bluuebunny/crossref_metadata_2025 huggingface dataset:
Intermittent Cervical Traction for Treating Neck Pain
Authors: Yang Jheng-Dao , Tam Ka-Wai , Huang Tsai-Wei , Huang Shih-Wei , Liou Tsan-Hon , Chen Hung-Chou
Published: October 2016

Study Design.

A meta-analysis.

Objective.

The aim of this study was to perform a comprehensive search of current literature and conduct a meta-analysis of randomized controlled trials (RCTs) to assess the neck pain relieving effect of intermittent cervical traction (ICT).

Summary of Background Data.

Neck pain is a common and disabling problem with a high prevalence in general population. It causes a considerable burden on the health care system with a substantial expenditure. ICT is a common component of physical therapy for neck pain in the outpatient clinic. However, the evidence regarding the effectiveness of ICT for neck pain is insufficient.

Methods.

Data were obtained from the PubMed, Cochrane Library, Embase, and Scopus databases from the database inception date to July 02, 2016. RCTs reporting the effects of ICT on neck pain, including those comparing the effects of ICT with those of a placebo treatment, were included. Two reviewers independently reviewed the studies, conducted a risk of bias assessment, and extracted data. The data were pooled in a meta-analysis by using a random-effects model.

Results.

The meta-analysis included seven RCTs. The results indicated that patients who received ICT for neck pain had significantly lower pain scores than those receiving placebos did immediately after treatment (standardized mean difference = −0.26, 95% confidence interval = −0.46 to −0.07). The pain scores during the follow-up period and the neck disability index scores immediately after treatment and during the follow-up period did not differ significantly.

Conclusion.

ICT may have a short-term neck pain-relieving effect. Some risks of bias were noted in the included studies, reducing the evidence level of this meta-analysis. Additional high-quality RCTs are required to clarify the long-term effects of ICT on neck pain.

Level of Evidence: 1
The Power of Low Back Pain Trials
Authors: Froud Robert , Rajendran Dévan , Patel Shilpa , Bright Philip , Bjørkli Tom , Eldridge Sandra , Buchbinder Rachelle , Underwood Martin
Published: October 2016

Study Design.

A systematic review of nonspecific low back pain trials published between 1980 and 2012.

Objective.

To explore what proportion of trials have been powered to detect different bands of effect size; whether there is evidence that sample size in low back pain trials has been increasing; what proportion of trial reports include a sample size calculation; and whether likelihood of reporting sample size calculations has increased.

Summary of Background Data.

Clinical trials should have a sample size sufficient to detect a minimally important difference for a given power and type I error rate. An underpowered trial is one within which probability of type II error is too high. Meta-analyses do not mitigate underpowered trials.

Methods.

Reviewers independently abstracted data on sample size at point of analysis, whether a sample size calculation was reported, and year of publication. Descriptive analyses were used to explore ability to detect effect sizes, and regression analyses to explore the relationship between sample size, or reporting sample size calculations, and time.

Results.

We included 383 trials. One-third were powered to detect a standardized mean difference of less than 0.5, and 5% were powered to detect less than 0.3. The average sample size was 153 people, which increased only slightly (∼4 people/yr) from 1980 to 2000, and declined slightly (∼4.5 people/yr) from 2005 to 2011 (P < 0.00005). Sample size calculations were reported in 41% of trials. The odds of reporting a sample size calculation (compared to not reporting one) increased until 2005 and then declined  

JOURNAL/spne/04.03/00007632-201706010-00018/display-formula1/v/2024-02-04T231331Z/r/image-tiff

.

Conclusion.

Sample sizes in back pain trials and the reporting of sample size calculations may need to be increased. It may be justifiable to power a trial to detect only large effects in the case of novel interventions.

