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Toll
Kinds of Toll Terms modified by Toll Selected AbstractsLamina propria dendritic cells: For whom the bell TOLLs?EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 6 2008Maria Rescigno PhD. Abstract One of the major tasks of the mucosal immune system is to discriminate between dangerous and harmless antigens that are encountered daily at mucosal sites. In the gastrointestinal tract, immune cells have to tolerate food antigens and commensal microbes but at the same time have to induce a prompt response against invasive pathogens, when needed. In this issue of the European Journal of Immunology, it is shown that intestinal dendritic cell (DC) populations can be distinguished based on the expression level of Toll-like receptors (TLR) and on the response of these TLR to their microbial ligands. DC either do not express TLR or they express them but respond in a non-inflammatory mode. In this commentary, these findings are discussed in the context of available knowledge on lamina propria DC. See accompanying article http://dx.doi.org/10.1002/eji.200737909 [source] Myopodia (postsynaptic filopodia) participate in synaptic target recognitionDEVELOPMENTAL NEUROBIOLOGY, Issue 1 2003Sarah Ritzenthaler Abstract Synaptic partner cells recognize one another by utilizing a variety of molecular cues. Prior to neuromuscular synapse formation, Drosophila embryonic muscles extend dynamic actin-based filopodia called "myopodia." In wild-type animals, myopodia are initially extended randomly from the muscle surface but become gradually restricted to the site of motoneuron innervation, a spatial redistribution we call "clustering." Previous experiments with prospero mutant embryos demonstrated that myopodia clustering does not occur in the absence of motoneuron outgrowth into the muscle field. However, whether myopodia clustering is due to a general signal from passing axons or is a result of the specific interactions between synaptic partners remained to be investigated. Here, we have examined the relationship of myopodia to the specific events of synaptic target recognition, the stable adhesion of synaptic partners. We manipulated the embryonic expression of ,PS2 integrin and Toll, molecules known to affect synaptic development, to specifically alter synaptic targeting on identified muscles. Then, we used a vital single-cell labeling approach to visualize the behavior of myopodia in these animals. We demonstrate a strong positive correlation between myopodia activity and synaptic target recognition. The frequency of myopodia clustering is lowered in cases where synaptic targeting is disrupted. Myopodia clustering seems to result from the adherence of a subset of myopodia to the innervating growth cone while the rest are eliminated. The data suggest that postsynaptic cells play a dynamic role in the process of synaptic target recognition. © 2003 Wiley Periodicals, Inc. J Neurobiol 55: 31,40, 2003 [source] The Drosophila PRR GNBP3 assembles effector complexes involved in antifungal defenses independently of its Toll -pathway activation functionEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 5 2010Alexey A. Matskevich Abstract The Drosophila Toll -signaling pathway controls the systemic antifungal host response. Gram-negative binding protein 3 (GNBP3), a member of the ,-glucan recognition protein family senses fungal infections and activates this pathway. A second detection system perceives the activity of proteolytic fungal virulence factors and redundantly activates Toll. GNBP3hades mutant flies succumb more rapidly to Candida albicans and to entomopathogenic fungal infections than WT flies, despite normal triggering of the Toll pathway via the virulence detection system. These observations suggest that GNBP3 triggers antifungal defenses that are not dependent on activation of the Toll pathway. Here, we show that GNBP3 agglutinates fungal cells. Furthermore, it can activate melanization in a Toll -independent manner. Melanization is likely to be an essential defense against some fungal infections given that the entomopathogenic fungus Beauveria bassiana inhibits the activity of the main melanization enzymes, the phenol oxidases. Finally, we show that GNBP3 assembles "attack complexes", which comprise phenoloxidase and the necrotic serpin. We propose that Drosophila GNBP3 targets fungi immediately at the inception of the infection by bringing effector molecules in direct contact with the invading microorganisms. [source] Inherited disorders of human Toll-like receptor signaling: immunological implicationsIMMUNOLOGICAL REVIEWS, Issue 1 2005Cheng-Lung Ku Summary:,In vitro nine of 10 known human Toll-like receptors (TLRs) are engaged by well-defined chemical agonists that mimic microbial compounds, raising the possibility that human TLRs play a critical role in protective immunity in vivo. We thus review here the recently described human primary immunodeficiencies caused by germline mutations in genes encoding molecules involved in cell signaling downstream from TLRs. Subjects with anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID) carry either X-linked recessive hypomorphic mutations in NEMO or autosomal dominant hypermorphic mutations in IKBA. Their cells show a broad defect in nuclear factor-,B (NF-,B) activation, with an impaired, but not abolished response to a large variety of stimuli including TLR agonists. EDA-ID patients show developmental anomalies of skin appendages and a broad spectrum of infectious diseases. Patients with autosomal recessive amorphic mutations in IRAK4 present a purely immunological syndrome and