Influenza virus vaccination in kidney transplant recipients: serum antibody response to different immunosuppressive drugs

Introduction: This study prospectively accessed the immune response to the inactivated influenza vaccine in renal transplant recipients receiving either azathioprine or mycophenolate mofetil (MMF). Side effects were investigated. Methods: Sixty-nine patients received one dose of inactivated trivalent influenza vaccine. Antihemagglutinin (HI) antibody response against each strain was measured before and one to six months after vaccination. Results: Geometric mean HI antibody titers for H1N1 and H3N2 strains increased from 2.57 and 2.44 to 13.45 (p = 0.001) and 7.20 (p < 0.001), respectively. Pre- and post-vaccination protection rates for H1N1 and H3N2 increased from 8.7% to 49.3% (p < 0.001); and 36.3% (p < 0.001) and seroconversion rates were 36% and 25.3%, respectively. There was no response to influenza B. The use of MMF reduced the H1N1 and H3N2 protection rates and the seroconversion rate for the H1N1 strain when compared with the use of azathioprine, and subjects transplanted less than 87 months also had inferior antibody response. Adverse events were mild and there were no change on renal function post-vaccination. Conclusion: Renal transplant patients vaccinated against influenza responded with antibody production for in. uenza A virus strains, but not for in. uenza B. Use of MMF and shorter time from transplantation decreased the immune response to the vaccine.

Comparative bioavailability of three ibuprofen formulations in healthy human volunteers

Objective: To assess the bioequivalence of three ibuprofen formulations (Test formulation: ibuprofen (400 mg capsule) manufactured by Cardinal Health Brasil 402 Ltda. (Sorocaba, Brazil) and licensed to Boehringer Ingelheim do Brasil Quim. e Farm. Ltda. (Sao Paulo, Brazil); Reference formulation (1): ibuprofen (Advil (R); 2 x 200 mg coated tablet) from Wyeth-Whitehall Ltda. (Itapevi, Brazil); Reference formulation (2): ibuprofen (Alivium (R); 8 ml x 50 mg/ml solution) from Schering Plough S.A. (Rio de Janeiro, Brazil)) in 24 healthy volunteers of both sexes. Methods: The study was conducted using an open, randomized, three-period crossover design with at least 5-day washout interval. Plasma samples were obtained over a 24-h period. Plasma ibuprofen concentrations were analyzed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) with negative ion electrospray ionization using multiple reaction monitoring (MRM). The following pharmacokinetic parameters were obtained from the ibuprofen plasma concentration vs. time curves: AUC(last), AUC(trunctmax) AUC(inf) and C-max. Results: The limit of quantification for ibuprofen was 0.1 mu g x ml(-1). The geometric mean with corresponding 90% confidence interval (CI) for Test/Reference (1) percent ratios were 114.24% (90% CI = 105.67, 123.50%) for C-max, 98.97% (90% CI = 94.69, 103.44%) for AUC(last) and 99.40% (90% CI = 95.21, 103.78%) for AUCinf. The geometric mean and respective 90% confidence interval (CI) for Test/Reference (2) percent ratios were 108.38% (90% Cl = 100.195, 117.25%) for C-max, 100.79% (90% CI = 96.39, 105.40%) for AUC(last) and 101.26% (90% CI = 96.94, 105.77%) for AUC(inf); t(max) for the 400 mg Test capsule was shorter than that for the 2 x 200 mg Reference (1) tablets (p < 0.002). Conclusion: Since the 90% CI for AUC(last), AUC(inf) and C-max ratios were within the 80 - 125% interval proposed by the US FDA, it was concluded that ibuprofen formulation manufactured by Cardinal Health Brasil 402 Ltda. and licensed to Boehringer Ingelheim do Brasil Quim. e Farm. Ltda. is bioequivalent to the Advil (R) and Alivium (R) formulations with regard to both the rate and the extent of absorption.

