Identification of abundant alkyl ether glycerophospholipids in the human lens by tandem mass spectrometry techniques

Previous studies have shown that the human lens contains glycerophospholipids with ether linkages. These lipids differ from conventional glycerophospholipids in that the sn-1 substituent is attached to the glycerol backbone via an 1-O-alkyl or an 1-O-alk-1'-enyl ether rather than an ester bond. The present investigation employed a combination of collision-induced dissociation (CID) and ozone-induced dissociation (OzID) to unambiguously distinguish such 1-O-alkyl and 1-O-alk-1'-enyl ethers. Using these methodologies the human lens was found to contain several abundant 1-O-alkyl glycerophos-phoethanolamines, including GPEtn(16:0e/9Z-18:1), GPEtn(11Z-18:1e/9Z-18:1), and GPEtn(18:0e/9Z-18:1), as well as a related series of unusual 1-O-alkyl glycerophosphoserines, including GPSer(16:0e/9Z-18:1), GPSer(11Z-18:1e/9Z-18:1), GPSer(18:0e/9Z-18:1) that to our knowledge have not previously been observed in human tissue. Isomeric 1-O-alk-1'-enyl ethers were absent or in low abundance. Examination of the double bond position within the phospholipids using OzID revealed that several positional isomers were present, including sites of unsaturation at the n-9, n-7, and even n-5 positions. Tandem CID/OzID experiments revealed a preference for double bonds in the n-7 position of 1-O-ether linked chains, while n-9 double bonds predominated in the ester-linked fatty acids [e.g., GPEtn(11Z-18:1e/9Z-18:1) and GPSer(11Z-18:1e/9Z-18:1)]. Different combinations of these double bond positional isomers within chains at the sn-1 and sn-2 positions point to a remarkable molecular diversity of ether-lipids within the human lens.

Elucidation of double bond position in unsaturated lipids by ozone electrospray ionization mass spectrometry

The position(s) of carbon-carbon double bonds within lipids can dramatically affect their structure and reactivity and thus has a direct bearing on biological function. Commonly employed mass spectrometric approaches to the characterization of complex lipids, however, fail to localize sites of unsaturation within the molecular structure and thus cannot distinguish naturally occurring regioisomers. In a recent communication \[Thomas, M. C.; Mitchell, T. W.; Blanksby, S. J. J. Am. Chem. Soc. 2006, 128, 58-59], we have presented a new technique for the elucidation of double bond position in glycerophospholipids using ozone-induced fragmentation within the source of a conventional electrospray ionization mass spectrometer. Here we report the on-line analysis, using ozone electrospray mass spectrometry (OzESI-MS), of a broad range of common unsaturated lipids including acidic and neutral glycerophospholipids, sphingomyelins, and triacylglycerols. All lipids analyzed are found to form a pair of chemically induced fragment ions diagnostic of the position of each double bond(s) regardless of the polarity, the number of charges, or the adduction (e.g., \[M - H](-), \[M - 2H](2-), \[M + H](+), \[M + Na](+), \[M + NH4](+)). The ability of OzESI-MS to distinguish lipids that differ only in the position of the double bonds is demonstrated using the glycerophosphocholine standards, GPCho(9Z-18:1/9Z-18:1) and GPCho(6Z-18:1/6Z-18:1). While these regioisomers cannot be differentiated by their conventional tandem mass spectra, the OzESI-MS spectra reveal abundant fragment ions of distinctive mass-to-charge ratio (m/z). The approach is found to be sufficiently robust to be used in conjunction with the m/z 184 precursor ion scans commonly employed for the identification of phosphocholine-containing lipids in shotgun lipidomic analyses. This tandem OzESI-MS approach was used, in conjunction with conventional tandem mass spectral analysis, for the structural characterization of an unknown sphingolipid in a crude lipid extract obtained from a human lens. The OzESI-MS data confirm the presence of two regioisomers, namely, SM(d18:0/15Z-24:1) and SM(d18:0/17Z-24:1), and suggest the possible presence of a third isomer, SM(d18:0/19Z-24:1), in lower abundance. The data presented herein demonstrate that OzESI-MS is a broadly applicable, on-line approach for structure determination and, when used in conjunction with established tandem mass spectrometric methods, can provide near complete structural characterization of a range of important lipid classes. As such, OzESI-MS may provide important new insight into the molecular diversity of naturally occurring lipids.

