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Abstract Background Most studies of the vaginal microflora have been based on culture or on qualitative molecular techniques. Here we applied existing real-time PCR formats for Lactobacillus crispatus, L. gasseri and Gardnerella vaginalis and developed new formats for Atopobium vaginae, L. iners and L. jensenii to obtain a quantitative non culture-based determination of these species in 71 vaginal samples from 32 pregnant and 28 non-pregnant women aged between 18 and 45 years. Results The 71 vaginal microflora samples of these women were categorized, using the Ison and Hay criteria, as refined by Verhelst et al. (2005), as follows: grade Ia: 8 samples, grade Iab: 10, grade Ib: 13, grade I-like: 10, grade II: 11, grade III: 12 and grade IV: 7. L. crispatus was found in all but 5 samples and was the most frequent Lactobacillus species detected. A significantly lower concentration of L. crispatus was found in grades II (p < 0.0001) and III (p = 0.002) compared to grade I. L. jensenii was found in all grades but showed higher concentration in grade Iab than in grade Ia (p = 0.024). A. vaginae and G. vaginalis were present in high concentrations in grade III, with log10 median concentrations (log10 MC), respectively of 9.0 and 9.2 cells/ml. Twenty (38.5%) of the 52 G. vaginalis positive samples were also positive for A. vaginae. In grade II we found almost no L. iners (log10 MC: 0/ml) but a high concentration of L. gasseri (log10 MC: 8.7/ml). By contrast, in grade III we found a high concentration of L. iners (log10 MC: 8.3/ml) and a low concentration of L. gasseri (log10 MC: 0/ml). These results show a negative association between L. gasseri and L. iners (r = -0.397, p = 0.001) and between L. gasseri and A. vaginae (r = -0.408, p < 0.0001). Conclusion In our study we found a clear negative association between L. iners and L. gasseri and between A. vaginae and L. gasseri. Our results do not provide support for the generally held proposition that grade II is an intermediate stage between grades I and III, because L. gasseri, abundant in grade II is not predominant in grade III, whereas L. iners, abundant in grade III is present only in low numbers in grade II samples.

The corpus callosum is a bundle of axon fibres that connects the two hemispheres of the brain. Neurodevelopmental disorders that feature dysgenesis of the corpus callosum as a core phenotype offer a valuable window into pathology derived from abnormal axon development. Here, we describe a cohort of eight patients with a neurodevelopmental disorder characterized by a range of deficits including corpus callosum abnormalities, developmental delay, intellectual disability, epilepsy and autistic features. Each patient harboured a distinct de novo variant in MYCBP2, a gene encoding an atypical really interesting new gene (RING) ubiquitin ligase and signalling hub with evolutionarily conserved functions in axon development. We used CRISPR/Cas9 gene editing to introduce disease-associated variants into conserved residues in the Caenorhabditis elegans MYCBP2 orthologue, RPM-1, and evaluated functional outcomes in vivo. Consistent with variable phenotypes in patients with MYCBP2 variants, C. elegans carrying the corresponding human mutations in rpm-1 displayed axonal and behavioural abnormalities including altered habituation. Furthermore, abnormal axonal accumulation of the autophagy marker LGG-1/LC3 occurred in variants that affect RPM-1 ubiquitin ligase activity. Functional genetic outcomes from anatomical, cell biological and behavioural readouts indicate that MYCBP2 variants are likely to result in loss of function. Collectively, our results from multiple human patients and CRISPR gene editing with an in vivo animal model support a direct link between MYCBP2 and a human neurodevelopmental spectrum disorder that we term, MYCBP2-related developmental delay with corpus callosum defects (MDCD)., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose/objectives: There is a robust body of research on which factors dental schools consider when selecting students for acceptance, but there is considerably less research regarding what factors dental applicants consider when selecting a particular program. The aim of this investigation was to better understand which factors most influenced students to matriculate at a particular dental school and how the value of these factors has changed over time., Methods: To answer this research question, an online survey was utilized to determine why students chose to attend Columbia University College of Dental Medicine (CUCDM). This survey was administered to students in the Class of 2023 and was compared to the responses of an identical survey that was administered to the Class of 2013. The response rate for the classes of 2013 and 2023 were 70.0% and 42.2%, respectively. Results from the Classes of 2013 and 2023 were analyzed using independent sample T-tests., Results: The Class of 2013 ranked academic reputation, location, and admissions into specialty programs as the three most important factors in their selection of a dental school. The Class of 2023 ranked tuition cost, perceived patient pool, and financial aid as their three most important factors., Conclusion(s): For dental schools to continue to successfully attract and enroll students, they must understand what motivates a student to matriculate in a specific dental program. One way to accomplish this is through the use of a survey., (© 2022 American Dental Education Association.)