A boarding school outbreak of pertussis in adolescents : value of laboratory diagnostic methods

Culture for Bordetella pertussis (B. pertussis) is the traditional gold standard for laboratory diagnosis of pertussis but is insensitive, especially later in the course of illness and in vaccinated persons. Interpretation of serology is limited by the lack of an appropriate reference standard. An outbreak of pertussis in a crowded boarding-school dormitory allowed evaluation of laboratory correlates of infection. Questionnaires, serum samples and throat swabs were collected from members of the exposed group. Serum samples from unexposed controls of a similar age group were used for comparison. B. pertussis PCR was performed on throat swabs, and sera were tested for IgA antibodies against whole-cell (WC) B. pertussis antigen and IgG antibodies to pertussis toxin (PT). The Centers for Disease Control and Prevention definition for pertussis was used to define clinical cases. We evaluated the use of a previously published cut-off for PT IgG of 125 EIA units (EU)/ml. Completed questionnaires were obtained from 115 students, of whom 85 (74%) reported coughing symptoms, including 32 (28%) who met the clinical case definition for pertussis. B. pertussis was detected by PCR in 17 (15%) and WC IgA in 22 (19%) students; neither correlated with symptoms, but dormitory of residence strongly predicted PCR status. The mean PT IgG geometric mean concentration, in this situation of high pertussis exposure, correlated with severity of symptoms and was significantly higher in both symptomatic and asymptomatic children exposed during the outbreak (P<0·001) than in control children. A cut-off for PT IgG of 125 EU/ml was too high in an outbreak situation to be sensitive enough to identify pertussis cases. A case of pertussis in a crowded boarding-school dormitory resulted rapidly in an outbreak. Serology and PCR were useful in identifying the outbreak and commencing disease control measures. The use of serology has mostly been evaluated in community serosurveys, where it is not possible to determine if immunity reflects vaccination, asymptomatic disease or symptomatic disease. This outbreak gave us the opportunity to evaluate the value of serology and PCR in the presence of confirmed exposure to pertussis.

Habitat suitability for marine fishes using presence-only modelling and multibeam sonar

Improved access to multibeam sonar and underwater video technology is enabling scientists to use spatially-explicit, predictive modelling to improve our understanding of marine ecosystems. With the growing number of modelling approaches available, knowledge of the relative performance of different models in the marine environment is required. Habitat suitability of 5 demersal fish taxa in Discovery Bay, south-east Australia, were modelled using 10 presence-only algorithms: BIOCLIM, DOMAIN, ENFA (distance geometric mean [GM], distance harmonic mean [HM], median [M], area-adjusted median [Ma], median + extremum [Me], area-adjusted median + extremum [Mae] and minimum distance [Min]), and MAXENT. Model performance was assessed using kappa and area under curve (AUC) of the receiver operator characteristic. The influence of spatial range (area of occupancy) and environmental niches (marginality and tolerance) on modelling performance were also tested. MAXENT generally performed best, followed by ENFA-GM and -HM, DOMAIN, BIOCLIM, ENFA-M, -Min, -Ma, -Mae and -Me algorithms. Fish with clearly definable niches (i.e. high marginality) were most accurately modelled. Generally, Euclidean distance to nearest reef, HSI-b (backscatter), rugosity and maximum curvature were the most important variables in determining suitable habitat for the 5 demersal fish taxa investigated. This comparative study encourages ongoing use of presence-only approaches, particularly MAXENT, in modelling suitable habitat for demersal marine fishes.

Is this D vitamin to worry about? Vitamin D insufficiency in an inpatient sample

Objective: The aim of the present study was to investigate the relationship between reduced serum vitamin D levels and psychiatric illness.

Method: This study was an audit of serum 25-hydroxyvitamin D (25-OHD) levels measured routinely in a sample of 53 inpatients in a private psychiatric clinic. These levels were compared with those of controls without psychiatric illness.

Results: The median levels of serum 25-OHD were 43.0 nmol L⁻¹ (range 20–102 nmol L⁻¹) in the patient population, 46.0 nmol L⁻¹ (range 20–102 nmol L⁻¹) in female patients (n =33) and 41.5 nmol L⁻¹ (range 22–97 nmol L⁻¹) in male patients (n =20). The proportion of vitamin D insufficiency (serum 25-OHD ≤50 nmol L⁻¹) in this patient population was 58%. Furthermore, 11% had moderate deficiency (serum 25-OHD ≤25 nmol L⁻¹). There was a 29% difference between mean levels in the patient population and control sample (geometric mean age- and season-adjusted levels: 46.4 nmol L⁻¹ (95% confidence interval (CI) =38.6–54.9 nmol L⁻¹) vs 65.3 nmol L⁻¹ (95%CI =63.2–67.4 nmol L⁻¹), p <0.001).

Conclusion: Low levels of serum 25-OHD were found in this patient population. These data add to the literature suggesting an association between vitamin D insufficiency and psychiatric illness, and suggest that routine monitoring of vitamin D levels may be of benefit given the high yield of clinically relevant findings.

