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A general method for nested RT-PCR amplification and sequencing the complete HCV genotype 1 open reading frame.

BACKGROUND: Hepatitis C virus (HCV) is a pathogenic hepatic flavivirus with a single stranded RNA genome. It has a high genetic variability and is classified into six major genotypes. Genotype 1a and 1b cause the majority of infections in the USA. Viral genomic sequence information is needed to correlate viral variation with pathology or response to therapy. However, reverse transcription-polymerase chain reaction (RT-PCR) of the HCV genome must overcome low template concentration and high target sequence diversity. Amplification conditions must hence have both high sensitivity and specificity yet recognize a heterogeneous target population to permit general amplification with minimal bias. This places divergent demands of the amplification conditions that can be very difficult to reconcile. RESULTS: RT and nested PCR conditions were optimized independently and systematically for amplifying the complete open reading frame (ORF) from HCV genotype 1a and 1b using several overlapping amplicons. For each amplicon, multiple pairs of nested PCR primers were optimized. Using these primers, the success rate (defined as the rate of production of sufficient DNA for sequencing with any one of the primer pairs for a given amplicon) for amplification of 72 genotype 1a and 1b patient plasma samples averaged over 95% for all amplicons. In addition, two sets of sequencing primers were optimized for each genotype 1a and 1b. Viral consensus sequences were determined by directly sequencing the amplicons. HCV ORFs from 72 patients have been sequenced using these primers. Sequencing errors were negligible because sequencing depth was over 4-fold and both strands were sequenced. Primer bias was controlled and monitored through careful primer design and control experiments. CONCLUSION: Optimized RT-PCR and sequencing conditions are useful for rapid and reliable amplification and sequencing of HCV genotype 1a and 1b ORFs.

DNA, Complementary↗

Promises and pitfalls of long-read sequencing for resolving microbial complexity.

Long-read sequencing (LRS) has driven a transition in microbial genomics, overcoming the assembly fragmentation inherent to short-read sequencing. This review elucidates the impact of LRS across isolate genomics, metagenomics, and multi-omics domains. By spanning extensive repetitive regions, LRS facilitates the reconstruction of circular chromosomes and precisely resolves mobile genetic elements (MGEs). In metagenomics, LRS enables strain-level resolution, the recovery of circular metagenome-assembled genomes, and the precise localization of MGEs within host replicons. Furthermore, the single-molecule, amplification-free properties of LRS provide enhanced resolution of native epigenetic modifications and full-length transcriptomes. Despite these advancements, widespread implementation remains constrained by multidimensional challenges, including stringent high-molecular-weight DNA requirements, depth deficits, and computational overhead. Nevertheless, LRS is increasingly becoming the method of choice for isolate genomics and metagenomics. As detection technologies and algorithms progress, LRS will further improve our ability to decipher the structural and functional diversity of microbial ecosystems.

Metagenomics↗

Preliminary results on a dedicated silicon diode detector for proton dosimetry.

The present work reports preliminary measurements on the behaviour of a new p-type stereotactic silicon diode. Hi-pSi, produced by Scanditronix and dedicated to proton dosimetry. Diode response was investigated in low-energy proton beams (26.7 MeV and 12 MeV nominal energy), mainly with attention to stability, linearity, dose rate and energy dependence of the detector response. Three different Hi-pSi diodes of the same type were investigated. The diode response was linear with dose and the standard deviation of repeated readings was less than 2.5%. A marked dependence on dose rate was observed for one of the diodes (a response increase of 47% in the 0.7-11 Gy x min(-1) range). After the dose rate and water to silicon mass collision stopping power ratio correction of the diode response in the depth dose measurements, the difference, at the Bragg peak, with respect to the reference chamber was about 4%, ascribed to poor knowledge of the materials in front of the sensitive volume. The diode response was also nearly independent of linear energy transfer (LET) in the 9.6-21.5 MeV effective energy range.

Phantoms, Imaging↗

Screening of elevated glucose levels in gingival crevice blood using a novel, sensitive self-monitoring device.