Purpose: To investigate the effect of PLXNA1 variants on the phenotype of patients with autosomal dominant and recessive inheritance patterns and to functionally characterize the zebrafish homologs plxna1a and plxna1b during development., Methods: We assembled ten patients from seven families with biallelic or de novo PLXNA1 variants. We describe genotype-phenotype correlations, investigated the variants by structural modeling, and used Morpholino knockdown experiments in zebrafish to characterize the embryonic role of plxna1a and plxna1b., Results: Shared phenotypic features among patients include global developmental delay (9/10), brain anomalies (6/10), and eye anomalies (7/10). Notably, seizures were predominantly reported in patients with monoallelic variants. Structural modeling of missense variants in PLXNA1 suggests distortion in the native protein. Our zebrafish studies enforce an embryonic role of plxna1a and plxna1b in the development of the central nervous system and the eye., Conclusion: We propose that different biallelic and monoallelic variants in PLXNA1 result in a novel neurodevelopmental syndrome mainly comprising developmental delay, brain, and eye anomalies. We hypothesize that biallelic variants in the extracellular Plexin-A1 domains lead to impaired dimerization or lack of receptor molecules, whereas monoallelic variants in the intracellular Plexin-A1 domains might impair downstream signaling through a dominant-negative effect., (© 2021. The Author(s).)

The COVID-19 pandemic has necessitated a multifaceted rapid response by the scientific community, bringing researchers, health officials, and industry together to address the ongoing public health emergency. To meet this challenge, participants need an informed approach for working safely with the etiological agent, the novel human coronavirus SARS-CoV-2. Work with infectious SARS-CoV-2 is currently restricted to high-containment laboratories, but material can be handled at a lower containment level after inactivation. Given the wide array of inactivation reagents that are being used in laboratories during this pandemic, it is vital that their effectiveness is thoroughly investigated. Here, we evaluated a total of 23 commercial reagents designed for clinical sample transportation, nucleic acid extraction, and virus inactivation for their ability to inactivate SARS-CoV-2, as well as seven other common chemicals, including detergents and fixatives. As part of this study, we have also tested five filtration matrices for their effectiveness at removing the cytotoxic elements of each reagent, permitting accurate determination of levels of infectious virus remaining following treatment. In addition to providing critical data informing inactivation methods and risk assessments for diagnostic and research laboratories working with SARS-CoV-2, these data provide a framework for other laboratories to validate their inactivation processes and to guide similar studies for other pathogens., (© Crown copyright 2020.)

Pathogenic de novo variants in the X-linked gene SLC35A2 encoding the major Golgi-localized UDP-galactose transporter required for proper protein and lipid glycosylation cause a rare type of congenital disorder of glycosylation known as SLC35A2-congenital disorders of glycosylation (CDG; formerly CDG-IIm). To date, 29 unique de novo variants from 32 unrelated individuals have been described in the literature. The majority of affected individuals are primarily characterized by varying degrees of neurological impairments with or without skeletal abnormalities. Surprisingly, most affected individuals do not show abnormalities in serum transferrin N-glycosylation, a common biomarker for most types of CDG. Here we present data characterizing 30 individuals and add 26 new variants, the single largest study involving SLC35A2-CDG. The great majority of these individuals had normal transferrin glycosylation. In addition, expanding the molecular and clinical spectrum of this rare disorder, we developed a robust and reliable biochemical assay to assess SLC35A2-dependent UDP-galactose transport activity in primary fibroblasts. Finally, we show that transport activity is directly correlated to the ratio of wild-type to mutant alleles in fibroblasts from affected individuals., (© 2019 Wiley Periodicals, Inc.)

