Spatially disaggregated population estimates in the absence of national population and housing census data.

Population numbers at local levels are fundamental data for many applications, including the delivery and planning of services, election preparation, and response to disasters. In resource-poor settings, recent and reliable demographic data at subnational scales can often be lacking. National population and housing census data can be outdated, inaccurate, or missing key groups or areas, while registry data are generally lacking or incomplete. Moreover, at local scales accurate boundary data are often limited, and high rates of migration and urban growth make existing data quickly outdated. Here we review past and ongoing work aimed at producing spatially disaggregated local-scale population estimates, and discuss how new technologies are now enabling robust and cost-effective solutions. Recent advances in the availability of detailed satellite imagery, geopositioning tools for field surveys, statistical methods, and computational power are enabling the development and application of approaches that can estimate population distributions at fine spatial scales across entire countries in the absence of census data. We outline the potential of such approaches as well as their limitations, emphasizing the political and operational hurdles for acceptance and sustainable implementation of new approaches, and the continued importance of traditional sources of national statistical data.

Predominant bacterial species in subgingival plaque in dogs.

BACKGROUND AND OBJECTIVE: The dog has been used extensively for experimental and microbiological studies on periodontitis and peri-implantitis without detailed knowledge about the predominant flora of the subgingival plaque. This study was designed to evaluate the predominant cultivable bacterial species in dogs and compare them phenotypically and genotypically with corresponding human species. MATERIAL AND METHODS: Four subgingival samples were taken from two upper premolars in each of six Labrador retrievers. The samples from each dog were processed for anaerobic culture. From the samples of each dog, the five or six predominating bacteria based on colony morphology were selected and pure cultured. Each of the strains was characterized by Gram stain, anaerobic/aerobic growth and API-ZYM test. Eighteen strains showing clear-cut phenotypic differences were further classified based on DNA sequencing technology. Cross-reactions of DNA probes from human and dog strains were also tested against a panel of both human and dog bacterial species. RESULTS: Thirty-one strains in the dogs were isolated and characterized. They represented 21 different species, of which six belonged to the genus Porphyromonas. No species was found consistently in the predominant flora of all six dogs. Porphyromonas crevioricanis and Fusobacterium canifelinum were the two most prevalent species in predominant flora in dogs. DNA probes from human and dog species cross-reacted to some extent with related strains from humans and dogs; however, distinct exceptions were found. CONCLUSION: The predominant cultural subgingival flora in dogs shows great similarities with the subgingival bacteria from humans at the genus level, but distinct differences at the species level; however, a genetic relatedness could be disclosed for most strains investigated.

A two-tiered approach to long-range climate forecasting.

Long-range global climate forecasts were made by use of a model for predicting a tropical Pacific sea-surface temperature (SST) in tandem with an atmospheric general circulation model. The SST is predicted first at long lead times into the future. These ocean forecasts are then used to force the atmospheric model and so produce climate forecasts at lead times of the SST forecasts. Prediction of seven large climatic events of the 1970s to 1990s by this technique are in good agreement with observations over many regions of the globe.

Wound-related pain is underestimated in patients with diabetic foot ulcers.

Few studies have assessed pain in neuropathic and neuroischaemic foot ulcers. This pilot study found that patients with these ulcers do experience pain, and that the intensity and nature of the pain was similar in both types of ulcer.

Exploring the high-resolution mapping of gender-disaggregated development indicators.

