse event developments.

Anorexia e bulimia – corpo perfeito versus morte / Anorexia and bulimia – perfect body versus death

A anorexia nervosa e a bulimia nervosa são transtornos alimentares (TA) de difícil tratamento e de alta morbidade. OPrograma de Transtornos Alimentares (AMBULIM) do IPq-FMUSP caracteriza-se como o primeiro centro brasileiro multidisciplinarpara o tratamento, ensino e pesquisa da área. O atendimento embasa-se em ações multidisciplinares envolvendo,essencialmente, o acompanhamento médico, nutricional e psicológico. A atividade física merece atenção, poishá evidências da associação da dependência ao exercício com os TA. Observamos um processo lento e gradativo, como comprometimento da saúde física, emocional e social desse paciente, com uma recusa mórbida em ganhar peso. Suascrenças pessoais, muitas vezes, embasam-se no fato de que “ser magro(a)”, “estar magro(a)” é a chave para o seu sucessopessoal, afetivo e social. A expectativa de corpo difundida na sociedade contemporânea, caracterizada por uma noção deperfeição ligada à magreza, acaba por influenciar a imagem corporal, elemento essencial na etiologia dos TA. A mídia,por sua vez, oferece instruções explícitas sobre como atingir o ideal de beleza, promovendo a crença de que as pessoaspodem, e de fato devem, controlar sua forma e peso corporais. O trabalho desenvolvido pelo profissional da saúde com opaciente que desenvolve TA é intenso e repleto de desafios, devendo ir além da intervenção assistencial. É esperado quepossa compartilhar seus conhecimentos com a população e informá-la acerca dos riscos e formas de cuidados, evitando,assim, que o TA seja um dos caminhos trilhado por muitos jovens.

Nervous anorexia and nervous bulimia are food disturbances (FD) of difficult treatment and of rise morbidity. The Programof Food Disturbances (Ambulim) of IPq-FMUSP is the first multidisciplinary Brazilian center for the treatment, teachingand research of the area. The service is based on multidisciplinary actions integrating essentially medical, nutritional andpsychological assistance. Physical activity is considered, since there are evidences of the association of dependence toexercise with FD. We observe a slow and gradual process leading to physical, emotional and social health worsening of apatient, with a morbid refusal to gaining weight. Her personal beliefs very often are based on the fact that “to be thin”, “staythin” is the key for her personal, affective and social success. The expectation about the body spread in the contemporarysociety, characterized by a notion of perfection connected to slimness, influences the physical image, essential element theetiology of FD. The media, by their turn, offer explicit instructions about how to reach the ideal of beauty, promoting thebelief that persons can, and in fact have to, to control his physical condition and weight. The work developed by a healthprofessional with a patient who develops FD is intense and full with challenges, and must go beyond health care. It is expectedthat professionals could share their knowledge with the population, warning it about the risks and care modalitiesin order to prevent FDs to be a life style choice for young people.

Risk factors in the development of stem cell therapy.

Stem cell therapy holds the promise to treat degenerative diseases, cancer and repair of damaged tissues for which there are currently no or limited therapeutic options. The potential of stem cell therapies has long been recognised and the creation of induced pluripotent stem cells (iPSC) has boosted the stem cell field leading to increasing development and scientific knowledge. Despite the clinical potential of stem cell based medicinal products there are also potential and unanticipated risks. These risks deserve a thorough discussion within the perspective of current scientific knowledge and experience. Evaluation of potential risks should be a prerequisite step before clinical use of stem cell based medicinal products.The risk profile of stem cell based medicinal products depends on many risk factors, which include the type of stem cells, their differentiation status and proliferation capacity, the route of administration, the intended location, in vitro culture and/or other manipulation steps, irreversibility of treatment, need/possibility for concurrent tissue regeneration in case of irreversible tissue loss, and long-term survival of engrafted cells. Together these factors determine the risk profile associated with a stem cell based medicinal product. The identified risks (i.e. risks identified in clinical experience) or potential/theoretical risks (i.e. risks observed in animal studies) include tumour formation, unwanted immune responses and the transmission of adventitious agents.Currently, there is no clinical experience with pluripotent stem cells (i.e. embryonal stem cells and iPSC). Based on their characteristics of unlimited self-renewal and high proliferation rate the risks associated with a product containing these cells (e.g. risk on tumour formation) are considered high, if not perceived to be unacceptable. In contrast, the vast majority of small-sized clinical trials conducted with mesenchymal stem/stromal cells (MSC) in regenerative medicine applications has not reported major health concerns, suggesting that MSC therapies could be relatively safe. However, in some clinical trials serious adverse events have been reported, which emphasizes the need for additional knowledge, particularly with regard to biological mechanisms and long term safety.

