Stability after thawing of RBCs frozen with the high- and low-glycerol method

BACKGROUND: RBCs can be frozen with either the high-glycerol method (HGM) or the low-glycerol method (LGM). To date, the use of frozen RBCs is hampered by a 24-hour outdating period after thawing. A closed washing system (ACP 215) may solve this problem. STUDY DESIGN AND METHODS: We compared the effects of high- (40%) and low-glycerol (19%) concentration, with and without freezing (at -80 degrees C for HGM, -196 degrees C for LGM) on the in vitro quality of RBCs after deglycerolization with the closed washing system and during storage at 4 degrees C in SAGM after thawing. RESULTS: Glycerol treatment by itself induced hemolysis during processing, which was more pronounced in HGM cells. The freeze-thaw-wash process decreased the stability of RBCs, particularly in LGM cells during storage after thawing. In contrast to LGM cells, in HGM cells no additional effect of freeze or thaw on stability of washed cells was seen during the first week of storage after thawing. Changes in osmotic resistance and cellular metabolism could not explain the observed differences in RBC stability. CONCLUSION: The closed washing system is able to process both high- and low-glycerol-treated RBCs. Stability after washing during cold storage in SAGM, as measured by hemolysis, is better for HGM cells as compared to LGM cells.     

Mechanical Properties and Eco-Efficiency of Steel Fiber Reinforced Alkali-Activated Slag Concrete

Conventional concrete production that uses ordinary Portland cement (OPC) as a binder seems unsustainable due to its high energy consumption, natural resource exhaustion and huge carbon dioxide (CO₂) emissions. To transform the conventional process of concrete production to a more sustainable process, the replacement of high energy-consumptive PC with new binders such as fly ash and alkali-activated slag (AAS) from available industrial by-products has been recognized as an alternative. This paper investigates the effect of curing conditions and steel fiber inclusion on the compressive and flexural performance of AAS concrete with a specified compressive strength of 40 MPa to evaluate the feasibility of AAS concrete as an alternative to normal concrete for CO₂ emission reduction in the concrete industry. Their performances are compared with reference concrete produced using OPC. The eco-efficiency of AAS use for concrete production was also evaluated by binder intensity and CO₂ intensity based on the test results and literature data. Test results show that it is possible to produce AAS concrete with compressive and flexural performances comparable to conventional concrete. Wet-curing and steel fiber inclusion improve the mechanical performance of AAS concrete. Also, the utilization of AAS as a sustainable binder can lead to significant CO₂ emissions reduction and resources and energy conservation in the concrete industry.     

Course and Predictors of Suicidality Over the First Two Years of Treatment in First-Episode Schizophrenia Spectrum Psychosis

The objective of this study was to investigate the course of suicidal behavior over the first 2 years of comprehensive, integrated treatment in two groups of patients with DSM-IV first episode schizophrenia spectrum psychosis, where one group was recruited through an early detection program. We have previously shown that the rate of severe suicidal behavior was lower in the earlier detected group than in the other. First episode schizophrenia is a high risk period for suicidality, but we found low rates of completed suicides and suicide attempts in both groups after 2 years in treatment, with no between-groups differences. Severe suicidality (plans and attempts) was predicted by drug abuse, dissatisfaction with life and severe suicidality at start of treatment.     

Comparing antiretroviral treatment outcomes between a prospective community-based and hospital-based cohort of HIV patients in rural Uganda

BACKGROUND: Improved availability of antiretroviral therapy in sub-Saharan Africa is intended to benefit all eligible HIV-infected patients; however in reality antiretroviral services are mainly offered in urban hospitals. Poor rural patients have difficulty accessing the drugs, making the provision of antiretroviral therapy inequitable. Initial tests of community-based treatment programs in Uganda suggest that home-based treatment of HIV/AIDS may equal hospital-based treatment; however the literature reveals limited experiences with such programs. THE RESEARCH: This intervention study aimed to; 1) assess the effectiveness of a rural community-based ART program in a subcounty (Rwimi) of Uganda; and 2) compare treatment outcomes and mortality in a rural community-based antiretroviral therapy program with a well-established hospital-based program. Ethics approvals were obtained in Canada and Uganda. RESULTS AND OUTCOMES: Successful treatment outcomes after two years in both the community and hospital cohorts were high. All-cause mortality was similar in both cohorts. However, community-based patients were more likely to achieve viral suppression and had good adherence to treatment. The community-based program was slightly more cost-effective. Per capita costs in both settings were unsustainable, representing more than Uganda's Primary Health Care Services current expenditures per person per year for all health services. The unpaid community volunteers showed high participation and low attrition rates for the two years that this program was evaluated. CHALLENGES AND SUCCESSES: Key successes of this study include the demonstration that antiretroviral therapy can be provided in a rural setting, the creation of a research infrastructure and culture within Kabarole's health system, and the establishment of a research collaboration capable of enriching the global health graduate program at the University of Alberta. Challenging questions about the long-term feasibility and sustainability of a community-based ARV program in Uganda still remain. THE PARTNERSHIP: This project is a continuation of previous successful collaborations between the School of Public Health of Makerere University, the School of Public Health of University of Alberta, the Kabarole District Administration and the Kabarole Research and Resource Center.     

