The role of altruism vs self-interest in COVID-19 vaccination uptake in the United Kingdom.

OBJECTIVES: The aim of the present study was to explore self-interest, kin altruism and non-kin altruism reasons that influence people to vaccinate against COVID-19. STUDY DESIGN: This was a cross-sectional study using a fully repeated measures design. METHODS: Participants (N = 178) answered questions on perceived threat and likelihood of infection, vaccination status and opinion on mandatory vaccination. Participants also rated a set of statements that asked how likely these would influence them and others to vaccinate against COVID-19. Statements reflected self-interest, kin altruism or non-kin altruism. RESULTS: Just more than half of the sample (50.8%) reported the likelihood of infection as somewhat or extremely likely, and almost three-fourths (74.2%) reported that COVID-19 posed a minor or moderate threat to their physical health. Almost three-fourths (74.3%) of the sample were vaccinated, with just more than half (56.2%) in favour of mandatory vaccination. A 2 (self/other) × 3 (self-interest/kin altruism/non-kin altruism) fully repeated measures analysis of variance showed that kin-altruistic reasons were rated most highly, regardless of whether this was regarding oneself or others. Participants rated others as having greater self-interest reasons for vaccination compared with oneself, whereas non-kin altruism reasons for vaccination were rated higher for oneself, compared with others. CONCLUSION: Highlighting the benefits of vaccination for close relatives and vulnerable others in the population would be a useful strategy for government to use when urging the public to vaccinate against COVID-19.

Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study.

AIMS: To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer. METHODS: This multicentre, prospective, observational study reviewed participants' data at 12 months after culture of a diabetic foot ulcer requiring antibiotic therapy. From participants' notes, we obtained information on the incidence of wound healing, ulcer recurrence, lower extremity amputation, lower extremity revascularization and death. We estimated the cumulative incidence of healing at 6 and 12 months, adjusted for lower extremity amputation and death using a competing risk analysis, and explored the relationship between baseline factors and healing incidence. RESULTS: In the first year after culture of the index ulcer, 45/299 participants (15.1%) had died. The ulcer had healed in 136 participants (45.5%), but recurred in 13 (9.6%). An ipsilateral lower extremity amputation was recorded in 52 (17.4%) and revascularization surgery in 18 participants (6.0%). Participants with an ulcer present for ~2 months or more had a lower incidence of healing (hazard ratio 0.55, 95% CI 0.39 to 0.77), as did those with a PEDIS (perfusion, extent, depth, infection, sensation) perfusion grade of ≥2 (hazard ratio 0.37, 95% CI 0.25 to 0.55). Participants with a single ulcer on their index foot had a higher incidence of healing than those with multiple ulcers (hazard ratio 1.90, 95% CI 1.18 to 3.06). CONCLUSIONS: Clinical outcomes at 12 months for people with an infected diabetic foot ulcer are generally poor. Our data confirm the adverse prognostic effect of limb ischaemia, longer ulcer duration and the presence of multiple ulcers.

Alpha-fetoprotein and human chorionic gonadotrophin-beta as prognostic markers in neuroendocrine tumour patients.

Serum chromogranin A is the most useful general and prognostic tumour marker available for neuroendocrine tumour (NET) patients. The role of other tumour markers is less clear. In order to determine the diagnostic and prognostic value of serum alpha-fetoprotein (AFP) and human chorionic gonadotrophin-beta (hCGbeta) in NETs, a database containing biochemical, histological, and survival data on 360 NET patients was constructed. This data was statistically assessed, using Statistical Package for the Social Sciences, to determine the utility of commonly measured tumour markers with particular emphasis on AFP and hCGbeta. Alpha-fetoprotein and hCGbeta were raised in 9.5 and 12.3% of patients respectively and jointly raised in 9.1% of patients in whom it was measured. Alpha-fetoprotein levels associated strongly and positively with tumour grade, serum CgA and hCGbeta levels, and worse survival. Human chorionic gonadotrophin-beta levels also associated strongly and positively with serum CgA and AFP levels, and worsening survival. Alpha-fetoprotein and hCGbeta are elevated in high-grade NETs, with a rapidly progressive course and poorer survival. They also correlate with chromogranin-A, which is known to be a marker of tumour burden and to have prognostic value. Thus AFP and hCGbeta are clinically important in NETs and when elevated are poor prognostic markers.