OBJECTIVE: To test the feasibility of using gingival crevice blood (GCB) collected during routine periodontal examination to estimate blood glucose levels using a novel and very sensitive self-monitoring device (FreeStyle). SUBJECTS AND METHODS: Forty-six patients (20 male, 26 female; age range 12-56 years, mean age 36 +/- 11 years) seeking dental treatment took part in the study. Three and 4 patients reported diabetes mellitus type 1 and 2, respectively; 24 had gingivitis, of which 22 were moderate or advanced periodontitis. Periodontal probing depth (PD) and clinical attachment loss was measured at 6 sites of every tooth present, and bleeding on probing (BOP) was recorded. A site with profuse BOP was chosen for glucose determination. Measurements in GCB were compared with those of conventional capillary fingerstick blood (CFB). RESULTS: Sufficiently large GCB volumes provided glucometer readings in 32 cases (range 1.17-10.00 mmol/l). The CFB readings ranged between 1.39 and 11.50 mmol/l. If low amounts of crevice blood prohibited a glucometer reading, significantly lower mean numbers of sites with BOP (26 vs. 67, p <0.001) and elevated PD > or =4 mm (2 vs. 21, p <0.05) were seen. Agreement between the two measurements was low, the mean difference was -1.22, and limits of agreement (1.96 times the standard deviation of differences) were +/-2.89 mmol/l. CONCLUSION: The present study failed to provide any evidence for the usefulness of GCB for testing blood glucose during routine periodontal examination.

Adolescent↗

Studies on the technique of vitreous fluorophotometry.

We examined the sources of artifacts of vitreous fluorophotometry (VF), a technique used to assess the permeability of the blood-retinal barrier. By performing in vitro measurements in a model eye and in vivo readings in humans, we investigated the influence of various concentrations of fluorescein in the anterior chamber and in the retina on the measurements performed in the vitreous. Upper limits for the artifactual effects are set under clinical conditions, and a way to account for them is proposed. Special attention is given to depth resolution, which was investigated as a function of the region being scanned, the beam width, and the probe size. Further, preliminary results indicate that a procedure to account for light attenuation by the lens is feasible. It appears that reliable quantitative results can be obtained by VF, provided that the artifacts are acknowledged, minimized, and corrected.

Anterior Chamber↗

Comparison of absorbed dose in bone substitute material and water using ionization measurements.

Absorbed dose in a liquid substitute for bone has been compared with absorbed dose in water for 9-, 12-, and 15-MeV electron beams using ionization chamber measurements. The ionization readings were converted to dose using collisional mass stopping power ratios. The collisional mass stopping powers for the liquid substitute of bone were calculated using the Monte Carlo Code PEGS4. The results of our study show that there is an increase in dose in the liquid bone substitute compared to water at shallow depths. The maximum increase in dose was 5%, 4%, and 2% at depths of 1.2, 1.5, and 2.0 cm, respectively, for 9-, 12-, and 15-MeV electrons. The density of the liquid bone substitute was 1360 kg/m3 and the effective atomic number was 11.

Bone and Bones↗

Porous media matric potential and water content measurements during parabolic flight.

Control of water and air in the root zone of plants remains a challenge in the microgravity environment of space. Due to limited flight opportunities, research aimed at resolving microgravity porous media fluid dynamics must often be conducted on Earth. The NASA KC-135 reduced gravity flight program offers an opportunity for Earth-based researchers to study physical processes in a variable gravity environment. The objectives of this study were to obtain measurements of water content and matric potential during the parabolic profile flown by the KC-135 aircraft. The flight profile provided 20-25 s of microgravity at the top of the parabola, while pulling 1.8 g at the bottom. The soil moisture sensors (Temperature and Moisture Acquisition System: Orbital Technologies, Madison, WI) used a heat-pulse method to indirectly estimate water content from heat dissipation. Tensiometers were constructed using a stainless steel porous cup with a pressure transducer and were used to measure the matric potential of the medium. The two types of sensors were placed at different depths in a substrate compartment filled with 1-2 mm Turface (calcined clay). The ability of the heat-pulse sensors to monitor overall changes in water content in the substrate compartment decreased with water content. Differences in measured water content data recorded at 0, 1, and 1.8 g were not significant. Tensiometer readings tracked pressure differences due to the hydrostatic force changes with variable gravity. The readings may have been affected by changes in cabin air pressure that occurred during each parabola. Tensiometer porous membrane conductivity (function of pore size) and fluid volume both influence response time. Porous media sample height and water content influence time-to-equilibrium, where shorter samples and higher water content achieve faster equilibrium. Further testing is needed to develop these sensors for space flight applications.

