Beneficial changes in rumen bacterial community profile in sheep and dairy calves as a result of feeding the probiotic Bacillus amyloliquefaciens H57.

AIMS: The probiotic Bacillus amyloliquefaciens H57 increased weight gain, increased nitrogen retention and increased feed intake in ruminants when administered to the diet. This study aims to develop a better understanding of this probiotic effect by analysing changes in the rumen prokaryotic community. METHODS AND RESULTS: Sequencing the 16S rRNA gene PCR amplicons of the rumen microbiome, revealed that ewes fed H57 had a significantly different rumen microbial community structure to Control sheep. In contrast, dairy calves showed no significant differences in rumen community structure between treatment groups. In both instances, H57 was below detection in the rumen community profile and was only present at low relative abundance as determined by qPCR. CONCLUSIONS: The altered rumen microbial community in sheep likely contributes to increased weight gain through more efficient digestion of plant material. As no change occurred in the rumen community of dairy calves it is suggested that increased weight gain may be due to changes in community function rather than structure. The low relative abundance of H57 as determined by qPCR, suggests that weight gain was not directly mediated by the probiotic, but rather by influencing animal behaviour (feed consumption) and/or altering the native rumen community structure or function. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides a novel look at the rumen prokaryotic community in both sheep and dairy calves when fed H57. These findings improve our understanding for the potential rumen community involvement in H57-enabled weight gain. The study reveals that the probiotic B. amyloliquefaciens H57 is capable of benefiting ruminants without colonizing the rumen, suggesting an indirect mechanism of action.

The Internal Medicine Subinternship--Now More Important than Ever: A Joint CDIM-APDIM Position Paper.

For decades, the internal medicine (IM) subinternship has served as a critical interface between undergraduate and graduate medical education. As such, the vast majority of U.S. medical schools offer this rotation to help students prepare for post-graduate training. Historically an experiential rotation, a formal curriculum with specific learning objectives was eventually developed for this course in 2002. Since then, graduate medical education (GME) has changed significantly with the regulation of duty hours, adoption of competency-based education, and development of training milestones and entrustable professional activities. In response to these and many other changes to residency training and medical practice, in 2010, the Association of Program Directors in Internal Medicine (APDIM) surveyed its members-with input from the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force-to determine which core skills program directors expected from new medical school graduates. The results of that survey helped to inform a joint CDIM-APDIM committee's decision to re-evaluate the goals of the IM subinternship in an effort to enhance the transition from medical school to residency. This joint committee defined the minimum expectations of what constitutes an IM subinternship rotation, proposed recommended skills for IM subinterns, and discussed challenges and future directions for this crucial course.

Global Governance for Health: how to motivate political change?

In this article, we address a central theme that was discussed at the Durham Health Summit: how can politics be brought back into global health governance and figure much more prominently in discussions around policy? We begin by briefly summarizing the report of the Lancet - University of Oslo Commission on Global Governance for Health: 'The Political Origins of Health Inequity' Ottersen et al. In order to provide compelling evidence of the central argument, the Commission selected seven case studies relating to, inter alia, economic and fiscal policy, food security, and foreign trade and investment agreements. Based on an analysis of these studies, the report concludes that the problems identified are often due to political choices: an unwillingness to change the global system of governance. This raises the question: what is the most effective way that a report of this kind can be used to motivate policy-makers, and the public at large, to demand change? What kind of moral or rational argument is most likely to lead to action? In this paper we assess the merits of various alternative perspectives: health as an investment; health as a global public good; health and human security; health and human development; health as a human right; health and global justice. We conclude that what is required in order to motivate change is a more explicitly political and moral perspective - favouring the later rather than the earlier alternatives just listed.

Rods-cones and melanopsin detect light and dark to modulate sleep independent of image formation.

Light detected in the retina modulates several physiological processes including circadian photo-entrainment and pupillary light reflex. Intrinsically photosensitive retinal ganglion cells (ipRGCs) convey rod-cone and melanopsin-driven light input to the brain. Using EEGs and electromyograms, we show that acute light induces sleep in mice during their nocturnal active phase whereas acute dark awakens mice during their diurnal sleep phase. We used retinal mutant mouse lines that lack (i) the ipRGCs, (ii) the photo-transduction pathways of rods and cones, or (iii) the melanopsin protein and showed that the influence of light and dark on sleep requires both rod-cone and melanopsin signaling through ipRGCs and is independent of image formation. We further show that, although acute light pulses overcome circadian and homeostatic drives for sleep, upon repeated light exposures using a 3.5 h/3.5 h light/dark cycle, the circadian and homeostatic drives override the light input. Thus, in addition to their known role in aligning circadian physiology with day and night, ipRGCs also relay light and dark information from both rod-cone and melanopsin-based pathways to modulate sleep and wakefulness.