Ozone-induced dissociation : Elucidation of double bond position within mass-selected lipid ions

Ions formed from lipids during electrospray ionization of crude lipid extracts have been mass-selected within a quadrupole linear ion trap mass spectrometer and allowed to react with ozone vapor. Gas-phase ion-molecule reactions between unsaturated lipid ions and ozone are found to yield two primary product ions for each carbon-carbon double bond within the molecule. The mass-to-charge ratios of these chemically induced fragments are diagnostic of the position of unsaturation within the precursor ion. This novel analytical technique, dubbed ozone-induced dissociation (OzID), can be applied both in series and in parallel with conventional collision-induced dissociation (CID) to provide near-complete structural assignment of unknown lipids within complex mixtures without prior fractionation or derivatization. In this study, OzID is applied to a suite of complex lipid extracts from sources including human lens, bovine kidney, and commercial olive oil, thus demonstrating the technique to be applicable to a broad range of lipid classes including both neutral and acidic glycerophospholipids, sphingomyelins, and triacylglycerols. Gas-phase ozonolysis reactions are also observed with different types of precursor ions including \[M + H](+), \[M + Li](+), \[M + Na](+), and \[M H](-): in each case yielding fragmentation data that allow double bond position to be unambiguously assigned. Within the human lens lipid extract, three sphingomyelin regioisomers, namely SM(d18:0/15Z-24:1), SM(d18:0/17Z-24:1), and SM(d18:0/19Z-24:1), and a novel phosphatidylethanolamine alkyl ether, GPEtn(11Z-18:1e/9Z18:1), are identified using a combination of CID and OzID. These discoveries demonstrate that lipid identification based on CID alone belies the natural structural diversity in lipid biochemistry and illustrate the potential of OzID as a complementary approach within automated, high-throughput lipid analysis protocols.

Understanding the abnormal brain activity in epilepsy as a potential predictor of the onset of an epileptic seizure

