Engagement of the inhibitory receptor CD158a interrupts TCR signaling,preventing dynamic membrane reorganization in CTL/tumor cell interaction

Renal cell carcinoma (RCC) infiltrating lymphocytes (TILs) express killer cell immunoglobulinlike receptors (KIRs) that inhibit the antitumor CD8(+) T-cell lysis. In the present study, to better examine the functional consequences of KIR engagement on cytotoxic T lymphocyte (CTL)/tumor interaction, we have investigated the influence of KIR CD158a on early steps of T-cell activation. We show that coengagement of T-cell receptor (TCR) and CD158a by tumor cells inhibited tyrosine phosphorylation of early signaling proteins ZAP-70 and LAT, lipid raft coalescence, and TCR/CD3 accumulation at the CTL/tumor cell interface. In addition, the guanine exchange factor Vav was not phosphorylated, and no actin cytoskeleton rearrangement was observed. Our data indicate a role of KIR CD158a in the dynamic events induced by TCR triggering, preventing CTL membrane reorganization, and subsequent completion of CTL activation program. Accordingly, the expression of CD158 by TILs may favor tumor cell escape to the immune response.     

Carcinoma of colon presenting as fever of unknown origin

Fever of unknown origin (FUO) is defined as fever of more than 38.3 degrees C, the cause of which remains elusive after 1 week of intensive investigation. Most cases of FUO are restricted to infections, malignancies, and inflammatory diseases. FUO was previously reported as the presenting symptom of a few solid tumors such as lymphoma, renal cell carcinoma, and hepatocellular carcinoma. Colon carcinoma manifesting as FUO has been rarely reported. We describe three female patients who presented with classical FUO and microcytic anemia. As a control, we retrospectively evaluated 28 matched patients with carcinoma of colon and no fever. The evaluation included review of patient files, clinical and laboratory data, and pathologic specimens. In the three patients (mean age, 58 years) who presented with FUO and had left-sided colon carcinoma and microcytic anemia, pathologic evaluation of the tumor tissues demonstrated a severe organized inflammatory process forming abscesses in the pericolic fat. The 28 control matched patients showed no such histopathologic changes. In patients presenting with FUO, especially those who present with microcytic anemia, even with no bowel disturbances or elevated carcinoembryonic antigen levels, diagnostic workup should include a search for occult colorectal carcinoma. In our three cases, it appears that microabscesses in the pericolic fat are the cause of fever.     

Impact of carboxylation and hydrolysis functionalisations on the anti-oil staining behaviour of textiles grafted with poly(N-isopropylacrylamide) hydrogel

Novel hydrogel-modified textiles have been prepared through photografting poly(N-isopropylacrylamide) (PNIPAAm) onto pristine and functionalised polyethylene terephthalate (PET) surfaces. In this work, two types of functionalisation, carboxylation (CPET) and hydrolysis (HPET), were performed to scrutinise the hydrogel grafting efficiency. Basic characterisation of the pristine, functionalised and grafted textiles was carried out via fourier transform infrared spectroscopy (FTIR), atomic force microscopy (AFM) and field emission scanning electron microscopy (FESEM) analyses. Then, the functional characteristics of these samples were determined based on the oil staining performance. Functionalisation of the PET textiles via hydrolysis and carboxylation gives rise to different chemical reactivity and interactions on the PET surface. Impressively, the surface formed via hydrolysis functionalisation of PET was found to be more efficient compared to that formed via carboxylation, and the untreated one. The HPET surface was remarkably more hydrophilised and rougher than both the UPET and CPET surfaces. The accessibility of the –OH groups for hydrogen abstraction from HPET has a great impact on the hydrogel grafting onto the HPET surface. All the grafted textiles (PNIPAAm-g-UPET, PNIPAAm-g-CPET and PNIPAAm-g-HPET) demonstrated anti-oil staining behaviour at 27 °C. In particular, PNIPAAm-g-HPET textiles with a high degree of grafting (DG) exhibited the fastest rate for oil to de-stain from the surface. Moreover, the reversible transition of PNIPAAm hydrogels around the lower critical solution temperature (LCST) ∼ 32 °C from hydrophilic to hydrophobic generates switchable surfaces of the textiles with regard to the oil wettability. Specifically, PNIPAAm-g-HPET textiles also displayed the highest degree of wettability switching as a result of having the highest DG. Taken together, the PNIPAAm hydrogels grafted onto PET textiles were significantly enhanced though hydrolysis functionalisation and possessed excellent switchable surfaces toward oil-staining, having great potential to be used for applications in oil and water separation as well as smart textiles.

Functionalisation, especially via hydrolysis, has created efficient PNIPAAm hydrogels grafted onto PET textiles with superior anti-oil staining performance.     

Partners in Health: A Conceptual Framework for the Role of Community Health Workers in Facilitating Patients' Adoption of Healthy Behaviors

We formulated a conceptual framework that begins to answer the national call to improve health care access, delivery, and quality by explaining the processes through which community health workers (CHWs) facilitate patients’ adoption of healthy behaviors. In September 2011 to January 2012, we conducted a qualitative study that triangulated multiple data sources: 26 in-depth interviews, training documents, and patient charts. CHWs served as partners in health to immigrant Filipinos with hypertension, leveraging their cultural congruence with intervention participants, employing interpersonal communication techniques to build trust and rapport, providing social support, and assisting with health behavior change. To drive the field forward, this work can be expanded with framework testing that may influence future CHW training and interventions.Community health workers (CHWs) are laypeople from within the communities where they work, who share common characteristics with their patients (e.g., ethnicity, culture, race, and language).1–4 CHWs have demonstrated effectiveness in an array of conditions, ranging from maternal and child health to chronic disease management.4–12 A systematic review of randomized controlled trials on CHW effectiveness determined that CHWs address health issues among various ethnic and racial groups, help improve use of early intervention services for children at risk for developmental delay, improve screening for breast and cervical cancer, and aid in improving dietary behaviors and blood pressure control.10CHWs have specific training in providing basic nutrition and health promotion services; they aim to improve health care access through a set of core skills,13,14 advocacy, outreach, and education.2,15,16 They function in multiple roles: bridging communication between patients and providers, providing health education and counseling, and monitoring health status.7,12 Thus, CHWs have a tremendous potential to influence and improve health outcomes.Although CHWs play integral roles in supporting patients’ individual health behaviors,17–23 the processes through which they are influential are poorly understood.21 Increasing use of this model in the United States, and recommendations in the Patient Protection and Affordable Care Act to integrate CHWs as part of health care teams,24 underscore the need to advance the knowledge base surrounding CHWs and to better understand mechanisms of this role. We developed a conceptual framework to explicate the processes through which CHWs facilitate the adoption of healthy behaviors among their patients.