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Genomics is a crucial part of managing surgical disease. This review focuses on some of the genomic advances that are available now and looks to the future of their application in surgical practice. Whole-genome sequencing enables unbiased coverage across the entire human genome of approximately three billion base pairs. Newer technologies, such as those that permit long-read sequence analysis, provide additional information in longer phased fragment and base pair epigenomic (methylomic) data. Whole-genome sequencing is currently available in England for cancers in children, teenagers and young adults, central nervous system tumours, sarcoma and haematological malignancies. Circulating tumour DNA (ctDNA), immunotherapy and pharmacogenomics have emerged as groundbreaking approaches in the field of cancer treatment. These are now revolutionising the way oncologists and surgeons approach curative cancer surgery. Cancer vaccines offer an innovative approach to reducing recurrence after surgery by priming the immune system to trigger an immune response. The Cancer Vaccine Launch Pad project facilitates cancer vaccine studies in England. The BNT122-01 trial is recruiting patients with ctDNA-positive high-risk colorectal cancer after surgery to assess the impact of cancer vaccines. The evolving landscape of cancer treatment demands a dynamic and integrated approach from the surgical multidisciplinary team. Immunotherapy, ctDNA, pharmacogenomics, vaccines, mainstreaming and whole-genome sequencing are just some of the innovations that have the potential to redefine the standards of care. The continued exploration of these innovative diagnostics and therapies, the genomic pathway evolution and their application in diverse cancer types highlights the transformative impact of precision medicine in surgery.

Objectives: Maternal health behaviours (MHBs) can influence pregnancy outcomes. Despite efforts internationally to encourage positive MHBs, women often fail to comply with pregnancy guidelines. International studies show differences in MHBs between nationalities and an effect of time spent in the host country. There is limited Irish data in this area, with no previous research relating to the effect of time in Ireland., Study Design: This study is a cross-sectional analysis of the Growing Up in Ireland infant cohort, a nationally representative longitudinal study., Methods: Examination of the MHBs of non-Irish nationals during pregnancy and the effect of time in Ireland on the said behaviours., Results: An association was found between time spent in Ireland and increased alcohol consumption prevalence. Those living in Ireland for ≤5 years were 60.8% less likely to consume alcohol during pregnancy (0.000) and 29.3% less likely to take folic acid before conception (0.021). Those who smoked during pregnancy were 98.6% more likely to consume alcohol (0.000) and those who consumed alcohol were 95.2% more likely to smoke during pregnancy (0.000)., Conclusions: The results demonstrate differences in MHBs and the influence of time living in Ireland. These findings are of relevance for policy and intervention planning to optimise pregnancy outcomes among non-nationals., (Copyright © 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Textile fibres can be transferred directly, person to person or person to scene (primary transfer), or indirectly via an intermediate (secondary transfer). In criminal cases involving a transfer of textile fibres, it is often the case that whilst the provenance of recovered 'crime significant' fibres is accepted by the defence, it is a particular activity leading to their transfer to a surface in question which is disputed. In such circumstances, transfer and persistence studies relating to fibres on a particular substrate in particular conditions assist in evaluating whether the presence of crime relevant fibres is more likely to have occurred by one particular activity compared to another. This study investigates the effect of a time delay between the primary transfer of fibres to a garment on the numbers of subsequently secondarily transferred fibres to a seat. Two donor garments composed of polyester and cotton fibres respectively were employed in this study and secondarily transferred to seats after time intervals of 0, 0.5, 2, 6 and 24h. The number of secondarily transferred fibres were recorded according to fibre type and time interval and compared against levels recorded at the primary transfer stage. The results showed that only a relatively small percentage of the original primary transfer is likely to be secondarily transferred and that the numbers found were inversely proportional to the time interval between the primary and secondary transfer. In addition, it was found that the secondary transfer of cotton fibres was an order of magnitude higher than for polyester., (Copyright © 2017 Elsevier B.V. All rights reserved.)

