Multiple Functions of Lysyl Oxidase Like-2 in Oral Fibroproliferative Processes.

Gingival overgrowth is a side effect of certain medications, including calcium channel blockers, cyclosporin A, and phenytoin. Phenytoin-induced gingival overgrowth is fibrotic. Lysyl oxidases are extracellular enzymes that are required for biosynthetic cross-linking of collagens, and members of this enzyme family are upregulated in fibrosis. Previous studies in humans and in a mouse model of phenytoin-induced gingival overgrowth have shown that LOXL2 is elevated in the epithelium and connective tissue in gingival overgrowth tissues and not in normal tissues. Here, using a novel LOXL2 isoform-selective inhibitor and knockdown studies in loss- and gain-of-function studies, we investigated roles for LOXL2 in promoting cultures of human gingival fibroblasts to proliferate and to accumulate collagen. Data indicate that LOXL2 stimulates gingival fibroblast proliferation, likely by a platelet-derived growth factor B receptor-mediated mechanism. Moreover, collagen accumulation was stimulated by LOXL2 enzyme and inhibited by LOXL2 inhibitor or gene knockdown. These studies suggest that LOXL2 could serve as a potential therapeutic target to address oral fibrotic conditions.

Outbreak of gentamicin-resistant, meticillin-susceptible Staphlococcus aureus on a neonatal unit.

BACKGROUND: This report describes an outbreak of gentamicin-resistant, meticillin-resistant Staphylococcus aureus (GR MSSA) which occurred on a 21-bed neonatal unit (NNU) in Ninewells Hospital, Dundee, UK. METHODS: An outbreak investigation was triggered by two new GR MSSA isolates from babies admitted directly to the NNU who had acquired this organism during their stay. Data on MSSA cases and antibiograms of patient isolates were flagged as an alert, and microbiology records were trawled to detect previous cases. FINDINGS: Eight babies were affected by the outbreak strain over six months. Typing of all isolates by pulsed-field gel electrophoresis and spa typing showed that all were clonal complex 30, spa type t012. None of the outbreak strains were associated with bacteraemia, apart from one baby who was born at 24 weeks of gestation with a birth weight of 500 g. Observation of practice and environmental swabbing of an incubator suggested that this was the most likely source of spread of the outbreak strain. Three of 11 surfaces sampled were positive for the outbreak strain. On inspection, it was found that the impeller was not removed routinely during cleaning, and debris was seen in the housing. Swabs that were taken from the impeller and housing yielded the outbreak strain. CONCLUSION: GR MSSA isolates from the NNU have been set up as an alert organism on the infection control system. No further cases were detected over one year of follow-up after full compliance with the new guidelines for cleaning and disinfection of incubators was implemented.

Short communication: Automated detection of behavioral changes from respiratory disease in pre-weaned calves.

Group housing of calves can pose a challenge in identifying respiratory disease; therefore, it is necessary to develop tools that can identify these disease events. In this experiment, pre-weaned calves (n = 30) were housed in groups with an automatic calf feeder and were fitted with an accelerometer. Step activity, lying behaviors, and feeding behaviors were recorded to determine the effect of respiratory disease. All calves were health scored twice daily, and calves with respiratory scores ≥5 were diagnosed with respiratory disease (n = 10). Each diseased calf was match paired with a healthy control based on the date of disease diagnosis, breed, and age. Control calves were determined to be healthy if they had respiratory scores ≤4, as well as fecal, navel, and joint scores of 0 or 1. Diseased calves were less active before, on the day of, and after respiratory disease diagnosis. Furthermore, diseased calves had reduced lying frequencies starting 2 d before diagnosis, as well as after diagnosis. Last, diseased calves consumed less milk on the day of diagnosis when compared with healthy controls. Step activity, lying bouts, and milk intake may prove to be a useful tool in identifying respiratory disease under practical farming, but this requires further research.

Impact of a targeted direct marketing price promotion intervention (Buywell) on food-purchasing behaviour by low income consumers: a randomised controlled trial.