Level of Evidence: 3
Examination of an Electronic Patient Record Display Method to Protect Patient Information Privacy
Authors: Niimi Yukari , Ota Katsumasa
Published: October 2016

Electronic patient records facilitate the provision of safe, high-quality medical care. However, because personnel can view almost all stored information, this study designed a display method using a mosaic blur (pixelation) to temporarily conceal information patients do not want shared. This study developed an electronic patient records display method for patient information that balanced the patient’s desire for personal information protection against the need for information sharing among medical personnel. First, medical personnel were interviewed about the degree of information required for both individual duties and team-based care. Subsequently, they tested a mock display method that partially concealed information using a mosaic blur, and they were interviewed about the effectiveness of the display method that ensures patient privacy. Participants better understood patients’ demand for confidentiality, suggesting increased awareness of patients’ privacy protection. However, participants also indicated that temporary concealment of certain information was problematic. Other issues included the inconvenience of removing the mosaic blur to obtain required information and risk of insufficient information for medical care. Despite several issues with using a display method that temporarily conceals information according to patient privacy needs, medical personnel could accept this display method if information essential to medical safety remains accessible.
Vermilion Only Cross-lip Flap for Treating Whistle Deformity in Secondary Bilateral Cleft Lip Repair
Authors: Sheckter Clifford C. , Menard Robert M.
Published: October 2016

Bilateral cleft lip repairs can result in various secondary deformities. One more commonly seen deformity, the whistle deformity, is characterized by a reduced or absent tubercle, orbicularis muscle diastasis, and abnormalities of the philtrum with notched appearance of cupid’s bow. Various techniques have been described to address these problems. One common procedure is the lip-switch flap originally described by Abbe in 1898, which has been modified by various surgeons. In these procedures, lower lip vermilion, mucosa, orbicularis, and lip skin are transposed to the upper lip on a pedicle that is later divided. In all these variations of the lip-switch procedure, the transposed tissue involves the entire lower lip skin—leaving large, unsightly, and unnecessary scars. It also brings abnormal tissue into the philtrum further distorting the upper lip. A modified cross-lip flap that is limited to the taking only mucosa, vermilion, and orbicularis is feasible and provides an optimal reconstruction without compromising additional tissue.
Chair Yoga: Feasibility and Sustainability Study With Older Community-Dwelling Adults With Osteoarthritis
Authors: McCaffrey Ruth , Park Juyoung , Newman David
Published: October 2016

This study measured the feasibility of completing a randomized control trial on an 8-week seated yoga program for older adults with osteoarthritis. Part of the feasibility of this program was to determine whether participants would continue the yoga practice at home using a guide book after the 8-week program. Findings demonstrated that once participants were not in a group setting for the yoga, they did not continue with yoga practice. This outcome demonstrates the need for group programs for older adults to promote adherence to movement-based programs. (Trial registration: ClinicalTrials.Gov: NCT02113410).
CALCIFICATION OF A HYDROPHILIC ACRYLIC INTRAOCULAR LENS AFTER PARS PLANA VITRECTOMY
Authors: Khurana Rahul N. , Werner Liliana
Published: October 2016

Purpose:

Anterior surface calcification of a hydrophilic acrylic intraocular lens (IOL) associated with iatrogenic exposure of air after an uncomplicated pars plana vitrectomy is described.

Methods:

The clinical and histochemical findings of a patient who developed postoperative opacification of a hydrophilic acrylic intraocular lens are retrospectively reviewed.

Results:

A 63-year-old woman developed fine granular opacifications on the anterior surface of the intraocular lens 8 months after a pars plana vitrectomy with iatrogenic exposure of air. The intraocular lens was explanted and histochemical analysis confirmed the presence of calcium.

Conclusion:

Physicians should be aware of this complication and be cautious about the use of intraocular gas in either the front or the back of the eye in patients with hydrophilic acrylic intraocular lenses.
Recovery-Oriented Mental Health Practice in a Community Care Unit: An Exploratory Study
Authors: McKenna Brian , Oakes Jane , Fourniotis Niki , Toomey Nigel , Furness Trentham
Published: October 2016

