Serologic evidence of Anaplasma phagocytophilum infections in patients with a history of tick bite in central Slovakia

The aim of this study was to determine the risks of human anaplasmosis in an area of central Slovakia endemic for Lyme borreliosis. The circulation of Anaplasma phagocytophilum in ticks and wild animals has been observed in natural foci in this area for several years. Samples of human sera from patients with Lyme borreliosis and persons with a history of recent tick bite and clinical symptoms indicating Lyme borreliosis were collected in central Slovakia. A total of 76 human sera were analyzed using an indirect HGE IgG immunofluorescent assay kit. IgG antibodies against A. phagocytophilum were found in 19 (25%) sera (15 female, 4 male patients). A. phagocytophilum infection was serologically confirmed in one (3.8%) child, 12 (38.7%) persons aged 22-56 and six (31.6%) persons older than 56. A statistically significant difference in seroprevalence (P < 0.01) was observed between children (3.8%, 1/26) and adults (36%, 18/50). Antibodies against A. phagocytophilum were detected in seven patients with clinically diagnosed Lyme borreliosis and in another seven individuals with assessed antiborrelia antibodies. IgG antibodies against A. phagocytophilum were detected in five persons seronegative for borrelia. The most frequent clinical symptoms in patients with positive A. phagocytophilum serology were cephalalgia, arthralgia, myalgia, fever, exanthema, neurological symptoms and lymphadenopathy. Positive sera were obtained from patients living in villages and towns in the orographic entities Vtácnik (5/19), Stiavnické vrchy (1/19), Kremnické vrchy (10/19) and Ziarska kotlina (3/19). Our results demonstrate the risk of acquiring A. phagocytophilum infection in natural foci in central Slovakia. Human anaplasmosis should be considered in the differential diagnosis, especially in cases of acute febrile illness with tick-bite history.     

How to support me in connected learning: Youth perspectives on adult supportive behavior and its benefits

This study examined the various ways adults engage and support youth in connected learning settings, which are focused on supporting youth in their interests or passions. Youth from 5 Chicago community‐based, out‐of‐school time (OST) programs participated in focus groups on the topic of adult–youth relationships. Participants reported characteristics and behaviors of supportive adults as well as the outcomes associated with those behaviors. Analyses revealed that the following characteristics of adults enabled engagement and relationship development: (a) mutual respect, (b) genuine interest, (c) ongoing communication and friendship, and (d) going above and beyond. Youth also identified the specific ways that adults supported them: (a) guidance and motivation, (b) skill‐based support, (c) role modeling, (d) connecting, (e) emotional support, and (f) cultivating youth voice. Finally, participants reported the following outcomes related to such support: (a) social capital, (b) a sense of empowerment and control of their futures, and (c) a sense of acceptance and validation. This study is a contribution to the literature on adult–youth relationships in connected learning sites and draws attention to the potential socioemotional and instructional benefits of such programs. Our study also highlights the various ways that adults in OST programs can successfully engage youth and form relationships.     

Characterization of four clones derived from human adenocarcinoma cell line, HT29, and analysis of their response to sodium butyrate

The differentiation of colorectal cancer cells is associated with the arrest of tumor growth and tumor regression. However, the mechanism of such tumor cell differentiation has not yet been elucidated. Several adenocarcinoma cell lines, including HT29 which differentiates only upon stimulation with a differentiation agent, have been used for the study of colorectal cells. Since we had previously obtained variable results during analyses of these cells, we selected several clones of this cell line. In this study, four clones of the parental HT29 cells, H8, G9, G10 and A3, were characterized. All of them differentiated upon treatment with sodium butyrate as the differentiation agent but they appeared different in their response regarding some of the markers of differentiation. As revealed by ultrastructural analysis, H8 and G10 clones formed numerous intercellular cysts with microvilli whereas these structures were found only occasionally in G9 and A3 clones. An elevated level of the indicator of cell differentiation, CEACAM 1, was found in H8 and G10 clones and the activity of alkaline phosphatase, another important marker of colorectal cell differentiation, was up-regulated and highly increased upon butyrate treatment in the H8 clone. Phosphorylation of p38 MAPK was increased in H8 and A3 butyrate-treated clones. According to the levels of cleaved PARP and activated caspase-3, the apoptotic response to butyrate appeared similar in all four clones, while electronoptic analysis revealed that clones G9 and A3 were more perceptive to butyrate-induced apoptosis. In conclusion, our data showed considerable heterogeneity in morphology and some enzymatic activity of the cloned cells. This fact may contribute to the evidence that many HT29 cells possess multipotent information similar to that of stem cells of the normal intestinal crypt.     

