Interactive effects of elevated temperature and CO2 levels on energy metabolism and biomineralization of marine bivalves Crassostrea virginica and Mercenaria mercenaria.

The continuing increase of carbon dioxide (CO2) levels in the atmosphere leads to increases in global temperatures and partial pressure of CO2 (PCO2) in surface waters, causing ocean acidification. These changes are especially pronounced in shallow coastal and estuarine waters and are expected to significantly affect marine calcifiers including bivalves that are ecosystem engineers in estuarine and coastal communities. To elucidate potential effects of higher temperatures and PCO2 on physiology and biomineralization of marine bivalves, we exposed two bivalve species, the eastern oysters Crassostrea virginica and the hard clams Mercenaria mercenaria to different combinations of PCO2 (~400 and 800µatm) and temperatures (22 and 27°C) for 15weeks. Survival, bioenergetic traits (tissue levels of lipids, glycogen, glucose and high energy phosphates) and biomineralization parameters (mechanical properties of the shells and activity of carbonic anhydrase, CA) were determined in clams and oysters under different temperature and PCO2 regimes. Our analysis showed major inter-species differences in shell mechanical traits and bioenergetics parameters. Elevated temperature led to the depletion of tissue energy reserves indicating energy deficiency in both species and resulted in higher mortality in oysters. Interestingly, while elevated PCO2 had a small effect on the physiology and metabolism of both species, it improved survival in oysters. At the same time, a combination of high temperature and elevated PCO2 lead to a significant decrease in shell hardness in both species, suggesting major changes in their biomineralization processes. Overall, these studies show that global climate change and ocean acidification might have complex interactive effects on physiology, metabolism and biomineralization in coastal and estuarine marine bivalves.

Impact of pap test compliance and cervical cancer screening intervals on human papillomavirus vaccine acceptance.

OBJECTIVES: The objective of this study was to determine the impact of Pap test compliance and cervical cancer screening intervals on human papillomavirus (HPV) vaccination acceptance. MATERIALS AND METHODS: A convenience sample of 499 women 21 to 65 years old completed a 37-question survey in Augusta and Savannah, GA. The survey assessed their knowledge about HPV, cervical cancer, and the HPV vaccine. The questionnaire also determined their Pap test compliance and how longer Pap test intervals would influence their willingness to receive the HPV vaccine. Differences between categorical variables and knowledge scores were examined using χ test and unequal-variance t tests, respectively. RESULTS: Pap test-noncompliant women were more likely to get the HPV vaccine if they only needed a Pap test every 10 years compared with Pap test-compliant women (27.6% vs 14.6%, p = .02). A greater number (83.5%) of Pap test-noncompliant women preferred the HPV vaccine plus every 10-year Pap test option compared with Pap test-compliant women (31.3%, p < .0001). Most women (87%) responded that they would likely get the HPV vaccine if it would safely reduce the frequency of Pap testing. CONCLUSIONS: Women are receptive to getting the HPV vaccine in exchange for longer cervical cancer screening intervals. Moreover, Pap test-noncompliant women are more likely to get the HPV vaccine if Pap testing was needed less frequently. Increasing the Pap testing interval may be an excellent method to improving HPV vaccine acceptance in women at highest risk for cervical cancer.

In vitro study of variables relevant to perioperative care of the surgical patient: glucose, osmolarity, and rewarming.

BACKGROUND: We sought to determine the effects of altering osmolarity and the reversibility of the detrimental immunologic effects of hypothermia on human monocyte HLA-DR surface expression and reactive oxygen species (ROS) formation. STUDY DESIGN: The effects of altering osmolarity on HLA-DR surface expression and ROS formation were assessed using lipopolysaccharide (LPS)-treated samples treated with either saline, glucose, or mannitol, incubated at 37°C for 2 hours. HLA-DR surface receptor expression and ROS formation were determined after incubation. The effects of the reversibility of hypothermia were measured by incubating LPS-treated samples at 34°C, 37°C, and 40°C for 1 hour. The samples were subsequently rewarmed at 40°C for 1 and 2 hours. The effects of rewarming on HLA-DR surface receptor expression and ROS formation were reassessed. RESULTS: In the osmolarity experiments, there was a 49% decrease in ROS formation in samples treated with mannitol as compared with saline and glucose. Alterations of osmolarity had no significant effect on HLA-DR surface expression. In the rewarming experiments, rewarming for either 1 or 2 hours abolished any significant differences in HLA-DR surface expression and ROS formation between samples preincubated at the different temperatures. CONCLUSIONS: The presumed inert mannitol was found to significantly decrease ROS formation, but had no effect on HLA-DR surface expression. In addition, the effects of hypothermia on HLA-DR surface expression or ROS formation may be better reversed within 2 hours than in 1 hour.

Optimizing surgical care: a contemporary assessment of temperature, oxygen, and glucose.

Factors such as temperature, oxygen, and glucose have recently been implicated in the development of surgical sepsis by either promoting or attenuating protective components of the innate immune response. Reducing infective sequelae and the improvement of the quality of care of surgical patients is a top practice priority today. These factors and their associated effects are discussed through the examination of recent clinical and scientific studies to provide an up-to-date evidence-based review.