The ORNATE India Project: United Kingdom-India Research Collaboration to tackle visual impairment due to diabetic retinopathy.

INTRODUCTION: The ORNATE India project is funded by the UK Research and Innovation (UKRI) through the Global Challenges Research Fund. The aim is to build research capacity and capability in India and the UK to tackle global burden of diabetes-related visual impairment. As there are over 77 million people with diabetes in India, it is challenging to screen every person with diabetes annually for sight-threatening diabetic retinopathy (DR). Therefore, alternate safe approaches need to be developed so that those at-risk of visual impairment due to DR is identified promptly and treated. METHODS: The project team utilised diverse global health strategies and research methods to co-design work packages to build research capacity and capability to ensure effective, affordable and efficient DR services are made available for the population. The strategies and methods employed included health system strengthening; implementation science; establishing care pathways; co-designing collaborative studies on affordable technologies, developing quality standards and guidelines to decrease variations in care; economic analysis; risk modelling and stratification. Five integrated work packages have been developed to deal with all aspects of DR care. These included implementation of a DR screening programme in the public health system in a district in Kerala, evaluating regional prevalence of diabetes and DR and assessing ideal tests for holistic screening for diabetes and its complications in 20 areas in India, utilising artificial intelligence on retinal images to facilitate DR screening, exploring biomarker and biosensor research to detect people at risk of diabetes complications, estimating cost of blindness in India and risk modelling to develop risk-based screening models for diabetes and its complications. A large collaborative network will be formed to propagate research, promote shared learning and bilateral exchanges between high- and middle-income countries to tackle diabetes-related blindness.

Milk production responses to different strategies for feeding supplements to grazing dairy cows.

Milk production responses of grazing cows offered supplements in different ways were measured. Holstein-Friesian cows, averaging 45 d in milk, were allocated into 8 groups of 24, with 2 groups randomly assigned to each of 4 feeding strategies. These were control: cows grazed a restricted allowance of perennial ryegrass pasture supplemented with milled wheat grain fed in the milking parlor and alfalfa hay offered in the paddock; FGM: same pasture and allowance as the control supplemented with a formulated grain mix containing wheat grain, corn grain, and canola meal fed in the parlor and alfalfa hay fed in the paddock; PMRL: same pasture and allowance as the control, supplemented with a PMR consisting of the same FGM but mixed with alfalfa hay and presented on a feed pad after each milking; and PMRH: same PMR fed in the same way as PMRL but with a higher pasture allowance. For all strategies, supplements provided the same metabolizable energy and grain:forage ratio [75:25, dry matter (DM) basis]. Each group of 24 cows was further allocated into 4 groups of 6, which were randomly assigned to receive 8, 12, 14, or 16 kg of DM supplement/cow per d. Thus, 2 replicated groups per supplement amount per dietary strategy were used. The experiment had a 14-d adaptation period and a 14-d measurement period. Pasture allowance, measured to ground level, was approximately 14 kg of DM/d for control, FGM, and PMRL cows, and 28 kg of DM/d for the PMRH cows, and was offered in addition to the supplement. Positive linear responses to increasing amounts of supplement were observed for yield of milk, energy-corrected milk, fat, and protein for cows on all 4 supplement feeding strategies. Production of energy-corrected milk was greatest for PMRH cows, intermediate for FGM and PMRL cows, and lowest for control cows. Some of these differences in milk production related to differences in intake of pasture and supplement. Milk fat concentration decreased with increasing amount of supplement for all feeding strategies, but the decline was most marked for the control cows. Milk protein concentration increased for all groups as the amount of supplement increased, but was greater for FGM, PMRL, and PMRH cows than control cows. It is concluded that when supplements are fed to grazing dairy cows, inclusion of corn grain and canola meal can increase milk production even at similar metabolizable energy intakes, and that it does not matter whether these supplements are fed as a PMR or in the parlor and paddock.

Effects of different strategies for feeding supplements on milk production responses in cows grazing a restricted pasture allowance.