We demonstrate for the first time a waveguide-based frequency shifter on the silicon photonic platform using single-sideband modulation. The device is based on silicon-organic hybrid (SOH) electro-optic modulators, which combine conventional silicon-on-insulator waveguides with highly efficient electro-optic cladding materials. Using small-signal modulation, we demonstrate frequency shifts of up to 10 GHz. We further show large-signal modulation with optimized waveforms, enabling a conversion efficiency of -5.8 dB while suppressing spurious side-modes by more than 23 dB. In contrast to conventional acousto-optic frequency shifters, our devices lend themselves to large-scale integration on silicon substrates, while enabling frequency shifts that are several orders of magnitude larger than those demonstrated with all-silicon serrodyne devices.

We demonstrate a silicon-organic hybrid (SOH) Mach-Zehnder modulator (MZM) generating four-level amplitude shift keying (4ASK) signals at symbol rates of up to 64 GBd both at room temperature and at an elevated temperature of 80°C. The measured line rate of 128 Gbit/s corresponds to the highest value demonstrated for silicon-based MZM so far. We report bit error ratios of 10 -10 (64 GBd BPSK), 10 -5 (36 GBd 4ASK), and 4 × 10 -3 (64 GBd 4ASK) at room temperature. At 80 °C, the respective bit error ratios are 10 -10 , 10 -4 , and 1.3 × 10 -2 . The high-temperature experiments were performed in regular oxygen-rich ambient atmosphere.

Multilocus phylogeography can uncover taxonomically unrecognized lineage diversity across complex biomes. The Australian monsoonal tropics include vast, ecologically intact savanna-woodland plains interspersed with ancient sandstone uplands. Although recognized in general for its high species richness and endemism, the biodiversity of the region remains underexplored due to its remoteness. This is despite a high rate of ongoing species discovery, especially in wetter regions and for rock-restricted taxa. To provide a baseline for ongoing comparative analyses, we tested for phylogeographic structure in an ecologically generalized and widespread taxon, the gecko Heteronotia binoei. We apply coalescent analyses to multilocus sequence data (mitochondrial DNA and eight nuclear DNA introns) from individuals sampled extensively and at fine scale across the region. The results demonstrate surprisingly deep and geographically nested lineage diversity. Several intra-specific clades previously shown to be endemic to the region were themselves found to contain multiple, short-range lineages. To infer landscapes with concentrations of unique phylogeographic diversity, we probabilistically estimate the ranges of lineages from point data and then, combining these estimates with the nDNA species tree, estimate phyloendemism across the region. Highest levels of phyloendemism occur in northern Top End, especially on islands, across the topographically complex Arnhem escarpment, and across the sandstone ranges of the western Gulf region. These results drive home that deep phylogeographic structure is prevalent in tropical low-dispersal taxa, even ones that are ubiquitous across geography and habitats., (© 2015 John Wiley & Sons Ltd.)

We report on high-speed plasmonic-organic hybrid Mach-Zehnder modulators comprising ultra-compact phase shifters with lengths as small as 19 µm. Choosing an optimum phase shifter length of 29 µm, we demonstrate 40 Gbit/s on-off keying (OOK) modulation with direct detection and a BER < 6 × 10(-4). Furthermore, we report on a 29 µm long binary-phase shift keying (BPSK) modulator and show that it operates error-free (BER < 1 × 10(-10)) at data rates up to 40 Gbit/s and with an energy consumption of 70 fJ/bit.

A target fibre study was carried out to assess the random prevalence of two ostensibly commonly encountered synthetic fibre types; black acrylic and blue polyester. The study was performed in an environment which maximised the number of random contacts between textile garments in the population and specific surfaces, namely; seating relating to buses, public houses and cinemas found within a large urban conurbation. Surface debris tapings were collected from samples of bus seats (30), pub seats (54) and cinema seats (53). Using low power stereomicroscopy, a total of 114 and 68 fibres, superficially similar to the respective black acrylic and blue polyester target fibres, were recovered from these tapings. The full range of comparative microscopical and instrumental analysis used in operational forensic laboratories was performed on the recovered fibres. No matches were found with either of the target fibres. These findings are in accordance with similar studies which show that the probability of an 'adventitious' match with a particular fibre type/colour combination is extremely low. In addition, the findings demonstrate that the current techniques and instrumentation employed by operational forensic laboratories are fit for purpose. Importantly, the findings demonstrate that databases and surveys (e.g. fibre population studies) which do not consider the analytical/comparison processes, must not be used in isolation when evaluating fibre evidence at source level., (Copyright © 2015 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.)