Carryover effects of potassium supplementation on calcium homeostasis in dairy cows at parturition.

The purpose of this study was to test whether supplementation with K improves bone mineral density (BMD) in older cows so that by parturition their bone is better able to mobilize Ca. Twenty-four Holstein Friesian cows (6 mo pregnant, lactating, and in their third or later lactation) were allocated to 2 equal groups and individually fed twice daily a total diet comprising low K oaten hay plus a pelleted concentrate fortified with or without K(2)CO(3) to achieve 3.12% K/kg of DM in the total diet of the K-supplemented (KS) cows compared with 1.50% K/kg of DM for the control cows. The cows were fed their respective diets from the beginning of their sixth month of pregnancy until 2 wk before the expected date of parturition. The strategy was to use K to stimulate a mild increase in extracellular pH to potentially improve BMD well before parturition, when high K contents in the diet are considered safe, but cease supplementing in the few weeks prepartum, when high intakes of K are known to be problematic. The expectation was that the effect of the denser bone would carry through to benefit the cow's plasma Ca, P, and Mg status at parturition. Prior to the period of K supplementation, the cows were part of a commercial pasture-based herd, to which they were returned at the end of the supplementation period and treated as 1 group from at least 11 d prepartum until the end of the study at d 42 of the next lactation. Supplementation with K successfully induced a sustained increase of urinary pH throughout late lactation and into the dry period, as expected. The KS cows consistently averaged a urine pH 0.25+/-0.10 U higher than the controls. However, there was no significant effect of K supplementation on BMD, bone mineral concentrations, plasma osteocalcin, urinary deoxypyridinoline:creatinine plasma Ca, or plasma P concentrations during or immediately after the cessation of supplementation, nor where there any carryover effects during parturition or by d 42 of lactation. Instead, there was an unexpected decrease in the concentration of Mg in plasma of the KS cows compared with the control cows that extended from 0.5 to 2.5 d postpartum. The timing of the decline in plasma Mg was paralleled by declines in plasma concentrations of 1,25 dihydroxy-vitamin D(3) and urinary excretion of Ca and Mg, whereas urinary excretion of P increased; all changes were consistent with a hypomagnesemia that could increase the risk of hypocalcemia. These data suggest that, in addition to the well-documented negative effects of K when fed immediately at parturition, the effects of high dietary K diets can carry over for at least 11 d to trigger a mild hypomagnesemia at parturition. Because K supplementation did not improve BMD prepartum, it was not possible to conclude for or against an ability of denser bone to reduce the risk of hypocalcemia in older cows at parturition.

Characterization of Mg2+ binding to the DNA repair protein apurinic/apyrimidic endonuclease 1 via solid-state 25Mg NMR spectroscopy.

Apurinic/apyrimidinic endonuclease 1 (APE1), a member of the divalent cation-dependent phosphoesterase superfamily of proteins that retain the conserved four-layered alpha/beta-sandwich structural core, is an essential protein that functions as part of base excision repair to remove mutagenic and cytotoxic abasic sites from DNA. Using low-temperature solid-state (25)Mg NMR spectroscopy and various mutants of APE1, we demonstrate that Mg(2+) binds to APE1 and a functional APE1-substrate DNA complex with an overall stoichiometry of one Mg(2+) per mole of APE1 as predicted by the X-ray work of Tainer and co-workers (Mol, C. D.; Kuo, C. F.; Thayer, M. M.; Cunningham, R. P.; Tainer, J. A. Nature 1995, 374 , 381-386). However, the NMR spectra show that the single Mg(2+) site is disordered. We discuss the probable reasons for the disorder at the Mg(2+) binding site. The most likely source of this disorder is arrangement of the protein-ligands about the Mg(2+) (cis and trans isomers). The existence of these isomers reinforces the notion of the plasticity of the metal binding site within APE1.

Base excision repair and the central nervous system.

