The G Protein-Coupled Receptor, VPAC1, Mediates Vasoactive Intestinal Peptide-Dependent Functional Homeostasis of the Gut Microbiota.

BACKGROUND AND AIMS: Vasoactive intestinal peptide (VIP) is a neuropeptide involved in the regulation of feeding behavior and circadian rhythms, metabolism, and immunity. Previous studies revealed the homeostatic effects of VIP signaling on the gut microbiota. VIP-deficient mice demonstrate a gut microbiota dysbiosis characterized by reduced α-diversity and decreased relative abundance (RA) of Gram-positive Firmicutes. However, the mechanism by which VIP signaling affects changes in the microbiota is unknown. METHODS: To investigate the role of the 2 cognate G protein-coupled receptors for VIP (VPAC1 and VPAC2) in VIP-mediated homeostasis of the microbiota, fecal samples from VPAC1- and VPAC2-deficient, heterozygous, and wild-type littermate mice were assessed via targeted amplicon sequencing. Their microbiota profiles were additionally compared with microbiota from VIP-deficient, heterozygous, and wild-type littermates, where genotype-dependent changes in the composition and predicted function of each cohort were compared. RESULTS: While wild-type mice in each line differed in α-diversity and ß-diversity, consistent changes in both metrics were observed in VIP-deficient and VPAC1-deficient mice. This includes a dramatic reduction in α-diversity, increased RA of Proteobacteria and Bacteroidetes, and decreased RA of Lachnospiraceae, Ruminococcaceae, Muribaculaceae, and Rikenellaceae. Specific amplicon sequence variants and predicted functions found to differ significantly based on VIP or VPAC1 genotype were concordant in their directions of change. Multiplatform predicted functional profiling suggested a defective VIP-VPAC1 axis was associated with reduced amino acid degradation along with reduced quinol and quinone biosynthesis. Furthermore, alterations in predicted functions include increased sugar degradation, nitrate reduction, and fatty acid biosynthetic pathways, among other changes. CONCLUSION: We conclude that VIP signaling through VPAC1 is critical for the maintenance of normal function of the gut microbiota.

Comparison of Three Point-of-Care Ultrasound Views and MRI Measurements for Optic Nerve Sheath Diameter: A Prospective Validity Study.

INTRODUCTION: Point-of-care ultrasound of the optic nerve sheath diameter (ONSD) to diagnose increased intracranial pressure (ICP) is of great interest in various clinical scenarios. Yet, the lack of examination standardization has made clinical utility difficult. We compare three ultrasound ocular plane views (inferior, sagittal, and transverse), which are currently used in the literature to evaluate their consistency. Comparisons for each view to magnetic resonance imaging (MRI) measurements were also made. METHODS: Fifty-one patients with recent MRI of the brain, but without clinical or radiological signs of elevated ICP, were selected to undergo ocular sonography via three ultrasound planes (inferior, sagittal, and transverse). Optic nerve sheath was measured in each ultrasound view as well with MRI. Image quality scores were assigned for the ultrasound views in different orientations. The three ocular plane views were analyzed for correlation. In addition, correlation of the three ocular ultrasound views with MRI was also performed. RESULTS: Correlation analysis showed a wide variability in the correlation between different ultrasound views with magnitude range of 0.1 to 0.8 and directions being both positive and negative. There was a difference in image quality scores between the ultrasound views. The inferior and transverse orientations were superior to the sagittal orientation in achieving high image quality. Comparison to MRI measurements did not demonstrate a significant correlation. CONCLUSION: Our findings suggest that absolute measurements should not be compared across different ultrasound orientations given the wide variability in the correlation between the ultrasound views used to assess the optic nerve sheath. The inferior and transverse ultrasound views are the most likely to yield high-quality images, although the specific view, for the best image, in an individual patient can vary. We would caution against absolute values of ONSD to indicate increased ICP, as it may be view dependent.

The Primary Gait Screen in Parkinson's disease: Comparison to standardized measures.