Stereotactic radiofrequency amygdalohippocampectomy: Does reduction of entorhinal and perirhinal cortices influence good clinical seizure outcome?

Purpose: Stereotactic radiofrequency amygdalohippocampectomy (SAHE) has been modified recently in our center for the therapy of mesial temporal epilepsy (MTLE). It has promising clinical results comparable with microsurgical amygdalohippocampectomy despite smaller volume reduction of the hippocampus. We hypothesized that the extent of perirhinal and entorhinal cortex (PRC, EC) reduction could explain the clinical outcome. Therefore, we performed, retrospectively, volumetric analysis of PRC and EC and compared it with the seizure control. Methods: Twenty‐six consecutive patients with MTLE treated by SAHE were included. PRC and EC volumes were measured from magnetic resonance imaging (MRI) records obtained before and 1 year after SAHE. The clinical outcome was assessed each year after SAHE using Engel’s classification. Key Findings: Twenty‐six patients were analyzed. The volume of PRC decreased by 46 ± 17% (p < 10⁻¹²); EC volume decreased by 56 ± 20% (p < 10⁻¹⁰). Two years after the procedure, 73% of patients were classified as Engel’s I, 19% as Engel’s II; in 2 (8%) the treatment failed (were reoperated). Eighteen patients finished 3 years follow‐up; 72% of them were classified as Engel’s I, 17% as Engel’s II, and in 2 (11%) above‐mentioned patients the treatment failed. Thirteen patients finished 4 years of follow‐up, 11 of them as Engel’s I. There was no significant correlation of the clinical outcome to PRC and EC volume reductions. Significance: The clinical effect of SAHE is not clearly explained by the volume reductions of PRC and EC (nor of the hippocampus and the amygdala). It promotes opinion that the extent of resection/destruction is not important for seizure outcomes.     

Interdisciplinary European Guidelines for Surgery for Severe (Morbid) Obesity

Foreword In 2005, for the first time, an expert panel named “The Bariatric Scientific Collaborative Group” (BSCG), was appointed through a joint effort of the major European Scientific Societies which are active in the field of obesity management. Societies that constituted this panel were: International Federation for the Surgery of Obesity – European Chapter (IFSO-EC), European Association for the Study of Obesity (EASO), European Childhood Obesity Group (ECOG) and the International Obesity Task Force (IOTF) which was represented during the completion process by its representatives. The BSCG was composed of officers representing the respective Scientific Societies (including four acting Presidents, two past Presidents, one Honorary President, and three Executive Directors). The panel was also balanced by the presence of many other opinion leaders in the field of obesity. The BSCG composition allowed coverage of the key disciplines in comprehensive obesity management, as well as being reflective of European geographic and ethnic diversity. This joint BSCG Expert Panel has convened several meetings which were entirely focused on guideline creation during the past 2 years. There was a specific effort to develop and concur on clinical guidelines which reflect current knowledge, expertise and evidence- based data on treatment of morbid obesity.     

Viral evolution in macaques coinfected with CCR5- and CXCR4-tropic SHIVs in the presence or absence of vaccine-elicited anti-CCR5 SHIV neutralizing antibodies

Macaques were immunized with SF162 Env-based gp140 immunogens and challenged simultaneously with the CCR5-tropic homologous SHIV(SF162P4) and the CXCR4-tropic heterologous SHIV(SF33A) viruses. Both mock-immunized and immunized animals became dually infected. Prior immunization preferentially reduced the viral replication of the homologous virus during primary infection but the relative replication of the two coinfecting viruses during chronic infection was unaffected by prior immunization, despite the fact that five of six immunized animals maintained a significantly lower overall viral replication that the control animals. Neutralizing antibodies participated in controlling the replication of SHIV(SF162P4), but not that of SHIV(SF33A). Dual infection resulted in the emergence and predominance within the circulating CCR5 virus pool, of a variant with a distinct neutralization phenotype. The signature of this variant was the presence of three amino acid changes in gp120, two of which were located in the receptor and coreceptor binding sites. Also, a significant fraction of the viruses circulating in the blood, as early as two weeks post-infection, was recombinants and prior immunization did not prevent their emergence. These findings provide new insights into the dynamic interaction of CCR5- and CXCR4-tropic HIV isolates that are potentially relevant in better understanding HIV-mediated pathogenesis.