BACKGROUND: Price promotions are a promising intervention for encouraging healthier food purchasing. We aimed to assess the impact of a targeted direct marketing price promotion combined with healthy eating advice and recipe suggestions on the purchase of selected healthier foods by low income consumers. METHODS: We conducted a randomised controlled trial (n = 53 367) of a direct marketing price promotion (Buywell) combined with healthy eating advice and recipe suggestions for low income consumers identified as 'less healthy' shoppers. Impact was assessed using electronic point of sale data for UK low income shoppers before, during and after the promotion. RESULTS: The proportion of customers buying promoted products in the intervention month increased by between 1.4% and 2.8% for four of the five products. There was significantly higher uptake in the promotion month (P < 0.001) for the intervention group than would have been expected on the basis of average uptake in the other months. When product switching was examined for semi-skimmed/skimmed milk, a modest increase (1%) was found in the intervention month of customers switching from full-fat to low-fat milk. This represented 8% of customers who previously bought only full-fat milk. The effects were generally not sustained after the promotion period. CONCLUSIONS: Short-term direct marketing price promotions combined with healthy eating advice and recipe suggestions targeted at low income consumers are feasible and can have a modest impact on short-term food-purchasing behaviour, although further approaches are needed to help sustain these changes.

Planktonic marine iron oxidizers drive iron mineralization under low-oxygen conditions.

Observations of modern microbes have led to several hypotheses on how microbes precipitated the extensive iron formations in the geologic record, but we have yet to resolve the exact microbial contributions. An initial hypothesis was that cyanobacteria produced oxygen which oxidized iron abiotically; however, in modern environments such as microbial mats, where Fe(II) and O2 coexist, we commonly find microaerophilic chemolithotrophic iron-oxidizing bacteria producing Fe(III) oxyhydroxides. This suggests that such iron oxidizers could have inhabited niches in ancient coastal oceans where Fe(II) and O2 coexisted, and therefore contributed to banded iron formations (BIFs) and other ferruginous deposits. However, there is currently little evidence for planktonic marine iron oxidizers in modern analogs. Here, we demonstrate successful cultivation of planktonic microaerophilic iron-oxidizing Zetaproteobacteria from the Chesapeake Bay during seasonal stratification. Iron oxidizers were associated with low oxygen concentrations and active iron redox cycling in the oxic-anoxic transition zone (<3 µm O2 , <0.2 µm H2 S). While cyanobacteria were also detected in this transition zone, oxygen concentrations were too low to support significant rates of abiotic iron oxidation. Cyanobacteria may be providing oxygen for microaerophilic iron oxidation through a symbiotic relationship; at high Fe(II) levels, cyanobacteria would gain protection against Fe(II) toxicity. A Zetaproteobacteria isolate from this site oxidized iron at rates sufficient to account for deposition of geologic iron formations. In sum, our results suggest that once oxygenic photosynthesis evolved, microaerophilic chemolithotrophic iron oxidizers were likely important drivers of iron mineralization in ancient oceans.

A case of wrist tenosynovitis caused by Mycobacterium kansasii in a renal transplant recipient.

Mycobacterial infection in an organ transplant recipient is a diagnostic and therapeutic challenge. Diagnosis is often delayed, resulting in significant morbidity. Anti-microbial chemotherapy needs careful selection to prevent potentially significant complications, such as organ rejection and dose-related toxicities. We present the case of a 61-year-old Caucasian male kidney transplant recipient with chronic tenosynovitis of the left wrist. Histological findings of the synovial biopsy revealed multinucleated giant cell epithelioid granuloma. Culture of synovial fluid grew Mycobacterium kansasii. Treatment with rifampicin, ethambutol, and clarithromycin proved curative, but the patient developed irreversible ethambutol-related optic neuritis.

Partners in our care: patient safety from a patient perspective.

The voice and role of "patient" in patient safety were explored by the Calgary Health Region's Patient and Family Safety Council perspective and the Calgary Health Region, Calgary, Alberta, Canada--an important collaboration for enhanced patient safety. Insights into patient safety were shared and coauthored in this article by the Patient and Family Safety Council with members of the Calgary Health Region staff. The Patient and Family Safety Council members were asked to respond to articles written about the role of patient in patient safety, without direct communication with patients. The authors of this article intended to demonstrate only a few of the ways in which patient involvement and feedback through partnership turn knowledge into action and help inform patients about safety practices and procedures.

Endocrine and ingestive behavioral responses to fluid deprivation in sheep chronically exposed to ethanol.

