Responses to Subchronic Inhalation of Low Concentrations of Diesel Exhaust and Hardwood Smoke Measured in Rat Bronchoalveolar Lavage Fluid

Abstract

Air pollution exposure is associated with adverse health effects, but the causal components and mechanisms are unclear. We compared effects of daily exposure for 6 mo to diesel exhaust (DE) or hardwood smoke (HWS) at 4 concentrations between 30 and 1000 μg/³ of total particulate matter, or filtered air, in male and female rats. Lung lavage fluid was assayed for toxicity indicators, cytokines, and glutathione. Statistical analyses included pairwise comparisons with control and exposure-related trends, modeled using techniques that facilitated evaluation of nonlinear exposure effects. Lactate dehydrogenase increased with exposure concentration in DE-exposed females, but in other groups, low exposure concentrations caused increases while higher concentrations had less effect. Total protein in the HWS-exposed males and females followed similar patterns. Alkaline phosphatase increased in DE-exposed females, but decreased in HWS-exposed males and females. β-Glucuronidase decreased in HWS- and DE-exposed males, but HWS-exposed females showed decreases at low exposure concentrations and weak increases at higher exposure concentrations. Macrophage inflammatory protein-2 decreased in HWS-exposed males and females and DE-exposed females. Tumor necrosis factor-α levels decreased in DE-exposed females and males, but HWS-exposed males showed small increases. DE did not affect total glutathione in either gender, but HWS decreased glutathione in females, while in males, increases at low exposure concentrations but not at higher exposure levels were observed. Thus, these two combustion emissions differentially affect lung responses, with gender affecting response patterns. Furthermore, effects may be nonmonotonic functions of exposure levels, with maximal responses in environmentally or occupationally relevant exposure ranges.     

Addiction treatment outcomes,process and change: Texas Institute of Behavioral Research at Texas Christian University

For more than 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services and various cognitive and behavioral interventions. Emphasis has been on studies in real‐world settings and the use of multivariate methodologies to address evaluation issues within the context of longitudinal natural designs. Historically, its program of addiction treatment research may be divided into three sequential epochs—the first era dealt mainly with client assessment and its role in treatment outcome and evaluation (1969–89), the second focused upon modeling the treatment process and the importance of conceptual frameworks (1989–2009) in explaining the relationships among treatment environment, client attributes, treatment process and outcome, and the third (and current) era has expanded into studying tactical deployment of innovations and implementation. Recent projects focus upon adapting and implementing innovations for improving early engagement in adolescent residential treatment settings and drug‐dependent criminal justice populations. Related issues include the spread of human immunodeficiency virus/acquired immune deficiency syndrome and other infectious diseases, organizational and systems functioning, treatment costs and process related to implementation of evidence‐based practices.     

An evaluation of the psychometric properties of the Purdue Pharmacist Directive Guidance Scale using SPSS and R software packages

BackgroundThe Purdue Pharmacist Directive Guidance (PPDG) Scale was developed to assess patients’ perceptions of the level of pharmacist-provided (1) instruction and (2) feedback and goal-setting—2 aspects of pharmaceutical care. Calculations of its psychometric properties stemming from SPSS and R were similar, but distinct differences were apparent.ObjectiveUsing SPSS and R software packages, researchers aimed to examine the construct validity of the PPDG using a higher order factoring procedure; in tandem, McDonald's omega and Cronbach's alpha were calculated as means of reliability analyses.MethodsNinety-nine patients with either type I or type II diabetes, aged 18 years or older, able to read and write English, and who could provide written-informed consent participated in the study. Data were collected in 8 community pharmacies in New Mexico. Using R, (1) a principal axis factor analysis with promax (oblique) rotation was conducted, (2) a Schmid-Leiman transformation was attained, and (3) McDonald's omega and Cronbach's alpha were computed. Using SPSS, subscale findings were validated by conducting a principal axis factor analysis with promax rotation; strict parallels and Cronbach's alpha reliabilities were calculated.ResultsMcDonald's omega and Cronbach's alpha were robust, with coefficients greater than 0.90; principal axis factor analysis with promax rotation revealed construct similarities with an overall general factor emerging from R.ConclusionsFurther subjecting the PPDG to rigorous psychometric testing revealed stronger quantitative support of the overall general factor of directive guidance and subscales of instruction and feedback and goal-setting.     

