Hepatitis B revaccination for healthcare workers who are anti-HBs-negative after receiving a primary vaccination series

INTRODUCTION: This study aimed to evaluate the response to hepatitis B (HB) revaccination of healthcare workers (HCW) who are negative for antibodies to HB surface antigen (anti-HBs) after a complete vaccination series. METHODS: HCW whose anti-HBs test was performed > 90 days after a HB vaccination course were given a 4th dose. A post-vaccination test was done within 30 to 90 days. RESULTS: One hundred and seventy HCW were enrolled: 126 (74.1%) were anti-HBs-positive after the 4th dose. CONCLUSIONS: Rechecking anti-HBs after the 4th HB vaccine dose is a practical approach in case of post-vaccination tests performed >90 days after the full vaccination course.

Social anxiety and negative early life events in university students

INTRODUCTION: There is substantial evidence regarding the impact of negative life events during childhood on the aetiology of psychiatric disorders. We examined the association between negative early life events and social anxiety in a sample of 571 Spanish University students. METHODS: In a cross-sectional survey conducted in 2007, we collected data through a semistructured questionnaire of sociodemographic variables, personal and family psychiatric history, and substance abuse. We assessed the five early negative life events: (i) the loss of someone close, (ii) emotional abuse, (iii) physical abuse, (iv) family violence, and (v) sexual abuse. All participants completed the Liebowitz Social Anxiety Scale. RESULTS: Mean (SD) age was 21 (4.5), 75% female, LSAS score was 40 (DP = 22), 14.2% had a psychiatric family history and 50.6% had negative life events during childhood. Linear regression analyses, after controlling for age, gender, and family psychiatric history, showed a positive association between family violence and social score (p = 0.03). None of the remaining stressors produced a significant increase in LSAS score (p > 0.05). CONCLUSION: University students with high levels of social anxiety presented higher prevalence of negative early life events. Thus, childhood family violence could be a risk factor for social anxiety in such a population.

HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

Abstract Background HPV persistence is a key determinant of cervical carcinogenesis. The influence of postpartum on HPV clearance has been debated. This study aimed to assess HPV clearance in later pregnancy and postpartum among HIV-positive and negative women. Methods We conducted a follow-up study with 151 HPV-positive women coinfected with HIV, in 2007–2010. After baseline assessment, all women were retested for HPV infection using PCR in later pregnancy and after delivery. Multivariable logistic regressions assessed the putative association of covariates with HPV status in between each one of the successive visits. Results Seventy-one women (47%) have eliminated HPV between the baseline visit and their second or third visits. HIV-positive women took a significantly longer time (7.0 ± 3.8 months) to clear HPV, compared to those not infected by HIV (5.9 ± 3.0 months). HPV clearance was significantly more likely to take place after delivery than during pregnancy (84.5% x 15.5%). Conclusions Both HIV-positive and negative women presented a significant reduction in HPV infection during the postpartum period. HIV-positive status was found to be associated with a longer period of time to clear HPV infection in pregnant women.

IFN-γ-induced priming maintains long-term strain-transcending immunity against blood-stage Plasmodium chabaudi malaria

The mechanism by which protective immunity to Plasmodium is lost in the absence of continued exposure to this parasite has yet to be fully elucidated. It has been recently shown that IFN-γ produced during human and murine acute malaria primes the immune response to TLR agonists. In this study, we investigated whether IFN-γ-induced priming is important to maintain long-term protective immunity against Plasmodium chabaudi AS malaria. On day 60 postinfection, C57BL/6 mice still had chronic parasitemia and efficiently controlled homologous and heterologous (AJ strain) challenge. The spleens of chronic mice showed augmented numbers of effector/effector memory (TEM) CD4(+) cells, which is associated with increased levels of IFN-γ-induced priming (i.e., high expression of IFN-inducible genes and TLR hyperresponsiveness). After parasite elimination, IFN-γ-induced priming was no longer detected and protective immunity to heterologous challenge was mostly lost with >70% mortality. Spontaneously cured mice had high serum levels of parasite-specific IgG, but effector T/TEM cell numbers, parasite-driven CD4(+) T cell proliferation, and IFN-γ production were similar to noninfected controls. Remarkably, the priming of cured mice with low doses of IFN-γ rescued TLR hyperresponsiveness and the capacity to control heterologous challenge, increasing the TEM cell population and restoring the CD4(+) T cell responses to parasites. Contribution of TLR signaling to the CD4(+) T cell responses in chronic mice was supported by data obtained in mice lacking the MyD88 adaptor. These results indicate that IFN-γ-induced priming is required to maintain protective immunity against P. chabaudi and aid in establishing the molecular basis of strain-transcending immunity in human malaria.

