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Biomedical subjects

D A Anderson

Publications and source records attributed to D A Anderson.

At least 19 recordsLinked to original sources

A hydrophobic domain in the large envelope protein is essential for fusion of duck hepatitis B virus at the late endosome.

The duck hepatitis B virus (DHBV) envelope is comprised of two transmembrane (TM) proteins, the large (L) and the small (S), that assemble into virions and subviral particles. Secondary-structure predictions indicate that L and S have three alpha-helical, membrane-spanning domains, with TM1 predicted to act as the fusion peptide following endocytosis of DHBV into the hepatocyte. We used bafilomycin A1 during infection of primary duck hepatocytes to show that DHBV must be trafficked from the early to the late endosome for fusion to occur. Alanine substitution mutations in TM1 of L and S, which lowered TM1 hydrophobicity, were used to examine the role of TM1 in infectivity. The high hydrophobicity of the TM1 domain of L, but not of S, was shown to be essential for virus infection at a step downstream of receptor binding and virus internalization. Using wild-type and mutant synthetic peptides, we demonstrate that the hydrophobicity of this domain is required for the aggregation and the lipid mixing of phospholipid vesicles, supporting the role of TM1 as the fusion peptide. While lipid mixing occurred at pH 7, the kinetics of insertion of the fusion peptide was increased at pH 5, consistent with the location of DHBV in the late-endosome compartment and previous studies of the nonessential role of low pH for infectivity. Exchange of the TM1 of DHBV with that of hepatitis B virus yielded functional, infectious DHBV particles, suggesting that TM1 of all of the hepadnaviruses act similarly in the fusion mechanism.

Animals↗

Perception of teasing in underweight persons: a modification of the perception of teasing scale.

The psychometric properties of the Perception of Teasing Scale-Underweight, a modified version of the Perception of Teasing Scale (1), were examined. One hundred eighty-three college students (81 male; 102 female; age range 17-57 years) completed questionnaires about underweight-related and competency-related teasing experiences, eating attitudes, body image, self-esteem, and mood. Factor analysis suggested the Perception of Teasing Scale-Underweight has a two-factor structure, measuring both underweight-related and competency-related teasing experiences. Significant correlations (p<0.05) were found between the Perception of Teasing Scale-Underweight, Beck Depression Inventory, Fear of Negative Appearance Evaluation Scale, Multidimentional Body-Self Relations Questionnaire-Appearance Scales, Multiaxial Eating Disorder Scale, Social Physique Anxiety Scale, and Rosenberg Self-Esteem Scale. The pattern of correlations differed between the entire sample and those with a body mass index <21. One-way analysis of variance analyses found significant differences (p<0.05) between those with body mass index (BMI) <21 and those with BMI >21 for the weight-related event and weight-related impact scales, indicating that the measure discriminates between those individuals most likely to have been underweight as adolescents versus those most likely to have been normal weight or overweight. This measure provides a sound psychometric tool for examining underweight-related and competency-related teasing experiences. The impact of appearance and competence related teasing in underweight persons is less well understood than in overweight samples; therefore, future work should be conducted with a more underweight sample to bridge this gap in the literature.

Adult↗

A survey of the use of assessment instruments by eating disorder professionals in clinical practice.

Accurate assessment is important in all phases of the treatment process, but there is little information about the assessment procedures utilized by those treating eating disorders in clinical practice. This study surveyed the assessment practices of eating disorder specialists. A brief questionnaire was sent to 480 eating disorder specialists in clinical practice; 95 were returned (19.8% return rate). The questionnaire asked specific questions about what assessment methods and measures they used for initial assessment and diagnosis as well as for treatment outcome. A significant minority of respondents used no validated measures at any stage of the assessment process, and even among those who did use well-validated assessment instruments, only a few instruments were used with any regularity. These results raise some potentially troubling issues concerning the typical assessment practices of clinicians. More collaboration between researchers and clinicians is needed to improve this situation.

Adult↗

Retrovirally delivered random cyclic Peptide libraries yield inhibitors of interleukin-4 signaling in human B cells.