more restricted defects, with specific impairment of the Toll and interleukin-1 receptor (TIR),interleukin-1 receptor-associated kinase (IRAK) signaling pathway. In these subjects, the NF-,B- and mitogen-activated protein kinase-mediated induction of inflammatory cytokines in response to TIR agonists is impaired. The patients present a narrow range of pyogenic bacterial infections that become increasingly rare with age. Altogether, these data suggest that human TLRs play a critical role in host defense. However, they do not provide compelling evidence, as even the infectious phenotype of patients with mutations in IRAK4 may result from impaired signaling via receptors other than TLRs. Paradoxically, these experiments of nature raise the possibility that the entire set of human TLRs is largely redundant in protective immunity in vivo. [source] Expression of immune responsive genes in cell lines from two different Anopheline speciesINSECT MOLECULAR BIOLOGY, Issue 6 2006C. Luna Abstract Malaria infection results in increased expression of immune responsive genes, including those encoding antimicrobial peptides such as Gambicin (Gam1) and Cecropin A (Cec1). Understanding how these genes are regulated will provide insights how the mosquito immune system is activated by Plasmodium. We previously have shown that Cec1 was primarily regulated by the Imd-Relish (REL2) pathway in the Anopheles gambiae Sua1B cell line. We show here that expression of Defensin A (Def1) and Gam1 was reduced after RNA interference against components of the Imd- REL2 pathway in An. gambiae cell lines. Interestingly, promoter reporters of these antimicrobial peptides were expressed at very low level in the cell line MSQ43 from Anopheles stephensi. Surprisingly, over-expression of either NF-,B transcription factor REL1 or REL2 alone is sufficient to induce the expression of Cec1, Gam1 and Def1. These results suggest that expression of these antimicrobial peptides (AMP) in vivo may be regulated by both the Toll and Imd pathways. We also show here for the first time that Tep4, a gene encoding a thioester containing protein, is regulated by REL2. Taken together, these results suggest that there are significant overlaps of genes regulated by the Toll-Rel1 and Imd-Rel2 pathways. Further, the different expression patterns in two different Anopheline cell lines provide a platform to identify other key positive and negative regulators of the antimicrobial peptide genes. [source] Innate immunity in Drosophila: Pathogens and pathwaysINSECT SCIENCE, Issue 1 2008Shubha Govind Abstract Following in the footsteps of traditional developmental genetics, research over the last 15 years has shown that innate immunity against bacteria and fungi is governed largely by two NF-,B signal transduction pathways, Toll and IMD. Antiviral immunity appears to stem from RNA interference, whereas resistance against parasitoids is conferred by Toll signaling. The identification of these post-transcriptional regulatory mechanisms and the annotation of most Drosophila immunity genes have derived from functional genomic studies using "model" pathogens, intact animals and cell lines. The D. melanogaster host has thus provided the core information that can be used to study responses to natural microbial and metazoan pathogens as they become identified, as well as to test ideas of selection and evolutionary change. These analyses are of general importance to understanding mechanisms of other insect host-pathogen interactions and determinants of variation in host resistance. [source] Innate immunity against malaria parasites in Anopheles gambiaeINSECT SCIENCE, Issue 1 2008Yang Chen Abstract Malaria continues to exert a huge toll in the world today, causing approximately 400 million cases and killing between 1-2 million people annually. Most of the malaria burden is borne by countries in Africa. For this reason, the major vector for malaria in this continent, Anopheles gambiae, is under intense study. With the completion of the draft sequence of this important vector, efforts are underway to develop novel control strategies. One promising area is to harness the power of the innate immunity of this mosquito species to block the transmission of the malaria parasites. Recent studies have demonstrated that Toll and Imd signaling pathways and other immunity-related genes (encoding proteins possibly function in recognition or as effector molecules) play significant roles in two different arms of innate immunity: level of infection intensity and melanization of Plasmodium oocysts. The challenges in the future are to understand how the functions of these different genes are coordinated in defense against malaria parasites, and if different arms of innate immunity are cross,regulated or coordinated. [source] Circulating cell wall components derived from gram-negative, not gram-positive, bacteria cause a profound induction of the gene-encoding Toll-like receptor 2 in the CNSJOURNAL OF NEUROCHEMISTRY, Issue 3 2001Nathalie Laflamme The recent characterization of human homologs of Toll may be the missing link for the transduction events leading to nuclear factor-,B (NF-,B) activity and proinflammatory gene transcription during innate immune response. Mammalian cells may express as many as 10 distinct Toll-like receptors (TLRs), although TLR2 is a key receptor for recognizing cell wall components of Gram-positive bacteria. The present study investigated the effects of circulating bacterial cell wall components on the expression of the gene-encoding TLR2 across the mouse brain. Surprisingly, while Gram-negative components caused a robust increase in TLR2 transcription