Improved understanding of geographical variation and inequity in health status, wealth and access to resources within countries is increasingly being recognized as central to meeting development goals. Development and health indicators assessed at national or subnational scale can often conceal important inequities, with the rural poor often least well represented. The ability to target limited resources is fundamental, especially in an international context where funding for health and development comes under pressure. This has recently prompted the exploration of the potential of spatial interpolation methods based on geolocated clusters from national household survey data for the high-resolution mapping of features such as population age structures, vaccination coverage and access to sanitation. It remains unclear, however, how predictable these different factors are across different settings, variables and between demographic groups. Here we test the accuracy of spatial interpolation methods in producing gender-disaggregated high-resolution maps of the rates of literacy, stunting and the use of modern contraceptive methods from a combination of geolocated demographic and health surveys cluster data and geospatial covariates. Bayesian geostatistical and machine learning modelling methods were tested across four low-income countries and varying gridded environmental and socio-economic covariate datasets to build 1×1 km spatial resolution maps with uncertainty estimates. Results show the potential of the approach in producing high-resolution maps of key gender-disaggregated socio-economic indicators, with explained variance through cross-validation being as high as 74-75% for female literacy in Nigeria and Kenya, and in the 50-70% range for many other variables. However, substantial variations by both country and variable were seen, with many variables showing poor mapping accuracies in the range of 2-30% explained variance using both geostatistical and machine learning approaches. The analyses offer a robust basis for the construction of timely maps with levels of detail that support geographically stratified decision-making and the monitoring of progress towards development goals. However, the great variability in results between countries and variables highlights the challenges in applying these interpolation methods universally across multiple countries, and the importance of validation and quantifying uncertainty if this is undertaken.

TMEM43/LUMA is a key signaling component mediating EGFR-induced NF-κB activation and tumor progression.

Epidermal growth factor receptor (EGFR) family members play pivotal roles in cell proliferation, differentiation and survival. Overexpression and mutations of EGFRs, or aberrant EGFR signaling are commonly associated with the development of various cancers, where constitutive NF-κB activation is often found to promote the expression of various proteins involved in the proliferation, survival, migration and epithelial-to-mesenchymal transition of cancer cells. However, the mechanism of EGFR-induced NF-κB activation is not fully defined. Here, we used a Bimolecular Fluorescence Complementation-based functional genomics method to perform a high throughput screening and identified TMEM43/LUMA as a critical component in EGFR signaling network, mediating EGFR-induced NF-κB activation. Our data show that EGFR recruits TMEM43 following EGF stimulation. TMEM43 interacts with the scaffold protein CARMA3 and its associating complex to induce downstream NF-κB activation, and plays a critical role in controlling cell survival. TMEM43 deficiency significantly affects colony formation, survival of anoikis-induced cell death, migration and invasion of cancer cells in vitro, as well as tumor progression in vivo. Importantly, higher expression of TMEM43 closely correlates with brain tumor malignancy, and suppression of TMEM43 expression in brain tumor cells inhibited their growth both in vitro and in vivo. Altogether, our studies reveal a crucial link of EGF receptor to NF-κB activation and tumor progression.

Recovery from orbital floor fractures: a prospective study of patients' and doctors' experiences.

This study aimed at investigating the extent to which remaining symptoms and signs troubled patients in the year after suffering from zygomatico-orbital fractures, and whether there was any discrepancy between patients' and doctors' opinions as to the presence of symptoms and signs. Over the course of 1 year, 46 patients were included. Symptoms and clinical findings were registered in a 'doctor's protocol', and patients described self-reported symptoms and signs using a visual analogue scales (VAS) in a questionnaire administered 5 times during the year after injury. The VAS proved to be a useful instrument for evaluating patient discomfort and indicating differences between patients' and doctors' opinions regarding the presence of symptoms and signs. Agreement between the two was good regarding the presence of objective and measurable signs, such as facial asymmetry and diplopia. When it came to sensibility and mouth-opening ability, however, discrepancies were evident. It is desirable that reliable methods for measuring sensibility and evaluating mouth opening are included in follow-up routines. This would increase our knowledge of the course of healing, prognosis and possibilities for the prevention and active treatment of these problems.

17 beta-Estradiol and progesterone concentrations in myometrium of pregnancy and their relationships to concentrations in peripheral plasma.

17 beta-Estradiol (E2) and progesterone (P) concentrations in blood and in the myometrium of human pregnancy at term (n=33) and in a few samples (n=5) around midterm of pregnancy were determined. E2 concentration in the myometrium (per g wet wt) at midterm was lower than the concentration in the plasma (per ml) so that the myometrium to plasma (My:Pl) ratio was 0.7. Relative to plasma concentration, the myometrial E2 increased little from midterm to term so that My:Pl was only 0.2 at term. Although P concentration in the myometrium was much greater than that in the plasma at midterm, My:Pl ratio being 2.2, it was lower than that in plasma at term so that My:Pl ratio was only 0.6. A fairly good correlation between plasma steroids and the myometrial steroids was observed at midterm but was distorted at term, probably due to saturation of the tissue-binding capacity. Steroid concentrations determined on the basis of protein showed a good correlation to the values expressed on the basis of wet weight. Whereas myometrial E2 concentration was significantly influenced by the distance from placenta, P concentration was not.