Inteins are polypeptide sequences found in a small set of primarily bacterial proteins that promote the splicing of flanking pre-protein sequences to generate mature protein products. Inteins can be engineered in a "split and inverted" configuration such that the protein splicing product is a cyclic polypeptide consisting of the sequence linking two intein subdomains. We have engineered a split intein into a retroviral expression system to enable the intracellular delivery of a library of random cyclic peptides in human cells. Cyclization of peptides could be detected in cell lysates using mass spectrometry. A functional genetic screen to identify 5-amino acid-long cyclic peptides that block interleukin-4 mediated IgE class switching in B cells yielded 13 peptides that selectively inhibited germ line epsilon transcription. These results demonstrate the generation of cyclic peptide libraries in human cells and the power of functional screening to rapidly identify biologically active peptides.

B-Lymphocytes↗

The efficacy of cognitive-behavioral therapy on the core symptoms of bulimia nervosa.

Cognitive behavioral therapy (CBT) is widely regarded as the treatment of choice for bulimia nervosa (BN), with previous reviews of the CBT outcome literature claiming an approximate 40%-50% recovery rate. Most of these reviews have focused on reductions of binge eating and purging; however, the cognitive model of BN that underlies the CBT approach identifies three additional symptoms as central to the disorder: restrictive eating, concerns with shape and weight, and self-esteem. The purpose of this review was to determine the effect of CBT on the five core symptoms of BN, particularly those neglected in previous reviews. This review found that while most studies provided outcome data on binge eating, purgative behavior, and concern with shape and weight, fewer studies provided data on restraint and self-esteem. While generally favorable, evidence for the efficacy of CBT on the core symptoms of BN was mixed, depending on the outcome measures used. Shortcomings in the literature are identified and suggestions to correct these shortcomings are provided.

Bulimia↗

Validity of test meals for determining binge eating.

Assessment of binge eating has been criticized because of serious doubts concerning the accuracy of self-report. This experiment tested the validity of a laboratory test meal as an indicator of binge eating. Eight individuals diagnosed with binge-eating disorder (BED), eight obese non-binge-eaters, and eight normal-weight non-binge-eaters ate a test meal under conditions designed to increase the likelihood of inducing a binge episode. Non-binge-eaters, regardless of weight, felt in control of their eating and ate a relatively small amount of the test meal, while participants with BED ate significantly more food and felt significantly more out of control. Eating behavior during test meals can be a useful indicator of BED diagnostic status and may be a useful method for objectively defining binge eating.

Journal Article↗

A confirmatory factor analysis of the cognitive capacity screening examination in a clinical sample.

Structured mental status examinations offer several advantages over unstructured mental status examinations; however, few have been subjected to advanced psychometric analysis. Confirmatory factor analysis empirically tests the predictive validity of individual test indices within an a priori methodological framework. With such analysis, one can test hypotheses about the structure of latent variability within a given data set. The purpose of this study was to perform a confirmatory factor analysis of the Cognitive Capacity Screening Examination, the most comprehensive of the brief structured mental status examinations. A confirmatory factor analysis of the Cognitive Capacity Screening Examination (CCSE) was performed by applying LISREL 7 to a sample of 924 male veterans, 409 patients from a chemical dependence treatment program, and 515 individuals from a psychology consultation service. Constructs were derived from previous exploratory analysis of the scale. The results of the confirmatory factor analysis and three indices of model fit support an 11 factor model more complex than that originally formulated for the CCSE. However, three of these factors (digit span with interference, complex mental mathematics, and verbal memory) were more sensitive to impairment than other factors, accounting for over 90% of the CCSE total score variance. Although the CCSE is a more complex test than originally envisioned by its designers, it may not be necessary to give all items on the test. Either a subset of the CCSE items (the CCSE-A) or a relatively brief, informal mental status exam may be adequate for many patients.

Cognition Disorders↗

Detection and characterisation of swine hepatitis E virus in New Zealand.