Biosensing Techniques↗

Universal influenza immunization. Were Ontario family physicians prepared?

OBJECTIVE: To explore family physicians' experiences during the first year of Ontario's universal influenza immunization program. DESIGN: Qualitative study using in-depth interviews. SETTING: Thames Valley region of southwestern Ontario. PARTICIPANTS: A maximum variation sample of nine family physicians selected by snowball sampling after initial consultation with a local family physician advisory committee. METHOD: Interviews were audiotaped and transcribed verbatim. Analysis was sequential, using a combination of editing, immersion, and crystallization. Interview transcripts were read by individual members of the team who met to compare findings at several stages during data collection. MAIN FINDINGS: The program affected family physicians because immunization strategies designed for immunizing high-risk patients needed to be modified to deal with greater numbers of patients. While generally supportive of the program, physicians found it difficult to implement. Responses reflected ongoing conflict between individual and public health priorities, particularly regarding children and pregnant women. CONCLUSION: The program could have been more effective if the culture and climate of Ontario family practice had been considered during its development and implementation.

Attitude of Health Personnel↗

Strategies to manage hypertension: a qualitative study with black Caribbean patients.

BACKGROUND: The detection of hypertension in black Caribbean populations is good, but its control is thought to be inadequate. AIM: To explore how black Caribbean patients with hypertension understand their condition, and the strategies they use in managing hypertension. DESIGN OF STUDY: Qualitative study using in-depth interviews. SETTING: One general practice in inner-city London. METHOD: Practice records were searched to identify black Caribbean patients with known and treated hypertension. Audiotaped in-depth interviews were conducted with all identified patients and transcripts of the interviews were analysed for thematic content. RESULTS: We interviewed 19 black Caribbean patients with hypertension. Participants reported physical symptoms for elevated blood pressure; a minority relied on symptoms to determine their medicine use. A majority of participants equated 'normal' blood pressure readings with being cured and with no need for prescribed medicine. All participants had been prescribed antihypertension medication, and seven reported taking medication as prescribed. Those who did not, reported diverse and dynamic patterns of medication consumption. Some who had achieved normal blood pressure equated this with being cured and stopped medication, resuming when diagnosed with high blood pressure. Some modified their use of tablets according to bodily symptoms that they felt indicated higher or lower blood pressure. Some stopped or reduced medication because of unwanted effects and almost half of the participants used Caribbean 'bush' remedies. CONCLUSION: These findings suggest that some patients are making reasoned decisions about blood pressure management, drawing on medical information, their own bodily experiences of illness and sociocultural notions and practices. However, this may lead to medication use that diverges from that which is recommended. This study indicates a continued need to address these patients' perspectives and develop and evaluate new strategies to achieve hypertension control in this group.

Adult↗

The bleaching depth of a 35% hydrogen peroxide based in-office product: a study in vitro.

OBJECTIVES: The aim of the present study was to quantify the penetration of 35% hydrogen peroxide into enamel and dentine and to relate this to the resultant shade change of the tooth. METHOD: The crowns of 24 caries and developmental defect free human maxillary incisors were stained internally with a standardised tea solution. Twelve specimens were power bleached with light activated 35% hydrogen peroxide and 12 placed in water; both exposure times were 30min. Three different shade assessment methods (Vita shade guide [SG], shade vision system [SVS] and a chromometer) were employed prior to, after tea staining and after power bleaching/water treatments. Twelve specimens each from the bleach group and the water control water group were sectioned mesio-distally. An additional 12 specimens from the bleach and the control group were sectioned labio-palatally. The stain area for each specimen was measured using image analysis software. RESULTS: With tea staining, the mean changes in Vita shade guide units (SGU) ranged from 3.66 to 8.33. With the SVS system changes of 3.66-9 units were seen. Chromometer readings showed that following bleaching the L* values moved in the direction of black (3.8-6.7) and a* and b* values were in the red (0.3) and yellow (1.5) direction, respectively. Samples bleached and sectioned mesio-distally showed stain coverage of 28.6-39.4%, while palatal sections showed stain coverage of 58-72%. Control samples, whether sectioned mesio-distally or labio-palatally, showed staining throughout the dentine (97-100% coverage). CONCLUSION: A 35% hydrogen peroxide in-office bleaching gel demonstrated bleaching into dentine of uniform depth.