Endocrine responses to fluid deprivation/restoration and preference for ethanol solution vs. water were assessed in sheep maintained for 5 months on a 10% ethanol solution as their sole source of fluid. Blood pressure, body weight, plasma composition and hormone levels of the alcohol maintained sheep were all within a normal range, except for high plasma concentrations of ANG II and ALDO. During fluid deprivation, AVP concentration increased and fluid-deprived sheep displayed a natriuresis and then a rehydration anti-natriuresis. Sheep did not drink the 10% ethanol solution avidly upon fluid restoration, preferring to drink steadily over the following 24 h; there was an associated increase in blood alcohol concentration (BAC). PRC, ANG II and ALDO all increased throughout the fluid restoration period, whereas plasma AVP and ANP gradually fell. In a separate experiment when water was also supplied to the sheep, they preferred water to 10% ethanol; however, alcohol intake was not eliminated. Overall, this degree of chronic consumption of 10% ethanol solution did not appear to adversely affect physiological mechanisms concerned with body fluid homeostasis after fluid deprivation conditions.

Natural experiments: an underused tool for public health?

Policymakers and public health researchers alike have demanded better evidence of the effects of interventions on health inequalities. These calls have been repeated most recently in the UK in the final Wanless report, which spoke of the "almost complete lack of an evidence base on the cost-effectiveness of public health interventions", and pointed more generally to the limited evidence base for public health policy and practice. Wanless and others have suggested that the gaps may be partially filled by exploiting the opportunities offered by "natural experiments", such as changes in employment opportunities, housing provision, or cigarette pricing. Natural experiments have an important contributions to make within the health inequalities agenda. First, they can play an important role in investigating the determinants of health inequalities. Second, they can assist in the identification of effective interventions, an area where it is widely acknowledged that the evidence-base is currently sparsely populated. This paper discusses some of the benefits and limitations of using this type of evidence, drawing on two ongoing quasi-experimental studies as examples.

Assessment of airway function in young children with asthma: comparison of spirometry, interrupter technique, and tidal flow by inductance plethsmography.

The assessment of airway function in young children requires adaptation of techniques designed for adults and/or application of techniques that do not require complex respiratory maneuvers. We sought to assess two methods of measuring airway function: time to peak expiratory flows as a ratio of expiratory time (T(PTEF)/T(E)), derived from respiratory inductance plethysmography, and total respiratory resistance by the interrupter technique (Rint), both obtained during quiet tidal breathing. Both techniques were referenced to FEV1 and flow at 50% expired volume (FEF50) from conventional spirometry in 30 children aged 4-8 years (median age, 6.9; range, 4.5-8.5 years) with a physician diagnosis of asthma and who were able to perform FEV1 with a repeatability of at least 8%. T(PTEF)/T(E) and Rint were performed in random order followed by spirometry, in order to reduce the possible effects of pulmonary stretch on tidal breathing measures. Coefficients of variation (CV) and mean absolute change/baseline standard deviation were derived for each measurement. Baseline FEV1 did not correlate significantly with T(PTEF)/T(E) (r = 0.025), but did correlate with Rint (r = 0.737, P < 0.001); respective relationships for change after bronchodilator were r = 0.09 (ns) and r = 0.64 (P < 0.001). FEF50 also correlated significantly with Rint (R = 0.769, P < 0.001) but not with T(PTEF)/T(E). FEV1 and FEF50 both increased postbronchodilator, with respective mean changes of 11.4% and 28% (P < 0.001), while Rint decreased by 24.3% (P < 0.001). No significant changes were noted for T(PTEF)/T(E). T(PTEF)/T(E) derived from inductance plethysmography does not detect mild airway obstruction or modest changes in airway caliber following bronchodilator in young children with asthma. The interrupter technique may have a role in assessing baseline airway function and response to therapy in children unable to perform reliable spirometry, and/or when the investigator wishes to avoid the possible influence of forced maneuvers on airway tone.

Assessing practice nurses' change in nutrition knowledge following training from a primary care dietitian.

The expanding role of the Primary Health Care Team (PHCT) has led to more opportunities to offer dietary advice to patients. However, members of the PHCT appear to lack nutritional knowledge and confidence when giving dietary advice. This work assesses the changes in Practice Nurses' (PNs) nutrition knowledge and confidence when giving dietary advice to patients, following training from a dietitian. Base line nutrition knowledge of PNs and their confidence when giving dietary advice was assessed in 30 GP Practices by questionnaire. Following Practice-based training from a dietitian, change in knowledge and confidence was assessed using the same questionnaire. Paired and unpaired analysis was carried out on the PN's knowledge and confidence scores respectively. Nutrition knowledge increased significantly after training. The mean difference (95% confidence interval) pre- and post-training was 11.6 (7.8, 15.4). After training 88% of PNs reported having good or excellent confidence compared with 27% before training (chi-squared test p < 0.001). Nutrition training from a dietitian improves nutrition knowledge of PNs. It also improves their confidence and is recommended to support their role in providing accurate and consistent dietary advice to patients.