The objectives of the present study were to establish the presence of hepatitis E virus (HEV) in New Zealand pigs, first by testing for HEV antibody in pig herds throughout New Zealand to measure the herd prevalence, then by attempting to amplify HEV genomic sequences by PCR. Antibody was measured by two independently designed ELISA serology tests. HEV RNA fragments were amplified by RT-PCR of nucleic acid extracted from faeces of 10-12-week-old piglets using primers targeting ORF1, ORF2, and ORF2/3. PCR products were subject to phylogenetic analysis. Antibody to HEV was found throughout New Zealand pig herds as well as in the different age groups within the herds. Twenty herds from 22 tested were positive for HEV antibody (91% herd prevalence). Phylogenetic analysis of the amplified sequences placed this New Zealand strain of HEV closest to the human European strain It-1 (AF 110390) and U.S. swine strain (AF 082843) with 88% and 83% similarity respectively in ORF1. It was concluded that HEV is widely distributed in the New Zealand pig population. Phylogenetic analysis shows that this is a new HEV strain, grouping most closely with the United States/European cluster, which includes HEV strains of both human and swine origin.

Animals↗

Recombinant subunit ORF2.1 antigen and induction of antibody against immunodominant epitopes in the hepatitis E virus capsid protein.

A recombinant subunit antigen (ORF2.1), representing the carboxy-terminal 267 amino acids of the 660-amino-acid hepatitis E virus (HEV) capsid protein, was expressed in Escherichia coli and used for the immunisation of rats. Purified antigen formulated with either Aluminium Hydroxide Gel Adjuvant (Alum) or Titermax gave high and equivalent levels of antibody after three doses. Responses to two doses of 15, 75, or 150 microg antigen, formulated with Alum and given at 0 and 4 weeks, were also equivalent by 17 weeks after immunisation. Rats initially developed antibody to a wide range of linear epitopes in the ORF2.1 region, but by 27 weeks the predominant response detected by Western immunoblotting was restricted to the conformational epitope unique to ORF2.1 [Li et al. (1997) Journal of Medical Virology 52:289-300], a pattern that was also observed when comparing acute-phase patient serum samples with serum samples from convalescing patients. Antibody from immunised rats blocked the majority of patients' serum reactivity in enzyme-linked immunosorbent assay against both ORF2.1 (57-92% inhibition) and virus-like particles of HEV produced using the baculovirus system (74-97% inhibition). Together, these results suggest that the ORF2.1 subunit vaccine induces an antibody response against immunodominant, conformational epitopes in the viral capsid, which largely mimics that seen in convalescent patients, who are presumed to be immune to HEV infection.

Adjuvants, Immunologic↗

A phase II study of the 5-lipoxygenase inhibitor, CV6504, in advanced pancreatic cancer: correlation of clinical data with pharmacokinetic and pharmacodynamic endpoints.

PURPOSE: Primary objective was to determine response rate of patients with advanced pancreatic cancer to a novel lipoxygenase and thromboxane A2 synthetase inhibitor (CV6504); secondary objectives included estimation of pharmacokinetics of CV6504, target-enzyme inhibition, safety and tolerance, quality of life and survival. PATIENTS AND METHODS: Thirty-one patients with advanced pancreatic cancer were planned to receive CV6504, 100 mg TDS, orally for three months, at which point CT scans were performed to assess therapeutic response rates. Steady state concentrations of CV6504 and thromboxane B2 (an indirect measure of thromboxane A2 synthetase (TA2S) inhibition) were made. Of the 31 patients entered into the study, 23 were considered fully evaluable for response. RESULTS: The drug was well tolerated with few side effects; no partial or complete responses were seen, but 10 patients had stable disease at 3 months; quality of life was maintained during therapy; mean CV6504 steady state plasma concentrations of 14 +/- 6 ng/ml resulting in 75 +/- 18% inhibition of TA2S were achieved; median-survival time for all patients considered eligible for assessment of efficacy was 36.6 weeks after the initial dose of study medication. The actuarial one-year survival was approximately 25%. CONCLUSION: CV6504 inhibits its target enzyme in vivo, maintains stable disease in 32% of evaluable patients and is well tolerated.

Antineoplastic Agents↗

The perceived relative worth of reaching and maintaining goal weight.