within the cerebral tissue, peptidoglycan (PGN) and lipoteichoic acid (LTA), either alone or combined, failed to modulate the receptor transcript. Indeed, the mRNA levels for TLR2 in the choroid plexus and few other regions of the brain remained similar between vehicle-, LTA-, PGN-, and LTA/PGN-administered mice at all the times evaluated (i.e. 30 min to 24 h post-intraperitoneal injection). This contrasts with the profound de novo expression of TLR2 following a single systemic injection of the lipopolysaccharide (LPS). The signal was first detected in regions devoid of blood,brain barrier and few blood vessels and microcapillaries. A second wave of TLR2 expression was also detected from these structures to their surrounding parenchymal cells that stained for a microglial marker iba1. The rapid induction of I,B, (index of NF-,B activity) and up-regulation of the adaptor protein MyD88 suggest that LPS-induced TLR2 transcription may be dependent on the NF-,B pathway. These data provide the evidence that TLR2 is not only present in the brain, but its encoding gene is regulated by cell wall components derived from Gram-negative, not Gram-positive, bacteria. The robust wave of TLR2-expressing microglial cells may have a determinant impact on the innate immune response that occurs in the brain during systemic infection by Gram-negative, not Gram-positive, bacteria. [source] Ethanol-Regulated Genes That Contribute to Ethanol Sensitivity and Rapid Tolerance in DrosophilaALCOHOLISM, Issue 2 2010Eric C. Kong Background:, Increased ethanol intake, a major predictor for the development of alcohol use disorders, is facilitated by the development of tolerance to both the aversive and pleasurable effects of the drug. The molecular mechanisms underlying ethanol tolerance development are complex and are not yet well understood. Methods:, To identify genetic mechanisms that contribute to ethanol tolerance, we examined the time course of gene expression changes elicited by a single sedating dose of ethanol in Drosophila, and completed a behavioral survey of strains harboring mutations in ethanol-regulated genes. Results:, Enrichment for genes in metabolism, nucleic acid binding, olfaction, regulation of signal transduction, and stress suggests that these biological processes are coordinately affected by ethanol exposure. We also detected a coordinate up-regulation of genes in the Toll and Imd innate immunity signal transduction pathways. A multi-study comparison revealed a small set of genes showing similar regulation, including increased expression of 3 genes for serine biosynthesis. A survey of Drosophila strains harboring mutations in ethanol-regulated genes for ethanol sensitivity and tolerance phenotypes revealed roles for serine biosynthesis, olfaction, transcriptional regulation, immunity, and metabolism. Flies harboring deletions of the genes encoding the olfactory co-receptor Or83b or the sirtuin Sir2 showed marked changes in the development of ethanol tolerance. Conclusions:, Our findings implicate novel roles for these genes in regulating ethanol behavioral responses. [source] RLM3, a TIR domain encoding gene involved in broad-range immunity of Arabidopsis to necrotrophic fungal pathogensTHE PLANT JOURNAL, Issue 2 2008Jens Staal Summary Here, we describe the rapid cloning of a plant gene, Leptosphaeria maculans 3 (RLM3Col), which encodes a putative Toll interleukin-1 receptor-nucleotide binding (TIR-NB) class protein, which is involved in defence against the fungal pathogen L. maculans and against three other necrotrophic fungi. We have, through microarray-based case control bulk segregant comparisons of transcriptomes in pools of Col-0 × An-1 progeny, identified the absence of a locus that causes susceptibility in An-1. The significance of this locus on chromosome 4 for L. maculans resistance was supported by PCR-based mapping, and denoted resistance to RLM3Col. Differential susceptible phenotypes in four independent T-DNA insertion lines support the hypothesis that At4g16990 is required for RLM3Col function. The mutants in RLM3Col also exhibited an enhanced susceptibility to Botrytis cinerea, Alternaria brassicicola and Alternaria brassicae. Complementations of An-1 and T-DNA mutants using overexpression of a short transcript lacking the NB-ARC domain, or a genomic clone, restored resistance to all necrotrophic fungi. The elevated expression of RLM3Col on B. cinerea -susceptible mutants further suggested convergence in signalling and gene regulation between defence against B. cinerea and L. maculans. In the case of L. maculans, RLM3Col is required for efficient callose deposition downstream of RLM1Col. [source] How to kill a mocking bug?CELLULAR MICROBIOLOGY, Issue 4 2006Vitor B. Pinheiro Summary All metazoans have evolved means to protect themselves from threats present in the environment: injuries, viruses, fungi, bacteria and other parasites. Insect protection includes innate physical barriers and both cellular and humoral responses. The insect innate immune response, best characterized in Drosophila melanogaster, is a rapid broad response, triggered by pathogen-associated molecular patterns (PAMPs) recognition, which produces a limited range of effectors that does not alter upon continued pathogen exposure and lacks immunological memory. The Drosophila response, particularly its humoral response, has been investigated by both low and high-throughput methods. Three signalling pathways conserved between insects and mammals have been implicated in this response: Toll (equivalent to mammalian TLR), Imd (equivalent to TNF,) and Hop (equivalent to JAK/STAT). This review provides