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Epigenetic acquisition of inducibility of type III cytotoxicity in P. aeruginosa.

BACKGROUND: Pseudomonas aeruginosa, an opportunistic pathogen, is often encountered in chronic lung diseases such as cystic fibrosis or chronic obstructive pneumonia, as well as acute settings like mechanical ventilation acquired pneumonia or neutropenic patients. It is a major cause of mortality and morbidity in these diseases. In lungs, P. aeruginosa settles in a biofilm mode of growth with the secretion of exopolysaccharides in which it is encapsulated, enhancing its antibiotic resistance and contributing to the respiratory deficiency of patients. However, bacteria must first multiply to a high density and display a cytotoxic phenotype to avoid the host's defences. A virulence determinant implicated in this step of infection is the type III secretion system (TTSS), allowing toxin injection directly into host cells. At the beginning of the infection, most strains isolated from patients' lungs possess an inducible TTSS allowing toxins injection or secretion upon in vivo or in vitro activation signals. As the infection persists most of the bacteria permanently loose this capacity, although no mutations have been evidenced. We name "non inducible" this phenotype. As suggested by the presence of a positive feedback circuit in the regulatory network controlling TTSS expression, it may be due to an epigenetic switch allowing heritable phenotypic modifications without genotype's mutations. RESULTS: Using the generalised logical method, we designed a minimal model of the TTSS regulatory network that could support the epigenetic hypothesis, and studied its dynamics which helped to define a discriminating experimental scenario sufficient to validate the epigenetic hypothesis. A mathematical framework based on formal methods from computer science allowed a rigorous validation and certification of parameters of this model leading to epigenetic behaviour. Then, we demonstrated that a non inducible strain of P. aeruginosa can stably acquire the capacity to be induced by calcium depletion for the TTSS after a short pulse of a regulatory protein. Finally, the increased cytotoxicity of a strain after this epigenetic switch was demonstrated in vivo in an acute pulmonary infection model. CONCLUSION: These results may offer new perspectives for therapeutic strategies to prevent lethal infections by P. aeruginosa by reverting the epigenetic inducibility of type III cytotoxicity.

Bacterial Proteins↗

Promoting the oral health of older adults through the chronic disease model: CDC's perspective on what we still need to know.

The Centers for Disease Control and Prevention (CDC) has adopted a multicomponent approach to health promotion: the Chronic Disease Model. Among its underlying public health principles are 1) recognition of the universal preference for primary prevention of disease, 2) awareness that prevention often takes place outside of clinical settings and is influenced by behaviors that can be affected by social circumstances and institutional policies, 3) the need to base program efforts on the best available science, 4) the special responsibility of public health for at-risk populations, and 5) the need for population-based approaches. Such approaches require public health agencies to build programs that engage broad networks of partners; monitor diseases, risk factors, and behaviors; implement proven prevention strategies; and evaluate programs rigorously. If CDC is to implement comprehensive programs to promote the oral health of elderly people, more information is needed. In this short report we comment on gaps in knowledge concerning the components of programs, measurement of oral diseases and risk factors, and the effectiveness of preventive interventions at the self-care, clinical, and community levels for dental caries and oral and pharyngeal cancers.

Aged↗

[Hygeia and Panacea in health and society. Health systems: a product of social evolution].

Biomedical and social sciences are getting closer, thus reducing the existing chasm between the social determinants of health and health policy. The determinants such as income, education, health production at home, environment, employment, dietary habits, social support networks, gender, and migration, among others, have a strong and definitive influence on the health state of the population. This paper gains an insight into the influence on the population's health covered by the Instituto Mexicano del Seguro Social (IMSS) of some of these determinants, such as demographic changes (birth rate decrease, ageing, and increase of temporary migration), economic changes (progressive incorporation of women to the labour market), and lifestyle aspects. These determinants pose economic and ethical dilemmas, among others, that IMSS must solve through its policymaking process. The concept of effective health policy is proposed. This concept includes a comprehensive health policy capable of considering social determinants and epidemiological changes within its inception, and at the same time, it is able to respond to the population's health needs. It is deduced that it is necessary for the health system to implement and evaluate plans and interventions that are structured and consistent with the population's health needs, thus contributing to reduce social inequities.