Accumulation of unfolded proteins in the endoplasmic reticulum (ER) initiates a stress response mechanism to clear out the unfolded proteins by either facilitating their re-folding or inducing their degradation. When this fails, an apoptotic cascade is initiated so that the affected cell is eliminated. IRE1α is a critical sensor of the unfolded-protein response, essential for initiating the apoptotic signaling. Here, we report an infantile neurodegenerative disorder associated with enhanced activation of IRE1α and increased apoptosis. Three unrelated affected individuals with congenital microcephaly, infantile epileptic encephalopathy, and profound developmental delay were found to carry heterozygous variants (c.932T>C [p.Leu311Ser] or c.935T>C [p.Leu312Pro]) in RNF13, which codes for an IRE1α-interacting protein. Structural modeling predicted that the variants, located on the surface of the protein, would not alter overall protein folding. Accordingly, the abundance of RNF13 and IRE1α was not altered in affected individuals' cells. However, both IRE1α-mediated stress signaling and stress-induced apoptosis were increased in affected individuals' cells. These results indicate that the RNF13 variants confer gain of function to the encoded protein and thereby lead to altered signaling of the ER stress response associated with severe neurodegeneration in infancy., (Copyright © 2018 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.)

The 2014 Ebola outbreak in West Africa required the rapid testing of clinical material for the presence of potentially high titre Ebola virus (EBOV). Safe, fast and effective methods for the inactivation of such clinical samples are required so that rapid diagnostic tests including downstream analysis by RT-qPCR or nucleotide sequencing can be carried out. One of the most commonly used guanidinium - based denaturing agents, AVL (Qiagen) has been shown to fully inactivate EBOV once ethanol is added, however this is not compatible with the use of automated nucleic acid extraction systems. Additional inactivation agents need to be identified that can be used in automated systems. A candidate inactivation agent is Triton X-100, a non-denaturing detergent that is frequently used in clinical nucleic acid extraction procedures and has previously been used for inactivation of EBOV. In this study the effect of 0.1% and 1.0% Triton X-100 (final concentration 0.08% and 0.8% respectively) alone and in combination with AVL on the viability of EBOV (10 6 TCID 50 /ml) spiked into commercially available pooled negative human serum was tested. The presence of viable EBOV in the treated samples was assessed by carrying out three serial passages of the samples in Vero E6 cells (37°C, 5% CO 2 , 1 week for each passage). At the end of each passage the cells were observed for evidence of cytopathic effect and samples were taken for rRT-PCR analysis for the presence of EBOV RNA. Before cell culture cytotoxic components of AVL and Triton X-100 were removed from the samples using size exclusion spin column technology or a hydrophobic adsorbent resin. The results of this study showed that EBOV spiked into human serum was not fully inactivated when treated with either 0.1% (v/v) Triton X-100 for 10 mins or 1.0% (v/v) Triton X-100 for 20 mins (final concentrations 0.08% and 0.8% Triton X-100 respectively). AVL alone also did not consistently provide complete inactivation. Samples treated with both AVL and 0.1% Triton X-100 for 10 or 20 mins were shown to be completely inactivated. This treatment is compatible with downstream analysis by RT-qPCR and next generation sequencing., (Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.)

The West African Ebola virus outbreak underlined the importance of delivering mass diagnostic capability outside the clinical or primary care setting in effectively containing public health emergencies caused by infectious disease. Yet, to date, there is no solution for reliably deploying at the point of need the gold standard diagnostic method, real time quantitative reverse transcription polymerase chain reaction (RT-qPCR), in a laboratory infrastructure-free manner. In this proof of principle work, we demonstrate direct performance of RT-qPCR on fresh blood using far-red fluorophores to resolve fluorogenic signal inhibition and controlled, rapid freeze/thawing to achieve viral genome extraction in a single reaction chamber assay. The resulting process is entirely free of manual or automated sample pre-processing, requires no microfluidics or magnetic/mechanical sample handling and thus utilizes low cost consumables. This enables a fast, laboratory infrastructure-free, minimal risk and simple standard operating procedure suited to frontline, field use. Developing this novel approach on recombinant bacteriophage and recombinant human immunodeficiency virus (HIV; Lentivirus), we demonstrate clinical utility in symptomatic EBOV patient screening using live, infectious Filoviruses and surrogate patient samples. Moreover, we evidence assay co-linearity independent of viral particle structure that may enable viral load quantification through pre-calibration, with no loss of specificity across an 8 log-linear maximum dynamic range. The resulting quantitative rapid identification (QuRapID) molecular diagnostic platform, openly accessible for assay development, meets the requirements of resource-limited countries and provides a fast response solution for mass public health screening against emerging biosecurity threats.