Resonant States in Negative Ions

Resonant states are multiply excited states in atoms and ions that have enough energy to decay by emitting an electron. The ability to emit an electron and the strong electron correlation (which is extra strong in negative ions) makes these states both interesting and challenging from a theoretical point of view. The main contribution in this thesis is a method, which combines the use of B splines and complex rotation, to solve the three-electron Schrödinger equation treating all three electrons equally. It is used to calculate doubly excited and triply excited states of 4S symmetry with even parity in He-. For the doubly excited states there are experimental and theoretical data to compare with. For the triply excited states there is only theoretical data available and only for one of the resonances. The agreement is in general good. For the triply excited state there is a significant and interesting difference in the width between our calculation and another method. A cause for this deviation is suggested. The method is also used to find a resonant state of 4S symmetry with odd parity in H2-. This state, in this extremely negative system, has been predicted by two earlier calculations but is highly controversial. Several other studies presented here focus on two-electron systems. In one, the effect of the splitting of the degenerate H(n=2) thresholds in H-, on the resonant states converging to this threshold, is studied. If a completely degenerate threshold is assumed an infinite series of states is expected to converge to the threshold. Here states of 1P symmetry and odd parity are examined, and it is found that the relativistic and radiative splitting of the threshold causes the series to end after only three resonant states. Since the independent particle model completely fails for doubly excited states, several schemes of alternative quantum numbers have been suggested. We investigate the so called DESB (Doubly Excited Symmetry Basis) quantum numbers in several calculations. For the doubly excited states of He- mentioned above we investigate one resonance and find that it cannot be assigned DESB quantum numbers unambiguously. We also investigate these quantum numbers for states of 1S even parity in He. We find two types of mixing of DESB states in the doubly excited states calculated. We also show that the amount of mixing of DESB quantum numbers can be inferred from the value of the cosine of the inter-electronic angle. In a study on Li- the calculated cosine values are used to identify doubly excited states measured in a photodetachment experiment. In particular a resonant state that violates a propensity rule is found.

Outcome of HIV-infected patients with hepatocellular carcinoma: a comparison with HIV negative controls

Background and rationale for the study. This study investigated whether human immunodeficiency virus (HIV) infection adversely affects the prognosis of patients diagnosed with hepatocellular carcinoma (HCC).Thirty-four HIV-positive patients with chronic liver disease, consecutively diagnosed with HCC from 1998 to 2007 were one-to-one matched with 34 HIV negative controls for: sex, liver function (Child-Turcotte-Pugh class [CTP]), cancer stage (BCLC model) and, whenever possible, age, etiology of liver disease and modality of cancer diagnosis. Survival in the two groups and independent prognostic predictors were assessed. Results. Among HIV patients 88% were receiving HAART. HIV-RNA was undetectable in 65% of cases; median lymphocyte CD4+ count was 368.5/mmc. Etiology of liver disease was mostly related to HCV infection. CTP class was: A in 38%, B in 41%, C in 21% of cases. BCLC cancer stage was: early in 50%, intermediate in 23.5%, advanced in 5.9%, end-stage in 20.6% of cases. HCC treatments and death causes did not differ between the two groups. Median survival did not differ, being 16 months (95% CI: 6-26) in HIV positive and 23 months (95% CI: 5-41) in HIV negative patients (P=0.391). BCLC cancer stage and HCC treatment proved to be independent predictors of survival both in the whole population and in HIV patients. Conclusions. Survival of HIV infected patients receiving antiretroviral therapy and diagnosed with HCC is similar to that of HIV negative patients bearing this tumor. Prognosis is determined by the cancer bulk and its treatment.