Levels of free and protein-bound progesterone in plasma during late pregnancy.

Using a filter method, levels of free (unbound) and protein-bound progesterone in blood samples were measured serially from the 23rd week of pregnancy until delivery in 16 healthy women. In addition, total estrogen and progesterone concentrations were determined by radioimmunoassay. The levels of both free and total progesterone increased steadily until the end of pregnancy. Free progesterone increased with advancing pregnancy more in proportion to the total progesterone, as it rose from 6% (of total) at week 24 to 13% at week 40. Both free and total progesterone decreased markedly very soon (2 h) after delivery. However, the corresponding decrease in the level of free progesterone was considerably less, with the result that it rose to 19% of the total, the greatest proportion of free progesterone observed at any time. The levels of both total estrogen and progesterone in plasma increased with advancing pregnancy, and at no time, prior to delivery, was there a significant fall in progesterone or an abrupt rise in estrogen.

Lining of viable and nonviable allogeneic and xenogeneic cardiovascular tissue with cultured adult human venous endothelium.

With the aim of creating a confluent endothelial lining of cultured adult human saphenous vein endothelial cells on cardiovascular bioprosthetic tissues in vitro, we performed seeding on deendothelialized segments of viable or devitalized (in deionized water) human vein, porcine aorta, and bioprosthetic tissues preserved in glutaraldehyde. After being seeded, specimens were kept for 7 days under culture conditions. On glutaraldehyde-preserved tissue, seeding was performed after 3 weeks of elution of glutaraldehyde. Evaluation was performed with hematoxylin-eosin staining, immunohistochemical staining of von Willebrand's factor and of collagen IV-related antigens, and scanning and transmission electron microscopy. The origin of the cells as derived from culture was verified by vital staining with a carbocyanine dye. Evaluation revealed a confluent lining of cultured human saphenous vein endothelial cells similar to native endothelium on both viable and nonviable human and porcine tissues. Collagen IV-related immunoreactivity was demonstrated close to the endothelial cells, corresponding to a de novo-formed basement membrane. Organelles and a basement membrane were demonstrated by transmission electron microscopy. The human saphenous vein endothelial cells seeded on glutaraldehyde-preserved tissues showed initial adherence but rounded up and detached on the second day of culture, probably because of residual glutaraldehyde. This study demonstrates that the native endothelium of allogenic or xenogeneic viable and nonviable vascular tissue may be replaced by cultured endothelium in vitro. The structural similarities with a native endothelium suggest that in vitro endothelialization with cultured autologous endothelial cells may be used to improve performance of cardiovascular bioprostheses.

Reduction of monocyte adhesion to xenogenic tissue by endothelialization: an adhesion molecule and time-dependent mechanism.

Great interest has been shown for the seeding of autologous endothelial cells on prosthetic materials. We investigated the inflammatory and immunogenic properties of xenogeneic tissue before and after seeding with cultured human great saphenous vein endothelial cells in vitro. Adhesion of monocytes to xenogeneic tissue with or without endothelium and the endothelial cell expression of E-selectin, intercellular adhesion molecule 1, vascular adhesion molecule 1, and major histocompatibility complex class II antigens were investigated 1, 3, and 7 days after seeding. Both monocyte adhesion and endothelial adhesion molecule expression were relatively high 1 day after seeding and were significantly lowered after 3 to 7 days. There was no difference between monocyte adhesion and adhesion molecule expression on viable or nonviable xenogeneic tissue. Monocyte adhesion and adhesion molecule expression increased after interleukin-1 beta or interferon-gamma stimulation of the endothelial cells. The results suggest that human endothelial cells exhibit an early proinflammatory and immunogenic activity immediately after seeding. Three and 7 days after seeding, the endothelialized surface is less adhesive for monocytes as compared with nonendothelialized tissue. These findings have implications when cultured or intraoperatively recruited endothelial cells are used clinically.