Aims: To determine whether microarray analysis could be employed for the differential identification of a range of environmental Bacillus sp. from four strains of Bacillus anthracis., Methods and Results: Oligonucleotide probes were designed that were specific to virulence factor genes of B. anthracis (pag, lef and cap), the variable number tandem repeat region of the B. anthracis vrrA gene and to the 16S-23S rRNA intergenic transcribed spacer region (ITS) and pleiotropic regulator (plcR) regions of the Bacillus cereus subgroup species. Generic probes were also designed to hybridize with conserved regions of the 16S rRNA genes of Bacillus (as a positive control), Neisseria sp., Pseudomonas sp., Streptococcus sp., Mycobacterium sp. and to all members of the Enterobacteriaceae to allow simultaneous detection of these bacteria. Identification of B. anthracis was found to rely entirely on hybridization of DNA specific to regions of the pag, lef and cap genes. Cross-reaction was observed between B. anthracis and other Bacillus species with all the other Bacillus probes tested. Results obtained using microarray hybridizations were confirmed using conventional microbiological techniques and found to have very high comparability., Conclusions: Microarray-based assays are an effective method for the identification of B. anthracis from mixed-culture environmental samples without problems of false-positivity that have been observed with conventional PCR assays., Significance and Impact of the Study: Identification of environmental Bacillus sp. by conventional PCR is prone to potential for reporting false-positives. This study provides a method for the exclusion of such isolates.

An oligonucleotide microarray system has been specifically designed to detect and differentiate Bacillus anthracis from other bacterial species present in clinical samples. The pilot-scale microarray initially incorporated probes to detect six common species of bacteria, which were fully evaluated. The microarray comprised long oligonucleotides (50--70-mer) designed to hybridise with the variable regions of the 16S rRNA genes. Probes which hybridised to virulence genes were also incorporated; for B. anthracis, these initially included the pag, lef, cap and vrrA (for partial genotyping) genes. Hybridisation conditions were initially optimised to be run using 5 x SSC, 0.1% SDS, 50 degrees C for 16 h. The detection limits of the microarray were determined under these conditions by titration of chromosomal DNA and unlabelled amplicons followed by hybridisation to determine the levels of sensitivity that could be obtained with the microarray. Two different amplification methodologies were also compared-specific-primer based PCR and random PCR (with the labelling stage incorporated). Higher sensitivity was obtained using specific PCR primers, however, since one of the desired outcomes of a microarray-based detection system was the high discrimination that it offered, random amplification and labelling was used as the amplification method of choice. The length of hybridisation was investigated using a time-course, and 1--2h was found to give optimal and higher signals than 16 h incubation. These results indicate that microarray technology can be employed in a diagnostic environment and moreover, results may be obtained in a similar time-scale to a standard PCR reaction, but with the advantage that no a priori knowledge of the infectious agent is required for detection.