BACKGROUND: Persons with Parkinson's disease exhibit gait deficits during comfortable-pace overground walking and data from pressure sensitive mats have been used to quantify gait performance. The Primary Gait Screen is a new assessment which includes gait initiation, overground walking, turning, and gait termination. Although overground assessments are useful, the Primary Gait Screen offers a more complex evaluation than traditional gait assessments. RESEARCH QUESTION: Is the overground walking portion of the Primary Gait Screen comparable to traditional gait assessments? METHODS: Persons with Parkinson's disease (N = 175; 47 F, 128 M; 67 ±â€¯9 yrs) prospectively completed 4 passes at a self-selected speed and two trials of the Primary Gait Screen on an 8 m long pressure-sensing mat. Spatiotemporal gait variables were computed and a repeated-measures MANOVA with a Bonferroni correction compared the spatiotemporal variables from the Primary Gait Screen to the self-selected trials: gait velocity, cadence, step length, step time, and stride length. RESULTS: The analyses failed to detect differences between the Primary Gait Screen and self-selected trials for gait velocity, step length, or stride length (p > .01). Post-hoc tests revealed decreased cadence and increased step time were the only differences between the Primary Gait Screen trials and the self-selected trial (p < .001). SIGNIFICANCE: Differences seen in cadence and step time during the Primary Gait Screen may be attributed to patients' strategy, but are likely not clinically meaningful. The Primary Gait Screen appears to be a comparable assessment of overground walking in persons with Parkinson's disease, and may be a useful and accurate clinical assessment of walking.

Fouling-Release Performance of Silicone Oil-Modified Siloxane-Polyurethane Coatings.

The effect of incorporation of silicone oils into a siloxane-polyurethane fouling-release coatings system was explored. Incorporation of phenylmethyl silicone oil has been shown to improve the fouling-release performance of silicone-based fouling-release coatings through increased interfacial slippage. The extent of improvement is highly dependent upon the type and composition of silicone oil used. The siloxane-polyurethane (SiPU) coating system is a tough fouling-release solution, which combines the mechanical durability of polyurethane while maintaining comparable fouling-release performance with regard to commercial standards. To further improve the fouling-release performance of the siloxane-PU coating system, the use of phenylmethyl silicones oils was studied. Coatings formulations were prepared incorporating phenylmethyl silicone oils having a range of compositions and viscosities. Contact angle and surface energy measurements were conducted to evaluate the surface wettability of the coatings. X-ray photoelectron spectroscopy (XPS) depth profiling experiments demonstrated self-stratification of silicone oil along with siloxane to the coating-air interface. Several coating formulations displayed improved or comparable fouling-release performance to commercial standards during laboratory biological assay tests for microalgae (Navicula incerta), macroalgae (Ulva linza), adult barnacles (Balanus amphitrite syn. Amphibalanus amphitrite), and mussels (Geukensia demissa). Selected silicone-oil-modified siloxane-PU coatings also demonstrated comparable fouling-release performance in field immersion trials. In general, modifying the siloxane-PU fouling-release coatings with a small amount (1-5 wt % basis) of phenylmethyl silicone oil resulted in improved performance in several laboratory biological assays and in long-term field immersion assessments.

Comparison of laboratory and field testing performance evaluations of siloxane-polyurethane fouling-release marine coatings.

A series of eight novel siloxane-polyurethane fouling-release (FR) coatings were assessed for their FR performance in both the laboratory and in the field. Laboratory analysis included adhesion assessments of bacteria, microalgae, macroalgal spores, adult barnacles and pseudobarnacles using high-throughput screening techniques, while field evaluations were conducted in accordance with standardized testing methods at three different ocean testing sites over the course of six-months exposure. The data collected were subjected to statistical analysis in order to identify potential correlations. In general, there was good agreement between the laboratory screening assays and the field assessments, with both regimes clearly distinguishing the siloxane-polyurethane compositions comprising monofunctional poly(dimethyl siloxane) (PDMS) (m-PDMS) as possessing superior, broad-spectrum FR properties compared to those prepared with difunctional PDMS (d-PDMS). Of the seven laboratory screening techniques, the Cellulophaga lytica biofilm retraction and reattached barnacle (Amphibalanus amphitrite) adhesion assays were shown to be the most predictive of broad-spectrum field performance.