Milk production responses of grazing cows offered supplements in different ways were measured. Holstein-Friesian cows, averaging 227 d in milk, were allocated into 6 groups of 36, with 2 groups randomly assigned to each of 3 feeding strategies: (1) cows grazed perennial ryegrass pasture supplemented with milled barley grain fed in the milking parlor and pasture silage offered in the paddock (control); (2) same pasture and allotment supplemented with the same amounts of milled barley grain and pasture silage, but presented as a mixed ration after each milking (PMR 1); and (3) same pasture and allotment, supplemented with a mixed ration of milled barley grain, alfalfa hay, corn silage, and crushed corn grain (PMR 2). For all strategies, supplements provided the same metabolizable energy and grain:forage ratio. [75:25, dry matter (DM) basis]. Each group of 36 cows was further allocated into 4 groups of 9, which were assigned to receive 6, 8, 10, or 12 kg of supplement DM/cow per day. Thus, there were 2 replicated groups per supplement amount per dietary strategy. The experiment had a 14-d adaptation period and an 11-d measurement period. Pasture allotment was approximately 14 kg of DM/d for all cows and was offered in addition to the supplement. Positive quadratic responses to increasing amounts of supplement were observed for yield of milk, energy-corrected milk (ECM), and fat and protein, and positive linear responses for concentrations of fat and protein for cows on all 3 supplement feeding strategies. No difference existed between feeding strategy groups in yield of milk, ECM, or protein at any amount of supplement offered, but yield and concentration of fat was higher in PMR 2 cows compared with control and PMR 1 cows at the highest amounts of supplementation. Responses in marginal ECM production per additional kilogram of supplement were also greater for PMR 2 than control and PMR 1 cows when large amounts of supplement were consumed. For all diets, marked daily variation occurred in ruminal fluid volatile fatty acids and pH, especially in cows fed the largest amounts of supplement. It was concluded that when supplements are fed to grazing dairy cows, a simple mix of grain and pasture silage has no benefit over traditional strategies of feeding grain in the parlor and forage in the paddock. However, yield of milk fat and marginal milk production responses can be greater if the strategy uses an isoenergetic ration that also contains alfalfa hay, corn silage, and corn grain.

Raspberry leaf in pregnancy: its safety and efficacy in labor.

OBJECTIVE: Many women consume the raspberry leaf herb during their pregnancies in the belief that it shortens labor and makes labor "easier." METHODOLOGY: Because of the paucity of research regarding this herb, particularly in relation to pregnancy and birth, the authors undertook a double-blind, randomized, placebo-controlled trial. The sample consisted of 192 low-risk, nulliparous women who birthed their babies between May 1999 and February 2000 at a large tertiary-level hospital in Sydney, Australia. The aim of the study was to identify the effect and safety of raspberry leaf tablets (2 x 1.2 g per day), consumed from 32 weeks' gestation until labor, on labor and birth outcomes. RESULTS: Raspberry leaf, consumed in tablet form, was found to cause no adverse effects for mother or baby, but contrary to popular belief, did not shorten the first stage of labor. The only clinically significant findings were a shortening of the second stage of labor (mean difference = 9.59 minutes) and a lower rate of forceps deliveries between the treatment group and the control group (19.3% vs. 30.4%). No significant relationship was found between tablet consumption and birth outcomes. CONCLUSION: The lack of significant differences between the groups on measures expected to demonstrate the effect of raspberry leaf ingestion during pregnancy on labor prompted consideration of the issue of effectiveness of dosage level. Suggestions for further research are offered.

Transcriptional repression by blimp-1 (PRDI-BF1) involves recruitment of histone deacetylase.

B-lymphocyte-induced maturation protein (Blimp-1) is a transcriptional repressor that is considered to be a master regulator of terminal B-cell development because it is sufficient to trigger differentiation in the BCL(1)-cell model. Transcription of the c-myc gene is repressed by Blimp-1 during B-cell differentiation. In this study, we have explored the mechanism by which Blimp-1 represses transcription by using Gal4-fusion protein assays and assays in which Blimp-1 represses the natural c-myc promoter. The results show that Blimp-1 represses the c-myc promoter by an active mechanism that is independent of the adjacently bound activator YY1. Blimp-1 contains two regions that independently associate with histone deacetylase (HDAC) and endogenous Blimp-1 in nuclear extracts binds in vitro to the c-myc Blimp-1 site in a complex containing HDAC. The functional importance of recruiting HDAC for Blimp-1-dependent repression of c-myc transcription is supported by two experiments. First, the HDAC inhibitor tricostatin A inhibits Blimp-1-dependent repression in cotransfection assays. Second, a chromatin immunoprecipitation assay shows that expression of Blimp-1 causes deacetylation of histone H3 associated with the c-myc promoter, and this deacetylation depends on the Blimp-1 binding site in the c-myc promoter.