Exposure to planar congeners of halogenated aromatic hydrocarbons (HAHs) leads to a myriad of toxicities, including developmental, reproductive, and immunotoxic effects. Halogenated aromatic hydrocarbons possessing structural similarity to TCDD, such as 3,3',4,4',5-pentachlorobiphenyl (PCB-126), are more prevalent in the environment than TCDD, and they elicit similar toxic effects, primarily through the cytosolic aromatic hydrocarbon receptor (AhR). While polychlorinated biphenyls (PCBs) are ubiquitous pollutants, they rarely exist alone in the environment. The aquatic biocide tributyltin (TBT) is also a widespread environmental contaminant, and numerous studies indicate that it has reproductive, developmental, and immunotoxic effects in a variety of organisms. Unlike planar HAHs, TBT is not associated with any known cellular receptor. The induction of cytochrome P-4501A (CYP1A) activity in most vertebrates is a classical physiological response to planar HAH exposure. TBT has been shown to inhibit the induction of cytochrome P-4.50s at high doses. Recent studies demonstrate that low levels of TBT potentiate PCB-126-associated CYP1A induction in channel catfish, Ictalurus punctatus, and in rodents following intraperitoneal injections. In this study, the effects of dietary exposures to TBT, PCB-126, and mixtures of the two on channel catfish hepatic CYP1A activity, as well as plasma lysozyme activity, were examined. Circulating lysozyme, a marker of proinflammatory responses, was monitored to determine the relative specificity of treatments for CYP1A induction. Plasma lysozyme levels were examined along with hepatic CYP1A protein induction and EROD activity following exposure to nominal doses of 1 and 100 ppb dietary TBT, PCB-126, or mixtures of the two. As expected, the highest level of PCB-126 induced CYP1A, and TBT did not. In mixtures, the low level of TBTpotentiated the ability of the high PCB-126 dose to induce CYP1A. Plasma lysozyme levels were suppressed by both concentrations of TBT and by the low concentrations of PCB- 126 during the initial phase of the response to Vibrio anguillarum. The normal and expected pattern of initial increases in circulating lysozyme levels following immunization, with subsequent return to baseline level, was disrupted by TBT. High levels of PCB-126 potentiated the lysozyme response. As seen with CYP1A activities, exposures to mixtures of TBT and PCB-126 resulted in a potentiation of plasma lysozyme levels. The data show that dietary TBT modulates PCB- 126-induced CYP1A activities and that these mixtures may have potent proinflammatory properties as well.

The authors studied indices of hematologic function and exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in Vietnam War veterans of Operation Ranch Hand--the Air Force unit responsible for the aerial spraying of Agent Orange and other herbicides in Vietnam. The herbicides were contaminated with TCDD. The authors measured TCDD serum levels in 1987 or later and extrapolated the result to the time of service in Vietnam. The authors studied serum TCDD level in relation to red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, white blood cell count, platelet count, and erythrocyte sedimentation rate at each of 4 physical examinations. Compared with veterans not involved in Operation Ranch Hand, those with the highest TCDD levels in Operation Ranch Hand had mean corpuscular volumes that were about 1% higher and platelet counts that were about 4% higher. These small increases were unlikely to be of clinical significance and may not have been caused by TCDD.

We studied cancer prevalence and exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) in veterans of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971. A comparison group of Air Force veterans who served in Southeast Asia during the same period and who were not involved with spraying herbicides was included. Comparison veterans were matched to Ranch Hand veterans on age, race, and military occupation. We measured dioxin in 1987 or 1992, extrapolated the result to the time of service in Southeast Asia, and assigned each Ranch Hand veteran to Background, Low, or High exposure categories. This study had low power to detect an effect for specific or rare cancers. The risk of cancer at sites other than the skin within 20 years of service was increased in the Low (odds ratio (OR) = 3.4, 95% confidence interval (CI) 1.5-8.0) and High (OR = 2.7, 95% CI 0.9-8.0) categories, but the pattern was inconsistent with another study, suggesting that the excess risk may not have been caused by dioxin exposure. Overall, we found no consistent evidence of a dose-response gradient and no significant increase in cancer risk in the High dioxin exposure category, the subgroup of greatest a priori interest.

The possible relationship between exposure to Agent Orange and its contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin), during the Vietnam War and chloracne was investigated. The index subjects were veterans of Operation Ranch Hand, the unit responsible for aerial herbicide spraying in Vietnam from 1962 to 1971. Other Air Force veterans who served in Southeast Asia during the same period, but who were not involved with spraying herbicides, served as comparisons. None of the Ranch Hand veterans were diagnosed with chloracne; therefore, we restricted our analyses to acne. We found no meaningful or consistent association between dioxin exposure and prevalence of acne without or with regard to anatomical location. These results suggested that exposure of Ranch Hand veterans to dioxin was insufficient for the production of chloracne or perhaps the exposure may have caused chloracne that resolved and was currently undetectable.