The antinociceptive efficacy of HWTX-I epidurally administered in rheumatoid arthritis rats

Rheumatoid arthritis (RA) is one of the inflammatory kinds of arthritis in the clinical situation, and cytosolic Ca2+ overload has been proposed as one of the primary factors for many inflammatory cells activation, which lead to relative enzymes and inflammatory factors release. It is therefore accepted that Ca2+ channel blockers can protect joint injury from inflammation. In the present study we investigated the possible molecular mechanism of the antinociceptive efficacy of HWTX-I, a spider peptide toxin blocking Ca2+ channels, on the rat rheumatoid arthritis model. Our study demonstrates that HWTX-I can relieve pain in the inflammatory joints and eliminate arthrocele to some degree. Moreover, HWTX-I can also decrease the concentration of tumour necrosis factor α (TNF-α) and increase the concentration of interleukin 4(IL-4) and interleukin 10(IL-10) in rat's serum. HWTX-I can also decrease the mRNA expression level of related factors of TNF-α, interleukin 1β (IL-1β) and interleukin 6(IL-6) in inflammatory pathways in rheumatoid arthritis. Therefore, the present results show that the epidural administration of HWTX-I is effective in antinociception in the rat model of rheumatoid arthritis, which may act through its inhibition on certain inflammatory pathways.     

First-episode psychosis patients recruited into treatment via early detection teams versus ordinary pathways: course, outcome and health service use during first 2 years

Aim: Within an early detection sector, to compare the 1‐ and 2‐year course and outcome of first‐episode psychosis patients coming into the treatment system via active outreach detection teams (DTs) versus those achieving help via ordinary referral channels (not‐DT). Methods: Longitudinal, comparative study of two parallel consecutive samples using structured clinical interview for the DSM‐IV, Positive and Negative Syndrome Scale Score, Global Assessment of Functioning Scale and Premorbid Assessment of Functioning Scale. Results: The DT group had significantly better functioning at baseline, but this was reversed after 3 months. At 2 years the groups had similar outcome. The DT group developed a more serious diagnostic pattern, had more cases of schizophrenia, and was more frequently treated on an outpatient basis only. Conclusions: The DTs recruited more chronic patients with poorer prognostic features, but fewer symptoms and better functioning at baseline. At 2 years the DT‐patients did as well as the not‐DT patients. They recovered more slowly, but given sufficient time, responded as well to therapy as the not‐DT group.     

Inhibition of bone resorption in cultures of mouse calvariae by apicularen A

Apicularens A and B were isolated from the myxobacterial genus Chondromyces apiculatus JW184. Apicularen A inhibited bafilomycin A1-sensitive ATP-dependent proton transport into microsome vesicles more potently than apicularen B. Bone resorption in cultures of mouse calvariae induced by human parathyroid hormone (PTH) or interleukin-1beta (IL-1beta) was inhibited by apicularen A at 10 and 100 nM, while apicularen B had no effect. The bisphosphonate incadronate inhibited bone resorption at 100 nM, being less effective than apicularen A. Our findings indicate that apicularen A inhibits bone resorption induced by PTH or IL-1beta more potently than apicularen B, probably due to inhibition of the V-ATPase.     

Early detection and intervention in first-episode schizophrenia: a critical review

OBJECTIVE: To review the literature on early intervention in psychosis and to evaluate relevant studies. Method: Early intervention was defined as intervention in the prodromal phase (primary prevention) and intervention after the onset of psychosis, i.e. shortening of duration of untreated psychosis (DUP) (secondary prevention). RESULTS: We found few studies aimed at early intervention, but many papers discussing the idea at a more general level. We identified no studies that prove that intervention in the prodromal phase is possible without a high risk for treating false positives. We identified some studies aimed at reducing DUP, but the results are ambiguous and, until now, no follow-up data showing a positive effect on prognosis have been presented. CONCLUSION: Early intervention in psychosis is a difficult and important challenge for the psychiatric health services. At the time being reduction of DUP seems to be the most promising strategy. Intervention in the prodromal phase is more ethically and conceptually problematic.