A recovery-oriented model of care has become the major focus of mental health service delivery in the state of Victoria, Australia. However, there is a total absence of knowledge of recovery-oriented mental health practice in community care units (CCUs). Therefore, the aims of this exploratory study were to: (a) describe what aspects of the current model of care fit within the domains of recovery; and (b) describe the pragmatic processes that staff use to mold their care within the domains of recovery. Twenty-one key stakeholders provided informed voluntary consent to participate in one-to-one interviews. Six content domains evolved to include: (a) a common vision: “a continuous journey”; (b) promoting hope; (c) promoting autonomy and self-determination; (d) meaningful engagement; (e) holistic and personalized care; and (f) community participation and citizenship. The CCU appeared to be on a journey of transformation toward personal recovery. However, clinicians were grappling with an identified tension among personal recovery and clinical recovery. The tension among personal recovery and clinical recovery may be attributed to the psychosocial rehabilitation model of care, which was previously systemic in Victorian CCUs.
Pediatric Oncology Clinic Care Model: Achieving Better Continuity of Care for Patients in a Medium-sized Program
Authors: Johnston Donna L. , Halton Jacqueline , Bassal Mylène , Klaassen Robert J. , Mandel Karen , Ramphal Raveena , Simpson Ewurabena , Peckan Li
Published: October 2016

Providing the best care in both the inpatient and outpatient settings to pediatric oncology patients is all programs goal. Using continuous improvement methodologies, we changed from a solely team-based physician care model to a hybrid model. All patients were assigned a dedicated oncologist. There would then be 2 types of weeks of outpatient clinical service. A “Doc of the Day” week where each oncologist would have a specific day in clinic when their assigned patients would be scheduled, and then a “Doc of the Week” week where one physician would cover clinic for the week. Patient satisfaction surveys done before and 14 months after changing the model of care showed that patients were very satisfied with the care they received in both models. A questionnaire to staff 14 months after changing showed that the biggest effect was increased continuity of care, followed by more efficient clinic workflow and increased consistency of care. Staff felt it provided better planning and delivery of care. A hybrid model of care with a primary physician for each patient and assigned clinic days, alternating with weeks of single physician coverage is a feasible model of care for a medium-sized pediatric oncology program.
Strangulation by Feeding Tube in a 23-Month-Old With Down Syndrome
Authors: Woodham Paige C. , Fulcher James W. , Ward Michael E.
Published: October 2016

Ligature strangulation, although typically homicidal in nature, has been reported as accidental in both the pediatric and adult populations. The unique mode of accidental strangulation with a gastric feeding tube in a 23-month-old with Down syndrome is currently unreported in the literature and has prompted us to report this case and look into safety modifications that can be made to these common medical devices. Given the number of children with gastric feeding tubes and concern over this exact scenario brought up by parents, it is unusual that a similar case has not been reported.
Determination of Phenotypic Resistance Cutoffs From Routine Clinical Data
Authors: Pironti Alejandro , Walter Hauke , Pfeifer Nico , Knops Elena , Lübke Nadine , Büch Joachim , Di Giambenedetto Simona , Kaiser Rolf , Lengauer Thomas ,   The EuResist Network Study Group
Published: October 2016

Background:

HIV-1 drug resistance can be measured with phenotypic drug-resistance tests. However, the output of these tests, the resistance factor (RF), requires interpretation with respect to the in vivo activity of the tested variant. Specifically, the dynamic range of the RF for each drug has to be divided into a suitable number of clinically meaningful intervals.

Methods:

We calculated a susceptible-to-intermediate and an intermediate-to-resistant cutoff per drug for RFs predicted by geno2pheno[resistance]. Probability densities for therapeutic success and failure were estimated from 10,444 treatment episodes. The density estimation procedure corrects for the activity of the backbone drug compounds and for therapy failure without drug resistance. For estimating the probability of therapeutic success given an RF, we fit a sigmoid function. The cutoffs are given by the roots of the third derivative of the sigmoid function.

Results:

For performance assessment, we used geno2pheno[resistance]RF predictions and the cutoffs for predicting therapeutic success in 2 independent sets of therapy episodes. HIVdb was used for performance comparison. On one test set (n = 807), our cutoffs and HIVdb performed equally well receiver operating characteristic curve [(ROC)–area under the curve (AUC): 0.68]. On the other test set (n = 917), our cutoffs (ROC–AUC: 0.63) and HIVdb (ROC–AUC: 0.65) performed comparatively well.