Effects of the protein kinase A inhibitor H-89 on Ca2+ regulation in isolated ferret ventricular myocytes.

We investigated the effects of a protein kinase A (PKA) inhibitor, H-89 {N-[2-(p-bromocinnamylamino)ethyl]-5-iso-quinolinesulphonamide}, on Ca2+ regulation in Fura-2-loaded ferret myocytes. H-89 (10 micromol/l) decreased the amplitude of the Fura-2 transient to 28. 2+/-4.3% (P<0.001) of control and prolonged its duration, characterized by a decrease in the rate of decline of Ca2+ to diastolic levels: t1/2 increased from 311+/-35 ms to 547+/-43 ms (P<0.001, n=7). Reduced Ca2+ uptake by the sarcoplasmic reticulum (SR) in the presence of H-89 was also indicated by a decrease in the SR Ca2+ content, as assessed with caffeine. The apparent slowing of the SR Ca2+-ATPase was not caused by changes in phosphorylation of phospholamban (PLB). However, Ca2+ uptake in microsomal vesicles prepared from canine hearts and fast-twitch rat skeletal muscle (which lacks PLB) was decreased by 34.1 and 46.8% (n=3), respectively, suggesting that H-89 has a direct inhibitory effect on the SR Ca2+-ATPase. In electrophysiological experiments, 5.0 micromol/l H-89 decreased the L-type Ca2+ current (ICa) by 39.5% (n=6) and slowed the upstroke of the action potential and, in some cases, caused loss of excitability without changes in the resting membrane potential. In summary, data show that [Ca2+ ]i regulation, and hence contraction, is sustained by PKA-mediated phosphorylation, even in the absence of beta-agonists. However, the use of H-89 as a tool to study the role of this signalling pathway is limited by the non-specific effects of H-89 on the SR Ca2+-ATPase.

Depletion of Ca2+ from the sarcoplasmic reticulum of cardiac muscle prompts phosphorylation of phospholamban to stimulate store refilling.

Nonmuscle cells have almost ubiquitously evolved a mechanism to detect and prevent Ca2+ store depletion-store operated calcium entry. No such mechanism has, as yet, been reported in cardiac myocytes. However, it is conceivable that such a mechanism may play an important role in cardiac Ca2+ homeostasis to ensure the availability of sufficient stored Ca2+ to maintain normal excitation contraction coupling. We present data that confirms the presence of a mechanism that is able to monitor the Ca2+ load of the SR and initiate a signaling process to accelerate Ca2+ uptake by the SR when store depletion is detected. Depletion of SR Ca2+ activates a protein kinase, the principal SR substrate of which is phospholamban. Phosphorylation of this SR protein promotes Ca2+ pump activity and therefore store refilling. Furthermore, a protein kinase activity associated with the SR that is inhibited by Ca2+ ions has been identified. We have measured lumenal [Ca2+] by using a fluorescent Ca2+ indicator and found that by initiating Ca2+ uptake and increasing Ca2+ load, we can inhibit the protein kinase activity associated with the SR. This confirms that a protein kinase, that is regulated by lumenal [Ca2+], has been identified and represents part of a previously unidentified signalling cascade. This local feedback mechanism would allow the myocyte to detect and prevent SR Ca2+ load depletion.

Decreased respiratory tolerance from intermittent asphyxia in rat sucklings.