The Brain Research Institute (BRI) uses various types of indirect measurements, including EEG and fMRI, to understand and assess brain activity and function. As well as the recovery of generic information about brain function, research also focuses on the utilisation of such data and understanding to study the initiation, dynamics, spread and suppression of epileptic seizures. To assist with the future focussing of this aspect of their research, the BRI asked the MISG 2010 participants to examine how the available EEG and fMRI data and current knowledge about epilepsy should be analysed and interpreted to yield an enhanced understanding about brain activity occurring before, at commencement of, during, and after a seizure. Though the deliberations of the study group were wide ranging in terms of the related matters considered and discussed, considerable progress was made with the following three aspects. (1) The science behind brain activity investigations depends crucially on the quality of the analysis and interpretation of, as well as the recovery of information from, EEG and fMRI measurements. A number of specific methodologies were discussed and formalised, including independent component analysis, principal component analysis, profile monitoring and change point analysis (hidden Markov modelling, time series analysis, discontinuity identification). (2) Even though EEG measurements accurately and very sensitively record the onset of an epileptic event or seizure, they are, from the perspective of understanding the internal initiation and localisation, of limited utility. They only record neuronal activity in the cortical (surface layer) neurons of the brain, which is a direct reflection of the type of electrical activity they have been designed to record. Because fMRI records, through the monitoring of blood flow activity, the location of localised brain activity within the brain, the possibility of combining fMRI measurements with EEG, as a joint inversion activity, was discussed and examined in detail. (3) A major goal for the BRI is to improve understanding about ``when'' (at what time) an epileptic seizure actually commenced before it is identified on an eeg recording, ``where'' the source of this initiation is located in the brain, and ``what'' is the initiator. Because of the general agreement in the literature that, in one way or another, epileptic events and seizures represent abnormal synchronisations of localised and/or global brain activity the modelling of synchronisations was examined in some detail. References C. M. Michel, G. Thut, S. Morand, A. Khateb, A. J. Pegna, R. Grave de Peralta, S. Gonzalez, M. Seeck and T. Landis, Electric source imaging of human brain functions, Brain Res. Rev. , 36 (2--3), 2001, 108--118. doi:10.1016/S0165-0173(01)00086-8 S. Ogawa, R. S. Menon, S. G. Kim and K. Ugurbil, On the characteristics of functional magnetic resonance imaging of the brain, Annu. Rev. Bioph. Biom. , 27 , 1998, 447--474. doi:10.1146/annurev.biophys.27.1.447 C. D. Binnie and H. Stefan, Modern electroencephalography: its role in epilepsy management, Clin. Neurophysiol. , 110 (10), 1999, 1671--1697. doi:10.1016/S1388-2457(99)00125-X J. X. Tao, A. Ray, S. Hawes-Ebersole and J. S. Ebersole, Intracranial eeg substrates of scalp eeg interictal spikes, Epilepsia , 46 (5), 2005, 669--76. doi:10.1111/j.1528-1167.2005.11404.x S. Ogawa, D. W. Tank, R. Menon, J. M. Ellermann, S. G. Kim, H. Merkle and K. Ugurbil, Intrinsic signal changes accompanying sensory stimulation: Functional brain mapping with magnetic resonance imaging, P. Natl. Acad. Sci. USA , 89 (13), 1992, 5951--5955. doi:10.1073/pnas.89.13.5951 J. Engel Jr., Report of the ilae classification core group, Epilepsia , 47 (9), 2006, 1558--1568. doi:10.1111/j.1528-1167.2006.00215.x L. Lemieux, A. Salek-Haddadi, O. Josephs, P. Allen, N. Toms, C. Scott, K. Krakow, R. Turner and D. R. Fish, Event-related fmri with simultaneous and continuous eeg: description of the method and initial case r port, NeuroImage , 14 (3), 2001, 780--7. doi:10.1006/nimg.2001.0853 P. Federico, D. F. Abbott, R. S. Briellmann, A. S. Harvey and G. D. Jackson, Functional mri of the pre-ictal state, Brain , 128 (8), 2005, 1811-7. doi:10.1093/brain/awh533 C. S. Hawco, A. P. Bagshaw, Y. Lu, F. Dubeau and J. Gotman, bold changes occur prior to epileptic spikes seen on scalp eeg, NeuroImage , 35 (4), 2007, 1450--1458. doi:10.1016/j.neuroimage.2006.12.042 F. Moeller, H. R. Siebner, S. Wolff, H. Muhle, R. Boor, O. Granert, O. Jansen, U. Stephani and M. Siniatchkin, Changes in activity of striato-thalamo-cortical network precede generalized spike wave discharges, NeuroImage , 39 (4), 2008, 1839--1849. doi:10.1016/j.neuroimage.2007.10.058 V. Osharina, E. Ponchel, A. Aarabi, R. Grebe and F. Wallois, Local haemodynamic changes preceding interictal spikes: A simultaneous electrocorticography (ecog) and near-infrared spectroscopy (nirs) analysis in rats, NeuroImage , 50 (2), 2010, 600--607. doi:10.1016/j.neuroimage.2010.01.009 R. S. Fisher, W. Boas, W. Blume, C. Elger, P. Genton, P. Lee and J. Engel, Epileptic seizures and epilepsy: Definitions proposed by the international league against epilepsy (ilae) and the international bureau for epilepsy (ibe), Epilepsia , 46 (4), 2005, 470--472. doi:10.1111/j.0013-9580.2005.66104.x H. Berger, Electroencephalogram in humans, Arch. Psychiat. Nerven. , 87 , 1929, 