Leptin in depressed women : Cross-sectional and longitudinal data from an epidemiologic study

Background There is conflicting evidence regarding levels of leptin in depression. In this study we aimed to investigate the relationship between serum leptin level and depression in a community sample of women using both cross-sectional and longitudinal data.

Methods From among 510 women aged 20–78 yr, 83 were identified with a lifetime history of major depressive disorder or dysthymia, ascertained using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID-I/NP). Serum leptin levels were measured by radioimmunoassay. Medication use and lifestyle were self-reported and body mass index (BMI) determined from measures of height and weight.

Results Using multiple linear regression, serum leptin levels were greater among women with a lifetime history of depression compared to women without any history of depression, independent of BMI. Adjusted geometric mean values of serum leptin were 16.37 (95%CI 14.70–18.23) ng/mL for depressed and 14.46 (95%CI 13.79–15.16) ng/mL for non-depressed women (P = 0.039). The hazard ratio (HR) for a de novo depressive disorder over five years increased 2.56-fold for each standard deviation increase in log-transformed serum leptin among non-smokers and this was not explained by differences in BMI, medications or other lifestyle factors (HR = 2.56, 95%CI 1.52-4.30). No association was observed for smokers.

Limitations There is potential for unrecognised confounding, recall bias and transient changes in body composition.

Conclusion Women with a lifetime history of depression have elevated levels of serum leptin, and elevated serum leptin predicts subsequent development of a depressive disorder.

Parent initiated prednisolone for acute asthma in children of school age : randomised controlled crossover trial

Objective To evaluate the efficacy of a short course of parent initiated oral prednisolone for acute asthma in children of school age.

Design Double blind, randomised, placebo controlled, crossover trial in which episodes of asthma, rather than participants, were randomised to treatment.

Setting The Barwon region of Victoria, Australia.

Participants Children aged 5-12 years with a history of recurrent episodes of acute asthma.

Intervention A short course of parent initiated treatment with prednisolone (1 mg/kg a day) or placebo.

Main outcome measures The primary outcome measure was the mean daytime symptom score over seven days. Secondary outcome measures were mean night time symptom score over seven days, use of health resources, and school absenteeism.

Results 230 children were enrolled in the study. Over a three year period, 131 (57%) of the participants contributed a total of 308 episodes of asthma that required parent initiated treatment: 155 episodes were treated with parent initiated prednisolone and 153 with placebo. The mean daytime symptom score was 15% lower in episodes treated with prednisolone than in those treated with placebo (geometric mean ratio 0.85, 95% CI 0.74 to 0.98; P=0.023). Treatment with prednisolone was also associated with a 16% reduction in the night time symptom score (geometric mean ratio 0.84, 95% CI 0.70 to 1.00; P=0.050), a reduced risk of health resource use (odds ratio 0.54, 95% CI 0.34 to 0.86; P=0.010), and reduced school absenteeism (mean difference −0.4 days, 95% CI −0.8 to 0.0 days; P=0.045).

Conclusion A short course of oral prednisolone initiated by parents when their child experiences an episode of acute asthma may reduce asthma symptoms, health resource use, and school absenteeism. However, the modest benefits of this strategy must be balanced against potential side effects of repeated short courses of an oral corticosteroid.

Effect of moisture content on the physical properties of fibered flaxseed

The physical properties of fibered flaxseed were investigated within moisture content varying from 6.21 to 16.29%. The length, width, thickness and geometric mean diameter increased from 4.20 to 4.44mm, 1.99 to 2.13mm, 0.91 to 0.95mm, and 1.95 to 2.06mm, respectively in the moisture content range. One thousand seed weight increased linearly from 4.22 to 4.62g. The bulk density decreased from 726.783 to 611.872kg/m3, while the true density increased from 1165.265 to 1289.341kg/m3 in the moisture content range. The porosity values of flaxseed increased linearly from 37.67 to 52.54%. The highest static coefficient of friction was found on the plywood surface, while the lowest on the stainless steel surface. The static coefficient of friction increased from 0.467 to 0.972, 0.442 to 0.864, 0.492 to 0.927, and 0.490 to 0.845 for plywood, stainless steel, aluminum sheet and galvanized iron, respectively. The angle of repose increased linearly from 25.7° to 33.8° in the moisture content range. The results are necessary for design of equipment to handling, transportation, processing, and the storage of flaxseed.