Objectives: The purpose of this study was to determine the accuracy of a commonly used veterinary wire tensioner., Methods: Wire tension was measured using a load cell after each of five tensioners were used to tension each of six wires to the 66, 84, and 118 mm ring settings in an adjustable custom testing fixture. Each tensioner then experienced simulated aging and testing was repeated. Percentage error was calculated for each ring size, before and after tensioner aging. Measured tension values were compared to manufacturer reported tension values for each ring size using a one-sample two-way t-test; p <0.05 was considered significant., Results: Compared to the manufacturer reported values, measured wire tension values were significantly lower for 66 mm and 84 mm rings and significantly higher for 118 mm rings, before and after simulated aging. Mean wire tension values did not significantly differ between individual wire tensioners., Clinical Significance: The tensioners tested achieved significantly different wire tension values than those reported by the manufacturer. This discrepancy could lead to under-tensioning and allowing excessive movement at a fracture site or over-tensioning, leading to wire breakage. We recommend tensioning wires at least to the recommended line on the device for 66 mm and 84 mm rings and at most to the recommended line for 118 mm rings. Further studies are needed to evaluate other veterinary wire tensioners and to develop a calibration method for these devices in practice.

We demonstrate silicon-organic hybrid (SOH) electro-optic modulators that enable quadrature phase-shift keying (QPSK) and 16-state quadrature amplitude modulation (16QAM) with high signal quality and record-low energy consumption. SOH integration combines highly efficient electro-optic organic materials with conventional silicon-on-insulator (SOI) slot waveguides, and allows to overcome the intrinsic limitations of silicon as an optical integration platform. We demonstrate QPSK and 16QAM signaling at symbol rates of 28 GBd with peak-to-peak drive voltages of 0.6 V(pp). For the 16QAM experiment at 112 Gbit/s, we measure a bit-error ratio of 5.1 × 10⁻⁵ and a record-low energy consumption of only 19 fJ/bit.

We demonstrate frequency comb sources based on silicon-organic hybrid (SOH) electro-optic modulators. Frequency combs with line spacings of 25 GHz and 40 GHz are generated, featuring flat-top spectra with less than 2 dB power variations over up to 7 lines. The combs are used for WDM data transmission at terabit/s data rates and distances of up to 300 km.

Objective: To determine if a novel radiographic stitching technique yields accurate tibial plateau angle (TPA) measurements in large and giant breed dogs., Methods: Three medio-lateral digital radiographic projections (traditional TPLO, stifle-centred, tarsus-centred) were obtained from each of 17 pairs of pelvic limbs from skeletally mature large and giant breed dogs. Eight observers performed image stitching followed by TPA measurements on the stitched (sTPA) and traditional radiographs (tTPA). The TPA was also measured on photographs made of isolated anatomical tibial specimens (aTPA). Measurements were compared between observers and between image type using ANOVA and correlation coefficients., Results: There was no statistically significant difference in TPA between observers for tTPA or sTPA radiographs (p >0.05); both sTPA and tTPA were highly correlated with aTPA and with each other (r = 0.88, 0.89, and 0.97 respectively)., Clinical Relevance: This novel digital stitching method provides an alternative technique for accurately measuring TPA utilizing a stifle-centred radiograph that may be useful when traditional TPLO radiographs are difficult to obtain. This may be particularly useful in large and giant breed dogs because collimation to include the entire tibial length can preclude proper centring of the radiographic beam over the stifle.