527--570. C. M. Michel, M. M. Murray, G. Lantz, S. Gonzalez, L. Spinelli and R. G. de Peralta, eeg source imaging, Clin. Neurophysiol. , 115 (10), 2004, 2195--2222. doi:10.1016/j.clinph.2004.06.001 P. L. Nunez and R. B. Silberstein, On the relationship of synaptic activity to macroscopic measurements: Does co-registration of eeg with fmri make sense?, Brain Topogr. , 13 (2), 2000, 79--96. doi:10.1023/A:1026683200895 S. Ogawa, T. M. Lee, A. R. Kay and D. W. Tank, Brain magnetic resonance imaging with contrast dependent on blood oxygenation, P. Natl. Acad. Sci. USA , 87 (24), 1990, 9868--9872. doi:10.1073/pnas.87.24.9868 J. S. Gati, R. S. Menon, K. Ugurbil and B. K. Rutt, Experimental determination of the bold field strength dependence in vessels and tissue, Magn. Reson. Med. , 38 (2), 1997, 296--302. doi:10.1002/mrm.1910380220 P. A. Bandettini, E. C. Wong, R. S. Hinks, R. S. Tikofsky and J. S. Hyde, Time course EPI of human brain function during task activation, Magn. Reson. Med. , 25 (2), 1992, 390--397. K. K. Kwong, J. W. Belliveau, D. A. Chesler, I. E. Goldberg, R. M. Weisskoff, B. P. Poncelet, D. N. Kennedy, B. E. Hoppelm, M. S. Cohen and R. Turner, Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation, P. Natl. Acad. Sci. USA , 89 (12), 1992, 5675--5679. doi:10.1073/pnas.89.12.5675 J. Frahm, K. D. Merboldt and W. Hnicke, Functional mri of human brain activation at high spatial resolution, Magn. Reson. Med. , 29 (1), 1993, 139--144. P. A. Bandettini, A. Jesmanowicz, E. C. Wong and J. S. Hyde, Processing strategies for time-course data sets in functional MRI of the human brain, Magn. Reson. Med. , 30 (2), 1993, 161--173. K. J. Friston, P. Jezzard and R. Turner, Analysis of functional MRI time-series, Hum. Brain Mapp. , 1 (2), 1994, 153--171. B. Biswal, F. Z. Yetkin, V. M. Haughton and J. S. Hyde, Functional connectivity in the motor cortex of resting human brain using echo-planar mri, Mag. Reson. Med. , 34 (4), 1995, 537--541. doi:10.1002/mrm.1910340409 K. J. Friston, J. Ashburner, C. D. Frith, J. Poline, J. D. Heather and R. S. J. Frackowiak, Spatial registration and normalization of images, Hum. Brain Mapp. , 3 (3), 1995, 165--189. K. J. Friston, S. Williams, R. Howard, R. S. Frackowiak and R. Turner, Movement-related effects in fmri time-series, Magn. Reson. Med. , 35 (3), 1996, 346--355. G. H. Glover, T. Q. Li and D. Ress, Image-based method for retrospective correction of physiological motion effects in fmri: Retroicor, Magn. Reson. Med. , 44 (1), 2000, 162--167. doi:10.1002/1522-2594(200007)44:13.0.CO;2-E K. J. Friston, O. Josephs, G. Rees and R. Turner, Nonlinear event-related responses in fmri, Magn. Reson. Med. , 39 (1), 1998, 41--52. doi:10.1002/mrm.1910390109 K. Ugurbil, L. Toth and D. Kim, How accurate is magnetic resonance imaging of brain function?, Trends Neurosci. , 26 (2), 2003, 108--114. doi:10.1016/S0166-2236(02)00039-5 D. S. Kim, I. Ronen, C. Olman, S. G. Kim, K. Ugurbil and L. J. Toth, Spatial relationship between neuronal activity and bold functional mri, NeuroImage , 21 (3), 2004, 876--885. doi:10.1016/j.neuroimage.2003.10.018 A. Connelly, G. D. Jackson, R. S. Frackowiak, J. W. Belliveau, F. Vargha-Khadem and D. G. Gadian, Functional mapping of activated human primary cortex with a clinical mr imaging system, Radiology , 188 (1), 1993, 125--130. L. Allison, Hidden Markov Models, Technical Report , School of Computer and Software Engineering, Monash University, 2000. R. J. Elliott, L. Aggoun and J.B. Moore, Hidden Markov Models: Estimation and Control, Appl. Math.-Czech. , 2004. B. Bhavnagri, Discontinuities of plane functions projected from a surface with methods for finding these , Technical Report, 2009. B. Bhavnagri, Computer Vision using Shape Spaces , Technical Report,1996, University of Adelaide. B. Bhavnagri, A method for representing shape based on an equivalence relation on polygons, Pattern Recogn. , 27 (2), 1994, 247--260. doi:10.1016/0031-3203(94)90057-4 D. F. Abbott, A. B. Waites, A. S. Harvey and G. D. Jackson, Exploring epileptic seizure onset with fmri, NeuroImage , 36(S1) (344TH-PM), 2007. M. C. Mackey and L. Glass, Oscillation and chaos in physiological control systems, Science , 197 , 1977, 287--289. S. H. Strogatz, SYNC - The Emerging Science of Spontaneous Order , Theia, New York, 2003. J. W. Kim, J. A. Roberts and P. A. Robinson, Dynamics of epileptic seizures: Evolution, spreading, and suppression, J. Theor. Biol. , 257 (4), 2009, 527--532. doi:10.1016/j.jtbi.2008.12.009 Y. Kuramoto, T. Aoyagi, I. Nishikawa, T. Chawanya T and K. Okuda, Neural network model carrying phase information with application to collective dynamics, J. Theor. Phys. , 87 (5), 1992, 1119--1126. V. B. Mountcastle, The columnar organization of the neocortex, Brain , 120 (4), 1997, 701. doi:10.1093/brain/120.4.701 F. L. Silva, W. Blanes, S. N. Kalitzin, J. Parra, P. Suffczynski and D. N. Velis, Epilepsies as dynamical diseases of brain systems: Basic models of the transition between normal and epileptic activity, Epilepsia , 44 (12), 2003, 72--83. F. H. Lopes da Silva, W. Blanes, S. N. Kalitzin, J. Parra, P. Suffczynski and D. N. Velis, Dynamical diseases of brain systems: different routes to epileptic seizures, ieee T. Bio-Med. Eng. , 50 (5), 2003, 540. L.D. Iasemidis, Epileptic seizure prediction and control, ieee T. Bio-Med. Eng. , 50 (5), 2003, 549--558. L. D. Iasemidis, D. S. Shiau, W. Chaovalitwongse, J. C. Sackellares, P. M. Pardalos, J. C. Principe, P. R. Carney, A. Prasad, B. Veeramani, and