Conclusions:

Our method can be used for calculating clinically relevant cutoffs for (predicted) RFs. The method corrects for the activity of the backbone drug compounds and for therapy failure without drug resistance. Our method's performance is comparable with that of HIVdb. RF cutoffs for the latest version of geno2pheno[resistance]have been estimated with this method.
Effect of Pregnancy on Response to Antiretroviral Therapy in HIV-Infected African Women
Authors: Kourtis Athena P. , Wiener Jeffrey , King Caroline C. , Heffron Renee , Mugo Nelly R. , Nanda Kavita , Pyra Maria , Donnell Deborah , Celum Connie , Lingappa Jairam R. , Baeten Jared M. ,   for the Partners in Prevention HSV/HIV Transmission Study and Partners PrEP Study Teams
Published: October 2016

Background:

While most recent evidence does not support a role for pregnancy in accelerating HIV disease progression, very little information is available on the effects of incident pregnancy in response to antiretroviral therapy (ART). Hormonal, immune, and behavioral changes during pregnancy may influence response to ART. We sought to explore the effects of incident pregnancy (after ART initiation) on virologic, immunologic, and clinical response to ART.

Methods:

Data were collected from HIV-infected women participating in 3 prospective studies (Partners in Prevention Herpes simplex virus/HIV Transmission Study, Couples Observational Study, and Partners Preexposure Prophylaxis Study) from 7 countries in Africa from 2004 to 2012. Women were included in this analysis if they were ≤45 years of age, were started on ART during the study and were not pregnant at ART initiation. Pregnancy was treated as a time-dependent exposure variable covering the duration of pregnancy, including all pregnancies occurring after ART initiation. Virologic failure was defined as a viral load (VL) greater than 400 copies per milliliter ≥6 months after ART initiation and viral suppression was defined as VL ≤400 copies per milliliter. Multivariable Cox proportional hazards models were used to assess the association between pregnancy and time to viral suppression, virologic failure, World Health Organization clinical stage III/IV, and death. Linear mixed-effects models were used to assess the association between pregnancy and CD4+count and VL. All analyses were adjusted for confounders, including pre-ART CD4+count and plasma VL.

Results:

A total of 1041 women were followed, contributing 1196.1 person-years of follow-up. Median CD4+count before ART initiation was 276 cells per cubic millimeter (interquartile range, 209–375); median pre-ART VL was 17,511 copies per milliliter (interquartile range, 2480–69,286). One hundred ten women became pregnant after ART initiation. Pregnancy was not associated with time to viral suppression (adjusted hazard ratio [aHR], 1.20, 95% confidence interval [CI]: 0.82 to 1.77), time to virologic failure (aHR, 0.67, 95% CI: 0.37 to 1.22), time to World Health Organization clinical stage III or IV (aHR, 0.79, 95% CI: 0.19 to 3.30), or time to death (aHR, 2.04, 95% CI: 0.25 to 16.8). Incident pregnancy was associated with an adjusted mean decrease in CD4+T-cell count of 47.3 cells per cubic millimeter (P< 0.001), but not with difference in VL (P= 0.06).

Conclusions:

For HIV-infected women on ART, incident pregnancy does not affect virologic control or clinical HIV disease progression. A modest decrease in CD4+T-cell count could be due to physiologic effects of pregnancy.
Brief Report: Impaired CD4 T-Cell Response to Autophagy in Treated HIV-1–Infected Individuals
Authors: Gómez-Mora Elisabet , Robert-Hebmann Véronique , García Elisabet , Massanella Marta , Clotet Bonaventura , Cabrera Cecilia , Blanco Julià , Biard-Piechaczyk Martine
Published: October 2016