Objectives: To describe the surgical treatment of pes varus in Dachshund dogs by medial opening wedge osteotomy of the distal tibia stabilized with a locking plate system and to retrospectively report the clinical and radiographic outcomes., Materials and Methods: Lameness in nine limbs of seven Dachshund dogs with pes varus deformity was treated with corrective osteotomy at or near the centre of rotation of angulation as defined by the intersection of the proximal and distal mechanical axes determined on caudo-cranial radiographs. Outcomes evaluated included comparison of pre- and postoperative radiographic measurements of frontal angulation and lameness assessment., Results: Lameness resolved in eight limbs and improved in one limb. All osteotomies healed and no implant complications were detected. Mean preoperative radiographic measurements were: mechanical medial proximal tibial angle (mMPTA) = 91.1° (range 87.6°-95°), mechanical medial distal tibial angle (mMDTA) = 62.1° (range 51.9°-69.6°). Mean postoperative measurements were: mMPTA 92.4° (range 78°-97.5°), mMDTA 81.8° (range 76°-87°). Measurable under- correction was common, though seldom visually or functionally evident., Clinical Significance: Pes varus deformity in Dachshunds can be treated by medial opening wedge osteotomy of the distal tibia stabilized with a locking plate system. Care to preserve the lateral cortex of the osteotomy may help avoid under-correction.

Textile fibres were transferred to a pig skin carcass and their persistence determined at daily intervals for up to a 12 day period during which time the carcass was left outdoors exposed to the prevailing weather conditions and animal activity. In the absence of strong winds and precipitation, the loss of fibres was found to be exponential. Stronger winds and heavier precipitation caused an increase in the rate of loss of fibres. The results of this study showed that the majority of fibres transferred to a body deposited outdoors, can be expected to be lost after the first 2 days, however, none of the experiments performed resulted in a complete loss of fibres, even after 12 days exposure. These persistence characteristics differed from those observed in a similar study using small sections of skin, rather than carcasses. The implications of the results of the present study in relation to the examination of fibre evidence in cases of homicide are discussed., (Copyright © 2011 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.)

When silicon strip and slot waveguides are coated with a 50 nm amorphous titanium dioxide (TiO2) film, measured losses at a wavelength of 1.55 μm can be as low as (2 ± 1)dB/cm and (7 ± 2)dB/cm, respectively. We use atomic layer deposition (ALD), estimate the effect of ALD growth on the surface roughness, and discuss the effect on the scattering losses. Because the gap between the rails of a slot waveguide narrows by the TiO2 deposition, the effective slot width can be back-end controlled. This is useful for precise adjustment if the slot is to be filled with, e. g., a nonlinear organic material or with a sensitizer for sensors applications.

CMOS-compatible optical modulators are key components for future silicon-based photonic transceivers. However, achieving low modulation voltage and high speed operation still remains a challenge. As a possible solution, the silicon-organic hybrid (SOH) platform has been proposed. In the SOH approach the optical signal is guided by a silicon waveguide while the electro-optic effect is provided by an organic cladding with a high χ(2)-nonlinearity. In these modulators the optical nonlinear region needs to be connected to the modulating electrical source. This requires electrodes, which are both optically transparent and electrically highly conductive. To this end we introduce a highly conductive electron accumulation layer which is induced by an external DC "gate" voltage. As opposed to doping, the electron mobility is not impaired by impurity scattering. This way we demonstrate for the first time data encoding with an SOH electro-optic modulator. Using a first-generation device at a data-rate of 42.7 Gbit/s, widely open eye diagrams were recorded. The measured frequency response suggests that significantly larger data rates are feasible.

The latest UK national human immunodeficiency virus (HIV) testing guidelines, released in September 2008, state that HIV testing should be offered to all patients with indicator conditions and considered in all general medical admissions in high-prevalence areas. We audited testing rates at Blackpool Victoria Hospital, a high-prevalence area, one year before and one year after the publication of the new guidelines. In the year after publication the rate of HIV testing in patients with indicator diseases was as follows: hepatitis B 6%, hepatitis C 28%, tuberculosis 9% and lymphoma 14%. The overall rate of HIV testing in acute medical admissions was 0.5%. Our results demonstrate that traditional methods of guideline dissemination did not lead to implementation. We are now assessing alternative methods such as marking all positive laboratory results for indicator diseases with the phrase 'HIV testing should be considered' and implementing universal opt-out screening in our Clinical Decisions Unit.