K. Tsakalis, Adaptive epileptic seizure prediction system, ieee T. Bio-Med. Eng. , 50 (5), 2003, 616--627. K. Lehnertz, F. Mormann, T. Kreuz, R.G. Andrzejak, C. Rieke, P. David and C. E. Elger, Seizure prediction by nonlinear eeg analysis, ieee Eng. Med. Biol. , 22 (1), 2003, 57--63. doi:10.1109/MEMB.2003.1191451 K. Lehnertz, R. G. Andrzejak, J. Arnhold, T. Kreuz, F. Mormann, C. Rieke, G. Widman and C. E. Elger, Nonlinear eeg analysis in epilepsy: Its possible use for interictal focus localization, seizure anticipation, and prevention, J. Clin. Neurophysiol. , 18 (3), 2001, 209. B. Litt and K. Lehnertz, Seizure prediction and the preseizure period, Curr. Opin. Neurol. , 15 (2), 2002, 173. doi:10.1097/00019052-200204000-00008 B. Litt and J. Echauz, Prediction of epileptic seizures, Lancet Neurol. , 1 (1), 2002, 22--30. doi:10.1016/S1474-4422(02)00003-0 M. M{a}kiranta, J. Ruohonen, K Suominen, J. Niinim{a}ki, E. Sonkaj{a}rvi, V. Kiviniemi, T. Sepp{a}nen, S. Alahuhta, V. J{a}ntti and O. Tervonen, {bold} signal increase preceeds eeg spike activity--a dynamic penicillin induced focal epilepsy in deep anesthesia, NeuroImage , 27 (4), 2005, 715--724. doi:10.1016/j.neuroimage.2005.05.025 K. Lehnertz, F. Mormann, H. Osterhage, A. M{u}ller, J. Prusseit, A. Chernihovskyi, M. Staniek, D. Krug, S. Bialonski and C. E. Elger, State-of-the-art of seizure prediction, J. Clin. Neurophysiol. , 24 (2), 2007, 147. doi:10.1097/WNP.0b013e3180336f16 F. Mormann, T. Kreuz, C. Rieke, R. G. Andrzejak, A. Kraskov, P. David, C. E. Elger and K. Lehnertz, On the predictability of epileptic seizures, Clin. Neurophysiol. , 116 (3), 2005, 569--587. doi:10.1016/j.clinph.2004.08.025 F. Mormann, R. G. Andrzejak, C. E. Elger and K. Lehnertz, Seizure prediction: the long and winding road, Brain , 130 (2), 2007, 314--333. doi:10.1093/brain/awl241 Z. Rogowski, I. Gath and E. Bental, On the prediction of epileptic seizures, Biol. Cybern. , 42 (1), 1981, 9--15. Y. Salant, I. Gath, O. Henriksen, Prediction of epileptic seizures from two-channel eeg, Med. Biol. Eng. Comput. , 36 (5), 1998, 549--556. doi:10.1007/BF02524422 J. Gotman and D.J. Koffler, Interictal spiking increases after seizures but does not after decrease in medication, Evoked Potential , 72 (1), 1989, 7--15. J. Gotman and M. G. Marciani, Electroencephalographic spiking activity, drug levels, and seizure occurence in epileptic patients, Ann. Neurol. , 17 (6), 1985, 59--603. A. Katz, D. A. Marks, G. McCarthy and S. S. Spencer, Does interictal spiking change prior to seizures?, Electroen. Clin. Neuro. , 79 (2), 1991, 153--156. A. Granada, R. M. Hennig, B. Ronacher, A. Kramer and H. Herzel, Phase Response Curves: Elucidating the dynamics of couples oscillators, Method Enzymol. , 454 (A), 2009, 1--27. doi:10.1016/S0076-6879(08)03801-9 doi:10.1016/S0076-6879(08)03801-9 H. Kantz and T. Schreiber, Nonlinear time series analysis , 2004, Cambridge Univ Press. M. V. L. Bennett and R. S Zukin, Electrical coupling and neuronal synchronization in the mammalian brain, Neuron , 41 (4), 2004, 495 --511. doi:10.1016/S0896-6273(04)00043-1 L.D. Iasemidis, J. Chris Sackellares, H. P. Zaveri and W. J. Williams, Phase space topography and the Lyapunov exponent of electrocorticograms in partial seizures, Brain Topogr. , 2 (3), 1990, 187--201. doi:10.1007/BF01140588 M. Le Van Quyen, J. Martinerie, V. Navarro, M. Baulac and F. J. Varela, Characterizing neurodynamic changes before seizures, J. Clin. Neurophysiol. , 18 (3), 2001, 191. J. Martinerie, C. Adam, M. Le Van Quyen, M. Baulac, S. Clemenceau, B. Renault and F. J. Varela, Epileptic seizures can be anticipated by non-linear analysis, Nat. Med. , 4 (10), 1998, 1173--1176. doi:10.1038/2667 A. Pikovsky, M. Rosenblum, J. Kurths and R. C. Hilborn, Synchronization: A universal concept in nonlinear science, Amer. J. Phys. , 70 , 2002, 655. H. R. Wilson and J. D. Cowan, Excitatory and inhibitory interactions in localized populations of model neurons, Biophys. J. , 12 (1), 1972, 1--24. D. Cumin and C. P. Unsworth, Generalising the Kuramoto model for the study of neuronal synchronisation in the brain, Physica D , 226 (2), 2007, 181--196. doi:10.1016/j.physd.2006.12.004 F. K. Skinner, H. Bazzazi and S. A. Campbell, Two-cell to N-cell heterogeneous, inhibitory networks: Precise linking of multistable and coherent properties, J. Comput. Neurosci. , 18 (3), 2005, 343--352. doi:10.1007/s10827-005-0331-1 W. W. Lytton, Computer modelling of epilepsy, Nat. Rev. Neurosci. , 9 (8), 2008, 626--637. doi:10.1038/nrn2416 R. D. Traub, A. Bibbig, F. E. N. LeBeau, E. H. Buhl and M. A. Whittington, Cellular mechanisms of neuronal population oscillations in the hippocampus in vitro, Ann. Rev. , 2004. R. D. Traub, A. Draguhn, M. A. Whittington, T. Baldeweg, A. Bibbig, E. H. Buhl and D. Schmitz, Axonal gap junc ions between principal neurons: A novel source of network oscillations, and perhaps epileptogenesis., Rev. Neuroscience , 13 (1), 2002, 1. doi:10.1146/annurev.neuro.27.070203.144303 M. Scheffer, J. Bascompte, W. A. Brock, V. Brovkin, S. R. Carpenter, V. Dakos, H. Held, E. H. van Nes, M. Rietkerk and G. Sugihara, Early-warning signals for critical transitions, Nature , 461 (7260), 2009, 53--59. doi:10.1038/nature08227 K. Murphy, A Brief Introduction to Graphical Models and Bayesian Networks , 2008, http://www.cs.ubc.ca/murphyk/Bayes/bnintro.html . R. C. Bradley, An elementary