The influence of extreme speeds on scapula kinematics and the importance of controlling the plane of elevation

BackgroundThe effect of high-speed movement on scapula kinematics is not clear from the literature. Understanding these effects is important for clinicians examining, managing and understanding scapula kinematic pathologies: impingement, glenohumeral instability, muscle patterning instability and athletic injuries. The scapula tracking methodology and the lack of quantified control of the movement's plane of elevation limits previous studies. The aim of the present study is to use improved dynamic scapula kinematic measurement to assess differences during planar movements across different speeds. Athletic and maximal speeds, neglected in previous studies, are the focus.MethodsThirteen subjects performed slow, fast and maximal scapula plane abduction and forward flexion. A previously validated skin-fixed scapula tracker was used and optimally calibrated. A stiff board controlled the plane of elevation. Scapula kinematics were consistent with the literature.FindingsLarge and statistically significant differences were found to exist between scapula kinematics at slow speeds compared to fast and maximal speeds in lateral rotation and protraction. Although some differences were observed in the plane of elevation between speeds, these were not considered to effect the conclusions.InterpretationThe speed of movement should be considered an important factor affecting scapula kinematics. Clinical studies analysing muscle recruitment strategies and causes of injury in athletic tasks must account for changing kinematics rather than extrapolating slow or static measures and effective clinical examination and management of pathology must take these kinematic changes into account. Control of the plane of movement is challenging and its effectiveness must be quantified in future kinematic studies.     

Out-of-Hospital Cardiac Arrest –Optimal Management

Out-of-hospital cardiac arrest (OHCA) has attracted increasing attention over the past years because outcomes have improved impressively lately. The changes for neurological intact outcomes has been poor but several areas have achieved improving survival rates after adjusting their cardiac arrest care. The pre-hospital management is certainly key and decides whether a cardiac arrest patient can be brought back into a spontaneous circulation. However, the whole chain of resuscitation including the in-hospital care have improved also. This review describes aetiologies of OHCA, risk and potential protective factors and recent advances in the pre-hospital and in-hospital management of these patients.     

A needs assessment study of what health care consumers seek from social media and social networking

Given that prevention is crucial to long healthy life and restraining escalating health care costs, this study examines social media and networking (SM&N) needs among health consumers regarding preventive health. Results showed the most important SM&N needs included: education about health issues, connecting to a support group, knowing the implications of health condition, opportunities and understanding of preventive health care, and tracking physical activity. Among demographic groups women, younger aged groups, and African Americans considered SM&N needs to be more important. Homemakers indicated greatest need for information about health issues and facilitating interaction with others. Full-time employees placed greater importance on managing their own health.     

Imaging mass spectrometry of intraspecies metabolic exchange revealed the cannibalistic factors of Bacillus subtilis

During bacterial cannibalism, a differentiated subpopulation harvests nutrients from their genetically identical siblings to allow continued growth in nutrient-limited conditions. Hypothesis-driven imaging mass spectrometry (IMS) was used to identify metabolites active in a Bacillus subtilis cannibalism system in which sporulating cells lyse nonsporulating siblings. Two candidate molecules with sequences matching the products of skfA and sdpC, genes for the proposed cannibalistic factors sporulation killing factor (SKF) and sporulation delaying protein (SDP), respectively, were identified and the structures of the final products elucidated. SKF is a cyclic 26-amino acid (aa) peptide that is posttranslationally modified with one disulfide and one cysteine thioether bridged to the α-position of a methionine, a posttranslational modification not previously described in biology. SDP is a 42-residue peptide with one disulfide bridge. In spot test assays on solid medium, overproduced SKF and SDP enact a cannibalistic killing effect with SDP having higher potency. However, only purified SDP affected B. subtilis cells in liquid media in fluorescence microscopy and growth assays. Specifically, SDP treatment delayed growth in a concentration-dependent manner, caused increases in cell permeability, and ultimately caused cell lysis accompanied by the production of membrane tubules and spheres. Similarly, SDP but not SKF was able to inhibit the growth of the pathogens Staphylococcus aureus and Staphylococcus epidermidis with comparable IC₅₀ to vancomycin. This investigation, with the identification of SKF and SDP structures, highlights the strength of IMS in investigations of metabolic exchange of microbial colonies and also demonstrates IMS as a promising approach to discover novel biologically active molecules.     

Modified technique to extract malpositioned or migrated self-expanding stents from the esophagus and stomach

Background and Aim:  Various methods have been used to remove self expandable stents (SES) because of either malposition or migration. The main difficulties encountered in such situations are the anatomic obstacle of the lower and upper esophageal sphincters as well as risk of mucosal injury during removal.
Methods:  We describe a modified approach using an esophagogastroduodenoscope (EGD) in combination with a foreign body hood protector, rat tooth forceps and snare allowing for successful SES removal from the upper gastrointestinal tract in four cases.
Results:  In all cases, the SES were successfully removed from upper gastrointestinal tract using this technique. No complications were noted after extraction.
Conclusion:  The foreign body hood protector combined with rat tooth forceps/snare technique is a safe and effective alternative to previously described methods for extraction of SES from the upper gastrointestinal tract. This method may be applicable for the removal of other such objects within the endoscope's reach.