Rapid visualization of viable and nonviable endothelium on cardiovascular prosthetic surfaces by means of fluorescent dyes.

Increasing interest in endothelialization of synthetic and tissue cardiovascular prostheses in vitro emphasizes the need for simple and rapid methods to evaluate presence of endothelium on surfaces. Scanning electron microscopy is a commonly used method for this purpose. In this study we investigated alternative and more rapid staining methods. Human saphenous vein endothelial cells in culture and on cardiovascular prosthetic materials (pyrolytic carbon, cusps of bioprosthetic heart valves, pig aorta, and expanded polytetrafluoroethylene) were labeled by exposing them to medium containing 5-chloromethylfluorescein diacetate or 1,1-dioctadecyl-3,3,3',3'-tetramethylindo carbocyanine perchlorate. For comparison, specimens were also fixed and processed for scanning electron microscopy. A bright fluorescence of endothelial cells labeled with 5-chlormethylfluorescein diacetate or 1,1-deoctadecyl-3,3,3',3'-tetramethylindo carbocyanine perchlorate wre clearly visualized in culture, on pyrolytic carbon, and on expanded polytetrafluoroethylene. Unfixed, prelabeled cells could be visualized immediately and unlabeled cells could be investigated for viability within 1 hour. Cells seeded on biologic tissue specimens could be visualized within 15 minutes with a modified hematoxylin-eosin staining. We suggest the use of these methods for rapid visualization of endothelium present on surfaces of cardiovascular prosthetic materials where they can partly replace the use of scanning electron microscopy.

In vitro endothelialization of bioprosthetic heart valves provides a cell monolayer with proliferative capacities and resistance to pulsatile flow.

OBJECTIVES: Degeneration of bioprosthetic heart valves has been suggested to be at least partly an immunogenic reaction toward the xenogeneic tissue. An autologous endothelial lining has been proposed to overcome this problem. We examined in vitro endothelialization of such tissue and retention of endothelial cells after exposure to flow resembling the in vivo situation. METHODS: Cultured human saphenous vein endothelial cells were used to in vitro endothelialize photo-oxidized bioprosthetic heart valves. The endothelialized valves were mounted in a specially designed flow device, creating a pulsatile flow through the valve. Maintenance of a confluent cell layer and deposition of basement membrane markers were determined with immunohistochemical labeling. RESULTS: Labeling of the main components of the basement membrane, laminin and collagen type IV, was verified within 6 hours after in vitro endothelialization. Under static conditions, 4-mm wide denudations were completely re-endothelialized in 4 days, which was similar to the growth rate on gelatin-coated cell culture plastic, which served as a control material. After exposure of endothelialized valves to pulsatile flows for 24 hours (80 beats/min, 3.4 L/min), there were minimal cell losses from the bioprostheses. The cell layer adapted to the pulsatile flow, as verified by rearrangement of morphology and intracellular stress fibers. CONCLUSIONS: This study shows the feasibility of in vitro endothelialization of photo-oxidized bioprosthetic heart valves. The cells are able to withstand a pulsatile flow in vitro, to develop basement membrane-like structures, and to re-endothelialize denuded areas. This technology may be used to enhance the performance of bioprosthetic heart valve prostheses.

In vitro endothelialization of photooxidatively stabilized xenogeneic pericardium.

The possibility of improving the performance of heart valve bioprostheses and vascular biografts by means of preendothelialization with cultured autologous cells has been suggested. Such culture techniques are available, but the glutaraldehyde-preserved heart valve prostheses used clinically appear cytotoxic. Recently, dye-mediated photooxidation has been reported to stabilize pericardial tissue, possibly through the cross-linking of collagen fibrils. We have seeded cultured adult human saphenous vein endothelial cells (HSVECs) onto photooxidatively stabilized tissue and investigated the morphologic characteristics 7 days later. A confluent lining of cultured HSVECs similar to native endothelium was demonstrated by scanning electron microscopy. The presence of von Willebrand's factor, an integrin located at the interendothelial cell contacts (PECAM/CD 31), and the basement membrane component collagen type IV was demonstrated using monoclonal antibodies. The results were similar for the HSVECs seeded onto both bovine and porcine pericardial tissues. The results clearly indicate that the dye-mediated photooxidation technique produces a tissue that is cell compatible. Provided the HSVECs remain attached and retain antithrombotic and antiinflammatory properties, this appears to be a feasible way of endothelializing bioprosthetic heart valves before implantation.