Increasing incidence of Clostridium difficile infection, Australia, 2011–2012

Objectives: To report the quarterly incidence of hospital-identified Clostridium difficile infection (HI-CDI) in Australia, and to estimate the burden ascribed to hospital-associated (HA) and community-associated (CA) infections. Design, setting and patients: Prospective surveillance of all cases of CDI diagnosed in hospital patients from 1 January 2011 to 31 December 2012 in 450 public hospitals in all Australian states and the Australian Capital Territory. All patients admitted to inpatient wards or units in acute public hospitals, including psychiatry, rehabilitation and aged care, were included, as well as those attending emergency departments and outpatient clinics. Main outcome measures: Incidence of HI-CDI (primary outcome); proportion and incidence of HA-CDI and CA-CDI (secondary outcomes). Results: The annual incidence of HI-CDI increased from 3.25/10 000 patient-days (PD) in 2011 to 4.03/10 000 PD in 2012. Poisson regression modelling demonstrated a 29% increase (95% CI, 25% to 34%) per quarter between April and December 2011, with a peak of 4.49/10 000 PD in the October–December quarter. The incidence plateaued in January–March 2012 and then declined by 8% (95% CI, − 11% to − 5%) per quarter to 3.76/10 000 PD in July–September 2012, after which the rate rose again by 11% (95% CI, 4% to 19%) per quarter to 4.09/10 000 PD in October–December 2012. Trends were similar for HA-CDI and CA-CDI. A subgroup analysis determined that 26% of cases were CA-CDI. Conclusions: A significant increase in both HA-CDI and CA-CDI identified through hospital surveillance occurred in Australia during 2011–2012. Studies are required to further characterise the epidemiology of CDI in Australia.

Professional Responsibility and Legal Ethics in Queensland [2nd Ed.]

Professional Responsibility and Legal Ethics in Queensland offers a proven, practical approach to identifying and resolving ethical issues that may arise in daily legal practice in Queensland. It is an excellent resource for practitioners and students alike who need to navigate relevant legislation and understand legal ethics through accessible, problem-based scenarios. The introduction of the Australian Solicitors Conduct Rules and Barristers’ Rule 2011, and changes to enforcement mechanisms where breaches have occurred, make the Second Edition essential reading for solicitors, barristers and law students in Queensland. Diverse practice structures, the enactment of the new rules, and other legislative developments will affect lawyers’ work and the way they must interact with their clients, with each other and with the court. Providing detailed explanation and analysis of these changes, the authors explain the ethical and regulatory environment for Queensland lawyers as the national legal services market continues to evolve.

Induction of epithelial-mesenchymal transition (EMT) in breast cancer cells is calcium signal dependent

Signals from the tumor microenvironment trigger cancer cells to adopt an invasive phenotype through epithelial-mesenchymal transition (EMT). Relatively little is known regarding key signal transduction pathways that serve as cytosolic bridges between cell surface receptors and nuclear transcription factors to induce EMT. A better understanding of these early EMT events may identify potential targets for the control of metastasis. One rapid intracellular signaling pathway that has not yet been explored during EMT induction is calcium. Here we show that stimuli used to induce EMT produce a transient increase in cytosolic calcium levels in human breast cancer cells. Attenuation of the calcium signal by intracellular calcium chelation significantly reduced epidermal growth factor (EGF)- and hypoxia-induced EMT. Intracellular calcium chelation also inhibited EGF-induced activation of signal transducer and activator of transcription 3 (STAT3), while preserving other signal transduction pathways such as Akt and extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation. To identify calcium-permeable channels that may regulate EMT induction in breast cancer cells, we performed a targeted siRNA-based screen. We found that transient receptor potential-melastatin-like 7 (TRPM7) channel expression regulated EGF-induced STAT3 phosphorylation and expression of the EMT marker vimentin. Although intracellular calcium chelation almost completely blocked the induction of many EMT markers, including vimentin, Twist and N-cadherin, the effect of TRPM7 silencing was specific for vimentin protein expression and STAT3 phosphorylation. These results indicate that TRPM7 is a partial regulator of EMT in breast cancer cells, and that other calcium-permeable ion channels are also involved in calcium-dependent EMT induction. In summary, this work establishes an important role for the intracellular calcium signal in the induction of EMT in human breast cancer cells. Manipulation of calcium-signaling pathways controlling EMT induction in cancer cells may therefore be an important therapeutic strategy for preventing metastases.