Polysulfone and polyacrylate-based zwitterionic coatings for the prevention and easy removal of marine biofouling.

A series of polysulfone and polyacrylate-based zwitterionic coatings were prepared on epoxy-primed aluminum substrata and characterized for their antifouling (AF) and fouling-release (FR) properties towards marine bacteria, microalgae and barnacles. The zwitterionic polymer coatings provided minimal resistance against bacterial biofilm retention and microalgal cell attachment, but facilitated good removal of attached microbial biomass by exposure to water-jet apparatus generated hydrodynamic shearing forces. Increasing the ion content of the coatings improved the AF properties, but required a stronger adhesive bond to the epoxy-primed aluminum substratum to prevent coating swelling and dissolution. Grafted poly(sulfobetaine) (gpSBMA), the most promising zwitterionic coating identified from microfouling evaluations, enabled the removal of four out of five barnacles reattached to its surface without incurring damage to their baseplates. This significant result indicated that gpSBMA relied predominately on its surface chemistry for its FR properties since it was very thin (~1-2 µm) relative to commercial coating standards (>200 µm).

Incidence and Predictors of Bacterial infection in Febrile Children with Sickle Cell Disease.

Children with sickle cell disease are at increased risk of developing bacteremia and other serious bacterial infections. Fever is a common symptom in sickle cell disease and can also occur with sickle cell crises and viral infections. We aimed to evaluate the incidence and predictors of bacteremia and bacterial infection in children with sickle cell disease presenting with fever to a district hospital and sickle cell center in London. A retrospective analysis was performed on all attendances of children (aged under 16 years) with sickle cell disease presenting with a fever of 38.5 °C or higher over a 1-year period. Confirmed bacterial infection was defined as bacteremia, bacterial meningitis, urinary tract infection (UTI), pneumonia, osteomyelitis or other bacterial infection with positive identification of organism. Children were defined as having a suspected bacterial infection if a bacterial infection was suspected clinically, but no organism was identified. Over a 1-year period there were 88 episodes analyzed in 59 children. Bacteremia occurred in 3.4% of episodes and confirmed bacterial infection in 7.0%. Suspected bacterial infection occurred in 33.0%. One death occurred from Salmonella typhirium septicemia. C-reactive protein (CRP) level and white blood cell (WBC) count were both significantly associated with bacterial infection (p = 0.004 and 0.02, respectively.) In conclusion, bacterial infections continue to be a significant problem in children with sickle cell disease. C-reactive protein was significantly associated with bacterial infections, and could be included in clinical risk criteria for febrile children with sickle cell disease.

Polyglycolic acid microneedles modified with inkjet-deposited antifungal coatings.

In this study, the authors examined use of piezoelectric inkjet printing to apply an antifungal agent, voriconazole, to the surfaces of biodegradable polyglycolic acid microneedles. Polyglycolic acid microneedles with sharp tips (average tip radius = 25 ± 3 µm) were prepared using a combination of injection molding and drawing lithography. The elastic modulus (9.9 ± 0.3 GPa) and hardness (588.2 ± 33.8 MPa) values of the polyglycolic acid material were determined using nanoindentation and were found to be suitable for use in transdermal drug delivery devices. Voriconazole was deposited onto the polyglycolic acid microneedles by means of piezoelectric inkjet printing. It should be noted that voriconazole has poor solubility in water; however, it is readily soluble in many organic solvents. Optical imaging, scanning electron microscopy, energy dispersive x-ray spectrometry, and Fourier transform infrared spectroscopy were utilized to examine the microneedle geometries and inkjet-deposited surface coatings. Furthermore, an in vitro agar plating study was performed on the unmodified, vehicle-modified, and voriconazole-modified microneedles. Unlike the unmodified and vehicle-modified microneedles, the voriconazole-modified microneedles showed antifungal activity against Candida albicans. The unmodified, vehicle-modified, and voriconazole-modified microneedles did not show activity against Escherichia coli, Pseudomonas aeruginosa, or Staphylococcus aureus. The results indicate that piezoelectric inkjet printing may be useful for loading transdermal drug delivery devices such as polyglycolic acid microneedles with antifungal pharmacologic agents and other pharmacologic agents with poor solubility in aqueous solutions.