Isolamento, variabilità ed espressione del gene PIMT in Girasole

Il vigore è un aspetto rilevante della qualità delle sementi, strettamente connesso al loro status fisiologico, al genotipo e alle condizioni di stoccaggio. Stress ossidativi e danni alle macromolecole sono alla base del deterioramento del seme, che è equipaggiato con sistemi protettivi e di riparazione. Uno di questi coinvolge l’L-isoaspartil metiltransferasi (PIMT) che ripara i misfolding proteici catalizzando la riconversione in aspartato dell’isoaspartile anomalo accumulato. Scopo di questo studio era valutare il possibile ruolo del meccanismo di riparazione di PIMT nel vigore del seme in girasole. Per questo il relativo gene è stato isolato e caratterizzato, la variabilità allelica determinata su un campione di linee inbred e l’espressione genica misurata in risposta all’invecchiamento accelerato (aging) e al priming. La sequenza codificante ottenuta è costituita da 4 esoni e contiene i 5 domini caratteristici delle metiltransferasi. Il gene mostra elevata similarità con gli ortologhi vegetali e scarsa diversità nucleotidica nei genotipi coltivati rappresentativi della variabilità della specie. Nella sequenza aminoacidica, comunque, sono state rinvenute tre sostituzioni che potrebbero influenzare la funzionalità enzimatica. Dal punto di vista fisiologico i genotipi considerati hanno esibito notevole variabilità di risposte ai trattamenti, sia in termini di vigore che di espressione genica. Aging e priming hanno prodotto generalmente gli effetti attesi, rispettivamente negativi e positivi, sulla germinabilità e sulla sua velocità. In generale l’espressione di PIMT è risultata massima nel seme secco, come riportato altrove, e ridotta dall’aging. Anche il priming ha diminuito l’espressione rispetto al seme quiescente, mentre il suo effetto dopo l’aging è risultato genotipo-dipendente. Tuttavia, nelle condizioni descritte, non si sono evidenziate correlazioni significative tra vigore ed espressione di PIMT, tali da suggerire un chiaro ruolo di questo meccanismo nella qualità fisiologica del seme.

Differential expression analysis for sequence count data via mixtures of negative binomials

The recent advent of Next-generation sequencing technologies has revolutionized the way of analyzing the genome. This innovation allows to get deeper information at a lower cost and in less time, and provides data that are discrete measurements. One of the most important applications with these data is the differential analysis, that is investigating if one gene exhibit a different expression level in correspondence of two (or more) biological conditions (such as disease states, treatments received and so on). As for the statistical analysis, the final aim will be statistical testing and for modeling these data the Negative Binomial distribution is considered the most adequate one especially because it allows for "over dispersion". However, the estimation of the dispersion parameter is a very delicate issue because few information are usually available for estimating it. Many strategies have been proposed, but they often result in procedures based on plug-in estimates, and in this thesis we show that this discrepancy between the estimation and the testing framework can lead to uncontrolled first-type errors. We propose a mixture model that allows each gene to share information with other genes that exhibit similar variability. Afterwards, three consistent statistical tests are developed for differential expression analysis. We show that the proposed method improves the sensitivity of detecting differentially expressed genes with respect to the common procedures, since it is the best one in reaching the nominal value for the first-type error, while keeping elevate power. The method is finally illustrated on prostate cancer RNA-seq data.