Autophagy restricts infection of CD4 T lymphocytes by HIV-1, but little is known about autophagy in treated HIV-1–infected individuals. We have analyzed the capability of CD4 T cells from aviremic-treated individuals to trigger autophagy and correlated this response with parameters known to be important for immunological recovery. Autophagy was significantly decreased in CD4 T cells from HIV-1–treated individuals compared with uninfected controls, and this defective autophagic response was more pronounced in individuals with poor CD4 T-cell recovery, suggesting a link between impaired autophagy in CD4 T cells and chronic immunological defects that remain in treated HIV infection.
Housing Stability and Medication Adherence among HIV-Positive Individuals in Antiretroviral Therapy: A Meta-Analysis of Observational Studies in the United States
Authors: Harris Rebecca Arden , Xue Xiaonan , Selwyn Peter A.
Published: October 2016

Background:

Previous research has produced inconsistent evidence of an association between housing stability and medication adherence among HIV-positive individuals in antiretroviral therapy.

Objective:

We conducted a meta-analysis of the housing–adherence relationship based on a comprehensive search of observational studies in the PubMed, Embase, and Cochrane databases (January 2000–January 2016). Ten qualifying studies were identified representing 10,556 individuals.

Methods:

A random-effects model was used to estimate the overall effect size and 95% confidence interval (CI). Robustness of the estimate was determined by sensitivity analysis. Heterogeneity was assessed by meta-regression analysis, subgroup analysis, and quality effects estimation. Publication bias was evaluated with a funnel plot and the Egger and Begg tests.

Results:

The summary effect for the association between housing stability and medication adherence was positive and significant (standardized mean difference = 0.15, 95% CI: 0.02 to 0.29). The association was slightly larger in the quality effects analysis (standardized mean difference = 0.20, 95% CI: 0.01 to 0.39). Sensitivity analysis disclosed that the association was robust at the P = 0.09 level. Results of the subgroup and meta-regression analyses were nonsignificant. Publication bias was not detected.

Conclusion:

Antiretroviral medication adherence is an increasing function of housing stability, but the magnitude of the effect is small. The finding challenges the view that unstable housing is incompatible with adherence and questions the potential benefit of deferring antiretroviral therapy initiation until the patient's housing circumstances are improved.
Combined Stent Insertion and High-intensity Focused Ultrasound Ablation for Patients With Malignant Obstructive Jaundice
Authors: Niu Su , Cheng Long , Qiao Yan , Fu Yu-Fei , Cao Chi
Published: October 2016

Purpose:

We aimed to determine the clinical effectiveness of combined stent insertion and high-intensity focused ultrasound (HIFU) ablation for patients with malignant obstructive jaundice (MOJ).

Materials and Methods:

From June 2013 to May 2015, consecutive patients with inoperable MOJ underwent biliary stent with or without HIFU ablation in our center. Treatment-related complications, stent patency time, and survival time were compared between 2 groups.

Results:

During the enrolled time, a total of 51 patients with MOJ underwent biliary stent with HIFU ablation (n=24) or biliary stent only (n=27) in our center. There was no significant difference in baseline data between 2 groups. Relief of jaundice was achieved in all patients in both groups. Cholangitis was observed in 2 patients in stent with HIFU ablation group and 1 patient in stent only group (P=0.483). Reobstruction of stent was observed in 4 patients in stent with HIFU ablation group and 8 patients in stent only group (P=0.276). The mean stent patency time was 367±41 days in stent with HIFU ablation group and 257±35 days in stent only group (P=0.037). The mean overall survival was 238±31 days in stent with HIFU ablation group and 152±20 days in stent only group (P=0.014).

Conclusions:

Combined biliary stent insertion and HIFU ablation is a safe and easy method for patients with MOJ, and seems to extend stent patency time and survival when compared with biliary stent only.
Obliterative Versus Reconstructive Prolapse Repair for Women Older than 70: Is There an Optimal Approach?
Authors: Dessie Sybil G. , Shapiro Alex , Haviland Miriam J. , Hacker Michele R. , Elkadry Eman A.
Published: October 2016

Objectives

This study aimed to evaluate outcomes among women 70 years and older who underwent obliterative compared with reconstructive procedures for pelvic organ prolapse.