Elevations in antidiuretic hormone and aldosterone as possible causes of fluid retention in the Maze procedure.

BACKGROUND: Reduced levels of atrial natriuretic peptide (ANP) has been suggested as a cause of fluid retention after combined Maze and valvular surgery. This study aimed to assess hormonal activation in the perioperative setting of isolated Maze procedures. METHODS: Changes in ANP, brain natriuretic peptide (BNP), antidiuretic hormone (ADH), aldosterone, and angiotensin II were measured in 16 patients (mean age 53+/-9 years) without concomitant heart disease undergoing the Maze (III) procedure. Ten matched patients (mean age 56+/-9 years) undergoing multivessel coronary artery bypass grafting served as controls. Measurements with hemodynamic correlates were obtained at baseline and after ventricular pacing (100 stimulations/minute), directly preoperatively, postoperatively and the first postoperative day. Weight gain and diuretic requirements were recorded. RESULTS: The major differences in hormonal response were significantly higher plasma levels of ADH (Maze preoperative 1.1+/-0.4, postoperative 24.9+/-16.7 pmol/L; controls preoperative 1.1+/-0.1, postoperative 3.7+/-3.5 pmol/L) and aldosterone (Maze preoperative 106+/-94, postoperative 678+/-343 pmol/L; controls preoperative 124+/-79, postoperative 171+/-93 pmol/L) in the Maze group on the first postoperative day (p < 0.001). Preoperative baseline plasma levels of ANP and pulmonary capillary wedge pressures (PCWP) were higher in the Maze group but this difference was abolished by pacing, and postoperatively, ANP levels changed in parallel to the PCWP in both groups. Diuretic requirements were significantly higher in the Maze group. CONCLUSIONS: Substantial increases in ADH and aldosterone were observed after the Maze procedure, indicating these hormones as important determinants in postoperative fluid retention. The role for ANP in this setting may be a less prominent than previously reported.

Inotropic effects of calcitonin gene-related peptide, vasoactive intestinal polypeptide and somatostatin on the human right atrium in vitro.

Inotropic responses to calcitonin gene-related peptide (alpha-CGRP), substance P, neurokinin A, capsaicin, neuropeptide Y, vasoactive intestinal polypeptide (VIP) and somatostatin (Som, 14 and 28 were analysed using the isolated, electrically driven auricle of the human right atrium. alpha-CGRP and VIP stimulated atrial contractility concentration dependently. alpha-CGRP was about 10-fold more potent than noradrenaline (NA) as an inotropic agent. Phentolamine plus metoprolol decreased the atrial response to NA significantly while the alpha-CGRP effect remained unchanged. Som did not influence the basal contractility of the atria, which, however, was inhibited by acetylcholine (ACh). ACh, Som 14 and Som 28 inhibited the NA-induced stimulation of atrial contractility, whereby Som 28 was more potent than Som 14. The inhibitory effects of ACh were completely blocked by atropine which did not influence the response to Som. Capsaicin, substance P, neurokinin A, neuropeptide Y (NPY) and the NPY fragments 1-19 and 26-36 did not induce any changes in contractility of the electrically driven human atrium. The present results suggest that some of the recently discovered neuropeptides (alpha-CGRP, VIP and Som) could be of importance in the regulation of cardiac contractility in man.

Staphylococcus saprophyticus found to be a common contaminant of food.