A cultural economy perspective on service sector migration in the global city: the case of Hong Kong.

PIP: The authors of this article posit that studies of international labor migration must include global economic forces and mediating sociocultural influences. This study used 1996 census and interview data from Hong Kong to analyze immigration patterns. Interviews were conducted among 975 skilled expatriates and among 40 less skilled migrants. The rate of growth of the immigrant population in Hong Kong, was higher in 1991 and 1996 than the native population, especially among Japanese and Filipinos. Filipinos were the largest and most economically active number of non-Chinese migrants in these years. In accordance with Hong Kong's restructuring, jobs shifted from plant and machine operators to service and shop sale workers. The proportion of the population working in manufacturing was 41% in 1991, and 19% in 1996. The proportion working in trade, hotel, and restaurant services increased from 19% to 25%. Over 80% of the US and Japanese worked in managerial and professional jobs. The concentration of US and Japanese workers reflects Hong Kong's position as a global financial center. The proportion of Chinese nationals and US and Japanese migrants engaged in financing, trade, or management jobs was greater than among natives. Chinese immigrants were more likely, and Filipinos and Thais were less likely, to have less skilled occupations than natives. There were also cultural differences between the high and low wage sector by country of origin. The case studies of migrants illustrate economic reasons for migration and cultural differences in type of employment. Filipinos were more likely to be maids than Thais.^ieng

A migration channels approach to the study of professionals moving to and from Hong Kong.

"This article evaluates the concept of migration channels, identifying the strengths and weaknesses that have emerged from use of a migration channels framework in international migration research. Using professional migration to and from Hong Kong in the 1990s as an empirical lens, it is argued that the meso-scale understanding offered by examining the effect of migration channels is valuable. This is illustrated in terms of the contrasting channels used by different professions, as well by migrants motivated to move by citizenship as opposed to career reasons."

Placing identity: interviews with Hong Kong Chinese immigrants in Britain and Canada.

"This paper explores the ¿borderline community of migration'.... The placing of migrant identities is examined in the context of Hong Kong immigrants in Britain and Canada. Changes in identity and the meaning of the multiplicity of migrant identities are explored through interview material. The tensions between the multiple facets of migrants' identities reflect the sociopolitical relationships within and between places. The resolution of these tensions is partially revealed in the hybridity and fluidity of migrants' articulation of their identities, whilst maintaining a primary identification with their culture of origin."

The effect of losartan on drinking and NaCl intake in the rat in response to hyperosmotic and hypovolaemic stimuli: effect of route of administration and strain of rat.

Intracerebroventricular 100,000 pmol losartan (an AT1-receptor blocker) inhibited the initial drinking response of Wistar rats to 1 ml 2 M NaCl given subcutaneously but the intake over 3 h was not significantly inhibited. The same dose of the AT2-receptor blocker PD123319 had a more long-lasting inhibitory effect. Rats of three different strain, Wistar, Wistar-Kyoto (WK), and SH (spontaneously hypertensive), were subjected to sodium depletion using frusemide and a low-sodium diet; in the 3 h after 1.8% NaCl was made available, the intakes were 11.6 +/- 1.7 (SEM), 4.1 +/- 1.2 and 12.4 +/- 1.3 ml, respectively; water intakes in the same period averaged 4.2 +/- 1.1, 5.0 +/- 1.1 and 8.3 +/- 1.8 ml. The intake of both fluids by Wistar rats was not significantly affected by either losartan or PD123319. The intake of both saline and water in SHR rats was reduced by losartan. In evaluating the effect of antagonists to angiotensin II on the intake of water and NaCl in response to perturbations of hydromineral balance, difference in the route of administration of the stimulus and strain of the animals used must therefore be taken into account.

Migrating to learn and learning to migrate: a study of the experiences and intentions of international student migrants.