Reactive oxygen species generated during normal cellular metabolism react with lipids, proteins, and nucleic acid. Evidence indicates that the accumulation of oxidative damage results in cellular dysfunction or deterioration. In particular, oxidative DNA damage can induce mutagenic replicative outcomes, leading to altered cellular function and/or cellular transformation. Additionally, oxidative DNA modifications can block essential biological processes, namely replication and transcription, triggering cell death responses. The major pathway responsible for removing oxidative DNA damage and restoring the integrity of the genome is base excision repair (BER). We highlight herein what is known about BER protein function(s) in the CNS, which in cooperation with the peripheral nervous system operates to control physical responses, motor coordination, and brain operation. Moreover, we describe evidence indicating that defective BER processing can promote post-mitotic (i.e. non-dividing) neuronal cell death and neurodegenerative disease. The focus of the review is on the core mammalian BER participants, i.e. the DNA glycosylases, AP endonuclease 1, DNA polymerase beta, X-ray cross-complementing 1, and the DNA ligases.

Parathyroid hormone-related protein inhibits stimulated uterine contraction in vitro.

The effect of parathyroid hormone-related protein (PTHrP) fragments 1-34, 38-64, and 67-86 on acetylcholine-stimulated rat uterine contraction was examined in vitro. In addition, the possibility that PTHrP-(38-64) or (67-86) influenced relaxation caused by PTHrP-(1-34) was also investigated. Contraction of uterine horns was stimulated with 10(-6) or 10(-5) M acetylcholine. PTHrP-(1-34) reduced the magnitude of acetylcholine-stimulated uterine contraction. This effect was dose related over a concentration range of 10(-9)-10(-6) M. Neither PTHrP-(38-64) or PTHrP-(67-86) at concentrations of 10(-8)-10(-6) M affected uterine contraction stimulated by 10(-6) M acetylcholine. These fragments did not affect the relaxation caused by 10(-7) M PTHrP-(1-34). These results demonstrate that (1) PTHrP-(1-34) at 10(-6) M influences contraction of the rat myometrium and (2) the muscle relaxant activity of PTHrP is associated with the first 34 N-terminal amino acids.

Calcitonin gene-related peptide immunostained axons provide evidence for fine primary afferent fibers in the dorsal and dorsolateral funiculi of the rat spinal cord.

The hypothesis being tested in the present paper is that there are large numbers of fine primary afferent axons in the dorsal and dorsolateral funiculi of the lumbar spinal cord of the rat. The data show numerous calcitonin gene-related peptide labeled fine myelinated and unmyelinated axons in these funiculi. Approximately 95% of the labeled axons disappear after dorsal rhizotomy. Accordingly, the hypothesis is confirmed. Thus it is becoming apparent that fine primary afferent fibers are more widely distributed in spinal white matter than had been previously recognized. Implications are that it is not possible to find areas in the spinal white matter that contain only large myelinated sensory axons and that significant numbers of fine primary afferent fibers will be lost even if lesions are restricted to the dorsal funiculus. The sizable population of fine myelinated primary afferent axons in the dorsal funiculus is emphasized. An obvious question, suggested by significant differences in average diameters of the axons in the different pathways, is whether there are differences in the types of information carried by the fine afferent fibers in their different locations in the white matter of the lumbar cord.

Organization of calcitonin gene-related peptide-immunoreactive terminals in the primate dorsal horn.

The present paper is concerned with the arrangement of axons and synaptic terminals immunostained for calcitonin gene-related peptide (CGRP), a primary afferent marker, in the primate (Macaca fascicularis) dorsal horn. The CGRP axons and terminals are uniformly distributed in laminae I and II outer (o) but they are concentrated laterally and distributed intermittently in the reticulated region of lamina V. A prominent bundle of labeled axons is seen in the sacral cord dorsal to the central canal. Emphasis is given to the relation of CGRP-immunoreactive terminals to other terminals, both labeled and unlabeled, in laminae I and IIo. In this regard, adjacent CGRP-immunoreactive terminals are often united by puncta adhaerentia. Of particular interest is the observation that CGRP-immunoreactive terminals can be found presynaptic to other terminals which sometimes resemble central primary afferent endings. In addition CGRP-immunoreactive terminals end on other CGRP terminals. Both findings suggest that primary afferent terminals interact synaptically with other primary afferent terminals.

Changes in dorsal horn synaptic disc numbers following unilateral dorsal rhizotomy.