Methods

This was a retrospective cohort study of patients 70 years and older who underwent surgical prolapse repair at our institution from January 2004 through June 2010. Only patients with at least 4 weeks of follow-up were included. Patient characteristics and relevant pre, intra, and postoperative information were abstracted from medical records. Severity of postoperative complications was classified using the Dindo surgical classification system.

Results

We analyzed 143 (97.3%) patients. Fifty-four (37.8%) women underwent an obliterative procedure, whereas 89 (62.2%) underwent a reconstructive procedure. Twenty-eight (31.5%) women who had a reconstructive surgery met our criteria for recurrent prolapse compared with only 5 (9.3%) women in the obliterative group (P = 0.002).

The incidence of intraoperative complication was 4.9%, and the incidence of any postoperative complication was 62.9%. Similar proportions of women who underwent each type of procedure experienced a postoperative complication. However, the severity of the complications differed between the groups (P = 0.02). In particular, 16.9% of women who had a reconstructive procedure experienced a grade III complication according to the Dindo scale compared with 13.0% of women who had an obliterative procedure.

Conclusions

The majority of women 70 years and older do not have high-grade complications after pelvic organ prolapse repair, but women who undergo reconstructive procedures are more likely to experience high-grade complications and recurrent prolapse compared with women who undergo obliterative procedures.
Analysis of Physical Therapy Intervention Outcomes for Urinary Incontinence in Women Older Than 65 Years in Outpatient Clinical Settings
Authors: Neville Cynthia E. , Beneciuk Jason , Bishop Mark , Alappattu Meryl
Published: October 2016

Background:

Conservative interventions provided by physical therapists for the treatment of bladder control problems in adult females are strongly supported in the literature and in clinical practice guidelines. However, physical therapy (PT) intervention outcomes specifically for women older than 65 years with urinary incontinence (UI) in outpatient settings in the United States have not been extensively reported.

Objectives:

To provide preliminary PT intervention outcome data specific to female patients older than 65 years receiving outpatient PT for UI.

Design:

Preliminary retrospective analysis of a convenience sample of women 65 to 93 years of age.

Methods:

Women older than 65 years with UI who were referred to outpatient PT and answered “yes” to a UI screening question at intake completed 3 UI surveys (3 Incontinence Questions [3IQ], Incontinence Impact Questionnaire Short-Form [IIQ-7] and the International Consultation on Incontinence Modular Questionnaire—Urinary Incontinence [ICIQ-UI]). Patients received individualized treatment provided by a physical therapist. Physical therapists were asked to administer the surveys again during and/or after treatment. Demographic, clinical, and health-related quality of life data were collected. Frequency of UI types, UI symptoms, and impact of quality of life were analyzed. Paired samples t test was used to evaluate the change in measures between the initial survey and a follow-up survey.

Results:

Surveys were collected from 62 women. Significant changes in scores on 2 outcome measures (ICIQ-UI and IIQ-7) indicated significant reductions in UI symptom severity and improvements in UI-related health-related quality of life after undergoing individualized PT treatment of UI.

Limitations:

The study population was a convenience sample. Data on treatment interventions were not collected.

Conclusions:

Individualized interventions provided by physical therapists have the potential to significantly improve symptom severity and health-related quality of life in women older than 65 years with different types of UI.
Anatomy and Neural Control of the Lower Urinary Tract and Pelvic Floor
Authors: Livingston Beven Pace
Published: October 2016

Urinary incontinence is a condition with multifaceted etiology and a significant health issue especially for aging men and women. The purpose of this report is to review the anatomy of the lower urinary tract and pelvic floor, along with the current understanding of the neural control pathways, which act reciprocally at all levels of the nervous system to control the pelvic floor and urinary bladder to maintain urinary continence. Understanding all of these elements and how they affect pelvic floor function, urethral function, or urinary bladder function will assist rehabilitation professionals in addressing this potentially devastating health problem.
Clinical Commentary: Pelvic Organ Prolapse and Incontinence
Authors: Hulme Janet A.
Published: October 2016

Background and Purpose:

Pelvic organ prolapse (POP) and urinary incontinence (UI) are more prevalent with increasing life expectancy. Up to 75% of women age 45 to 85 years have some degree of prolapse. Typical symptoms related to POP include pelvic pressure, pelvic and low back pain, urinary and bowel symptoms, and sexual dysfunction. The purpose of this report is to describe the theoretical basis of a novel conservative intervention for the treatment of symptoms related to POP and incontinence in older women through the use of a case description.