Outcomes research, an integral part of the nurse manager role, is important because it examines the end result of care and stimulates changes in nursing practice. Without outcomes research, the nurse manager lacks knowledge of what interventions have been tried or their resulting effectiveness. The move from episodic to a continuum of care emphasizes the need for continued research across all organizational boundaries. This paradigm shift questions traditions and requires finding new ways to plan and implement care. Nurse managers assure that they provide the leadership to develop and implement outcomes data to strengthen nursing's role on the health care team and to achieve positive patient outcomes.

This paper reports the results of a survey of 372 physicians working in regional hospitals in New Zealand. The survey was undertaken to determine if these physicians used their local medical library and what impact the literature obtained had on patient care. The 295 respondents (80.6% of the sample) expressed genuine interest in their library, with most visiting the library once a week or more. Patient care was ranked as the main reason for their visit; the second most important reason was keeping up-to-date on the latest research. Physicians indicated that information obtained at the library was used to confirm or change diagnoses, medications, or diagnostic tests, or to change advice given to patients. Information also was used to make decisions concerning early discharge, avoidance of hospital admission, or transfer of patients to another hospital. The survey also addressed the use of librarian services, sources of information used, and physicians' purchase of textbooks and journals. All comments by respondents were supportive of the library. The significance of libraries to clinical decision making, especially in small hospitals, is discussed.

This paper explores the principles of humanistic psychology and their application in the care of elderly institutionalized people. Activities already used by occupational therapists which can enhance the self-actualization process are described and other activities which could be incorporated into activity programs are suggested. The influence of staff attitudes on residents' well-being is a vital factor in geriatric care and must be taken into account in any form of programming.

This paper describes the use of videotaped interviews with volunteer patients as a method of teaching interviewing skills to first and second year occupational therapy students. It is hoped that this experience will enable students to conduct interviews in clinical or community settings with greater confidence and effectiveness.

Cats performed flexion movements of the forearm, and the discharge of interpositus and red nucleus neurons was examined for relationships to the motion and to the EMG activity of agonist and antagonist muscles. It is shown that, over a wide range in the time course of the motion, the activity of the neurons is covariant with both the EMG and the movement parameters, in particular, the velocity. Also, the discharge of the interpositus neurons is modulated in phase with the velocity of passive movement. It is concluded that during fast, intentional movements, sensory input data generated by motion is a major determinant of the output of the interpositus nucleus. Furthermore, the results are consistent with the concept that this output provides a continuous modulation of spinal segmental mechanisms by way of the red nucleus and rubrospinal tract.

Simple methods are described for following in vivo the rate of peptidylproline hydroxylation and for determining what proportion of the total proline incorporated into protein is hydroxylated.

This paper summarizes the results of a survey of the role of occupational therapy in provincial psychiatric hospitals in Ontario. Occupational therapy was found to provide major programming in three areas: 1) functional skills assessment and training, 2) life skills assessment and training and, 3) self awareness and personal growth. Subjects used a variety of frames of reference, but models based upon Glasser's Reality Therapy predominated. A complementary relationship was found between occupational therapy and vocational and recreational services, with occupational therapy playing a clinical or therapeutic role, while vocational and recreational services provided normalizing experiences. A comparison of occupational therapy programming in the institutions surveyed, with programming reported in the recent occupational therapy literature indicated that techniques and media utilized paralleled those used in acute and community psychiatric programs.

The relationship between unit activity in interpositus (8 units) and red nuclei (11 units) and the EMG activity of the biceps during intentional elbow flexion movements was investigated by means of cross-correlation analysis. This analysis showed that there were long-lasting (200 msec) changes in the probability of EMG activity both before and after a single spike in neurons which covaried with the motor output. The dependence of the activity of these units on sensory inputs was investigated by (1) calculating the quantitative relationship between angular displacement and unit activity and (2) recording unit activity after the sensory input from peripheral afferents had been eliminated by dorsal rhizotomy.