Avaliação da microinfltração bacteriológica em implantes hexágono externo com diferentes superfícies de parafuso / Bacterial microleakage in hexagonal implants with different screw surface

OBJETIVO: Avaliar a microinfltração bacteriana na interface entre implantes hexágono externo (HE) e pilares com diferentes tipos de parafusos. MATERIAIS E MÉTODOS: Foram selecionados 20 implantes HE e respectivo pilar, divididos em 2 grupos em função do tipo de parafuso do pilar (n=10). PT: Parafuso de Titânio e PDLC: Parafuso de Diamond Like Carbon (DLC). Uma suspensão bacteriana de Escherichia coli ATCC 35218 foi preparada a uma densidade padrão de 0,5 McFarland para inoculação de 0,5 µL de suspensão no interior dos implantes. Todos os pilares foram apertados com torque de 32 N seguindo recomendações do fabricante. A microinfltração foi avaliada pela análise da claridade da suspensão a cada 24 horas durante 14 dias. Ao final deste período a viabilidade da bactéria foi verifcada. RESULTADOS: Durante o período de acompanhamento nenhuma das amostras apresentou microinfltração bacteriana. Após 14 dias a viabilidade bacteriana foi comprovada. CON-CLUSÃO: Considerando as limitações deste estudo, pode-se concluir que não foi observada a microinfltração bacteriana na interface pilar/ implante nos grupos avaliados e não foi possível estabelecer a infuência de parafusos com diferentes superfícies nesta microinfltração.

The aim of this study was to evaluate the bacterial microleakage at the interface between external hexagon implant (HE) and abutments with diferent types of screws. 20 implants and respective abutments had been selected, divided into 2 groups, depending on the abutment screw (n=10): Titanium screw (PT) and "Diamond Like Carbon" DLC Screw (PDLC). Escherichia coli bacterial suspension ATCC 35218 was prepared at a density 0,5 McFarland standard for suspension inoculation of 0.5 mL in the inner of the implants. All abutments were tightened with 32 N following the manufacturer's recommendations. Microleaka-ge was assessed the clarity of the suspension every 24 hours for 14 days. To the end of this period the viability of the bacterium was verifed. At the time of accompaniment none of the samples presented bacterial microleakage. Microleakage was assessed the clarity of the suspension every 24 hours for 14 days. There-after the viability of bacteria was found. During the monitoring period none of the samples showed bacterial microleakage. After 14 days the bacterial viability was confrmed. Considering the limitations of this study, it can conclude that the Bacterial leakage was not observed in the abutment/implant interface in the evaluated groups and was unable to establish the infuence of screws with diferent surfaces in this microleakage.