Methods:

The conservative management program combines deep pelvic and hip muscle exercises with pelvic postural inversion. The case description exemplifies the treatment protocol that has the potential to reduce the severity or degree of prolapse and improve symptoms and quality of life in women with POP and associated UI.

Conclusion:

The basis for the novel conservative approach to treatment of POP and UI revolves around the perspective that POP is the functional failure of the pelvic organ support system and associated lumbopelvic hip musculoskeletal system. The combined organ and musculoskeletal system, the “pelvic core” system, includes all structures within the lower pelvis. As one organ's descent occurs, it leads to alterations in the position of adjacent organs, fascia, and muscles. Postural or positional inversion of the pelvis simultaneous with deep pelvic muscle and pelvic core exercises theoretically realigns the pelvic organs within the pelvic cavity and reduces strain on fascia and ligaments. Without the strain of the organs descending in the pelvis, the pelvic core muscles can theoretically work more efficiently for muscle strengthening and motor control retraining. Organ realignment and deep pelvic core muscle activation theoretically recreates the support system for optimal organ function and symptom-free daily activities.
Resolution of Calciphylaxis After Urgent Kidney Transplantation in 3 Patients With End-Stage Kidney Failure
Authors: Nordheim Espen , Dahle Dag Olav , Syse Ingrid Marie , Åsberg Anders , Reisæter Anna V. , Hartmann Anders
Published: October 2016

Background

Calcific uremic arteriolopathy (CUA), also referred to as calciphylaxis, is a rare and serious complication of kidney failure with limited treatment options. Kidney transplantation (KTX) restores kidney function and is hence a potential treatment option for CUA. We present 3 patients who had their CUA lesions successfully healed after urgent KTX.

Methods

Data were retrospectively retrieved from hospital records at our national transplant center.

Results

All 3 patients had previously been kidney transplanted and had experienced graft loss and were in stage 5 kidney failure when CUA developed. One patient was on warfarin treatment for pulmonary embolism. Skin lesions developed in the lower limbs in all 3 patients. Multidisciplinary care including intensified hemodialysis did not induce any clinically relevant improvement of the lesions. The recipients were enlisted on a clinically urgent waitlist for KTX and received a deceased donor kidney after 2 to 4 weeks. All recipients experienced good graft function. The lesions healed completely within 6 weeks in 2 patients. In the third patient, partial healing occurred after 2 months and complete healing was achieved 4 months after transplantation.

Conclusions

These cases indicate that urgent KTX may contribute to an efficient treatment for end-stage renal disease patients with CUA.
Inference of the drivers of collective movement in two cell types:Dictyosteliumand melanoma
Authors: Ferguson Elaine A. , Matthiopoulos Jason , Insall Robert H. , Husmeier Dirk
Published: October 2016

Collective cell movement is a key component of many important biological processes, including wound healing, the immune response and the spread of cancers. To understand and influence these movements, we need to be able to identify and quantify the contribution of their different underlying mechanisms. Here, we define a set of six candidate models—formulated as advection–diffusion–reaction partial differential equations—that incorporate a range of cell movement drivers. We fitted these models to movement assay data from two different cell types:Dictyostelium discoideumand human melanoma. Model comparison using widely applicable information criterion suggested that movement in both of our study systems was driven primarily by a self-generated gradient in the concentration of a depletable chemical in the cells' environment. For melanoma, there was also evidence that overcrowding influenced movement. These applications of model inference to determine the most likely drivers of cell movement indicate that such statistical techniques have potential to support targeted experimental work in increasing our understanding of collective cell movement in a range of systems.
Coordinated regulation of the ESCRT-III component CHMP4C by the chromosomal passenger complex and centralspindlin during cytokinesis
Authors: Capalbo Luisa , Mela Ioanna , Abad Maria Alba , Jeyaprakash A. Arockia , Edwardson J. Michael , D'Avino Pier Paolo
Published: October 2016