OBJECTIVE: To examine the perceived relative worth of reaching and maintaining a self-selected goal weight, for obese and non-obese individuals. DESIGN: Cross-sectional study. SUBJECTS: Twenty-five obese treatment-seekers (age 41.0 y, BMI 42.5) and a community sample of 31 obese (age 40.8 y, BMI 32.2) and 64 non-obese participants (age 32.4 y, BMI 23.4). MEASUREMENT: An 18-item forced-choice questionnaire evaluating what participants would hypothetically sacrifice to reach and maintain their goal weight. RESULTS: Most obese treatment-seekers would hypothetically endure much to achieve their desired weight. For example, 88% or more would forego a job promotion, retiring with full-pay, eliminating the national debt, or winning their dream house or car or an all-expense-paid vacation, and smaller majorities would suffer loss of half their income or a job demotion. Many non-treatment-seeking obese would forfeit future rewards to reach goal weight, but fewer would incur negative events. About a third of non-obese participants would forgo certain positive events, but few would suffer an adverse event to achieve goal weight. Within the combined obese sample, females viewed attaining goal weight as more important than did males, but there were no significant racial differences. An index of overall worth of weight goal was related positively to current weight and BMI and negatively to goal weight as percentage of current weight (P<0.01). CONCLUSION: Excessive value may be placed on attaining less than realistic weight goals, particularly but not exclusively by treatment-seeking and heavier obese people and those who desire greater weight loss. Clinicians should take this phenomenon into consideration, and public health initiatives should attempt to place body weight in a more balanced perspective.

Adult↗

Core protein phosphorylation modulates pregenomic RNA encapsidation to different extents in human and duck hepatitis B viruses.

To clarify the role of core protein phosphorylation in pregenomic-RNA encapsidation of human and duck hepatitis B viruses (HBV and DHBV, respectively), we have examined the phosphorylation states of different forms of intracellular HBV core protein and the phenotypic effects of mutations in the phosphorylation sites of HBV and DHBV core proteins. We show that HBV core protein is phosphorylated to similar extents in the form of protein dimers and after further assembly in pregenomic RNA-containing capsids. Individual and multiple substitutions of alanine and aspartic acid for serine in the phosphorylation sites of HBV core protein resulted in site-specific and synergistic effects on RNA encapsidation, ranging from 2-fold enhancement to more than 10-fold inhibition. Core protein variants with mutations in all phosphorylation sites exhibited dominant-negative effects on RNA encapsidation by wild-type protein. The results suggest that the presence of phosphoserine at position 162 of HBV core protein is required for pregenomic-RNA encapsidation, whereas phosphoserine at position 170 optimizes the process and serine might be preferable in position 155. Examination of the pregenomic-RNA-encapsidating capacities of DHBV core protein variants, in which four phosphorylation sites were jointly mutated to alanine or aspartic acid, suggests that phosphorylation of DHBV core protein at these sites may optimize pregenomic-RNA encapsidation but that its impact is much less profound than in the case of HBV. The possible mechanisms by which RNA encapsidation may be modulated by core protein phosphorylation are discussed in the context of the observed differences between the two viruses.

Amino Acid Sequence↗

Infection of polarized cultures of human intestinal epithelial cells with hepatitis A virus: vectorial release of progeny virions through apical cellular membranes.

Although hepatitis A virus (HAV) is typically transmitted by the fecal-oral route, little is known of its interactions with cells of the gastrointestinal tract. We studied the replication of HAV in polarized cultures of Caco-2 cells, a human cell line which retains many differentiated functions of small intestinal epithelial cells. Virus uptake was 30- to 40-fold more efficient when the inoculum was placed on the apical rather than the basolateral surface of these cells, suggesting a greater abundance of the cellular receptor for HAV on the apical surface. Infection proceeded without cytopathic effect and did not influence transepithelial resistance or the diffusion of inulin across cell monolayers. Nonetheless, there was extensive release of progeny virus, which occurred almost exclusively into apical supernatant fluids (36.4% +/- 12.5% of the total virus yield compared with 0.23% +/- 0.13% release into basolateral fluids). Brefeldin A caused a profound inhibition of HAV replication, but also selectively reduced apical release of virus. These results indicate that polarized human epithelial cell cultures undergo vectorial infection with HAV and that virus release is largely restricted to the apical membrane. Virus release occurs in the absence of cytopathic effect and may involve cellular vesicular transport mechanisms.

Antiviral Agents↗

Identification of immunodominant and conformational epitopes in the capsid protein of hepatitis E virus by using monoclonal antibodies.