an entry point to the insect immune system literature outlining the main themes in D. melanogaster bacterial pathogen detection and humoral and cellular immune responses. The Drosophila immune response is compared with other insects and the mammalian immune system. [source] ,We All Knew that a Cyclone Was Coming': Disaster Preparedness and the Cyclone of 1999 in Orissa, IndiaDISASTERS, Issue 4 2004Frank Thomalla Imagine that a cyclone is coming, but that those living in the affected areas do nothing or too little to protect themselves. This is precisely what happened in the coastal state of Orissa, India. Individuals and communities living in regions where natural hazards are a part of daily life develop strategies to cope with and adapt to the impacts of extreme events. In October 1999, a cyclone killed 10,000 people according to government statistics, however, the unofficial death toll is much higher. This article examines why such a large loss of life occurred and looks at measures taken since then to initiate comprehensive disaster-preparedness programmes and to construct more cyclone shelters. The role of both governmental organisations and NGOs in this is critically analysed. The good news is that, based on an assessment of disaster preparedness during a small cyclone in November 2002, it can be seen that at community-level awareness was high and that many of the lessons learnt in 1999 were put into practice. Less positive, however, is the finding that at the state level collaboration continues to be problematic. [source] Provision of oncology services in remote rural areas: a Scottish perspectiveEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2004S.M. SMITH research assistant There is a paucity of research into rural health care services. In particular little is known about the provision of specialist cancer services for patients who live in remote rural areas of the UK. This study set out to investigate current models of medical and clinical oncology care in Scotland. A national survey with key health professionals was conducted to identify rural oncology schemes currently in operation. Detailed quantitative data about the schemes together with qualitative data on how health professionals view current models of care were collected by a computer-assisted telephone survey. Schemes that currently provide outpatient and chemotherapy oncology services for remote rural patients fell into three categories: central clinics (5); shared care outreach clinics with chemotherapy provision (11); and shared care outreach clinics without chemotherapy provision (7). All radiotherapy was conducted at central clinics (5). Widely varying practices in delivery of cancer care were found across the country. The main issues for professionals about current models of care involved expertise, travelling and accessibility (for patients), communication and expansion of the rural service. Nation-wide consistency in cancer care has still to be achieved. Travelling for treatment was seen to take its toll on all patients but particularly for the very remote, elderly and poor. Most professionals believe that an expansion of rural services would be of benefit to these patients. It is clear, however, that the proper infrastructure needs to be in place in terms of local expertise, ensured quality of care, and good communication links with cancer centres before this could happen. [source] When half of the population died: the epidemic of hemorrhagic fevers of 1576 in MexicoFEMS MICROBIOLOGY LETTERS, Issue 1 2004Rodofo Acuna-Soto Abstract During the 16th century, Mexico suffered a demographic catastrophe with few parallels in world's history. In 1519, the year of the arrival of the Spaniards, the population in Mexico was estimated to be between 15 and 30 million inhabitants. Eighty-one years later, in 1600, only two million remained. Epidemics (smallpox, measles, mumps), together with war, and famine have been considered to be the main causes of this enormous population loss. However, re-evaluation of historical data suggests that approximately 60,70% of the death toll was caused by a series of epidemics of hemorrhagic fevers of unknown origin. In order to estimate the impact of the 1576 epidemic of hemorrhagic fevers on the population we analyzed the historical record and data from the 1570 and 1580 censuses of 157 districts. The results identified several remarkable aspects of this epidemic: First, overall, the population loss for these 157 districts was 51.36%. Second, there was a clear ethnic preference of the disease, the Spanish population was minimally affected whereas native population had high mortality rate. Third, the outbreak originated in the valleys of central Mexico whence it evolved as an expansive wave. Fourth, a positive correlation between altitude and mortality in central Mexico was found. Fifth, a specific climatic sequence of events was associated with the initiation and dissemination of the hemorrhagic fevers. Although the last epidemic of hemorrhagic fevers in Mexico ended in 1815, many questions remain to be answered. Perhaps the most relevant ones are whether there is a possible reemergence of the hemorrhagic fevers and how vulnerable we are to the disease. [source] The Haiti Earthquake: a salutary lesson in (non) earthquake engineeringGEOLOGY TODAY, Issue 2 2010Peter Styles A devastating earthquake of magnitude 7 struck very close and almost beneath Port au Prince the capital of Haiti, the western half of the island of Hispaniola, early in the morning of Tuesday, 12 January 2010 (Fig. 1). While in absolute terms this was by no means the largest earthquake recorded this year