The present study estimates the numbers of synaptic discs and numbers of degenerating synaptic terminals in laminae I-IV of the rat S2 dorsal horn ipsi- and contralateral to unilateral dorsal rhizotomy. These data allow us to estimate the loss of synapses of primary afferents and to correlate this loss with the rate of axon disappearance in the proximal stump of a transected S2 dorsal root. Our first findings are that 47% of the ipsilateral synapses and 27% of the contralateral synapses disappear within a day following unilateral rhizotomy. Conclusions are that the predominant synaptic population in this part of the rat spinal cord is of primary afferent origin and that there is an extensive bilateral projection of the dorsal root fibers. The contralateral projection is confirmed by the appearance of numerous degenerating terminals on the contralateral side. We also find that synaptic loss and appearance of degenerating terminals occur relatively synchronously in laminae I-IV. Finally we find that the time course of the synaptic loss correlates primarily with the disappearance of unmyelinated fibers in the proximal stump of the transected dorsal root.

Numbers of synapses in laminae I-IV of the rat dorsal horn.

The present study determines numerical densities (NVsyn) and total numbers of synaptic discs in laminae I-IV of the rat S2 dorsal horn. Previous methods for NVsyn have the advantage of being relatively simple, but these assume that the discs are round, flat, and of uniform size. In our material, serial reconstructions indicate that these assumptions are not met. Accordingly we use a stereological method that is not as dependent on these assumptions. This method is to divide the surface density of the discs by the mean surface area of a disc (NVsyn = SVsyn/Ssyn). We refer to this as a reconstruction method because synaptic discs are reconstructed from serial sections. We also calculate numerical densities by several previously used standard methods, and the findings are similar but not identical. We find that numerical density and total synaptic numbers are smallest in lamina I, and densities and total numbers are not significantly different when lamina II is compared to laminae III and IV. Thus the intense labeling of terminals with certain compounds that characterize lamina I and II does not imply an increase in total synaptic numbers or in synaptic density. In addition there is a general increase in synaptic densities and numbers as one proceeds from lamina I to lamina IV. Another point is that the numerical density of synapses in the dorsal horn is approximately that of the cerebral cortex. These data will serve as a basis from which to judge the effects of denervations and other manipulations that purportedly change synaptic numbers.

Ascending unmyelinated primary afferent fibers in the dorsal funiculus.

The primary purpose of the present study is to obtain evidence as to the destination of the recently discovered unmyelinated primary afferent fibers in the mammalian dorsal funiculus. To do this rat dorsal roots were transected unilaterally from segments T8 or T9 caudally, and the numbers of axons were determined in the C3 fasciculus gracilis in normal animals and from both sides of the rhizotomied animals. In addition, C3 fasciculus gracilis counts were done in animals that had complete T6 or T10 spinal transections. The data indicate that there is an 80% loss of unmyelinated axons ipsilaterally and a 60% loss contralaterally in the fasciculus gracilis of the rhizotomied animals. These findings are interpreted as indicating that a significant fraction of the unmyelinated fibers in the fasciculus gracilis ascend, presumably to the nucleus gracilis in the brain stem, and also that a significant number of these fibers branch. We also provide evidence for contralateral myelinated primary afferent fiber projection in the fasciculus gracilis and show that the myelinated primary afferent fibers seem to be a more diverse population than the unmyelinated primary afferent fibers in the C3 fasciculus gracilis.

Denervation-induced intraspinal synaptogenesis of calcitonin gene-related peptide containing primary afferent terminals.

The purpose of the present study is to provide evidence that chronic spinal denervation leads to an increase in numbers of synaptic terminals from a specific population of primary afferent fibers. Rats were unilaterally deafferented for 35 days (chronic denervation) by dorsal rhizotomies performed from T2 to T8 and T10 to L5, which isolates or spares the T9 root. The contralateral T9 root was spared by similar surgery 5 days (acute denervation) prior to sacrifice. The survival time on the chronic side presumably allows sprouting of T9 primary afferents to occur, whereas the time on the acute side does not. The terminals were labeled with calcitonin gene-related peptide (CGRP), which is a compound that labels a specific population of primary afferent fibers and terminals, and stereological methods were used to determine the numbers of immunolabeled terminals in laminae I and IIo on the chronic and acute sides of the T9 spinal cord. The findings are that the chronic side had approximately twice as many terminals as the acute side. This difference is statistically significant. These findings are compatible with the hypothesis that chronic denervation leads to synaptogenesis from surviving primary afferent fibers.

Spinal projection neurons to the laterodorsal pontine tegmental nucleus: relationship to preganglionic neurons and nitric oxide synthase.