Delivery of Health Care↗

Nanotribological effects of silicone type, silicone deposition level, and surfactant type on human hair using atomic force microscopy.

The atomic/friction force microscope (AFM/FFM) has recently become an important tool for studying the micro/nanoscale structure and tribological properties of human hair. Of particular interest to hair and beauty care science is how common hair-care materials, such as conditioner, deposit onto and change hair's tribological properties, since these properties are closely tied to product performance. Since a conditioner is a complex network of many different ingredients (including silicones for lubrication and cationic surfactants for static control and gel network formulation), studying the effects of these individual components can give insight into the significance each has on hair properties. In this study, AFM/FFM is used to conduct nanotribological studies of surface roughness, friction force, and adhesive forces as a function of silicone type, silicone deposition level, and cationic surfactant type. Changes in the coefficient of friction as a result of soaking hair in de-ionized water are also discussed.

Adhesiveness↗

Infection transmission science and models.

Infection transmission systems circulate infection through complex contact patterns related to both contact patterns and patterns of factors that affect the risk of transmission given contact. The nonlinear dynamics of infection transmission cause these patterns to make big differences in population infection levels. A science of infection transmission system analysis is needed to focus on those details that affect the control of infection transmission. This science must have a strong theoretical base because there is little chance that a dominantly data based approach not using mechanistic models of transmission will have any predictive value. The theoretical base should be built on linked transmission system models that are focused on making needed inferences for both building the theoretical base and making infection control decisions. The linking of different models is needed for a strategy of inference robustness assessment that is designed to find the model that is simple enough to effectively analyze the transmission system but not so simple that realistic violation of simplifying assumptions will change an inference. Types of models that should be used in such linked analyses include deterministic and stochastic compartmental models, discrete individual models with individual event histories but structured mass action mixing, network models that provide more detail as to who has contact with whom, and intermediate model forms such as correlation models that address some aspects of contact details while preserving the flexibility of deterministic compartmental models to structure mixing and analyze the system. While transmission system science is currently weak in regards both to its data base and its theory base, many things are now coming together that could make this science flourish. On the data side these include greater ability to detect infectious agent sequences in the environment and greater ability to sequence and genetically relate agents identified at different sites in the transmission system. On the theory sides, new model construction and model analysis methods are providing new potential to use the new sources of data. Also new parameter estimation methods provide new potential to combine models and data in effective analytic strategies.

Communicable Diseases↗

Design of radiolabelled ligands for the imaging and treatment of cancer.

The specialised medical field of Nuclear Medicine is concerned with the use of unsealed sources of radioactivity either to diagnose or treat a range of diseases. In this regard it can be distinguished from the field of Radiotherapy which uses sealed radioactive sources for treatment. The range of diseases in which Nuclear Medicine plays a role is wide and includes, among others, the fields of microbiology, endocrinology, neurology, oncology and cardiovascular medicine. However, cancer probably represents the most important and growing area of application for this modality. Nuclear Medicine employs radiopharmaceuticals. These are radiolabelled ligands that have the ability to interact with molecular targets that are relevant in the aetiology or treatment of cancer and in many respects Nuclear Medicine can be considered the archetype for the application of 'Molecular Medicine'. An example of a Nuclear Medicine Positron Emission Tomography (PET) scan is shown in Fig. 2. There is great interest in developing new radioligands that allow us to image the expression of the ever increasing range of biological pathways being discovered in the post-genomic area. Designing effective radiopharmaceuticals, however, requires an understanding of a number of radiopharmaceutical sciences including aspects of chemistry, physics, cell and molecular biology, and physiology.

Animals↗

Establishing a psychiatric library.

The amount of information in the psychiatric field has increased to such an extent that a specialized library is an essential part of the mental health facility. Guidelines are presented for establishing a psychiatric library, including staffing, budgeting, physical layout, and selection and handling of books, reference materials, journals and annuals, microfilm and microfiche, and audiovisuals. The expertise of the librarian is the single most important factor in determining the quality of the collection and the services provided, the author believes. Because of escalating costs, developing a cooperative library network of small, specialized mental health collections may be the most productive course for the future.