globally, the death toll is around 230 000, making it one of the world's worst earthquakes in terms of casualties in recorded history, with almost uncountable economic loss to one of the poorest countries in the world. Figure 1. Intensity map of 2010 Haiti earthquake (Image: USGS). [source] An outline of the current orthopaedic management of haemophilic disease of the upper limbHAEMOPHILIA, Issue 5 2007M. Z. B. CHOUDHURY Summary., There remains a relative paucity in the literature regarding upper limb manifestations of haemophilic arthropathy. Haemophilia has a wide range of clinical manifestations, often presenting with orthopaedic complications. These arise from multiple haemarthroses which exact a cumulative toll on the fabric of the joints. Although the lower limbs are predominantly affected due to their load-bearing nature, upper limb disease is common. This arises from the mechanical demands on the upper limb as the elbow and shoulder become partially weight bearing on use of walking aids such as elbow crutches. [source] Innate immunity against malaria parasites in Anopheles gambiaeINSECT SCIENCE, Issue 1 2008Yang Chen Abstract Malaria continues to exert a huge toll in the world today, causing approximately 400 million cases and killing between 1-2 million people annually. Most of the malaria burden is borne by countries in Africa. For this reason, the major vector for malaria in this continent, Anopheles gambiae, is under intense study. With the completion of the draft sequence of this important vector, efforts are underway to develop novel control strategies. One promising area is to harness the power of the innate immunity of this mosquito species to block the transmission of the malaria parasites. Recent studies have demonstrated that Toll and Imd signaling pathways and other immunity-related genes (encoding proteins possibly function in recognition or as effector molecules) play significant roles in two different arms of innate immunity: level of infection intensity and melanization of Plasmodium oocysts. The challenges in the future are to understand how the functions of these different genes are coordinated in defense against malaria parasites, and if different arms of innate immunity are cross,regulated or coordinated. [source] Adverse Outcomes of Osteoporotic Fractures in the General Population,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2003L Joseph Melton III MD Abstract Osteoporotic fractures exact a terrible toll on the population with respect to morbidity and cost, and to a lesser extent mortality, which will increase dramatically with the growing elderly population. Attention has focused on the 12-20% excess deaths after hip fracture, but most are caused by underlying medical conditions unrelated to osteoporosis. More important is fracture-related morbidity. An estimated 10% of patients are disabled by hip fracture, and 19% require institutionalization, accounting for almost 140,000 nursing home admissions annually in this country. Distal forearm and vertebral fractures less commonly result in nursing home placement, but about 10% of postmenopausal women have vertebral deformities that cause chronic pain, and a substantial minority have poor function after forearm fracture. These fractures interfere greatly with the activities of daily living, and all of them can have a substantial negative impact on quality of life. Annual expenditures for osteoporotic fracture care in the United States ($17.5 million in 2002 dollars) are dominated by hip fracture treatment, but vertebral fractures, distal forearm fractures, and importantly, the other fractures related to osteoporosis contribute one-third of the total. Although all fracture patients are at increased risk of future fractures, few of them are currently treated for osteoporosis, and only a subset (i.e., those with vertebral fractures) are considered candidates for many clinical trials. Eligibility criteria should be expanded and fracture end-points generalized to acknowledge the overall burden of osteoporotic fractures. [source] Obesity: attitudes of undergraduate student nurses and registered nursesJOURNAL OF CLINICAL NURSING, Issue 16 2009Man-Yuk Poon Aim., To investigate undergraduate student nurses' and registered nurses' attitudes towards obese persons and towards the management of obese patients. Background., Obesity is a global public health problem. Escalating rates of overweight and obesity are also taking a toll in Asian countries that have historically had much lower rates. Despite the growing prevalence of obesity worldwide, studies show that nurses and other health professionals hold negative attitudes towards obese people, which may affect the care of obese patients. Design., Cross-sectional study. Methods., A self-administered questionnaire was completed by 352 undergraduate student nurses and 198 registered nurses. The questionnaire consisted of the Fat Phobia Scale, the Attitudes Toward Obese Adult Patients Scale and a demographic profile. Data were analysed using descriptive statistics and student's t -tests. Results., Overall mean scores on the Fat Phobia Scale (3·53 SD 0·47) indicated average levels of fat phobia and mean scores on the Attitudes Toward Obese Adult Patients scale (2·64 SD 0·51) indicated neutral attitudes towards obese patients. Registered nurses had significantly higher levels of fat phobia and more negative attitudes than did student nurses. The majority of participants perceived that obese people liked food, overate and were shapeless, slow and unattractive. Additionally, over one-half of participants believed that obese adults should be put on a diet while in