Unlabelled: Despite federal, state, and local public health efforts to prevent and control hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, these diseases remain serious health problems in the United States. About 1%-2% of the U.S. population has chronic HBV or HCV infections, and each year about 15,000 people die from liver cancer or liver disease related to these preventable infections. The Institute of Medicine formed an expert committee to determine ways to reduce new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis and released its findings in a report. The major factor found to impede current efforts to prevent and control HBV and HCV is lack of knowledge and awareness about these diseases among healthcare and social-service providers, members of the public, and policy makers. Because the extent and seriousness of this public health problem is not appreciated, inadequate resources are being allocated to prevention, control, and surveillance programs. This situation has led to continued transmission of HBV and HCV and inadequate identification of and medical management for chronically infected people., Conclusion: To address the situation, the Institute of Medicine report makes recommendations in four areas: improved surveillance for HBV and HCV; improved knowledge and awareness among healthcare and social-service providers and the public, especially at-risk people; improved HBV vaccine coverage; and improved viral hepatitis services and access to those services.

We report on a patient who was initially suspected to have Beckwith-Wiedemann syndrome because of recurrent neonatal hypoglycaemias, macroglossia and overgrowth, but in whom no 11p15 abnormality could be found. Follow-up showed continued overgrowth and disturbed glucose homeostasis, a marked developmental delay, and severe behavioural problems especially caused by anxieties. Array comparative genomic hybridization analysis showed a de novo 12q24.31 interstitial deletion, which was confirmed by fluorescence in situ hybridization. The deleted region contains amongst others: HNF1 homeobox A (HNF1A) which is important for the regulation of gene expression in the liver and involved in maturity-onset diabetes of the young type 3 and insulin resistance; acyl-CoA dehydrogenase short chain (ACADS) which encodes an enzyme important in mitochondrial fatty acid beta-oxidation and can cause short-chain acyl-CoA dehydrogenese (SCAD) deficiency, and purinergic receptor P2X7 (P2RX7) which encodes a ligand-gated ion channel, and of which polymorphisms are found with increased frequency in patients with psychiatric disorders, especially anxieties. We conclude the present patient has a hitherto undescribed contiguous gene syndrome, which can initially resemble Beckwith-Wiedemann syndrome.

Background: Dexlansoprazole MR, a modified-release formulation of dexlansoprazole, an enantiomer of lansoprazole, effectively heals erosive oesophagitis., Aim: To assess dexlansoprazole MR in maintaining healed erosive oesophagitis., Methods: Patients (n = 451) with erosive oesophagitis healed in either of two dexlansoprazole MR healing trials randomly received dexlansoprazole MR 60 or 90 mg or placebo once daily in this double-blind trial. The percentage of patients who maintained healing at month 6 was analysed using life table and crude rate methods. Secondary endpoints were percentages of nights and of 24-h days without heartburn based on daily diaries., Results: Dexlansoprazole MR 60 and 90 mg were superior to placebo for maintaining healing (P < 0.0025). Maintenance rates were 87% and 82% for the 60 and 90 mg doses, respectively, vs. 26% for placebo (life table), and 66% and 65% vs. 14%, respectively (crude rate). Both doses were superior to placebo for the percentage of 24-h heartburn-free days (60 mg, 96%; 90 mg, 94%; placebo, 19%) and nights (98%, 97%, and 50%, respectively). Diarrhoea, flatulence, gastritis (symptoms) and abdominal pain occurred more frequently with dexlansoprazole MR than placebo, but were not dose-related., Conclusion: Dexlansoprazole MR effectively maintained healed erosive oesophagitis and symptom relief compared with placebo, and was well tolerated.

Objective: Variation in the serotonin transporter gene (SLC6A4) promoter region has been shown to influence depression in persons who have been exposed to a number of stressful life events., Method: We evaluated whether genetic variation in 5-HTTLPR, influences current depression, lifetime history of depression and quantitative measures of depression in persons with chronic psychotic disorders. This is an association study of a genetic variant with quantitative and categorical definitions of depression conducted in the southwest US, Mexico and Costa Rica. We analyzed 260 subjects with a history of psychosis, from a sample of 129 families., Results: We found that persons carrying at least one short allele had a statistically significant increased lifetime risk for depressive syndromes (P < 0.02, odds ratio 2.18, 95% CI 1.10-4.20)., Conclusion: The 'ss' or 'sl' genotype at the 5-HTTLPR promoter polymorphic locus increases the risk of psychotic individuals to develop major depression during the course of their illness.