Prenylated Alkylbisphenols from Grevillea whiteana

Eleven new bisresorcinols including four mixtures each of two isomers and one resorcinol/phloroglucinol derivative, together with five known resorcinols have been isolated from the ethyl acetate extract of sterns of Grevillea whiteana. The new Compounds were identified as 4-(3-hydroxy-3-methylbutyl)grebustol-B (10a), 4'-(3-hydroxy-3-methylbutyl)grebustol-B (10b), 4-(4-hydroxy-3-methylbutyl)grebustol-B (2a) and 4'-(4-hydroxy-3-methylbutyl) rebustol-B (2b), 2,2-dimethyldihydropyrano grebustol-B (11a) and iso-2,2-dimethyldihydropyranogrebustol-B (11b), 2,2-dimethyl-3 xi-hydroxydihydropyranogrebustol-B (7a) and iso-2,2-dimethyl-3 xi-hydroxydihydropyranogrebustol-B (7b), 15-(2-(4-hydroxy-3-methylbutyl)-resorcinol-5-yl)-1-(phloroglucinolyl )-9(Z)pentadecen-one (whiteanone) (4), 5,5'-(hexadecan-diyl)bisresorcinol (12) and 2-methyl-5,5'-(8(Z)hexadecen-1,16-diyl)bisresorcinol (9). This is the first record of pyranobisresorcinols in the genus and the first report of a phloroglucinol terminal Phenolic unit in any Grevillea species.

Prenylated bisresorcinols from Grevillea floribunda

Seven new bisresorcinol derivatives, together with four known resorcinols. have been isolated from the ethyl acetate extract of the sterns of Grevillea floribunda. Five of the new compounds (floribol A-E) were characterized as bisnorstriatol derivatives Substituted at C-2 of both resorcinol units with variously modified prenyl (3-methylbut-2-enyl) units. The remaining two new compounds are similarly Substituted derivatived of grebustol-B. (c) 2008 Phytochemical Society of Europe Published by Elsevier B.V. All rights reserved.

Review : "Genetic Privacy: A challenge to Medico-Legal Norms" by Laurie, G

The discovery by Watson and Crick of the structure of DNA is one of the great scientific discoveries. In the period since that discovery new areas of genetic research have opened up which hold out the hope of developing treatments or cures for many illnesses and diseases. Yet with these discoveries have also come an array of ethical and legal dilemmas about the use of genetic information and concerns about the potential for those with genetic diseases or conditions to be stigmatised and discriminated against. The discussion about the developments in genetic science has become increasingly, a debate about the use of genetic information within our society. Graeme Laurie’s book, Genetic Privacy: A Challenge to Medico-Legal Norms, guides the reader through the complexities of these debates by considering what we mean by privacy and asking whether our existing concepts are adequate to meet the challenges posed by the new genetics.

Evidence based physical activity for school-age youth

Objectives To review the effects of physical activity on health and behavior outcomes and develop evidence-based recommendations for physical activity in youth. Study design A systematic literature review identified 850 articles; additional papers were identified by the expert panelists. Articles in the identified outcome areas were reviewed, evaluated and summarized by an expert panelist. The strength of the evidence, conclusions, key issues, and gaps in the evidence were abstracted in a standardized format and presented and discussed by panelists and organizational representatives. Results Most intervention studies used supervised programs of moderate to vigorous physical activity of 30 to 45 minutes duration 3 to 5 days per week. The panel believed that a greater amount of physical activity would be necessary to achieve similar beneficial effects on health and behavioral outcomes in ordinary daily circumstances (typically intermittent and unsupervised activity). Conclusion School-age youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate, enjoyable, and involves a variety of activities.

Psychometric properties of the modified RESIDE physical activity questionnaire among low-income overweight women