Regulation der Funktion dendritischer Zellen im immunologischen steady state

Dendritische Zellen sind professionelle Antigenpräsentierende Zellen und übernehmen sowohl in der Aktivierung naiver T-Zellen als auch in der Aufrechterhaltung peripherer Toleranz eine zentrale Funktion. Ruhende Dendritische Zellen im immunologischen Steady State induzieren antigenspezifisch Toleranz in autoreaktiven T-Zellen, welche bei der negativen Selektion im Thymus nicht eliminiert wurden und verhindern somit die Entstehung von Autoimmunität. Mit Hilfe eines transgenen Maus Modells, welches die induzierbare Expression transgen kodierter CD8+ T-Zell-Epitope auf ruhenden Dendritischen Zellen erlaubt, konnten wir zeigen, dass die periphere Toleranz Induktion durch Dendritische Zellen in Abwesenheit von regulatorischen T-Zellen beeinträchtigt ist. Wir konnten verdeutlichen, dass für die Suppression von steady-state Dendritischen Zellen die Erkennung von MHC Klasse II Molekülen auf Dendritischen Zellen durch den T-Zell-Rezeptor regulatorischer T-Zellen zwingend erforderlich ist. In Abwesenheit dieser suppressiven Interaktion hatten Dendritische Zellen einen aktivierten Phänotyp und lösten eine funktionale T-Zell-Antwort aus, anstatt periphere Toleranz zu induzieren. Als Folge dessen entwickelten Mäuse, in denen Dendritische Zellen nicht antigenspezifisch mit suppressiven CD4+ T-Zellen interagieren konnten, spontane Autoimmunität, welche durch CD8+ T-Zellen mediiert wurde. Wir konnten weiterhin zeigen, dass der Verlust peripherer T-Zell Toleranz durch basale Level an Typ I Interferonen mediiert wird sowie durch CD40 Signale, welche von adaptiven Immunzellen geliefert werden.

Einfluss Zelltod-inhibierender Proteine des murinen Cytomegalovirus auf die Initiation der antiviralen CD8 T-Zellantwort

Die Inhibition des programmierten Zelltods ist ein essentieller Faktor der viralen Replikationsfähigkeit. Das murine Cytomegalovirus kodiert deshalb für verschiedene Zelltod-inhibierende Gene, um dem programmierten Zelltod zu entgehen bis die Virusproduktion abgeschlossen ist. Da die Expression des viralen anti-apoptotischen Gens M36 infizierte Makrophagen vor der Apoptose schützt (Menard et al., 2003), wurde in der vorliegenden Arbeit unter Verwendung der Deletionsmutante mCMV-ΔM36 (ΔM36) der Einfluss von Apoptose auf das Priming Epitop-spezifischer CD8 T-Zellen untersucht.rnInteressanterweise waren die Frequenzen mCMV-spezifischer CD8 T-Zellen nach Infektion mit ΔM36 für alle getesteten Epitope sowohl im Haplotyp H-2d als auch im Haplotyp H-2b deutlich erhöht. Zusätzlich konnte mit Hilfe der mCMV-ORF-Library eine Verbreiterung des CD8 T-Zellepitop-Repertoire nach Infektion mit ΔM36 nachgewiesen werden, was neben der quantitativen auch eine qualitative Steigerung des CD8 T-Zell-Primings aufzeigt.rnIn der funktionellen Revertante ΔM36-FADDDN wird die anti-apoptotische Funktion durch eine dominant-negative Form des zellulären Adapterproteins FADD (FADDDN) substituiert (Cicin-Sain et al., 2008), die das Apoptose-Signaling verhindert. In der vorliegenden Arbeit konnte gezeigt werden, dass die Expression von FADDDN nicht nur den Apoptose-Phänotyp wieder revertiert, sondern auch die Verbesserung des CD8 T-Zell-Primings aufhebt. Diese Beobachtung belegt eindeutig, dass das verbesserte CD8 T-Zell-Priming auf einer verstärkten Apoptose-Induktion beruht.Bemerkenswerterweise konnte das verbesserte Priming auch nach Deletion des anti-nekroptotischen Gens M45 nachgewiesen werden. So konnte nach Infektion mit mCMV-M45-BamX (M45-BamX) (Brune et al., 2001) gezeigt werden, dass auch die Induktion der Nekroptose zu einem verbesserten CD8 T-Zell-Priming sowie zu einer Verbreiterung des CD8 T-Zellepitop-Repertoires führt.Nach Infektion von Cross-Priming-defizienten 3d-Mäusen (Tabeta et al., 2006) konnte eine Steigerung mCMV-spezifischer CD8 T-Zell-Frequenzen in Abwesenheit von M36 oder M45 nicht beobachtet werden. Dieser Befund lässt auf ein erhöhtes Cross-Priming von CD8 T-Zellen durch ΔM36 oder M45-BamX infolge einer verstärkten Induktion des programmierten Zelltods schließen.rnIn der vorliegenden Arbeit konnte erstmals gezeigt werden, dass die Inhibition des programmierten Zelltods durch die mCMV-Gene M36 und M45 das CD8 T-Zell-Priming limitiert. Somit fördern virale Zelltod-inhibierende Gene die virale Replikationsfähigkeit, indem sie die Virusproduktion per se in der individuellen Zelle steigern und zusätzlich die Immunkontrolle reduzieren, was wiederum eine verbesserte Dissemination in vivo ermöglicht.