The region of the rat sacral parasympathetic nucleus (SPN) contains distinct subpopulations of neurons that project supraspinally or are preganglionic neurons. Some preganglionic neurons in the SPN serve as the motor outflow for urinary bladder contraction; other neurons in the SPN project to regions of the rostral pons that subserve micturition reflexes. Previous studies utilizing immunohistochemistry or staining for nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) have demonstrated that numerous neurons in the SPN contain nitric oxide synthase (NOS), the enzyme for nitric oxide synthesis. Thus, the objectives of this study were to determine 1) the distribution of neurons in the region of the SPN that project to the laterodorsal tegmentum (LDT) of the pons, 2) whether spinal neurons projecting to a peripheral autonomic ganglion also project to the LDT, and 3) whether NOS or NADPH-d is present in LDT projection neurons. Preganglionic neurons were identified by injecting the retrograde tracer fluorogold (FG) into the major pelvic ganglion (MPG). Supraspinally projecting neurons were identified by injecting the retrograde tracer fast blue (FB) into the LDT. Numerous FB-labeled neurons were present in the ipsi- and contralateral SPN and were immediately dorsal to FG-labeled preganglionic neurons. Neurons containing both tracers were not observed. Approximately 20% of preganglionic neurons, but no LDT projection neurons, were reactive for NOS and NADPH-d. These data suggest that the region of the SPN is a site for distinct subpopulations of neurons that project to the LDT and to the MPG and that NOS is contained in some preganglionic neurons, but is not a marker for LDT projection neurons.

Spontaneous dissection of the internal carotid artery. Its conservative management with heparin sodium.

A case of dissection of the internal carotid artery was managed by the use of heparin sodium. Angiographic studies on the 11th and 21st hospital days demonstrated the importance of at least three weeks of heparin therapy and the value of subsequent angiographic examinations.

A straight path-to where? Reply to Butterworth and Hadar.

Butterworth and Hadar (1989) discussed my earlier article (McNeill, 1985) but assumed their own linear theory and overlooked my proposal for an internal dialectic of imagery and language. This has led them into a whole series of misinterpretations.

Silence is liberating: removing the handcuffs on grammatical expression in the manual modality.

Grammatical properties are found in conventional sign languages of the deaf and in unconventional gesture systems created by deaf children lacking language models. However, they do not arise in spontaneous gestures produced along with speech. The authors propose a model explaining when the manual modality will assume grammatical properties and when it will not. The model argues that two grammatical features, segmentation and hierarchical combination, appear in all settings in which one human communicates symbolically with another. These properties are preferentially assumed by speech whenever words are spoken, constraining the manual modality to a global form. However, when the manual modality must carry the full burden of communication, it is freed from the global form it assumes when integrated with speech--only to be constrained by the task of symbolic communication to take on the grammatical properties of segmentation and hierarchical combination.

Peptide immunoreactivity of unmyelinated primary afferent axons in rat lumbar dorsal roots.

The present study demonstrates calcitonin gene-related peptide (CGRP), somatostatin (SOM), bombesin (BOM), and substance P (SP) at the electron microscopic level in lumbar dorsal root axons of normal rats. The highest percentages of labeled axons were for CGRP (14%) and then, in descending order, for SP (8.6%), SOM (6.8%), and BOM (3.1%). The labeled axons were exclusively unmyelinated for SP, SOM, and BOM, and predominantly unmyelinated for CGRP. These data are consistent with the data for labeled sensory cell bodies for these same compounds. We emphasize that these peptides were immunocytochemically visualized in the dorsal roots without experimental manipulation, such as colchicine or dorsal root ligation. Quantitative sampling of this type can be used to assay changes in response to physiological stimuli in numbers of sensory axons that contain identifiable concentrations of these peptides.

Hemodynamics of intravenous nitroglycerin during aortic clamping.

Anesthetic management and dosage schedules of vasodilators have not been standardized in many studies of aortic cross clamping (CCL). For this reason, 25 consecutive patients with arteriosclerotic disease of the aorta were studied, all having received the same anesthetic management. Six patients who received nitroglycerin during the cross clamp period, at a dosage of 0.25 micrograms/kg/min, were compared with 19 who underwent CCL without the drug. Contractility was maintained in the nitroglycerin group, but not in the other group. Despite a low cardiac index in both groups, peripheral blood flow was adequate only in the nitroglycerin group. Intrapulmonary shunt was higher in the nitroglycerin group, but it did not significantly decrease the Pao2. Nitroglycerin infusion seems to be helpful in maintaining pre-CCL contractility and adequacy of peripheral blood flow.