Characterization and immunolocalization of a cytosolic calcium-binding protein from Brassica napus and Arabidopsis pollen.

Two low-molecular-weight proteins have been purified from Brassica napus pollen and a gene corresponding to one of them has been isolated. The gene encodes an 8.6-kD protein with two EF-hand calcium-binding motifs and is a member of a small gene family in B. napus. The protein is part of a family of pollen allergens recently identified in several evolutionarily distant dicot and monocot plants. Homologs have been detected in Arabidopsis, from which one gene has been cloned in this study, and in snapdragon (Antirrhinum majus), but not in tobacco (Nicotiana tabacum). Expression of the gene in B. napus was limited to male tissues and occurred during the pollen-maturation phase of anther development. Both the B. napus and Arabidopsis proteins interact with calcium, and the potential for a calcium-dependent conformational change was demonstrated. Given this affinity for calcium, the cloned genes were termed BPC1 and APC1 (B. napus and Arabidopsis pollen calcium-binding protein 1, respectively). Immunolocalization studies demonstrated that BPC1 is found in the cytosol of mature pollen. However, upon pollen hydration and germination, there is some apparent leakage of the protein to the pollen wall. BPC1 is also concentrated on or near the surface of the elongating pollen tube. The essential nature of calcium in pollen physiology, combined with the properties of BPC1 and its high evolutionary conservation suggests that this protein plays an important role in pollination by functioning as a calcium-sensitive signal molecule.

Meeting the needs of patients' relatives.

Research into stress experienced by the relatives of patients in intensive care may be equally applicable to general wards. Patients are part of a family group and holistic care should include all family members. All nurses should review their practice in relation to relatives' needs.

Cloning of the gene encoding rat JAK2, a protein tyrosine kinase.

A complete cDNA clone encoding the rat JAK2 protein tyrosine kinase was isolated from an Nb2-SP (rat pre-T lymphoma cell line) cDNA library. The nucleotide (nt) and deduced amino acid (aa) sequences for this clone were determined and an open reading frame of 3399 bp, encoding a protein of a deduced mass of 130 kDa, was found. The coding regions of the rat and murine Jak2 clones share 93.4% nt identity and 97.1% aa identity. Northern analysis demonstrated that the 5-kb mRNA is highly abundant in brain and spleen, less abundant in skeletal muscle and testis, and detectable in kidney, heart, lung and liver. Translation of the rat Jak2 mRNA in rabbit reticulocytes results in a protein which is specifically immunoprecipitated by antibodies (Ab) recognizing JAK2, but not by Ab recognizing JAK1.

The apparent desensitization of student nurses during their professional socialization: a cognitive perspective.

It is argued that the structures and processes of traditional patterns of pre-registration nurse education in the United Kingdom led to an apparent and relative desensitization of student nurses to human need. The processes underpinning this apparent desensitization were those which promoted both a 'compartmentalization' of concepts for theory and concepts for practice in the cognitions of student nurses and their habituation to examples of poor nursing practice. These processes are described and their nursing pedagogical implications are discussed. It is suggested that unless clinical learning environments are deliberately manipulated to foster the construction and utilization of 'appropriate' action schemata, the considerable opportunities offered by the implementation of Project 2000 to improve both nursing education and nursing practice could be wasted. It is further suggested that this deliberate manipulation should include nurse tutors teaching theory and practice in clinical areas if they are seriously concerned to render nursing care more intelligently responsive to human need.

Alpha conditioning as an adjunct treatment for drug dependence: part I.

The effects of alpha conditioning on the habits of four methadone maintained patients were assessed. All four learned some control over alpha activity in the 5-week, 10-session training period. The most striking results, however, related to the subjects' substitution of self-initiated mental states associated with alpha for previously used drug-seeking or self-medicating methods of coping with everday problem situations. All four subject reported a decrease in illicit drug usage and an increased feeling of self-control. Verification of improvement in adjustment and drug abuse was shown by counseling reports and narcotic screens from the maintenance program.