Analysis of Variance↗

Beliefs about Learning in Children's Understanding of Science Texts.

This study examined elementary school children's beliefs about learning and assessed the influences of such beliefs on their understanding of science texts. Eighty-three children, 46 from Grade 4 and 37 from Grade 6, were administered a questionnaire on children's implicit notions of learning. Children were also asked to read a science text and complete several tasks that assessed their understanding of text information. Results indicated that older children were more likely to hold constructivist views of learning, and they also performed better than younger children on the text-processing tasks. As well, children's views of learning were significantly related to depth of text understanding when age effects were controlled. This study extends current research on epistemological beliefs of university and high school students. Implications of children's beliefs about learning and their roles in knowledge construction are discussed. Copyright 2001 Academic Press.

Journal Article↗

The change in ocular refractive components after cycloplegia in children.

PURPOSE: To study the change in ocular refractive components after cycloplegia in children. METHODS: Anterior chamber depth, lens thickness, vitreous chamber length, and ocular axial length were measured in 135 Chinese children (270 eyes) before and after cycloplegia. The corneal curvatures of 136 selected eyes were studied before and after cycloplegia with a computerized video keratoscope. RESULTS: Anterior chamber depth increased (P <.001) while both lens thickness and vitreous chamber length decreased (P <.001) significantly after cycloplegia regardless of the refractive state. However, axial length increased in hyperopic eyes (P =.027) but decreased in myopic eyes (P =.008) after cycloplegia. Mean corneal power of zones 3 mm (MD3, P =.009) and keratometer K1 readings increased (P =.025) in hyperopic eyes, while MD3 (P =.033), K1 (P =.039) and K2 (P =.003) readings decreased in myopic eyes significantly after cycloplegia. Similarly, mean corneal power of zones 5 mm and 7 mm in myopic eyes decreased dramatically (P <or=.001). In both hyperopic and myopic eyes, there was significant difference (P <.001) in the mean value of the upper and lower half of the vertical meridian, as well as the medial and lateral half of the horizontal meridian, respectively. CONCLUSIONS: Cycloplegia has a great influence on various refractive components in children. There is asymmetry of the corneal surface within the same horizontal or vertical meridian.

Accommodation, Ocular↗

Perspectives of people with enduring mental ill health from a community-based qualitative study.

BACKGROUND: The views of people with enduring mental ill health have received limited exploration. Existing work has largely focused on patients in specialist mental health settings, rather than on a wider range of patients in the community. AIM: To explore experiences and perceptions of health care of people with enduring mental ill health. DESIGN OF STUDY: A community-based qualitative study using theoretical sampling, in-depth interviews, and grounded methodology. SETTING: A total of 34 responders registered with four general practices, serving five wards with a mean Townsend Deprivation Score of 7.75. METHOD: Subjects were chosen using a theoretical sampling framework and they participated in one-to-one interviews which were audiotaped. Themes were identified and developed by reading transcripts, then they were further refined and classified manually by open coding into key categories using a grounded approach. RESULTS: The primary goal of the responders was to enhance, sustain, and take control of their mental health. The building of positive therapeutic relationships with professionals based upon effective communication, trust, and continuity were important to achieving this aim. However, the settings in which their health care took place could affect responders' attempts to deal with social stigma. Experiences of social isolation, socioeconomic privation, and stigmatisation were often pervasive. These compromised responders' opportunities and their capacity to enhance their mental health, compounding their illness and marginalisation. CONCLUSIONS: This study shows the potential of health professionals to empower people with enduring mental ill health, by attending to the quality of communication and continuity of care they provide and to where this takes place. It further underlines a need to address the social stigma and exclusion this group experiences.

Adult↗

Religious and spiritual resources, CAM, and conventional treatment in the lives of cancer patients.