hospital. Conclusions., Results of this study show that both registered nurses and student nurses have negative perceptions of obesity and are unlikely to attribute positive characteristics to obese individuals. That registered nurses hold more negative attitudes towards obese person is cause for concern. Relevance to clinical practice., Given the increasing prevalence of obesity and the disproportionate number of obese persons affected by many health conditions, current and future nurses should have positive professional attitudes towards obese individuals. Obesity needs to more be adequately addressed, both in basic nursing education programs and in continuing professional education for practising nurses. [source] August 2003: Reflections on a French Summer DisasterJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 4 2005Why were its medical consequences so serious? The heat wave of August 2003 caused a hecatomb in France. Its extent and consequences (INVS 2003) require analysis in order to understand why such a situation occurred and how to avoid that the same medical disaster will be caused in the future by identical climatic conditions. This natural disaster had no known precedent in France. The heatwave lasted for three weeks in August 2003 and led to 14800 deaths. However, the human toll of this catastrophe cannot be explained solely by the violence of the attack. Any analysis of this dramatic crisis, as for any public health threat, should take into account the agent involved, the population concerned, the specific relation between the agent and the target, and, based upon this, the crisis management needed. The analysis presented in this article, following the described line, shows that the crisis management was far from optimal. Learning from this situation should allow us to do better, next time such a climatic catastrophe occurs. A key factor is promoting adequate citizen response. [source] Applying lessons from China's Wenchuan earthquake to medical rescue following the Yushu earthquakeJOURNAL OF EVIDENCE BASED MEDICINE, Issue 2 2010Shaolin Deng A 7.1-magnitude earthquake hit China's Qinghai province,4000 meters above sea level, on April 14, 2010, just 702 days after Wenchuan Earthquake. As of 12:00 on April 19, the death toll stood at 1706, with 256 missing and 12,128 injured. West China Hospital (WCH), a regional state-level hospital of the Ministry of Health, sent a medical team with relief supplies within the first hour after Yushu earthquake and the team rushed to Yushu in the first day participating golden seventy-two hours rescue effort. The second day after Yushu earthquake, medical apparatuses and drugs valued at 5 million RMB were delivered to the rescue site and the second batch of medical team were positioned. Within 33 hours of the earthquake, 102 people, including 93 with earthquake-related injuries and 9 armed police with severe altitude sickness, were send to WCH by air in four batches. WCH organized its medical rescue efforts based on first-hand experience with medical rescue following Wenchuan earthquake, a series of evidence-based diagnosis and treatment standards, and "four concentration principles," namely concentrating the wounded, experts, resources, and treatments. Of the 93 cases with earthquake-related injuries, 54 were seriously wounded, and in the five days immediately following the earthquake, 58 underwent operations and none died. The experience learned from Wenchuan earthquake have been used, improved and sublimated more rapidly, appropriately, and effectively in the Yushu earthquake medical rescue. [source] Stress in Childhood and Adulthood: Effects on Marital Quality Over TimeJOURNAL OF MARRIAGE AND FAMILY, Issue 5 2005Debra Umberson We work from a stress and life course perspective to consider how stress affects trajectories of change in marital quality over time. Specifically, we ask whether stress is more likely to undermine the quality of marital experiences at different points in the life course. In addition, we ask whether the effects of adult stress on marital quality depend on childhood family stress experiences. Growth curve analysis of data from a national longitudinal survey (Americans' Changing Lives, N =1,059 married individuals) reveals no evidence of age differences in the effects of adult stress on subsequent trajectories of change in marital experiences. Our results, however, suggest that the effects of adult stress on marital quality may depend on childhood stress exposure. Stress in adulthood appears to take a cumulative toll on marriage over time,but this toll is paid primarily by individuals who report a more stressful childhood. This toll does not depend on the timing of stress in the adult life course. [source] Aging-dependent changes of microglial cells and their relevance for neurodegenerative disordersJOURNAL OF NEUROCHEMISTRY, Issue 5 2010Rommy Von Bernhardi J. Neurochem. (2010) 112, 1099,1114. Abstract Among multiple structural and functional brain changes, aging is accompanied by an increase of inflammatory signaling in the nervous system as well as a dysfunction of the immune system elsewhere. Although the long-held view that aging involves neurocognitive impairment is now dismissed, aging is a major risk factor for neurodegenerative diseases such as Alzheimer`s disease, Parkinson`s disease and Huntington's disease, among others. There are many age-related changes affecting the brain, contributing both to certain declining in function and increased frailty, which could singly and collectively affect neuronal viability and vulnerability. Among those changes, both inflammatory responses in aged