Combinatorial materials research applied to the development of new surface coatings XVI: fouling-release properties of amphiphilic polysiloxane coatings.

High-throughput methods were used to prepare and characterize the fouling-release (FR) properties of an array of amphiphilic polysiloxane-based coatings possessing systematic variations in composition. The coatings were derived from a silanol-terminated polydimethylsiloxane, a silanol-terminated polytrifluorpropylmethylsiloxane (CF3-PDMS), 2-[methoxy(polyethyleneoxy)propyl]-trimethoxysilane (TMS-PEG), methyltriacetoxysilane and hexamethyldisilazane-treated fumed silica. The variables investigated were the concentration of TMS-PEG and the concentration of CF3-PDMS. In general, it was found that the TMS-PEG and the CF3-PDMS had a synergist effect on FR properties with these properties being enhanced by combining both compounds into the coating formulations. In addition, reattached adult barnacles removed from coatings possessing both TMS-PEG and relatively high levels of CF3-PDMS displayed atypical base-plate morphologies. The majority of the barnacles removed from these coatings exhibited a cupped or domed base-plate as compared to the flat base-plate observed for the control coating that did not contain TMS-PEG or CF3-PDMS. Coating surface analysis using water contact angle measurements indicated that the presence of CF3-PDMS facilitated migration of TMS-PEG to the coating/air interface during the film formation/curing process. In general, coatings containing both TMS-PEG and relatively high levels of CF3-PDMS possessed excellent FR properties.

Invertible micellar polymer assemblies for delivery of poorly water-soluble drugs.

Strategically designed amphiphilic invertible polymers (AIPs) are capable of (i) self-assembling into invertible micellar assemblies (IMAs) in response to changes in polarity of environment, polymer concentration, and structure, (ii) accommodating (solubilizing) substances that are otherwise insoluble in water, and (iii) inverting their molecular conformation in response to changes in the polarity of the local environment. The unique ability of AIPs to invert the molecular conformation depending on the polarity of the environment can be a decisive factor in establishing the novel stimuli-responsive mechanism of solubilized drug release that is induced just in response to a change in the polarity of the environment. The IMA capability to solubilize lipophilic drugs and deliver and release the cargo molecules by conformational inversion of polymer macromolecules in response to a change of the polarity of the environment was demonstrated by loading IMA with a phytochemical drug, curcumin. It was demonstrated that four sets of micellar vehicles based on different AIPs were capable of delivering the curcumin from water to an organic medium (1-octanol) by means of unique mechanism: AIP conformational inversion in response to changing polarity from polar to nonpolar. The IMAs are shown to be nontoxic against human cells up to a concentration of 10 mg/L. On the other hand, the curcumin-loaded IMAs are cytotoxic to breast carcinoma cells at this concentration, which confirms the potential of IMA-based vehicles in controlled delivery of poorly water-soluble drug candidates and release by means of this novel stimuli-responsive mechanism.

A comparison of the antifouling/foul-release characteristics of non-biocidal xerogel and commercial coatings toward micro- and macrofouling organisms.

Five non-biocidal xerogel coatings were compared to two commercial non-biocidal coatings and a silicone standard with respect to antifouling (AF)/fouling-release (FR) characteristics. The formation and release of biofilm of the marine bacterium Cellulophaga lytica, the attachment and release of the microalga Navicula incerta, and the fraction removal and critical removal stress of reattached adult barnacles of Amphibalanus amphitrite were evaluated in laboratory assays. Correlations of AF/FR performance with surface characteristics such as wettability, surface energy, elastic modulus, and surface roughness were examined. Several of the xerogel coating compositions performed well against both microfouling organisms while the commercial coatings performed less well toward the removal of microalgae. Reattached barnacle adhesion as measured by critical removal stress was significantly lower on the commercial coatings when compared to the xerogel coatings. However, two xerogel compositions showed release of 89-100% of reattached barnacles. These two formulations were also tested in the field and showed similar results.

