Evidence for selection of insecticide resistance due to insensitive acetylcholinesterase by carbamate-treated nets in Anopheles gambiae s.s. (Diptera: Culicidae) from Côte d'Ivoire

Pyrethroid-treated nets are an efficient tool for reducing malaria transmission and morbidity. The recent evolution of pyrethroid resistance in several Anopheles species represents a major threat for the future success of roll back malaria in Africa. The possible use of nonpyrethroid insecticides, such as carbamates, on nets is a promising alternative solution because these insecticides are effective against susceptible and pyrethroid-resistant populations of Anopheles and Culex mosquitoes. Unfortunately, carbamate resistance as a result of insensitive acetylcholinesterase has recently been detected in Anopheles gambiae s.s. populations from C?te d'Ivoire. Using biochemical assays on surviving Anopheles mosquitoes from an experimental hut trial, we showed evidence for selection for an insensitive acetylcholinesterase mechanism by carbamate impregnated bednets. However, no such selection has been found with nets treated with pyrethroid alone or pyrethroid/carbamate "two-in-one" -treated nets. Because pyrethroid-impregnated nets were suspected to select for the Kdr mutation in An. gambiae, we propose that use of two-in-one nets could be a promising alternative strategy for the management of insecticide resistance in malaria vectors.     

Mathematical modelling of objectives in radiation therapy treatment planning.

We view radiation therapy treatment planning (RTTP) as a problem of constrained optimization. In this context, the 'optimal' treatment is one that maximizes some objective function subject to the inherent constraints of the problem. We discuss two objective functions which are motivated by biological considerations rather than mathematical expedience. One of these measures the 'goodness' of a treatment in terms of its probability of success. The other measures the degree to which a treatment succeeds in satisfying a system of constraints that are mutually contradictory. We describe how to actually perform the optimization of these objective functions in practice and show some numerical results which demonstrate advantages of these objective functions over their more conventional counterparts.     

Association between variation in the vesicular monoamine transporter 1 gene on chromosome 8p and anxiety-related personality traits

Vesicular monoamine transporters are involved in the presynaptic packaging of norepinephrine, dopamine and serotonin into storage vesicles. The vesicles release their content upon arrival of an action potential into the synaptic cleft. Dysregulation of monoaminergic neurotransmission has been long postulated to play a relevant role in the etiology of neuropsychiatric disorders. The gene encoding the vesicular monoamine transporter 1 (VMAT1/SLC18A1) maps to chromosome 8p21, a region where several linkage peaks overlap between schizophrenia, bipolar disorder and anxiety-related personality traits. In this study, we tested the hypothesis that the missence variation Thr136Ile in the VMAT1/SLC18A1 gene is associated with anxiety-related personality traits. We tested a total of 337 unrelated subjects of German descent (167 male, 170 female). All participants were carefully screened for psychiatric disorders. The self-report State–Trait Anxiety Inventory (STAI) was completed by all subjects. Genotypes were obtained for the Thr136Ile (rs1390938) variation in the VMAT1 gene for all subjects. Genotype effects on personality variables were computed with MANOVA including age as a co-variant and gender as independent factor (MANCOVA). Results show that STAI scores were significantly affected by genotype (F = 3.108; d.f. = 4,331; p = 0.015) and age (F = 7.233; d.f. = 2,331; p = 0.001) but not by gender. A gender-by-genotype effect was observed for both the STAI state (p = 0.052) and trait score (p = 0.035). Dissection of the group by gender and subsequent contrast analysis of the genotype effects performed within the female group showed significant results (STAI state: Thr/Ile vs. Ile/Ile: T = 4.408, p = 0.0004; STAI trait: Thr/Ile vs. Ile/Ile: T = 3.074, p = 0.009) but not in the male group. Our findings support the hypothesis that anxiety-related personality traits are associated with variation in the VMAT1/SLC18A1 gene.     