Humans↗

Role of a central laboratory in implementing national cholesterol education panel guidelines in rural practices: model system for managed care.

We describe the use of a central laboratory to identify patients who may be candidates for a hypercholesterolemia treatment program and to direct their referral into this program. The laboratory, providing service for 16 medical practices in a rural area of upstate New York, served as the entry point to the treatment program for those patients with serum cholesterol > or = 5.18 mmol/L. This treatment program, designed to follow the National Cholesterol Education Program Adult Treatment Panel Guidelines, was provided by the lipid referral center staff, including a registered dietitian and a lipid specialist. After introduction of this program, 52% of eligible patients received nutritional counseling for hypercholesterolemia, compared with only 29% in usual care settings. This program represents an enhanced role for laboratories in the implementation of treatment protocols typical of those adopted by managed care networks.

Counseling↗

Asymmetries between dominant and non-dominant hands in real and imagined motor task performance.

Motor imagery is a dynamic state in which an individual mentally simulates the performance of a specific motor action or motor task. Recent behavioural and neuroimaging evidence suggests that the same neurocognitive networks control real and imagined movements. This hypothesis was tested by investigating whether motor asymmetries related to cerebral dominance also occurred for imagined movements. Fifty subjects performed the visually guided pointing task of Sirigu et al. [Sirigu, A., Duhamel, J., Cohen, L., Pillon, B., Dubois, B. and Agid, Y., The mental representation of hand movements after parietal cortex damage. Science, 1996, 273, 1564-1567.] using their dominant and non-dominant hands. Analysis of group data indicated that both real and imagined movement conformed to Fitts' law. Analysis of individual data indicated that asymmetries arising from motor dominance in real movements also occurred for imagined movements. However, the relative slowing and error associated with the non-dominant hand was greater for imagined movements than for real movements. These asymmetries support the hypothesis that real and imagined movements are represented within the same neurocognitive networks but suggest that asymmetries in performance related to handedness are greater for imagined movements. In addition, while the visually guided pointing task provides a useful test of the ability to make imagined movements, asymmetries in the speed and reliability of imagined performance are significantly greater than those for real performance.

Adolescent↗

US biomedical research: basic, translational, and clinical sciences.

The National Institutes of Health (NIH) is the world's largest biomedical research agency, with a 75-year record of responding to the nation's key medical challenges. Today, medical science is entering a revolutionary period marked by a shift in focus from acute to chronic diseases, rapidly escalating health care costs, a torrent of biological data generated by the sequencing of the human genome, and the development of advanced high-throughput technologies that allow for the study of vast molecular networks in health and disease. This unique period offers the unprecedented opportunity to identify individuals at risk of disease based on precise molecular knowledge, and the chance to intervene to preempt disease before it strikes. Conceptually, this represents the core scientific challenge of the coming century. The NIH is committed to the discoveries that will change the practice of medicine as we know it in order to meet this challenge. The NIH Roadmap constitutes an important vehicle for generating change-a most critical element of this plan is the reengineering of the national clinical research enterprise. This reinvention will call for the transformation of translational clinical science and for novel interdisciplinary approaches that will advance science and enhance the health of the nation.

Awards and Prizes↗

Reconstructing protein complexes: from proteomics to systems biology.

Modern high throughput technologies in biological science often create lists of interesting molecules. The challenge is to reconstruct a descriptive model from these lists that reflects the underlying biological processes as accurately as possible. Once we have such a model or network, what can we learn from it? Specifically, given that we are interested in some biological process associated with the model, what new properties can we predict and subsequently test? Here, we describe, at an introductory level, a range of bioinformatics techniques that can be systematically applied to proteomic datasets. When combined, these methods give us a global overview of the network and the properties of the proteins and their interactions. These properties can then be used to predict functional pathways within the network and to examine substructure. To illustrate the application of these methods, we draw upon our own work concerning a complex of 186 proteins found in neuronal synapses in mammals. The techniques discussed are generally applicable and could be used to examine lists of proteins involved with the biological response to electric or magnetic fields.

Animals↗

Fetal alcohol syndrome through the eyes of parents.