Indirect rapid prototyping of antibacterial acid anhydride copolymer microneedles.

Microneedles are needle-like projections with microscale features that may be used for transdermal delivery of a variety of pharmacologic agents, including antibacterial agents. In the study described in this paper, an indirect rapid prototyping approach involving a combination of visible light dynamic mask micro-stereolithography and micromolding was used to prepare microneedle arrays out of a biodegradable acid anhydride copolymer, Gantrez(®) AN 169 BF. Fourier transform infrared spectroscopy, energy dispersive x-ray spectrometry and nanoindentation studies were performed to evaluate the chemical and mechanical properties of the Gantrez(®) AN 169 BF material. Agar plating studies were used to evaluate the in vitro antimicrobial performance of these arrays against Bacillus subtilis, Candida albicans, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Large zones of growth inhibition were noted for Escherichia coli, S. aureus, Enterococcus faecalis and B. subtilis. The performance of Gantrez(®) AN 169 BF against several bacteria suggests that biodegradable acid anhydride copolymer microneedle arrays prepared using visible light dynamic mask micro-stereolithography micromolding may be useful for treating a variety of skin infections.

Gag-specific CD4+ T-cell responses are associated with virological control of paediatric HIV-1 infection.

HIV-specific Elispot responses were investigated in 57 antiretroviral therapy-naive children, of median age 9.9 years. CD8(+) T-cell responses were detected in 96% children; Nef was the immunodominant protein. Responses broadened over time, but there was no association between magnitude, breadth or specificity of response and viraemia. Gag-specific CD4(+) T-cell responses, detectable in 26% children, correlated inversely with viraemia (R = -0.43, P < 0.001), suggesting that preservation of this cell population may be an important goal of therapeutic/vaccine strategies.

Combinatorial materials research applied to the development of new surface coatings XV: an investigation of polysiloxane anti-fouling/fouling-release coatings containing tethered quaternary ammonium salt groups.

As part of ongoing efforts aimed at the development of extensive structure−property relationships for moisture-curable polysiloxane coatings containing tethered quaternary ammonium salt (QAS) moieties for potential application as environmental friendly coatings to combat marine biofouling, a combinatorial/high-throughput (C/HT) study was conducted that was focused on four different compositional variables. The coatings that were investigated were derived from solution blends of a silanol-terminated polydimethylsiloxane (HO-PDMS-OH), QAS-functional alkoxysilane, and methyltriacetoxysilane. The compositional variables investigated were alkoxysilane functionality of the QAS-functional silane, chain length of the monovalent alkyl group attached to the QAS nitrogen atom, concentration of the QAS-functional alkoxysilane, and molecular weight of the HO-PDMS-OH. Of these variables, the composition of the alkoxysilane functionality of the QAS-functional silane was a unique variable that had not been previously investigated. The antifouling (AF) and fouling-release (FR) characteristics of the 24 unique coating compositions were characterized using HT assays based on three different marine microorganisms, namely, the two bacteria, Cellulophaga lytica and Halomonas pacifica, and the diatom, Navicula incerta. Coatings surfaces were characterized by surface energy, water contact angle hysteresis, and atomic force microscopy (AFM). A wide variety of responses were obtained over the compositional space investigated. ANOVA analysis showed that the compositional variables and their interactions significantly influenced AF/FR behaviors toward individual marine microorganisms. It was also found that utilization of the ethoxysilane-functional QASs provided enhanced AF character compared to coatings based on methoxysilane-functional analogues. This was attributed to enhanced surface segregation of QAS groups at the coating-air interface and confirmed by phase images using AFM.