The mode of transmission of Staphylococcus saprophyticus, a urinary tract pathogen, was investigated in three related studies. The presence of this organism was sought, during a period of 1 year, in 1331 specimens of various foods, in 920 beef and pork carcasses and on 107 cultures which had been inoculated directly from abattoir workers' protective gloves. Staphylococcus saprophyticus was found to contaminate 16.4% of the various food samples with a high prevalence of 34% in raw beef and pork. It was common in both domestic and imported raw meat products. There was no seasonal variation in the presence of S. saprophyticus in the samples obtained from carcasses. The bacterium was found in 69% of all cultures from the workers' protective gloves. We conclude that S. saprophyticus, originating from slaughtered animals, contaminates food and eventually colonizes the human intestinal tract.

Menstrual bleeding with copper-covered intrauterine contraceptive devices.

PIP: Menstrual blood loss was measured before and during use of 2 types of copper IUDs--TCu 200 and Cu-7 200--in 82 women aged 19-45 years. Of the women who reported normal menstrual periods, 50 were fitted with the TCu 200 and 16 received a Cu-7 200 IUD. The remaining 16 women, who described their periods as profuse, were fitted with a TCu 200 device. Blood loss was measured during 1-2 menstrual periods immediately prior to IUD insertion and during 2-3 periods during IUD use. In addition, study subjects were interviewed regarding side effects after they had been using the devise for 4-12 months. The amount of blood loss during the control menstrual periods was 37.2 + or - 3.6 ml in women later fitted with the TCu 200 and 35.7 + or - 5.2 ml in women fitted with the Cu-7 200 device. In the 3rd group--women who reported their menstrual blood loss as profuse--the amount of blood loss was 97.1 + or - 18.3 ml during the control cycle. In the TCu 200 group, blood loss after insertion of the device averaged 56.1 ml in the 1st menstrual period of IUD use, 60.8 ml in the 2nd period, and 44.8 ml in the 3rd period, for an overall average of 53.6 ml. In the Cu-7 200 group, blood loss after insertion averaged 44.4 ml in the 1st period after IUD insertion, 38.0 ml in the 2nd period, and 38.8 ml in the 3rd period, for an overall average of 39.7 ml. In the menorrhagia group, blood loss after IUD insertion was 113.3 ml in the 1st menstrual period after insertion, but declined to 103 ml in the 2nd and 3rd periods, for an overall average blood loss of 106.5 ml. The initial increase in blood loss after IUD insertion was associated with a slight fall in hemoglobin in all groups. At follow up after 4-12 months of IUD use, 32 subjects reported prolongation of menstruation while the remaining 50 indicated their period was unchanged or even shorter. It is concluded that the use of copper IUDs reduces the need for medication. Menstrual blood loss does increase in the 1st 2 periods, but by only half of that reported after insertion of non-copper IUDs.^ieng

Endothelialization of mechanical heart valves in vitro with cultured adult human cells.

Previous studies have shown that in vitro endothelialization of synthetic vascular prostheses with cultured autologous cells leads to a reduction in their thrombogenicity. It is possible that pre-endothelialization of mechanical heart valve prostheses would have a similarly advantageous effect. In this study we have therefore investigated the possibility of creating an endothelium layer on mechanical heart valve prostheses by seeding in vitro with cultured adult human endothelial cells. After harvest, endothelial cells were cultured for two to three weeks before seeding of six valves (three Monostrut, three CarboMedics bileaflet) with 1.5-2 x 10(5) cells/cm2. The valves were then kept under culture conditions for seven days. A confluent lining of cultured endothelial cells was observed in the scanning electron microscope on the parts covered with pyrolitic carbon, e.g. disc, leaflet, flange, and on carbon coated sewing rings. Untreated sewing rings showed a discontinuous endothelial lining. On the metallic surface only a few scattered cells were observed. Two endothelialized bileaflet valves were implanted in the mitral position in pig and permitted to perform physiologic work for one hour. A mainly continuous endothelium remained on the carbon covered sewing rings but the endothelium detached from the leaflets and flanges. This study demonstrates that mechanical heart valves do not contain cytotoxic compounds. It also demonstrates that cultured adult human endothelial cells are able to form a monolayer when seeded on monostrut and bileaflet valve prostheses. A significant number of cells remain on the sewing ring after pulsatile flow in the mitral position but not on the polished pyrolitic carbon surfaces.(ABSTRACT TRUNCATED AT 250 WORDS)