Enhanced recovery after surgery program for elective adbominal surgery at three Victorian hospitals

The aim of this study was to evaluate the anaesthesia care of an enhanced recovery after surgery (ERAS) program for patients having abdominal surgical in Victorian hospitals. The man outcome measure was the number of ERAS items implemented following introduction of the ERAS program. Secondary endpoints included process of care measures, outcomes and hospital stay. We used a before-and-after design; the control group was a prospective cohort (n=154) representing pre-existing practice for elective abdominal surgical patients from July 2009. The introduction of a comprehensive ERAS program took place over two months and included the education of surgeons, anaesthetists, nurses and allied health professionals. A post-implementation cohort (n=169) was enrolled in early 2010. From a total of 14 ERAS-recommended items, there were significantly more implemented in the post-ERAS period, median 8 (interquartile range of 7 to 9) vs 9 (8 to 10), P <0.0001. There were, however, persistent low rates of intravenous fluid restriction (25%) and early removal of urinary catheter (31%) in the post-ERAS period. ERAS patients had less pain and faster recovery parameters, and this was associated with a reduced hospital stay, geometric mean (SD) 5.7 (2.5) vs 7.4 (2.1) days, P=0.006. We found that perioperative anaesthesia practices can be readily modified to incorporate an enhanced recovery program in Victorian hospitals.

Enhanced Recovery After Surgery program for elective abdominal surgery at three Victorian hospitals

The aim of this study was to evaluate the anaesthesia care of an enhanced recovery after surgery (ERAS) program for patients having abdominal surgical in Victorian hospitals. The main outcome measure was the number of ERAS items implemented following introduction of the ERAS program. Secondary endpoints included process of care measures, outcomes and hospital stay. We used a before-and-after design; the control group was a prospective cohort (n=154) representing pre-existing practice for elective abdominal surgical patients from July 2009. The introduction of a comprehensive ERAS program took place over two months and included the education of surgeons, anaesthetists, nurses and allied health professionals. A post-implementation cohort (n=169) was enrolled in early 2010. From a total of 14 ERAS-recommended items, there were significantly more implemented in the post-ERAS period, median 8 (interquartile range 7 to 9) vs 9 (8 to 10), P <0.0001. There were, however, persistent low rates of intravenous fluid restriction (25%) and early removal of urinary catheter (31%) in the post-ERAS period. ERAS patients had less pain and faster recovery parameters, and this was associated with a reduced hospital stay, geometric mean (SD) 5.7 (2.5) vs 7.4 (2.1) days, P=0.006. We found that perioperative anaesthesia practices can be readily modified to incorporate an enhanced recovery program in Victorian hospitals.

Wettability investigation of UV/oand acid functionalized MWCNT and MWCNT/PMMA nanocomposites by contact angle measurement

The dispersion state of individual MWCNT in the polymer matrix influences the mechanical, thermal, and electrical properties of the resulting composite. One method of obtaining a good dispersion state of MWCNT in a polymer matrix is to functionalize the surface of MWCNT using various treatments to enhance the surface energy and increase the dispersibility of MWCNT. In this study, wettability and surface energy of UV/Oand acid-treated multiwall carbon nanotubes (MWCNTs) and its polymethyl methacrylate (PMMA) polymer nanocomposites were measured using contact angle analysis in various solvent media. Contact angle analysis was based on ethylene glycol-water-glycerol probe liquid set and data was further fitted into geometric mean (Fowkes), van Oss-Chaudhury-Good (GvOC), and Chang-Qing-Chen (CQC) models to determine both nonpolar and acid base surface energy components. Analysis was conducted on MWCNT thin films subjected to different levels of UV/Oand acid treatments as well as their resulting MWCNT/PMMA nanocomposites. Contact angle analysis of thin films and nanocomposites revealed that the total surface energy of all samples was well fitted with each other. In addition, CQC model was able to determine the surface nature and polarity of MWCNT and its nanocomposites. Results indicated that the wettability changes in the thin film and its nanocomposites are due to the change in surface chemistry. Finally, electrical properties of nanocomposites were measured to investigate the effect of surface functionality (acid or basic) on the MWCNT surfaces.