Although fetal alcohol syndrome (FAS) was first identified by research scientists in the USA in 1973, it was not until 1989 when an adoptive parent, Michael Dorris, wrote The Broken Cord, that a practical description of the disability came into public awareness. Within the next 2 years, parents of children diagnosed with this disability teemed up with interested professionals to organize the FAS Family Resource Institute (FAS*FRI). This educational non-profit organization has now devoted over a decade to their mission to identify, understand and care for individuals with fetal alcohol syndrome/effects (FAS/E) and to prevent this disability from occurring in future generations. Their mission has necessitated the identification of a behavioral phenotype for FAS/E, the development of a professional training curriculum, and operation of a national family advocacy and mentoring network. By adding their own families' experiences to the information gathered from thousands of other families with diagnosed children, they have accumulated enough experiential, frontline reports which are similar enough to serve as their research science base.

Child↗

The Visible Human Project: a resource for anatomical visualization.

The National Library of Medicine (NLM) has long been a world leader in the archiving and distribution of the print-based images of biology and medicine. NLM has also been a pioneer in the use of computer systems to encode and distribute textual knowledge of the life sciences. NLM's Long Range Planning effort of 1985-86 foresaw a coming era where NLM's Bibliographic and factual database services would be complemented by libraries of digital images, distributed over high speed computer networks and by high capacity physical media. The NLM Planning Panel on Electronic Imaging recommended that NLM should undertake the building a digital image library consisting of computerized tomography (CT) and magnetic resonance (MR) images, and cryosection images of a representative, carefully selected and prepared male and female cadaver--the "Visible Human ProjectJ." The male and female Visible Human data sets are now being made available through a license agreement with the NLM. The data sets are supporting a wide range of educational, diagnostic, treatment planning, and commercial uses. The value of this international resource in the public domain increases through its application. Its utility will continue to grow as related databases are attached to it, and as more attributes are given to its image elements.

Anatomy, Cross-Sectional↗

Impact of medical informatics on medical education.

In recent years, medical informatics has become a well-recognized branch of medicine. It is a multidisciplinary science that combines information technology and various specialties of medicine. The impact of medical informatics on medical education is advancing along with the rapid developments in computer science. Departments of medical informatics or similar divisions have appeared in schools of medicine in Taiwan in the past 5 years. At National Taiwan University College of Medicine, we offer curricula in basic computer concepts, network concepts, operating systems, word processing, database and data processing, computer media resources, multimedia computer statistics, intelligent health information systems, medical diagnostic support systems, and electronic medical record systems. Distance learning has also been favorably accepted on this campus. Recently, we proposed the concept of a virtual medical campus, which will break the physical barriers of time and space. We expect this revolution to influence every aspect of medicine, especially medical education.

Education, Medical↗

From data to knowledge--the Visible Human Project continues.

The U. S. National Library of Medicine (NLM) has long been a world leader in the archiving and distribution of the print-based images of biology and medicine. NLM has also been a pioneer in the use of computer systems to encode and distribute textual knowledge of the life sciences. NLM's Long Range Planning effort of 1985-86 foresaw a coming era where NLM's Bibliographic and factual database services would be complemented by libraries of digital images, distributed over high speed computer networks. The NLM Planning Panel on Electronic Imaging recommended that NLM should undertake the building a digital image library consisting of computerized tomography (CT) and magnetic resonance (MR) images, and cryosection images of a representative, carefully selected and prepared male and female cadaver--the "Visible Human Project ." The male and female Visible Human data sets are now being made available through a license agreement with the NLM. The data sets are supporting a wide range of educational, diagnostic, treatment planning, and commercial uses. The NLM, in partnership with other U.S. government research agencies has begun a three prong effort within the Visible Human Project to address: the creation of a new online, interactive, digital head-and-neck atlas; the development of a tool kit of computational programs capable of automatically performing many of the basic data handling functions required for using Visible Human data in applications; and the improved resolution of future Visible Human data sets through the reduction of the anatomical artifacts introduced by the methods used to stabilize and section the anatomical materials and the development of staining and wide-spectrum methods for increasing tissue contrast.

Anatomy, Artistic↗