CONTEXT: In addition to seeking conventional treatment from physicians, cancer patients will often use religious and spiritual resources (RSR) and complementary and alternative medicine (CAM). Patients' beliefs about the relationships among RSR, CAM, and conventional treatments may reflect belief systems not readily apparent to physicians. OBJECTIVE: 1) Identify the RSR used and explore themes in beliefs regarding RSR, CAM, and conventional treatment. 2) Investigate the nature of the relationships among RSR, CAM, and conventional treatment in the lives of cancer patients. DESIGN: Cancer patients in Hawaii were recruited from a group who had previously completed a questionnaire on CAM use. In-depth interviews were conducted with a selected subset of survey participants. PARTICIPANTS: 143 cancer patients were interviewed 2 to 3 years following diagnosis. RESULTS: Participants reported using a variety of RSR, including personal faith, individual (self) prayer, relationship/dialog with God, prayers from fellow church members and others, counseling from pastor/priest or leader of faith, reading the bible, attending religious services, meditation, finding and spending time at locations of spiritual energy (i.e., churches, specific geographical locations, or certain natural settings), and help or counseling by ancestor(s). They also expressed beliefs that RSR, CAM, and conventional treatment have both shared and distinct purposes. RSR themes included providing treatment or cure, supporting treatment or cure, and being part of life. CAM themes included providing treatment or cure, supporting treatment or cure, preventing cancer and recurrence, substitution for conventional treatment, and as a last resort. Participants believed the purposes of conventional treatment were to fight/cure cancer and to improve quality of life. CONCLUSIONS: RSR, CAM, and conventional treatment served both spiritual and physical purposes. When participants perceived a relationship between RSR, CAM, and conventional treatment, it reflected shared spiritual and physical purposes. Such associations were especially strong when RSR, CAM, and conventional treatment shared the common goals of providing treatment or cure and/or supporting treatment or cure. Perceptions of shared purpose were individual to each participant, with religious congruence and life history playing a role in beliefs about the relationship between RSR and CAM. Such beliefs can affect issues of control, spiritual well-being, coping, depression, decision-making, and possibly health outcomes in cancer patients. Therefore, they should be addressed by clinicians in discussions with their patients.

Adaptation, Psychological↗

Concomitant assessment of depth of sedation by changes in bispectral index and changes in autonomic variables (heart rate and/or BP) in pediatric critically ill patients receiving neuromuscular blockade.

OBJECTIVE: We evaluated whether or not changes in bispectral index (BIS) are associated with concomitant changes in autonomic variables that are in agreement with the different level of sedation that the changes in BIS indicate. DESIGN: A retrospective chart review. SETTING: A pediatric ICU of a children's hospital. METHODS AND MAIN RESULTS: Charts of patients who were receiving mechanical ventilation and IV sedation, neuromuscular blockade, and continuous BIS monitoring were enrolled in the study. Changes in BIS values > or = 30% from previous readings were evaluated to determine whether or not concomitant changes of > or = 10% in autonomic variables, in the same direction, coexisted. Forty-seven patients (35 male and 12 female) were enrolled in our study; ages ranged from 10 days to 18 years (mean, 4.2 +/- 6.2 years [+/- SD]). Twenty-five patients were < 1 year of age (53%). All patients were sedated and pharmacologically paralyzed. Overall, 387 BIS readings (15%) showed a > or = 30% change from the previously documented BIS number. These BIS changes were in agreement with heart rate (HR) changes, mean arterial pressure (MAP) changes, and both HR and MAP changes in 10.6%, 23.8%, and 5.7% of the time, respectively. The same analysis of agreement was done for patients < or = 1 year old, and results were no different from those of older patients. Among 21 patients who were not receiving any vasoactive drugs (alpha- and/or beta-adrenergic agonists) during the study period, 157 BIS recordings (15%) showed a > or = 30% change from the previously documented BIS number. The percents of agreement with HR, MAP, and HR and MAP for these patients were 14.6%, 17.2%, and 7.6%, respectively. In 26 patients who were receiving vasoactive medications during the study, 230 BIS recordings (15%) showed a > or = 30% change from the previously documented BIS number. For these patients, the percentages of agreement were 7.8%, 28.3%, and 4.3%, respectively. Agreement with MAP was significantly better than with HR for this group of patients (p < 0.05; Fisher Exact Test). SUMMARY: While significant changes in BIS are thought to reflect significant changes in depth of sedation, they have a very low rate of agreement with changes in vital signs. In the absence of BIS, the level of sedation of chemically paralyzed pediatric patients can be better guided by changes in MAP than in HR, particularly in patients receiving vasoactive drug treatment.