Optimal fire histories for biodiversity conservation

Fire is used as a management tool for biodiversity conservation worldwide. A common objective is to avoid population extinctions due to inappropriate fire regimes. However, in many ecosystems, it is unclear what mix of fire histories will achieve this goal. We determined the optimal fire history of a given area for biological conservation with a method that links tools from 3 fields of research: species distribution modeling, composite indices of biodiversity, and decision science. We based our case study on extensive field surveys of birds, reptiles, and mammals in fire-prone semi-arid Australia. First, we developed statistical models of species' responses to fire history. Second, we determined the optimal allocation of successional states in a given area, based on the geometric mean of species relative abundance. Finally, we showed how conservation targets based on this index can be incorporated into a decision-making framework for fire management. Pyrodiversity per se did not necessarily promote vertebrate biodiversity. Maximizing pyrodiversity by having an even allocation of successional states did not maximize the geometric mean abundance of bird species. Older vegetation was disproportionately important for the conservation of birds, reptiles, and small mammals. Because our method defines fire management objectives based on the habitat requirements of multiple species in the community, it could be used widely to maximize biodiversity in fire-prone ecosystems. © 2014 Society for Conservation Biology.

Spatial variability of aggregate stability in latosols under sugarcane

Solos submetidos ao mesmo sistema de manejo manifestam variabilidade espacial diferenciada de seus atributos. A variabilidade espacial da estabilidade de agregados foi caracterizada em um Latossolo Vermelho distrófico e Latossolo Vermelho eutroférrico, sob cultivo de cana-de-açúcar. Foram realizadas amostragens de terra nos pontos de interseção de uma malha de 10 x 10 linhas, espaçadas de 10 m, totalizando 100 pontos de amostragem por área, coletadas nas camadas de 0,0-0,2 e 0,2-0,4 m de profundidade, para determinação de diâmetro médio geométrico (DMG), diâmetro médio ponderado (DMP), agregados na classe >2,0 mm e teor de matéria orgânica do solo. O Latossolo Vermelho eutroférrico apresenta maior estabilidade de agregados quando comparado com o Latossolo Vermelho distrófico, condizente com o maior teor de argila, matéria orgânica e mineralogia gibbsítica. A evolução diferenciada dos Latossolos estudados explica os maiores alcances, o menor coeficiente de variação (CV) e a menor variabilidade, observados no Latossolo Vermelho eutroférrico para todos os atributos estudados.

Agregação de um argissolo sob pomar de goiabeiras após aplicação de resíduos da indústria processadora de goiaba

A utilização de resíduos da indústria de processamento de frutas na agricultura pode proporcionar melhorias à qualidade do solo. Dessa forma, objetivou-se com este estudo avaliar o efeito da aplicação de resíduos de sementes de goiaba na agregação e no estoque de carbono orgânico do solo (EC). O experimento esteve inserido em um pomar comercial irrigado de goiabeiras (cv. Paluma), com sete anos de idade, sobre um Argissolo Vermelho-Amarelo distrófico típico. O delineamento experimental foi em blocos casualizados e parcelas subdivididas, sendo cinco tratamentos (doses de: 0;9;18;27 e 36 Mg ha-1 de resíduo) e duas camadas de solo (0-0,10 e 0,10-0,20 m). Foi avaliado o mesmo tipo de solo sobre mata nativa adjacente à área experimental. As análises realizadas foram a distribuição do tamanho dos agregados estáveis em água, o diâmetro médio ponderado, o diâmetro médio geométrico, os agregados maiores que 2 mm e o EC. Os dados foram submetidos à análise de variância (Teste F), seguindo o delineamento em blocos casualizados com parcelas subdivididas (5 doses x 2 camadas). As médias dos tratamentos foram comparadas pelo teste de Tukey, a 5% de probabilidade, e as médias das camadas foram comparadas pelo teste F, a 5% de probabilidade. Os dados coletados no solo sob mata foram utilizados apenas como referência de um solo em estado natural e, portanto, não foram considerados como fator de variação nas análises de variância. Os valores dos índices de agregação com o estoque de carbono orgânico do solo foram submetidos à correlação de Pearson (p < 0,05). O efeito das doses de resíduo de sementes de goiaba sobre o estoque de carbono orgânico, na camada de 0-0,20 m do solo, foi avaliado por análise de regressão. Os tratamentos não diferiram em relação à agregação do solo, contudo EC foi diretamente relacionado à quantidade de resíduo aplicado ao solo. Houve correlação positiva e significativa entre os índices de agregação e o EC. A aplicação de resíduos de sementes de goiaba proporcionou melhoria da qualidade do solo.

Limestone and oyster shell for brown layers in their second egg production cycle

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)