To study the respiratory tolerance of rat pups to intermittent asphyxia induced by exposure to closed rebreathing, we randomized newborn rats from four litters into two treatment groups. Respiratory tolerance was defined as the time interval during asphyxia until the first episode of 30 seconds of apnea. Rats in the experimental group were asphyxiated once daily during the first 4 days of life. Rats in the control group were asphyxiated once on day 4 of life. Pups exposed to intermittent asphyxia had a significant reduction in respiratory tolerance compared with that of littermates asphyxiated once at the same age. These findings suggest that the ability of the young mammal to withstand re-exposure to asphyxia may be impaired.

Formation of cage-like particles by poly(amino acid)-based block copolymers in aqueous solution.

When dissolved in N,N-dimethylformamide and then dialyzed against phosphate-buffered saline, A-B-A block copolymers composed of poly [N5-(2-hydroxyethyl)-L-glutamine]-block-poly(gamma-benzyl-L-glutamate)- block-poly [N5-(2-hydroxyethyl)-L-glutamine] form particles. The particles are cage-like structures with average diameters of 300 nm (average polydispersity, 0.3-0.5). They are stable in aqueous solution at 4 degrees C for up to 3 weeks, at which time flocculation becomes apparent. Negative staining and freeze-fracture electron microscopy suggest that cage-like particles are formed by selective association of segregated micelle populations. A model of particle formation is presented in which B blocks form micelles in dimethylformamide. On dialysis against an aqueous solution, the extended A blocks then associate intermolecularly to form rod-shaped micelles, which connect the B block micelles. The result is a meshed cage-like particle. The implications of these observations on the aggregation behavior of polymeric surfactants in dilute solution are discussed.

Effects of splenectomy on Trypanosoma congolense infection in cattle.

The role of the spleen in cattle infected with Trypanosoma congolense was studied by comparing levels of parasitaemia, blood cell values, and body weights of intact and splenectomized cattle. A total of 28 Zebu x Hereford steers were used in two separate experiments. Seven animals were splenectomized at least four weeks prior to infection and two others were splenectomized 128 days after infection. Splenectomized animals were compared to 12 intact infected animals and seven intact uninfected controls. The splenectomized animals suffered no less severe anemia and no higher parasitaemia than the intact, infected cattle. Splenectomy in two animals during infection had no effect on packed cell volumes, parasitaemia or survival. Splenectomized cattle have lower levels of circulating lymphocytes following treatment than intact animals; also, the splenectomized steers lost more weight during the active infection.

Low protein C in the neonatal period.

Protein C was measured by electroimmunoassay in 47 infants within 24 h of delivery. Gestational age ranged from 28 to 43 weeks. The mean level was 27% (range less than 10-67%) of the normal adult mean. In the 22 infants who had no clinical problems, protein C levels correlated significantly with gestational age. In the 25 who were sick there was no correlation, and the mean level was significantly lower than that of the healthy infants. Postnatal rise was slow; on day 7 the mean was 32% and on day 28, 31%. Levels of protein C correlated significantly with prothrombin in both the healthy and sick infants. Crossed immunoelectrophoresis in the presence of calcium ions gave one protein C peak of the same electrophoretic mobility as is seen in plasma of healthy adults, indicating that the infants' protein C is gamma carboxylated. It is concluded that: (1) Protein C in neonates is in or below the range associated with thromboembolism in patients congenitally deficient in this protein; (2) protein C levels correlate with gestational age; and (3) the low levels during the neonatal period are not due to decreased gamma carboxylation but may reflect decreased synthesis when compared to the older child or the adult.

Nosocomial fungal infection during hospital renovation.

Nosocomial fungal pulmonary infections (Zygomycetes, Aspergillus sp.) developed in two premature infants in a special care unit (SCU) adjacent to an area of renovation. Inspection showed that inadequate barriers permitted the passage of airborne particles between the two areas, and cultures confirmed a significantly higher (p less than or equal to 0.05) density of mold spores in the SCU (0.88 cfu per hour per settling plate) compared to a construction-free comparison area (0.22 cfu per hour per settling plate). The major source of mold was the dust above the hospital's false ceiling. In another construction area, imperious barriers were shown to effectively restrict the dispersal of mold. Our experience adds Rhizopus to Aspergillus as a possible cause of construction-related nosocomial infection. Sporadic episodes will continue to occur until the hazards of renovation are appreciated and effective preventive measures are routinely instituted.