Objectives This study explored the criterion-related validity and test-retest reliability of the modified RESIDential Environment physical activity questionnaire and whether the instrument's validity varied by body mass index, education, race/ethnicity, or employment status. Design Validation study using baseline data collected for randomized trial of a weight loss intervention. Methods Participants recruited from health departments wore an ActiGraph accelerometer and self-reported non-occupational walking, moderate and vigorous physical activity on the modified RESIDential Environment questionnaire. We assessed validity (n = 152) using Spearman correlation coefficients, and reliability (n = 57) using intraclass correlation coefficients. Results When compared to steps, moderate physical activity, and bouts of moderate/vigorous physical activity measured by accelerometer, these questionnaire measures showed fair evidence for validity: recreational walking (Spearman correlation coefficients 0.23–0.36), total walking (Spearman correlation coefficients 0.24–0.37), and total moderate physical activity (Spearman correlation coefficients 0.18–0.36). Correlations for self-reported walking and moderate physical activity were higher among unemployed participants and women with lower body mass indices. Generally no other variability in the validity of the instrument was found. Evidence for reliability of RESIDential Environment measures of recreational walking, total walking, and total moderate physical activity was substantial (intraclass correlation coefficients 0.56–0.68). Conclusions Evidence for questionnaire validity and reliability varied by activity domain and was strongest for walking measures. The questionnaire may capture physical activity less accurately among women with higher body mass indices and employed participants. Capturing occupational activity, specifically walking at work, may improve questionnaire validity.

An integrative framework of supervisor responses to workgroup conflict

It is well-established that prolonged exposure to workplace conflict, as a work stressor, is linked to physical illness and psychological dysfunction in employees (see Spector and Jex, 1998; Romanov, Appelberg, Honkasalo, and Koskenvuo, 1996; Skogstad, Einarsen, Torsheim, Aasland, and Hetland, 2007). In addition to the negative implications for physiological and psychological health, workplace conflict has been shown to influence employee behaviors that have consequences for organizational effectiveness (e.g., turnover and impaired performance; see Bowling and Beehr, 2006; De Dreu and Weingart, 2003). Further, research suggests that managers spend approximately 20 percent of their time managing conflict (Thomas, 1992; Baron, 1989). There also are substantial financial implications associated with workplace conflict. For example, in the United Kingdom, costs at the national level for sickness absence and replacement costs has been estimated to be close to £2 billion per annum (Hoel, Sparks, and Cooper, 2001).

Calibration and validation of wearable monitors

Background Wearable monitors are increasingly being used to objectively monitor physical activity in research studies within the field of exercise science. Calibration and validation of these devices are vital to obtaining accurate data. This article is aimed primarily at the physical activity measurement specialist, although the end user who is conducting studies with these devices also may benefit from knowing about this topic. Best Practices Initially, wearable physical activity monitors should undergo unit calibration to ensure interinstrument reliability. The next step is to simultaneously collect both raw signal data (e.g., acceleration) from the wearable monitors and rates of energy expenditure, so that algorithms can be developed to convert the direct signals into energy expenditure. This process should use multiple wearable monitors and a large and diverse subject group and should include a wide range of physical activities commonly performed in daily life (from sedentary to vigorous). Future Directions New methods of calibration now use "pattern recognition" approaches to train the algorithms on various activities, and they provide estimates of energy expenditure that are much better than those previously available with the single-regression approach. Once a method of predicting energy expenditure has been established, the next step is to examine its predictive accuracy by cross-validating it in other populations. In this article, we attempt to summarize the best practices for calibration and validation of wearable physical activity monitors. Finally, we conclude with some ideas for future research ideas that will move the field of physical activity measurement forward.

Randomized trial of a clinic-based, community-supported, lifestyle intervention to improve physical activity and diet : The North Carolina enhanced WISEWOMAN project

Objective To determine if a clinic-based behavioral intervention program for low-income mid-life women that emphasizes use of community resources will increase moderate intensity physical activity (PA) and improve dietary intake. Methods Randomized trial conducted from May 2003 to December 2004 at one community health center in Wilmington, NC. A total of 236 women, ages 40–64, were randomized to receive an Enhanced Intervention (EI) or Minimal Intervention (MI). The EI consisted of an intensive phase (6 months) including 2 individual counseling sessions, 3 group sessions, and 3 phone calls from a peer counselor followed by a maintenance phase (6 months) including 1 individual counseling session and 7 monthly peer counselor calls. Both phases included efforts to increase participants' use of community resources that promote positive lifestyle change. The MI consisted of a one-time mailing of pamphlets on diet and PA. Outcomes, measured at 6 and 12 months, included the comparison of moderate intensity PA between study groups as assessed by accelerometer (primary outcome) and questionnaire, and dietary intake assessed by questionnaire and serum carotenoids (6 months only). Results For accelerometer outcomes, follow-up was 75% at 6 months and 73% at 12 months. Though moderate intensity PA increased in the EI and decreased in the MI, the difference between groups was not statistically significant (p = 0.45; multivariate model, p = 0.08); however, moderate intensity PA assessed by questionnaire (92% follow-up at 6 months and 75% at 12 months) was greater in the EI (p = 0.01; multivariate model, p = 0.001). For dietary outcomes, follow-up was 90% for questionnaire and 92% for serum carotenoids at 6 months and 74% for questionnaire at 12 months. Dietary intake improved more in the EI compared to the MI (questionnaire at 6 and 12 months, p < 0.001; serum carotenoid index, p = 0.05; multivariate model, p = 0.03). Conclusion The EI did not improve objectively measured PA, but was associated with improved self-reported and objective measures of dietary intake.