Einflu\ vonBordetella pertussis auf das lymphatische Gewebe von Mäusen

Zusammenfassung Verglichen mit phänotypisch normalen Kontrolltieren fanden sich bei NMRI-Mäusen mit kongenitaler Thymusaplasie nur wenige Peyersche Plaques, die zudem nur aus diffusen Lymphocytenansammlungen bestanden. Auch die Milzfollikel waren erheblich verkleinert, wobei die periarteriolären Follikelbereiche gelegentlich zellärmer erschienen. Das wei\e Blutbild der thymuslosen Tiere war durch eine mä\ige Lymphopenie charakterisiert. Obwohl die Milzen der Mäuse mit kongenitaler Thymusaplasie keine Verringerung der Zahlen an präexistenten 19S-Hämolysin-bildenden Zellen aufweisen, waren nach Erstimmunisierung mit 4·10⁸ Schaferythrocyten nur minimale Zahlen an 19S-Produzenten und 7 S-Produzenten nachweisbar. Die sekundäre antigene Stimulierung mit 4·10⁸ Schaferythrocyten führte zu keiner nennenswerten Gedächtnisreaktion, was anzeigt, da\ die Bildung von Gedächtniszellen ein thymusabhängiger Proze\ ist. Die alleinige intraperitoneale Injektion abgetöteter Zellen von B. pertussis führte zu Hypersplenie, Leukozytose und Vermehrung der präexistenten Zahlen an 19S-Hämolysin-bildenden Zellen. Im Gegensatz zu Normaltieren, wo die Leukocytose durch eine Vermehrung von Granulocyten und Lymphocyten charakterisiert ist, fehlte bei den thymuslosen Tieren die Lymphocytenvermehrung. Der Zunahme der Blutgranulocyten entsprach eine verstärkte Granulopoese in Leber und Milz. Bei Normaltieren fand sich nach Erstimmunisierung durch simultane Applikation von 4·10⁸ Schaferythrocyten und 3·10⁹ abgetöteten Zellen vonB. pertussis eine verstärkte und verlängerte Produktion von 19S- und besonders 7S-Hämolysin-bildenden Zellen, verbunden mit einer verstärkten Präparation des lymphoretikulären Gewebes für die anamnestische Reaktion. Bei den Mäusen mit kongenitaler Thymusaplasie beschränkte sich der Adjuvanseffekt allem auf die Frühphase der immunologischen Primärreaktion, was seinen Ausdruck in einer deutlichen Vermehrung der 19S-Produzenten und einer nur geringgradigen Vermehrung der 7S-Produzenten fand.

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Influence ofBordetella pertussis on the lymphatic tissue of miceVIII. The influence ofBordetella pertussis on the primary and secondary immune potential of thymusless (nude) mice

As compared to phenotypically normal controls, in the intestine of NMRI mice with congenital aplasia of the thymus (nude) only small numbers of Peyer's patches could be detected, which consisted of relatively diffuse accumulations of lymphocytes. The splenic follicles were likewise considerably reduced in size, whereby the thymus-dependent areas occasionally appeared to be deficient in lymphocytes. Furthermore, the thymusless mice were found to have blood lymphopenia. Although the spleens of nude mice contained rather enhanced numbers of pre-existing 19S hemolysin forming cells, only small numbers of 19S producers and very poor numbers of 7S hemolysin-forming spleen cells were demonstrable after the primary immunization with 4·10⁸ sheep erythrocytes. Secondary antigenic stimulation with an equal dose of the erythrocyte antigen did not result in a noteworthy secondary immune response. This evidently indicates that the production of memory cells is a thymus-dependent process. A single intraperitoneal injection of 3·10⁹ pertussis organisms led to splenomegaly, blood leukocytosis and augmentation of the pre-existing 19S hemolysin-forming spleen cells. Whilst in normal controls the blood leukocytosis was found to be due to an increase in both lymphocytes and granulocytes, in nude mice the leukocytosis was solely caused by the increase in granulocytes, this being associated with increased granulopoiesis in spleen and liver. The primary immunization of normal controls with 4·10⁸ sheep erythrocytes and 3·10⁹ pertussis organisms led to an increased and prolonged development of both 19S and 7S hemolysin-producing spleen cells. Furthermore, the bacterial adjuvant increased the process of priming for the secondary immune response. Unlike to this, in mice with congenital aplasia of the thymus adjuvancy of pertussis organisms was restricted to the early phase of the primary immune response, as is documented by the distinct augmentation of 19S producers and a poor increase in the numbers of 7S hemolysin-forming spleen cells.

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Diese Arbeit wurde durch die Deutsche Forschungsgemeinschaft gefördert.     

The Effect of Telephone-Administered Psychotherapy on Symptoms of Depression and Attrition: A Meta-Analysis

Increasingly, the telephone is being used to deliver psychotherapy for depression, in part as a means to reduce barriers to treatment. Twelve trials of telephone-administered psychotherapies, in which depressive symptoms were assessed, were included. There was a significant reduction in depressive symptoms for patients enrolled in telephone-administered psychotherapy as compared to control conditions ( d  = 0.26, 95% confidence interval [CI] = 0.14–0.39, p  < .0001). There was also a significant reduction in depressive symptoms in analyses of pretreatment to posttreatment change ( d  = 0.81, 95% CI = 0.50–1.13, p  < .0001). The mean attrition rate was 7.56% (95% CI = 4.23–10.90). These findings suggest that telephone-administered psychotherapy can produce significant reductions in depressive symptoms. Attrition rates were considerably lower than rates reported in face-to-face psychotherapy.     