Adolescent↗

Understanding the accessory viral proteins unique to the severe acute respiratory syndrome (SARS) coronavirus.

A novel coronavirus, termed the severe acute respiratory syndrome coronavirus (SARS-CoV), infected humans in Guangdong, China, in November 2002 and the subsequent efficient human-to-human transmissions of this virus caused profound disturbances in over 30 countries worldwide in 2003. Eventually, this epidemic was controlled by isolation and there has been no human infection reported since January 2004. However, research on different aspects of the SARS-CoV is not waning, as it is not known if this virus will re-emerge, especially since its origins and potential reservoir(s) are unresolved. The SARS-CoV genome is nearly 30 kb in length and contains 14 potential open reading frames (ORFs). Some of these ORFs encode for genes that are homologous to proteins found in all known coronaviruses, namely the replicase genes (ORFs 1a and 1b) and the four structural proteins: nucleocapsid, spike, membrane and envelope, and these proteins are expected to be essential for the replication of the virus. The remaining eight ORFs encodes for accessory proteins, varying in length from 39 to 274 amino acids, which are unique to SARS-CoV. This review will summarize the expeditious research on these accessory viral proteins in three major areas: (i) the detection of antibodies against accessory proteins in the serum of infected patients, (ii) the expression, processing and cellular localization of the accessory proteins, and (iii) the effects of the accessory proteins on cellular functions. These in-depth molecular and biochemical characterizations of the SARS-CoV accessory proteins, which have no homologues in other coronaviruses, may offer clues as to why the SARS-CoV causes such a severe and rapid attack in humans, while other coronaviruses that infect humans seem to be more forgiving.

Antibodies, Viral↗

[Method for determination of radiation effects in cosmonauts by board dosimeter readings made during orbital mission].

A technique for calculating the SS MIR absorbed doses from the galactic cosmic rays, protons of the Earth's radiation belts and solar flares is described. Calculated daily doses for different compartments along the MIR main axis are compared with doses calculated for the location of board radiometer R-16 in various periods of solar activity. Maximal doses in MIR compartments (in the absence of phantom) were compared with the doses in referential depths of a spherical phantom representing the blood forming tissue, skin, enteric epithelium, and the absorbed dose in the dosimeter location. This comparison allows more precise estimation of radiation hazard to cosmonauts in space flight.

Astronauts↗

cDNA cloning of the human peroxisomal enoyl-CoA hydratase: 3-hydroxyacyl-CoA dehydrogenase bifunctional enzyme and localization to chromosome 3q26.3-3q28: a free left Alu Arm is inserted in the 3' noncoding region.

Enoyl-CoA hydratase:3-hydroxyacyl-CoA dehydrogenase bifunctional enzyme is one of the four enzymes of the peroxisomal beta-oxidation pathway. Here, we report the full-length human cDNA sequence and the localization of the corresponding gene on chromosome 3q26.3-3q28. The cDNA sequence spans 3779 nucleotides with an open reading frame of 2169 nucleotides. The tripeptide SKL at the carboxy terminus, known to serve as a peroxisomal targeting signal, is present. DNA sequence comparison of the coding region showed an 80% homology between human and rat bifunctional enzyme cDNA. The 3' noncoding sequence contains 117 nucleotides homologous to an Alu repeat. Based on sequence comparison, we propose that these nucleotides are a free left Alu arm with 86% homology to the Alu-J family. RNA analysis shows one band with highest intensity in liver and kidney. This cDNA will allow in-depth studies of molecular defects in patients with defective peroxisomal bifunctional enzyme. Moreover, it will also provide a means for studying the regulation of peroxisomal beta-oxidation in humans.

3-Hydroxyacyl CoA Dehydrogenases↗