Avaliação comparativa da microinfiltração bacteriológica na interface pilar/implante em implantes hexágono externo com 10 e 20Ncm de torque / Comparative evaluation of the bacteriological microleakage in the implant/abutment interface in external hexagon implants with 10 and 20Ncm torque

O objetivo deste estudo foi avaliar a infltração na interface entre implantes hexágono externo (HE) e pilar cônico inseridos com diferentes torques. Uma suspensão bacteriana de Escherichia coli ATCC 35218 foi preparada em caldo nutritivo de Brain Heart Infusion a uma densidade padrão de 0,5 McFarland para inoculação dos implantes. Na primeira fase do experimento foram utilizados nove implantes (HE) e respectivo parafuso e pilar Cônico, divididos aleatoriamente em 3 grupos com diferentes volumes de inoculação da suspensão bacteriana (n=3). V0,5: 0,5 µL; V1,0: 1,0 µL e V1,5: 1,5 µL. Todos os implantes foram apertados com torque recomendado pelo fabricante. Na segunda fase do experimento foram utilizados 18 implantes e componentes semelhantes à fase 1. Estes foram inoculados com 0,5 µL de suspensão bacteriana e divididos em grupos apertados com diferentes torques (n=9). T10: 10 Ncm e T20: 20 Ncm. Os conjuntos foram avaliados pela análise da claridade da solução a cada 24 horas por 14 dias. Ao fnal deste período a viabilidade da bactéria foi verifcada. O teste de Kruskal-Wallis foi realizado para comparação entre os grupos (p<0,05). Na primeira fase V1,0 e V1,5 apresentaram indicativo de contaminação bacteriana em todas as amostras após 24 hs. Na segunda fase duas amostras do T10 e uma do T20 apresentaram resultado positivo para contaminação bacteriana. Os resultados mostraram que a intensidade do torque não infuenciou estaticamente na microinfiltração bacteriana em implantes HE. Após 14 dias a viabilidade bacteriana foi confirmada.

The aim of this study was to evaluate the infiltration at the interface between implant external hexagon (HE) and conical pillar inserted with different torques. A bacterial suspension of Escherichia coli ATCC 35 218 was prepared in nutrient broth of Brain Heart Infusion at a density of 0.5 McFarland standard for inoculation in the implants. In the first phase of the experiment, nine implants (HE) and its tapered abutment screw were randomly divided into three groups with diferent volumes of inoculation of bacterial suspension (n = 3). V0, 5: 0.5 mL, V1, 0: 1.0 mL and V1, 5: 1.5 mL. All implants were tightened with a recommended torque by the manufacturer. In the second phase of the experiment 18 implants and components were used similar to Phase 1. These were inoculated with 0.5 mL of bacterial suspension and divided into groups with diferent torques tight (n = 9). T10: 10 Ncm and T20: 20 Ncm. The sets were evaluated by the clarity of the solution every 24 hours for 14 days. Thereafter the viability of bacteria was found. The Kruskal-Wallis test was performed for comparison between groups (p < 0.05). In the first stage V1, and V 1, 5 presented indications of bacterial contamination in all samples after 24 hours. In the second phase of the two samples of T10 and T20 were positive for bacterial contamination. The results showed that the intensity of torque did not influence the microleakage statically bacterial HE implants. After 14 days the bacterial viability was confirmed.

Multiple sclerosis retrovirus particles and recombinant envelope trigger an abnormal immune response in vitro, by inducing polyclonal Vbeta16 T-lymphocyte activation.

A retroviral element (MSRV) defining a family of genetically inherited endogenous retroviruses (HERV-W) has recently been characterized in cell cultures from patients with multiple sclerosis (MS). To address the possible relationship with MS, direct detection of circulating virion RNA was proposed but revealed technically difficult to perform in standardized conditions, in the face of multiple endogenous HERV-W copies. A parallel approach has evaluated MSRV potential pathogenicity in relation to characteristic features of multiple sclerosis, in particular, T-lymphocyte-mediated immunopathology. We report here that MSRV particles induce T-lymphocyte response with a bias in the Vbeta16 chain usage in surface receptor, whatever the HLA DR of the donor. A recombinant MSRV envelope-but not core-protein reproduced similar nonconventional activation. Molecular analysis of Vbeta CDR3 showed that Vbeta16 expansions are polyclonal. Our results thus provide evidence that MSRV envelope protein can trigger an abnormal immune response with similar characteristics to that of superantigens.