Evaluation of coagulation activation after Rhinovirus infection in patients with asthma and healthy control subjects: an observational study

Background Asthma exacerbations are frequently triggered by rhinovirus infections. Both asthma and respiratory tract infection can activate haemostasis. Therefore we hypothesized that experimental rhinovirus-16 infection and asthmatic airway inflammation act in synergy on the haemostatic balance. Methods 28 patients (14 patients with mild allergic asthma and 14 healthy non-allergic controls) were infected with low-dose rhinovirus type 16. Venous plasma and bronchoalveolar lavage fluid (BAL fluid) were obtained before and 6 days after infection to evaluate markers of coagulation activation, thrombin-antithrombin complexes, von Willebrand factor, plasmin-antiplasmin complexes, plasminogen activator inhibitor type-1, endogenous thrombin potential and tissue factor-exposing microparticles by fibrin generation test, in plasma and/or BAL fluid. Data were analysed by nonparametric tests (Wilcoxon, Mann Whitney and Spearman correlation). Results 13 patients with mild asthma (6 females, 19-29 y) and 11 healthy controls (10 females, 19-31 y) had a documented Rhinovirus-16 infection. Rhinovirus-16 challenge resulted in a shortening of the fibrin generation test in BAL fluid of asthma patients (t = -1: 706 s vs. t = 6: 498 s; p = 0.02), but not of controls (t = -1: 693 s vs. t = 6: 636 s; p = 0.65). The fold change in tissue factor-exposing microparticles in BAL fluid inversely correlated with the fold changes in eosinophil cationic protein and myeloperoxidase in BAL fluid after virus infection (r = -0.517 and -0.528 resp., both p = 0.01). Rhinovirus-16 challenge led to increased plasminogen activator inhibitor type-1 levels in plasma in patients with asthma (26.0 ng/mL vs. 11.5 ng/mL in healthy controls, p = 0.04). Rhinovirus-16 load in BAL showed a linear correlation with the fold change in endogenous thrombin potential, plasmin-antiplasmin complexes and plasminogen activator inhibitor type-1. Conclusions Experimental rhinovirus infection induces procoagulant changes in the airways of patients with asthma through increased activity of tissue factor-exposing microparticles. These microparticle-associated procoagulant changes are associated with both neutrophilic and eosinophilic inflammation. Systemic activation of haemostasis increases with Rhinoviral load

Macroscopic authentication of Chinese materia medica (CMM): A UK market study of seeds and fruits

This small-scale macroscopic and quantitative authentication study, the first of its kind in the UK and elsewhere, assesses the identity and purity (excluding pesticides and heavy metals) of a selection of Chinese materia medica (CMM) seeds and fruits on the UK market. 25 fruit and seed CMM were chosen based on their inclusion in the Chinese Pharmacopoeia (2010, referred hereafter as ‘official species’), maximum dimension of 10 mm, and regular use in Traditional Chinese Medicine (TCM) practice in the UK according to UK practitioners. In 2012 samples were obtained from six TCM wholesale traders and eight retail dispensaries in southeast England. Macroscopic identity and purity testing was undertaken drawing on expertise at the Royal Botanic Gardens, Kew and its collection of vouchered CMM reference drugs, herbarium specimens and published identification texts. Of the 25 CMM requested from suppliers, 23 were obtained, represented by 211 samples. 191 samples were identified as being sourced from the correct drug; 20 were identified as sourced from unofficial species. Of the 191 correct samples, 5 displayed major contamination by other plant material, stones, earth, etc. (defined as > 5% of sample volume), and 12 had minor contamination (2–5%). 95% of samples derived from medicinally cultivated plants were sourced from an official species, 5% were contaminated; in contrast, 78% of wild-sourced CMM samples were sourced from an official species, and 14% showed contamination. These results aim to guide the further development of good practice in TCM herbal drug quality control, for which suggestions are provided

An assessment of diet overlap of two mesocarnivores in the North-West Province, South Africa

We used scat analysis to study the diet of two sympatric medium-sized carnivores: brown hyaena and black-backed jackal, in the NorthWest Province of South Africa. Seven major dietary categories were identified from the scats, with mammal remains being most common for both species. Brown hyaena scats contained more large mammal remains, which together with the presence of invertebrates (in 50% of all brown hyaena scats), suggests that they mainly scavenged. Jackal scats contained a higher proportion of small mammal remains, suggesting that jackals actively hunted more often than brown hyaenas did. The diets differed significantly between the two species, even though diet overlap was fairly high (0.79). Further analysis, albeit based on small sample sizes, suggests that diet of these mesopredators differ between protected reserves with apex predators and unprotected areas without apex predators, thus confounding generalizations. Further studies are therefore required to investigate possible mesopredator release when apex predators are absent