A preliminary study on the properties and fouling-release performance of siloxane-polyurethane coatings prepared from poly(dimethylsiloxane) (PDMS) macromers.

Siloxane-polyurethane fouling-release (FR) coatings based on aminopropyl terminated poly(dimethylsiloxane) (PDMS) macromers were prepared and characterized for FR performance via laboratory biological assays. These systems rely on self-stratification, resulting in a coating with a siloxane-rich surface and polyurethane bulk. Previously, these coating systems have used PDMS with multiple functional groups which react into the polyurethane bulk. Here, aminopropyl terminated PDMS macromers were prepared, where a single amine group anchors the PDMS in the coating. Coatings were prepared with four molecular weights (1000, 5000, 10,000, and 15,000 g mol⁻¹) and two levels of PDMS (5% and 10%). High water contact angles and low surface energies were observed for the coatings before and after water immersion, along with low pseudobarnacle removal forces. Laboratory bioassays showed reduced biofilm retention of marine bacteria, good removal of diatoms from coatings with low molecular weight PDMS, high removal of algal sporelings (young plants), and low removal forces of live barnacles.

Effects of comorbidities and implant reinforcement on outcomes after component reconstruction of the abdominal wall.

A series of patients undergoing component reconstruction of midline abdominal wall separations was analyzed to assess the effects of comorbidities and biological implant reinforcements on outcomes. Thirty-nine patients were identified as fitting the technical definition of component repairs and having at least 12 months of documented follow-up. This group of procedures had a 67% primary healing rate, 18% and 13% rate of major and minor complications, respectively, and a total of 90% successful reconstructions after secondary procedures. Variables assessed for outcome influences included etiology of the abdominal wall separation, obesity, diabetes, hypertension, and biological implant reinforcements, including absorbable mesh and biological implants. None of these factors significantly influenced outcome, although first time repairs and reinforced repairs had suggestively higher success rates. This data suggest that comorbidities do not influence outcomes of component abdominal wall repairs, and assessments of the problem and ongoing technical refinements of the procedure should be studied further.

Treatment of axillary hidradenitis with transposition flaps: a 6-year experience.

In our series, 15 patients underwent 21 procedures for wide resection of axillary hidradenitis with coverage by posteriorly based Limberg transposition flaps. Twenty flaps (95%) healed without axillary contracture. One failed flap required skin graft coverage. Transposition flap coverage in these patients was a reliable, single-stage reconstruction allowing prompt arm movement.

Combinatorial materials research applied to the development of new surface coatings XIII: an investigation of polysiloxane antimicrobial coatings containing tethered quaternary ammonium salt groups.

High-throughput biological assays were used to develop structure - antimicrobial relationships for polysiloxane coatings containing chemically bound (tethered) quaternary ammonium salt (QAS) moieties. The QAS-functional polysiloxanes were derived from solution blends of a silanol-terminated polydimethylsiloxane, a trimethoxysilane-functional QAS (QAS-TMS), and methylacetoxysilane. Since the QAS moieties provide antimicrobial activity through interaction with the microorganism cell wall, most of the compositional variables that were investigated were associated with the chemical structure of the QAS-TMS. Twenty different QAS-TMS were synthesized for the study and the antimicrobial activity of sixty unique polysiloxane coatings derived from these QAS-TMS determined toward Escherichia coli , Staphylococcus aureus , and Candida albicans . The results of the study showed that essentially all of the compositional variables significantly influenced antimicrobial activity. Surface characterization of these moisture-cured coatings using atomic force microscopy as well as water contact angle and water contact angle hysteresis measurements indicated that the compositional variables significantly affected coating surface morphology and surface chemistry. Overall, compositional variables that produced heterogeneous surface morphologies provided the highest antimicrobial activity suggesting that the antimicrobial activity was primarily derived from the relationship between coating chemical composition and self-assembly of QAS moieties at the coating/air interface. Using data modeling software, a narrow region of the compositional space was identified that provided broad-spectrum antimicrobial activity.