brains and the altered regulation of toll like receptors, which appears to be relevant for understanding susceptibility to neurodegenerative processes, are linked to pathogenic mechanisms of several diseases. Here, we review how aging and pro-inflammatory environment could modulate microglial phenotype and its reactivity and contribute to the genesis of neurodegenerative processes. Data support our idea that age-related microglial cell changes, by inducing cytotoxicity in contrast to neuroprotection, could contribute to the onset of neurodegenerative changes. This view can have important implications for the development of new therapeutic approaches. [source] Experiences of U.S. Military Nurses in the Iraq and Afghanistan Wars, 2003,2009JOURNAL OF NURSING SCHOLARSHIP, Issue 1 2010Elizabeth Scannell-Desch RN Abstract Purpose: The purpose of this study is to describe the lived experience of U.S. military nurses who served in Iraq or Afghanistan during the war years 2003 to 2009, and life after returning from war. Methods: Colaizzi's phenomenological method guided discovery. This method includes elements of both descriptive and interpretive phenomenology. The sample consisted of 37 military nurses who served in the Army, Navy, or Air Force in the Iraq or Afghanistan wars. Four data-generating questions guided the interview process. Most interviews were face-to-face and conducted in naturalistic settings chosen by the participants. Several interviews were conducted telephonically due to geographic constraints. Data analysis followed Colaizzi's method of analysis. Seven themes emerged from the data, including "deploying to war;""remembrance of war: most chaotic scene;""nurses in harm's way: more than I bargained for;""kinship and bonding: my military family;""my war stress: I'm a different person now;""professional growth: expanding my skills;" and "listen to me: advice to deploying nurses." Analysis continued until data saturation was achieved. Results: Results indicated that wartime deployment was a difficult challenge, lessons learned should be shared with nurses deploying in future years, homecoming was more difficult than most nurses anticipated, and reintegration after coming home takes time and effort. Conclusions: Nursing in war is a unique experience regardless of education, preparation and training. There are a myriad of variables that enter into the experience and effect outcomes, both personal and professional. Clinical Relevance: Wartime nursing is a reality in the current clinical practice arena. War takes its toll on everyone involved, including the caregivers. Nurses returning from war can provide valuable insights to those that follow. [source] Mapping Growth into Economic DevelopmentAMERICAN JOURNAL OF ECONOMICS AND SOCIOLOGY, Issue 5 2004Has Elite Political Instability Mattered in Sub-Saharan Africa? The study finds that elite political instability (PI),the incidence of coups d'etat,has negatively influenced the mapping of GDP growth into economic development, measured as the algebraic difference in the United Nations Human Development Index, in Sub-Saharan Africa (SSA) between 1970 and 1985. Taking into account the additional adverse impact of PI on economic development through its deleterious influence on economic growth, the study estimates that PI has exacted a substantial toll in SSA's economic development. [source] Cancer Pain: An Age-Based AnalysisPAIN MEDICINE, Issue 10 2010Carmen R. Green MD Abstract Objective., Although cancer pain (consistent and breakthrough pain [BTP; pain flares interrupting well-controlled baseline pain]) is common among cancer patients, its characteristics, etiology, and impact on health-related quality of life (HRQOL) across the lifespan are poorly understood. Design., This longitudinal study examines age-based differences and pain-related interference in young and old patients with cancer-related pain over 6 months. Patients in the community with stage III or IV breast, prostate, colorectal, or lung cancer, or stage II,IV multiple myeloma with BTP completed surveys (upon initial assessment, 3 and 6 months) assessing consistent pain, BTP, depressed affect, active coping ability, and HRQOL using previously validated measures. Results., Respondents (N = 96) were 70% white and 66% female, with a mean age of 57 ± 10 years. There were no significant differences in pain severity based upon age. However, the younger group experienced more pain flares with greater frequency (P = 0.05). The oldest group had better emotional functioning at baseline but worse physical functioning at 6 months. Younger groups also had worse cognitive functioning at 6 months (P = 0.03). Pain interference was independent of age. Conclusions., These data provide evidence for the significant toll of cancer pain on overall health and well-being of young and old adults alike but demonstrate an increased toll for younger adults (especially financially). Beyond race and gender disparities, further health care disparities in the cancer and cancer pain were identified by age, illustrating the need for additional research across the lifespan in diverse cancer survivors. [source] Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates, 2000PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2004Hillard Weinstock CONTEXT In the United States, young people aged 15,24 represent 25% of the sexually experienced population. However, the incidence and prevalence of sexually transmitted diseases (STDs) among this age-group are unknown. METHODS Data from a variety of sources were used to estimate the incidence and prevalence of STDs among 15,24-year-olds in the United States in 