Wiley

Edema and insufficient blood perfusion are common problems in reconstructive surgery. The blood vasculature is reconstructed in microvascular flaps, whereas lymphatic vessel function is lost after surgical incision. Here, we demonstrate that vascular endothelial growth factor C (VEGF‐C) gene transfer can be used to reconstruct a lymphatic vessel network severed by incision of skin flaps. We used adenoviral VEGF‐C gene transfer at the edges of epigastric skin flaps in mice. Our results show that VEGF‐C gene expression results in the formation of anastomoses between the lymphatic vessels of the skin flap and the surrounding lymphatic vasculature. Some spontaneous lymphangiogenesis also took place in the control mice, but the lymphatic vessels generated remained nonfunctional even 2 months postoperatively. In contrast, the VEGF‐C treated mice demonstrated persistent lymphatic vessel function during the 2 month follow‐up despite the transient nature of the adenoviral VEGF‐C gene expression. The restoration of lymphatic function by VEGF‐C in skin flaps provides new tools to promote vascular perfusion and to reduce tissue edema in skin and muscle flaps. These results have important implications for the prevention and treatment of surgically induced secondary lymphedema.

Alive & Thrive (A&T), in partnership with the Government of Viet Nam, is among the first to manage a network of 780 franchises that provide good‐quality infant and young child nutrition counseling. This paper describes our experience in nesting the A&T project monitoring into the public health system and using monitoring data to strengthen franchise performance. Paper based forms are filled at village and commune level. Data are entered into excel forms at the district level, aggregated at the province level and submitted upwards to regional and national levels. The system has a 99% reporting rate. Training and regular supportive supervision ensure data quality. Data are analyzed on a monthly basis and shared back down the chain in user‐friendly formats to enable management decisions. Franchises with low performance receive targeted assistance on demand generation and quality improvement. High‐performing franchises receive performance‐based awards. Data reveal that services reach almost 2/3 of children 0‐23 months in the catchment areas. August 2013, a total of 95,000 monthly contacts was provided through the network with 73% of contacts being with repeat clients. A robust program monitoring can function well within a public health system, when the system is streamlined and user‐friendly; and its findings are shared back in a timely manner to facilitate evidence‐based decision making to improve quality.

Grant Funding Source: Bill & Melinda Gates Foundation, through Alive & Thrive Initiative, managed by FHI360

Bacteria synthesize numerous types of sphingolipids with various physiological functions. Despite their roles in mediating host inflammation, cellular differentiation, and protection from environmental stress, their biosynthetic pathway remains undefined since several essential eukaryotic ceramide synthesis enzymes have no bacterial homologue. Using genetic and biochemical approaches, we identified the complete pathway for bacterial ceramide synthesis. Bioinformatic and phylogenetic analyses revealed the presence of these genes in a broad range of bacterial taxa and led to our discovery of the first Gram‐positive species to produce ceramides. Biochemical experiments with purified proteins support a model in which the bacterial pathway operates in a different order than in eukaryotes. Furthermore, phylogenetic analyses are consistent with the independent evolution of the bacterial and eukaryotic ceramide pathways. Current work is being done to elucidate the specific subcellular localization of the synthetic enzymes and identify additional proteins required for the transport of sphingolipids to the outer membrane of Gram‐negative bacteria.

Chronic inflammation and cancer are already known to be two intertwined processes and many studies have suggested that the hindrance of the former can serve as an effective preventive measure for the occurrence of colorectal carcinoma (CRC). The current study was done in order to evaluate both the anti‐inflammatory and cytotoxic properties of ethanol extracts of Averrhoa bilimbi leaves in light of its potential as a source of an effective chemotherapeutic agent against CRC. In this study, RAW 264.7 murine macrophage cells and HT‐29 human colorectal carcinoma cells were used to evaluate the anti‐inflammatory and anti‐tumor properties of the extract, respectively. Cell viability analysis, NO assay, RT‐PCR assay, Western blot analysis, flow cytometry analysis and antioxidant assays were used to evaluate the chemotherapeutic properties of the extract. It was shown that treatment with low doses (25, 50 and 100 μg/mL) of the extract has potent anti‐inflammatory activity through alterations in nuclear factor‐kappa B (NF‐KB) activity, nitric oxide (NO) production and cycloxygenase‐2 (COX‐2) release. The extract also shows potent cytotoxic activity against the cancer cell line used in the study. It was seen that the extract shows anti‐tumor properties through the promotion of apoptosis, through up regulation of the Smac/DIABLO‐caspase cascade, and cell cycle arrest, through up regulation of the tumor suppressor gene p21. Antioxidant screening showed that the extract possesses antioxidant activity supporting its anti‐inflammatory and anticancer activities. In conclusion, the current study shows that Averrhoa bilimbi can be a source of bioactive compounds which can be used as a potential chemotherapeutic agent against colorectal carcinoma by virtue of its chemopreventive (anti‐inflammatory) and chemotoxic (cytotoxic) properties.