Growth inhibition and transformation of a human fetal tracheal epithelial cell line by long-term exposure to diethylnitrosamine

In order to obtain more information on the in vitro transformationof human cells, a human fetal tracheal epithelial cell line(FHET16/5) was exposed for a long time to diethylnitrosamine(DEN). In 20 passages, this cell line (diploid, male) maintainedstrong immunohistochemical reactivity for carcino-embryonnicantigen and wool merokeratin; it was negative for vimentin.The cells contained PAS-positive mucous substances and ultrastructurallywere found to have desmosomelike attachments. Treatment of thecells was with 0.3% dimethyl sulphoxide (DMSO), or DMSO with150, 450, 1000 or 2000 µg/ml of DEN. It was started atthe ninth passage and continued for six passages over 9 weeksfor the control (DMSO) and the three lowest control doses ofDEN, and for three passages over 9 weeks for the 2000 µg/mlDEN group. Cells grown for 13 days after the end of treatmentwere plated in soft agar and injected subcutaneously in nudemice. The frequency of anchorage-independent colonies grownin soft agar was directly related to DEN dose. Colony-formingefficiency, as an expression of toxic effect, was also dosedependent. Autoradiographically detected unscheduled DNA synthesisindicated an association between anchorage-independent transformationand DNA alterations induced by DEN. Cells injected into nudemice did not produce tumours during a 6-month period, but invasivenesswas observed when cells from the 2000 µg/ml DEN groupwere transplanted on the dermis of cultured chick embryo skin.The results indicate that DEN causes anchorage-independent transformationaccompanied by unscheduled DNA synthesis in a fetal human trachealepithelial cell line.     

Bereavement. State of the art and state of the science

For bereavement research to fulfill its potential, its practical applications with defined patient groups needs to demonstrate a superiority over treatment based largely on intuition and common sense. The "art" of the therapist needs science to move beyond the present impasse in the management of bereavement.     

Difficulties in navigating the intersection of generalist and specialist palliative care services: A cross-sectional study of bereaved family's experiences of care at home in New Zealand

A generalist–specialist model of palliative care is well established as a framework for the provision of community care in resource-rich countries. However, evidence is lacking regarding how the model is experienced by family carers and the extent to which access to both generalist and specialist palliative care is equitable. A cross-sectional postal survey was undertaken to explore bereaved family's experiences of generalist palliative care and its intersection with hospice services in the last 3 months of life. A modified version of the Views of Informal Carers—Evaluation of Services survey was sent to 4,778 bereaved family. Data were collected between February 2017 and October 2018. Chi-square was utilised to identify factors that impacted on experiences of generalist palliative care; analysis of free text data comprising 45,823 words was undertaken using a directed content analysis approach. Eight hundred and twenty-six questionnaires were returned (response rate = 21%). Seventy per cent of people (n = 579) spent some time at home in the last 3 months prior to death. People who received support from hospice were more likely to receive support from multiple other services. Those who received no community services were less likely to feel supported by their general practitioner, less likely to spend the last 2 days of life or die at home. Feeling supported had a strong association with services working well together, being involved in decision-making and being aware of the poor prognosis. The provision of palliative care is complicated by a lack of integration with specialist palliative care and may be the basis of continuing inequities in the provision of community care at the end of life. The assumption at a policy level that “generalists” are willing and able to play a key role in palliative care provision needs to be further challenged.     

Understanding the Enablers and Barriers to Appropriate Infants and Young Child Feeding Practices in India: A Systematic Review

Despite efforts to promote infant and young child feeding (IYCF) practices, there is no collective review of evidence on IYCF enablers and barriers in India. This review was conducted using 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase, and Ovid MEDLINE, were searched for published studies on factors associated with IYCF practices in India from 1 January 1993, to 30 April 2020. IYCF practices examined were early initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, introduction to solid semi-solid or soft foods, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, continued breastfeeding at two years, predominant breastfeeding, and bottle feeding. In total, 6968 articles were retrieved, and 46 studies met the inclusion criteria. The common enablers of IYCF were higher maternal socioeconomic status (SES) and more frequent antenatal care visits (ANC) (≥3). Common barriers to IYCF practices were low SES and less frequent ANC. The review showed that the factors associated with IYCF practices in India are largely modifiable and multi-factorial. Improving IYCF practices would require the adoption of both facilities- and community-based policy interventions at the subnational and national levels in India.