2000. The quality and reliability of the estimates were categorized as good, fair or poor, depending on the quality of the data source. RESULTS Approximately 18.9 million new cases of STD occurred in 2000, of which 9.1 million (48%) were among persons aged 15,24. Three STDs (human papillomavirus, trichomoniasis and chlamydia) accounted for 88% of all new cases of STD among 15,24-year-olds. CONCLUSIONS These estimates emphasize the toll that STDs have on American youth. More representative data are needed to help monitor efforts at lowering the burden of these infections. [source] Mental retardation and prenatal methylmercury toxicityAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2006Leonardo Trasande MD Abstract Background Methylmercury (MeHg) is a developmental neurotoxicant; exposure results principally from consumption of seafood contaminated by mercury (Hg). In this analysis, the burden of mental retardation (MR) associated with methylmercury exposure in the 2000 U.S. birth cohort is estimated, and the portion of this burden attributable to mercury (Hg) emissions from coal-fired power plants is identified. Methods The aggregate loss in cognition associated with MeHg exposure in the 2000 U.S. birth cohort was estimated using two previously published dose-response models that relate increases in cord blood Hg concentrations with decrements in IQ. MeHg exposure was assumed not to be correlated with native cognitive ability. Previously published estimates were used to estimate economic costs of MR caused by MeHg. Results Downward shifts in IQ resulting from prenatal exposure to MeHg of anthropogenic origin are associated with 1,566 excess cases of MR annually (range: 376,14,293). This represents 3.2% of MR cases in the US (range: 0.8%,29.2%). The MR costs associated with decreases in IQ in these children amount to $2.0 billion/year (range: $0.5,17.9 billion). Hg from American power plants accounts for 231 of the excess MR cases/year (range: 28,2,109), or 0.5% (range: 0.06%,4.3%) of all MR. These cases cost $289 million (range: $35 million,2.6 billion). Conclusions Toxic injury to the fetal brain caused by Hg emitted from coal-fired power plants exacts a significant human and economic toll on American children. Am. J. Ind. Med. 49:153,158, 2006. © 2006 Wiley-Liss, Inc. [source] "Roll Back Malaria, Roll in Development"?POPULATION AND DEVELOPMENT REVIEW, Issue 1 2009Reassessing the Economic Burden of Malaria Recent efforts to mobilize support for malaria control have highlighted the economic burden of malaria and the value of malaria control for generating economic development. These claims have a long history. Beginning in the early twentieth century, they became the primary justification for malaria-control programs in the American South and in other parts of the globe, including British India. Economists conducted none of these studies. Following World War II and the development of new anti-malarial drugs and pesticides, including DDT, malaria control and eradication were increasingly presented as instruments for eliminating economic underdevelopment. By the 1960s, however, economists and demographers began to raise serious substantive and methodological questions about the basis of these claims. Of particular concern was the role of rapid population growth, resulting in part from the decline of malaria mortality, in undermining the short-term economic gains achieved through malaria control. Despite these concerns, malaria continues to be presented as an economic problem in the work of Jeffrey Sachs and others, justifying massive investments in malaria control. The methodological basis of these claims is examined. The paper concludes that while malaria takes a dreadful toll in human lives and causes significant economic losses for individuals, families, and some industries, the evidence linking malaria control to national economic growth remains unconvincing. In addition, the evidence suggests that there are potential costs to justifying malaria-eradication campaigns on macroeconomic grounds. [source] Demographic Data on the Victims of the September 11, 2001 Terror Attack on the World Trade Center, New York CityPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2002Article first published online: 27 JAN 200 The magnitude of the death toll resulting from the attack on the World Trade Center is without precedent in the history of terrorist acts. Because of the scale and destructiveness of the buildings' collapse, a final list of the victims required a lengthy process, more so than was the case at the other sites of terrorist violence on the same day,at the Pentagon, Virginia (193 killed, 68 of these on American Airlines Flight 77), and near Shanksville, Pennsylvania (45 killed in the crash of United Airlines Flight 93). After the passing of a year, the list of the victims in New York, while essentially complete, is still not officially closed. On August 19, 2002, the city's medical examiner's office issued a list containing 2,819 names. Reproduced below are some data, released by the city's office of vital statistics, on the demographic characteristics of 2,723 victims (59 of these on United Airlines Flight 175 and 89 on American Airlines Flight 11) for whom a death certificate had been issued,an exacting procedure,as of August 16,2002. The cause of death, in each instance, was entered as homicide. The age distribution reflects the character of the World Trade Center,a workplace,and the time of day,early for tourist visits. The youngest victims perished as passengers in the two airplanes flown into the twin towers. [source] | |||||||||||||||||||||||||||||||||||||||||||