The adverse effects of high oral osmolal mixtures in neonates. A review and a study of the osmolality of calcium preparations.

In both animals and humans, there are numerous clinical, physiologic, and morphologic alterations that occur when hypertonic solutions are introduced into the alimentary tract. The most serious adverse effect observed in the human infant is necrotizing enterocolitis. A short in vitro study analyzing osmolalities of drug-formula mixtures at various dilutions, conducted by the authors, showed that an unacceptable degree of high osmolality may be achieved in the preparation of common medications used in newborn nurseries. Although review of the literature confirms that, in general, the osmolalities of mixtures fed to newborns should not exceed 460 mOsm/kg H2O, lower levels would be preferable in ill and low birth weight newborns. When possible, consideration should be given to the use of parenteral medication for the critically ill neonate. Ideally, the osmolalities of mixtures fed to newborns should be measured if they are not known or cannot be calculated.

Pathogenic factors in bronchopulmonary dysplasia.

Serum factors related to oxygen exposure were studied in 56 full-term cord blood samples and in 69 newborn infants of varying gestational age (GA). Serum malondialdehyde (MDA), which reflects membrane lipid peroxidation, was elevated during the first 2 d of life and rose to a peak at 3-5 d of life. This peak value was unrelated to GA or to assisted ventilation. The serum antioxidant, vitamin E, showed a significant rise by 6-10 d, and came into the adult range after d 11. Vitamin E levels did not correlate with GA, assisted ventilation, or the development of bronchopulmonary dysplasia (BPD). Serum ceruloplasmin, another antioxidant, was measured both by activity assay and by protein concentration assay. Little activity was found in cord blood. Ceruloplasmin activity increased during the first 48 h of life, and both activity and protein concentration correlated with GA at that time. Infants who subsequently developed BPD had a less active protein than infants on ventilators who did not develop BPD. In addition, activity and protein levels on 3-5 d were lower in infants on ventilators than in those not requiring assisted ventilation. Serum levels of alpha-1-AP activity and protein concentration were also correlated with GA during the first 48 h of life. The less mature infants had levels of activity and protein which were significantly less than the more mature infants and significantly less than the full-term cord values. The proportion of active protein correlated with GA at 3-5 d, indicating that the less mature infants had a lower proportion of active protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Impact of intermittent prolonged asphyxia in rat sucklings on growth and development.

Each of four litters of newborn rats was categorized first by sex and then within each litter, each sex-specific group was randomized into three treatment groups: an experimental (asphyxiated on 4 consecutive days from birth), a partial control (asphyxiated once on the fourth day of life), and a control group (never asphyxiated). Asphyxiation was carried out by enclosing pups individually in air tight fixed volume jars until they attained 30 second apnea. Weight and physical and reflex development of the rat pups were assessed daily. The data was analyzed by using ANOVA and ANCOVA to adjust for birth weight.

Experimental chemotherapy of Taenia saginata cysticercosis - a field trial.

The resistance to reinfection of calves following chemotherapy of T. saginata cysticercosis with praziquantel was investigated in a field situation in East Africa. Thirty animals from the treated group were compared with thirty animals from the untreated group after 15 months following chemotherapy. Slicing revealed that 100% in the untreated group were infected, compared with 43.5% of the animals in the treated group. 52% of the untreated group had viable cysts in contrast to only one animal (4.3%) in the treated group. Serological investigations were also conducted on sera obtained before and after chemotherapy. Successful chemotherapy resulted in temporarily increased titres in the treated group as compared to the untreated group.