"The research reported here evaluates whether students come to the UK mainly for educational reasons, and therefore perceive their stay as temporary, or whether emigration for study is being used as part of a conscious strategy by people intending to become future labour migrants.... The simplest interpretation of the results appears to be that migration, experienced as a result of international moves for study purposes, does not influence planning of further migration moves. But the research also indicates that migration for education is closely tied to other types of population redistribution and should be treated by population geographers as an integral part of international migration systems." Data were collected by questionnaire survey from 349 engineering students at Hong Kong universities and 82 Hong Kong students studying engineering in the UK.

Tapping the television cable.

Immediate access to patient data is essential to support good clinical decision making and support. However, away from the surgery, the doctor is currently unable to have any access to the clinical database. Solutions exist to support remote access, such as modems or radio data networks, but these are slow, with typical speeds in the 2-10 kbaud region. We propose a novel solution, to use the TV cable already installed in many homes. Using this technology, a suitably equipped computer (RF modern) is capable of connecting at speeds in excess of 500 kbaud and will run applications in exactly the same way as if connected to a surgery network: the cable TV becomes a LAN, but on a metropolitan scale. Brunel University, in collaboration with the Cable Corporation, has been piloting such a network. Issues include not only levels of service, but also security on the network and access, since the data are being effectively received in every home. However, close scrutiny of channel use can create closed networks reserved for specific users. The technology involves use of an RF modem to transmit data on a reverse channel (based at 16 MHz) on each subnet to a router at the head end of the cable network. This frequency translates the packet and retransmits it to all the subnets on a forward channel (based at 178 MHz). Each channel occupies the bandwidth normally allocated to one TV channel. Access is based on a modified CSMA/CD protocol, so treating the cable network as single multiple access network. The modem comes as a standard card installed in a PC and appears much as an ethernet card, but at reduced speed. With an NDIS driver it is quite able to support almost any network software, and has successfully demonstrated Novell and TCP/IP. We describe the HomeWorker network and the results from a pilot study being undertaken to determine the performance of the system and its impact on working practice.

The use of anti-depressants and benzodiazepines in the perpetrators and victims of accidents.

The objective of this study was to determine whether there is a greater incidence of psychotropic drugs in the blood of those 'responsible' for an accident compared with those not 'responsible' for an accident. Blood samples were taken from people involved in accidents presenting at the accident and emergency departments of two teaching hospitals over a five-month period and analysed for the presence of alcohol, tricyclic anti-depressants (TCAs) and benzodiazepines (BZs). Details of the accident were used to produce a test group (accidents where a drug may have contributed) and a control group (accidents where the presence of a drug could not have been a factor). In total, 229 samples were collected. The only criterion for inclusion in the study was that the accident was of sufficient severity to merit the routine taking of a blood sample, in which case an additional amount was taken for the purposes of this investigation. In all, 63 samples (27.5%) were positive for at least one of alcohol, TCA or BZ. Of the accidents represented by these samples, 48 could have been caused by the presence of the drug (responsible group) and 15 could not (not responsible group). There was a significantly greater representation of TCAs and BZs in the blood taken from the responsible group compared with the not responsible group (P < 0.0045).

Demography, destiny and population policies.

PIP: This article considers the aftermath of the 1994 Cairo Conference on Population and Development and the later Laxon, Sweden meeting of about 40 academic geographers, who addressed the implications of the Plan of Action for national policy. A recent International Union for the Scientific Study of Population (IUSSP) member synthesized conference impact on member nations. Martens from IUSSP offered the critique that the 381 recommendations were philosophically incoherent and poorly integrated and did not distinguish between government as a "doer of things" from government as "organizer and guarantor of a legal-institutional framework for allowing individuals and voluntary groups to seek improvements." This article discusses the apparent gulf between the views of population researchers and that of policy makers. It is reasoned that population policies do matter. The Club of Rome world model confirmed rapid population growth during 1972-90. Population policies in the past emphasized a societal perspective rather than an individual one. Policies impact on individual decision making. Most population geographers emphasize four features of social change. 1) Policy must address suitable measures for easing social, economic, and political tensions that arise in the temporary experience of high population growth. 2) More sensitive models of demographic behavior need to be developed, in order to account for the highly uneven patterns of fertility and mortality. Policy should not focus exclusively on family planning and should take into account the cultural and socioeconomic context. 3) Migration pressures from poor to rich countries have increased. Policy should address international migration. 4) People adapt quickly to new policy measures and apply policies effectively in their own life. Policies fail when the top-down approach does not include adequate research into values and behavior of the persons most affected by policy. These four points were discussed throughout this issue of "Applied Geography."^ieng