Antibody to the capsid (PORF2) protein of hepatitis E virus (HEV) is sufficient to confer immunity, but knowledge of B-cell epitopes in the intact capsid is limited. A panel of murine monoclonal antibodies (MAbs) was generated following immunization with recombinant ORF2.1 protein, representing the C-terminal 267 amino acids (aa) of the 660-aa capsid protein. Two MAbs reacted exclusively with the conformational ORF2.1 epitope (F. Li, J. Torresi, S. A. Locarnini, H. Zhuang, W. Zhu, X. Guo, and D. A. Anderson, J. Med. Virol. 52:289-300, 1997), while the remaining five demonstrated reactivity with epitopes in the regions aa 394 to 414, 414 to 434, and 434 to 457. The antigenic structures of both the ORF2.1 protein expressed in Escherichia coli and the virus-like particles (VLPs) expressed using the baculovirus system were examined by competitive enzyme-linked immunosorbent assays (ELISAs) using five of these MAbs and HEV patient sera. Despite the wide separation of epitopes within the primary sequence, all the MAbs demonstrated some degree of cross-inhibition with each other in ORF2. 1 and/or VLP ELISAs, suggesting a complex antigenic structure. MAbs specific for the conformational ORF2.1 epitope and a linear epitope within aa 434 to 457 blocked convalescent patient antibody reactivity against VLPs by approximately 60 and 35%, respectively, while MAbs against epitopes within aa 394 to 414 and 414 to 434 were unable to block patient serum reactivity. These results suggest that sequences spanning aa 394 to 457 of the capsid protein participate in the formation of strongly immunodominant epitopes on the surface of HEV particles which may be important in immunity to HEV infection.

Amino Acids↗

The explosive human immunodeficiency virus type 1 epidemic among injecting drug users of Kathmandu, Nepal, is caused by a subtype C virus of restricted genetic diversity.

An explosive epidemic of human immunodeficiency virus type 1 (HIV-1) has been documented among the injecting drug user population of Kathmandu, Nepal, whose seropositivity rate has risen from 0 to 40% between 1995 and 1997. By using Catrimox to preserve whole-blood RNA at ambient temperature for transportation, HIV-1 envelope V3-V4 sequences were obtained from 36 patients in this group. Analysis of the sequences indicated a homogenous epidemic of subtype C virus, with at least two independent introductions of the virus into the population. Viral diversity was restricted within two transmission subclusters, with the majority of variation occurring in V4. Calculation of the synonymous-to-nonsynonymous mutation ratio (Ks:Ka) across this region showed that significant evolutionary pressure had been experienced during the rapid horizontal spread of the virus in this population, most strongly directed to the region between V3 and V4.

Adult↗

Uncoating kinetics of hepatitis A virus virions and provirions.

When the growth kinetics of immature hepatitis A virus provirions and mature virions were monitored, distinct eclipse phases were noted for both types of particles. Strikingly, uncoating of virions occurred around 4 h postinfection, while uncoating of provirions occurred predominantly between 8 and 10 h postinfection. It is proposed that the heterogeneous mixture of infectious hepatitis A virus particles (virions and provirions) typically present in inocula is responsible for the normally asynchronous nature of hepatitis A virus uncoating kinetics.

Hepatovirus↗

A vestigial X open reading frame in duck hepatitis B virus.

Duck hepatitis B virus (DHBV) appears to lack a homologue of the X protein found in mammalian hepadnaviruses. By replacing stop codons in the corresponding region of the DHBV genome, a hypothetical protein which closely matches the hydrophilicity profile of X proteins can be predicted, despite limited sequence homology. We conclude that a full-length X protein was once a common feature of the hepadnaviruses, conserved in structure but not sequence.

Amino Acid Sequence↗

Interdisciplinary shared governance: a partnership model for high performance in a managed care environment.

Today's managed care environment is forcing hospitals to seek new and innovative ways to deliver a seamless continuum of high-quality care and services to defined populations at lower costs. Many are striving to achieve this goal through the implementation of shared governance models that support point-of-service decision making, interdisciplinary partnerships, and the integration of work across clinical settings and along the service delivery continuum. The authors describe the key processes and strategies used to facilitate the design and successful implementation of an interdisciplinary shared governance model at The University Hospital, Cincinnati, Ohio. Implementation costs and initial benefits obtained over a 2-year period also are identified.

Cost-Benefit Analysis↗