Background: Montelukast is an antagonist of cys-leukotriene receptors used mainly in the treatment of asthma- and seasonal-allergic rhinitis. Initial reports concerning the use of montelukast in atopic dermatitis (AD) have been encouraging, although not consistent., Objectives: We have undertaken a randomized, double-blind, parallel-group, placebo-controlled trial to investigate further the efficacy of montelukast in the treatment of atopic eczema., Methods: Following a screening visit, subjects received placebo treatment for 2 weeks in a single-blind phase, followed after visit 2 by an 8-week, double-blind period of treatment with montelukast 10 mg daily or placebo. Subjects were patients aged 16-60 years under our care for treatment of AD of moderate severity, defined by a six-area, six-sign atopic dermatitis (SASSAD) score in the range 12-50. Response to treatment was assessed by investigators and by subjects using a seven-point scale, with response defined as marked improvement or better. In addition, the SASSAD score was used to monitor the severity of clinical signs. The proportion of skin involved was estimated and visual analogue scales were used to record the severity of pruritus and sleep disturbance. Topical corticosteroid usage was recorded using a five-point scale. Adverse events were recorded., Results: Sixty subjects were recruited and 54 completed the study. The treatment groups were well matched for disease severity at baseline (SASSAD scores were 25 and 29 in the montelukast and placebo groups, respectively). There were no significant differences between the treatment groups in any of the parameters used to assess treatment response. The improvement in mean SASSAD score from baseline (visit 2) to the end of treatment was marginally superior in the placebo group, 1.41 points on montelukast vs. 1.76 on placebo, a difference of 0.35 (95% confidence interval -6.1 to 6.8). Adverse events were generally of a mild nature except for a brief septicaemic illness in one subject receiving montelukast., Conclusions: The data do not support previous reports of efficacy of montelukast in treatment of AD.

A range of fibre samples was measured using J&M MSP400 and J&M MSP800 microspectrophotometers across the visible and UV/visible wavelength ranges respectively. The first derivative of the absorbance spectra was then calculated and studied. When the absorbance spectra produced for some samples were broad and featureless, the first derivative spectra provided more points of comparison that facilitated discrimination. For many of the samples, calculating the first derivative did not result in any additional discrimination due to the high number of points of comparison present in the absorbance spectra. However, for the samples that exhibited a high level of intra-sample colour variation (e.g. through uneven dye uptake common in cotton and wool, etc.), which was evident in the absorbance spectra, the associated first derivative spectra highlighted this variation between the fibres and could potentially have resulted in false exclusions. The results show that whilst calculating first derivative can be a useful aid in the comparison of spectra, a high degree of caution is required when applying this method to fibres which exhibit a large intra-sample variation in colour.

Background: Although many studies have reported impairments of neurocognitive performance in patients with anorexia nervosa (AN), these have involved a wide range of assessment methods and some findings are inconsistent., Method: Twenty-five female in-patients with a DSM-IV diagnosis of AN, identified from three units specializing in the treatment of eating disorders, volunteered for the study. Twenty-five non-clinical control subjects were recruited, matched for age, gender and estimated IQ. Subjects were assessed with a range of computer-administered neurocognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB), which has been validated in many studies of neuropsychiatric disorders., Results: The patient group showed significant but moderate impairments (i.e. less than one standard deviation below the mean performance of the control group) on tests of spatial recognition memory, a planning task and rapid visual information processing, while a subgroup of patients (n = 14) showed greater degrees of impairments on at least one of these tests. The degrees of impairments did not correlate with body mass index (BMI). No impairments were observed on tests of spatial span, pattern recognition memory, spatial working memory, matching-to-sample, paired associates learning and set-shifting., Conclusions: The findings, in relation to a mean BMI of 15.3, are compatible with, in general, subtle impairments in neurocognition in AN. However, in those patients with relatively severe degrees of impairments, these may have adverse effects on complex tasks of social and occupational functioning. Further research is needed on the nature of relevant causal mechanisms, including the effects of potentially confounding variables.