Long-term changes in soil microbial communities during primary succession

Soil microbial communities (SMCs) play a critical role in the cycling of carbon and nutrients in terrestrial ecosystems, as well as regulating plant productivity and diversity. However, very little is known about long-term (decades-centuries) structural changes in these communities. The development of aboveground-belowground linkages during century-scale succession is also poorly understood. Our study addressed this knowledge gap by investigating SMC and plant communities undergoing primary succession on an 850-year chronosequence of lava flows in Iceland. We hypothesised that communities of microfungi and bacteria would respond to progressive changes in vegetation and that SMC diversity would increase with terrain age. Soil samples were collected from three lava flows at different stages of primary succession (165, 621 and 852 years after lava flow emplacement). Plant community composition was surveyed as the samples were collected. The composition of the SMCs present in the soil was determined using amplicon pyrosequencing. The physical and chemical properties of the soil were also analysed. The results of the study indicated changes in plant and fungal communities with increasing terrain age. Distinct plant and fungal assemblages were identified on the three sites and both communities became richer and more diverse with increasing terrain age. There was also evidence to suggest the development of mycorrhizal associations on older sites. In contrast, the composition and structure of the bacterial communities did not change systematically with terrain age. Similarly, there were few changes in soil properties: SOM concentrations and pH, both of which have been demonstrated to be important to SMCs, were constant across the chronosequence. These results suggest that plant community composition is significant for fungal communities, but less relevant for bacterial communities. This finding has implications for studies of primary succession and the biogeochemical impact of vegetation change in high-latitude ecosystems.This work was funded by a Small Ecological Project Grant from the British Ecological Society (grant number 2812/3507) and grants from the John Fell Fund, University of Oxford (grant number 091/148) and Trinity College, University of Cambridge.This is the accepted manuscript. The final version is available at http://www.sciencedirect.com/science/article/pii/S003807171300429X

Optimising use of electronic health records to describe the presentation of rheumatoid arthritis in primary care: a strategy for developing code lists

Background Research using electronic health records (EHRs) relies heavily on coded clinical data. Due to variation in coding practices, it can be difficult to aggregate the codes for a condition in order to define cases. This paper describes a methodology to develop ‘indicator markers’ found in patients with early rheumatoid arthritis (RA); these are a broader range of codes which may allow a probabilistic case definition to use in cases where no diagnostic code is yet recorded. Methods We examined EHRs of 5,843 patients in the General Practice Research Database, aged ≥30y, with a first coded diagnosis of RA between 2005 and 2008. Lists of indicator markers for RA were developed initially by panels of clinicians drawing up code-lists and then modified based on scrutiny of available data. The prevalence of indicator markers, and their temporal relationship to RA codes, was examined in patients from 3y before to 14d after recorded RA diagnosis. Findings Indicator markers were common throughout EHRs of RA patients, with 83.5% having 2 or more markers. 34% of patients received a disease-specific prescription before RA was coded; 42% had a referral to rheumatology, and 63% had a test for rheumatoid factor. 65% had at least one joint symptom or sign recorded and in 44% this was at least 6-months before recorded RA diagnosis. Conclusion Indicator markers of RA may be valuable for case definition in cases which do not yet have a diagnostic code. The clinical diagnosis of RA is likely to occur some months before it is coded, shown by markers frequently occurring ≥6 months before recorded diagnosis. It is difficult to differentiate delay in diagnosis from delay in recording. Information concealed in free text may be required for the accurate identification of patients and to assess the quality of care in general practice

Why I tense up when you watch me: inferior parietal cortex mediates an audience’s influence on motor performance

The presence of an evaluative audience can alter skilled motor performance through changes in force output. To investigate how this is mediated within the brain, we emulated real-time social monitoring of participants’ performance of a fine grip task during functional magnetic resonance neuroimaging. We observed an increase in force output during social evaluation that was accompanied by focal reductions in activity within bilateral inferior parietal cortex. Moreover, deactivation of the left inferior parietal cortex predicted both inter- and intra-individual differences in socially-induced change in grip force. Social evaluation also enhanced activation within the posterior superior temporal sulcus, which conveys visual information about others’ actions to the inferior parietal cortex. Interestingly, functional connectivity between these two regions was attenuated by social evaluation. Our data suggest that social evaluation can vary force output through the altered engagement of inferior parietal cortex; a region implicated in sensorimotor integration necessary for object manipulation, and a component of the action-observation network which integrates and facilitates performance of observed actions. Social-evaluative situations may induce high-level representational incoherence between one’s own intentioned action and the perceived intention of others which, by uncoupling the dynamics of sensorimotor facilitation, could ultimately perturbe motor output

The clock genes Period 2 and Cryptochrome 2 differentially balance bone formation

Background: Clock genes and their protein products regulate circadian rhythms in mammals but have also been implicated in various physiological processes, including bone formation. Osteoblasts build new mineralized bone whereas osteoclasts degrade it thereby balancing bone formation. To evaluate the contribution of clock components in this process, we investigated mice mutant in clock genes for a bone volume phenotype. Methodology/Principal Findings: We found that Per2Brdm1 mutant mice as well as mice lacking Cry2-/- displayed significantly increased bone volume at 12 weeks of age, when bone turnover is high. Per2Brdm1 mutant mice showed alterations in parameters specific for osteoblasts whereas mice lacking Cry2-/- displayed changes in osteoclast specific parameters. Interestingly, inactivation of both Per2 and Cry2 genes leads to normal bone volume as observed in wild type animals. Importantly, osteoclast parameters affected due to the lack of Cry2, remained at the level seen in the Cry2-/- mutants despite the simultaneous inactivation of Per2. Conclusions/Significance: This indicates that Cry2 and Per2 affect distinct pathways in the regulation of bone volume with Cry2 influencing mostly the osteoclastic cellular component of bone and Per2 acting on osteoblast parameters

Provision of foot health services for people with rheumatoid arthritis in New South Wales: a web-based survey of local podiatrists

Background: It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists' perceptions of the nature of podiatric foot care provision for people who have RA in NSW.Methods: An anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices.Results: 86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self-referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents.Conclusions: The results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms. © 2013 Hendry et al.; licensee BioMed Central Ltd