Growth hormone (GH)-releasing hormone increases the expression of the dominant-negative GH isoform in cases of isolated GH deficiency due to GH splice-site mutations

An autosomal dominant form of isolated GH deficiency (IGHD II) can result from heterozygous splice site mutations that weaken recognition of exon 3 leading to aberrant splicing of GH-1 transcripts and production of a dominant-negative 17.5-kDa GH isoform. Previous studies suggested that the extent of missplicing varies with different mutations and the level of GH expression and/or secretion. To study this, wt-hGH and/or different hGH-splice site mutants (GH-IVS+2, GH-IVS+6, GH-ISE+28) were transfected in rat pituitary cells expressing human GHRH receptor (GC-GHRHR). Upon GHRH stimulation, GC-GHRHR cells coexpressing wt-hGH and each of the mutants displayed reduced hGH secretion and intracellular GH content when compared with cells expressing only wt-hGH, confirming the dominant-negative effect of 17.5-kDa isoform on the secretion of 22-kDa GH. Furthermore, increased amount of 17.5-kDa isoform produced after GHRH stimulation in cells expressing GH-splice site mutants reduced production of endogenous rat GH, which was not observed after GHRH-induced increase in wt-hGH. In conclusion, our results support the hypothesis that after GHRH stimulation, the severity of IGHD II depends on the position of splice site mutation leading to the production of increasing amounts of 17.5-kDa protein, which reduces the storage and secretion of wt-GH in the most severely affected cases. Due to the absence of GH and IGF-I-negative feedback in IGHD II, a chronic up-regulation of GHRH would lead to an increased stimulatory drive to somatotrophs to produce more 17.5-kDa GH from the severest mutant alleles, thereby accelerating autodestruction of somatotrophs in a vicious cycle.

Negative appendicectomy and perforation rates in patients undergoing laparoscopic surgery for suspected appendicitis

Despite widespread use of imaging technologies including ultrasonography and computed tomography, rates of negative appendicectomy and perforated appendicitis remain high. This trend analysis examined whether rates of negative appendicectomy and perforated appendicitis have decreased over time, and sought to evaluate clinical predictors associated with negative appendicectomy and perforated appendicitis.

Video-based quantification of body movement during social interaction indicates the severity of negative symptoms in patients with schizophrenia

In schizophrenia, nonverbal behavior, including body movement, is of theoretical and clinical importance. Although reduced nonverbal expressiveness is a major component of the negative symptoms encountered in schizophrenia, few studies have objectively assessed body movement during social interaction. In the present study, 378 brief, videotaped role-play scenes involving 27 stabilized outpatients diagnosed with paranoid-type schizophrenia were analyzed using Motion Energy Analysis (MEA). This method enables the objective measuring of body movement in conjunction with ordinary video recordings. Correlations between movement parameters (percentage of time in movement, movement speed) and symptom ratings from independent PANSS interviews were calculated. Movement parameters proved to be highly reliable. In keeping with predictions, reduced movement and movement speed correlated with negative symptoms. Accordingly, in patients who exhibited noticeable movement for less than 20% of the observation time, prominent negative symptoms were highly probable. As a control measure, the percentage of movement exhibited by the patients during role-play scenes was compared to that of their normal interactants. Patients with negative symptoms differed from normal interactants by showing significantly reduced head and body movement. Two specific positive symptoms were possibly related to movement parameters: suspiciousness tended to correlate with reduced head movement, and the expression of unusual thought content tended to relate to increased movement. Overall, a close and theoretically meaningful association between the objective movement parameters and the symptom profiles was found. MEA appears to be an objective, reliable and valid method for quantifying nonverbal behavior, an aspect which may furnish new insights into the processes related to reduced expressiveness in schizophrenia.