The human 60 kDa and microbial 65 kDa heat shock proteins (HSP) have been implicated in the pathogenesis of chronic periodontitis (P) and coronary heart disease (CHD). We have studied four male non-smoking cohorts of 81 subjects, matched for age. Group (a) consisted of a healthy group with minimal gingivitis (n = 18), group (b) were patients with P (n = 23), group (c) patients with CHD and minimal gingivitis (n = 20) and group (d) patients with CHD and P (n = 20). T cells separated from peripheral blood were found to be primed to both microbial HSP65 and human HSP60 but significant CD4, human leucocyte antigen (HLA) class II-restricted proliferative responses were found only with the human HSP60 in patients with P (P < 0.001) and CHD without (P < 0.001) or with (P < 0.00001) periodontitis. Dose-dependent inhibition of T cell proliferative responses was carried out to determine the receptors involved in recognition of HSP60 and HSP65. Monoclonal antibodies to CD14 showed inhibition of T cell proliferation stimulated by both HSP60 and HSP65, consistent with the role of CD14 as a receptor for these HSPs in P and CHD. The toll-like receptor 2 (TLR-) and TLR-4 were then studied and these showed that TLR-4 was recognized by microbial HSP65, whereas TLR-2 was recognised by human HSP60 in both P and CHD. However, a dissociation was found in the HSP60 and TLR4 interaction, as TLR4 appeared to have been recognized by HSP60 in P but not in CHD. The results suggest an autoimmune or cross-reactive CD4(+) class II-restricted T cell response to the human HSP60 in P and CHD. Further studies are required to determine if there is a common epitope within HSP60 that stimulates T cell proliferation in P and CHD.

In this study, the effects of fibre type, hair style, time and fibre persistence on the secondary transfer of mask fibres to pillowcases via head hair were studied. Volunteers with a range of hair styles, and masks consisting of different fibre compositions were used in the study. Fibres from the masks were found to transfer from donor subjects to the pillowcases up to 14 nights after the mask had been worn. On average, the number of secondarily transferred fibres found decreased with time; however, this decrease appeared to be more 'linear' in nature, rather than an exponential decay. The greatest degree of secondary transfer occurred with cotton, then acrylic, then wool. In a primary transfer/persistence experiment with a 50% acrylic/50% wool mask, wool was found to persist in the hair more readily than acrylic. The results also showed that the greatest degree of secondary transfer occurred via short straight and long straight hair, with no clear pattern emerging between medium length hair (both straight and curly) and with long curly hair. The implications of these findings for the assessment and interpretation of casework are considered along with data obtained from related studies.

This collection of abstracts provides an account of four presentations at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology (WAAVP)(held in New Orleans, LA, USA from 10–14 August 2003) in a symposium session on zoonotic protozoan parasites found in the marine environment and chaired by Ronald Fayer and David Lindsay.The focus was on three genera of parasites of veterinary and public health concern—Toxoplasma,Giardia, and Cryptosporidium with emphasis on their epidemiology in the marine environment.

Objectives: To compare budesonide, a locally acting glucocorticoid with minimal systemic exposure, with conventional glucocorticoid treatment and placebo in rheumatoid arthritis., Methods: A double blind, randomised, controlled trial over 12 weeks in 143 patients with active rheumatoid arthritis, comparing budesonide 3 mg daily, budesonide 9 mg daily, prednisolone 7.5 mg daily, and placebo. Particular attention was paid to the pattern of clinical response and to changes in the four week period following discontinuation of treatment., Results: There were improvements in tender joint count and swollen joint count on budesonide 9 mg compared with placebo (28% for tender and 34% for swollen joint counts, p<0.05). Prednisolone 7.5 mg gave similar results, while budesonide 3 mg was less effective. ACR20 response criteria were met by 25% of patients on placebo, 22% on budesonide 3 mg, 42% on budesonide 9 mg, and 56% on prednisolone 7.5 mg. A rapid and significant reduction in symptoms and signs in response to budesonide 9 mg and prednisolone 7.5 mg was evident by two weeks and maximal at eight weeks. There was no evidence that budesonide provided a different pattern of symptom control from prednisolone, or that symptoms became worse than placebo treatment levels after discontinuation of glucocorticoid treatment. Adverse effects attributable to glucocorticoids were equally common in all groups., Conclusions: The symptomatic benefits of budesonide 9 mg and prednisolone 7.5 mg are achieved within a short time of initiating treatment, are maintained for three months, and are not associated with any rebound in symptoms after stopping treatment.