The chromosomal passenger complex (CPC)—composed of Aurora B kinase, Borealin, Survivin and INCENP—surveys the fidelity of genome segregation throughout cell division. The CPC has been proposed to prevent polyploidy by controlling the final separation (known as abscission) of the two daughter cells via regulation of the ESCRT-III CHMP4C component. The molecular details are, however, still unclear. Using atomic force microscopy, we show that CHMP4C binds to and remodels membranes
in vitro
. Borealin prevents the association of CHMP4C with membranes, whereas Aurora B interferes with CHMP4C's membrane remodelling activity. Moreover, we show that CHMP4C phosphorylation is not required for its assembly into spiral filaments at the abscission site and that two distinctly localized pools of phosphorylated CHMP4C exist during cytokinesis. We also characterized the CHMP4C interactome in telophase cells and show that the centralspindlin complex associates preferentially with unphosphorylated CHMP4C in cytokinesis. Our findings indicate that gradual dephosphorylation of CHMP4C triggers a ‘relay’ mechanism between the CPC and centralspindlin that regulates the timely distribution and activation of CHMP4C for the execution of abscission.
Expression of a hindlimb-determining factorPitx1in the forelimb of the lizardPogona vitticepsduring morphogenesis
Authors: Melville Jane , Hunjan Sumitha , McLean Felicity , Mantziou Georgia , Boysen Katja , Parry Laura J.
Published: October 2016

With over 9000 species, squamates, which include lizards and snakes, are the largest group of reptiles and second-largest order of vertebrates, spanning a vast array of appendicular skeletal morphology. As such, they provide a promising system for examining developmental and molecular processes underlying limb morphology. Using the central bearded dragon (Pogona vitticeps) as the primary study model, we examined limb morphometry throughout embryonic development and characterized the expression of three known developmental genes (GHR, Pitx1andShh) from early embryonic stage through to hatchling stage via reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry (IHC). In this study, all genes were found to be transcribed in both the forelimbs and hindlimbs ofP. vitticeps.While the highest level ofGHRexpression occurred at the hatchling stage,Pitx1andShhexpression was greatest earlier during embryogenesis, which coincides with the onset of the differentiation between forelimb and hindlimb length. We compared our finding ofPitx1expression—a hindlimb-determining gene—in the forelimbs ofP. vitticepsto that in a closely related Australian agamid lizard,Ctenophorus pictus, where we foundPitx1expression to be more highly expressed in the hindlimb compared with the forelimb during early and late morphogenesis—a result consistent with that found across other tetrapods. Expression ofPitx1in forelimbs has only rarely been documented, including viain situhybridization in a chicken and a frog. Our findings from both RT-qPCR and IHC indicate that further research across a wider range of tetrapods is needed to more fully understand evolutionary variation in molecular processes underlying limb morphology.
An affinity-directed protein missile system for targeted proteolysis
Authors: Fulcher Luke J. , Macartney Thomas , Bozatzi Polyxeni , Hornberger Annika , Rojas-Fernandez Alejandro , Sapkota Gopal P.
Published: October 2016

The von Hippel–Lindau (VHL) protein serves to recruit the hypoxia-inducible factor alpha (HIF1α) protein under normoxia to the CUL2 E3 ubiquitin ligase for its ubiquitylation and degradation through the proteasome. In this report, we modify VHL to engineer an affinity-directed protein missile (AdPROM) system to direct specific endogenous target proteins for proteolysis in mammalian cells. The proteolytic AdPROM construct harbours a cameloid anti-green fluorescence protein (aGFP) nanobody that is fused to VHL for either constitutive or tetracycline-inducible expression. For target proteins, we exploit CRISPR/Cas9 to rapidly generate human kidney HEK293 and U2OS osteosarcoma homozygous knock-in cells harbouring GFP tags at the VPS34 (vacuolar protein sorting 34) and protein associated with SMAD1 (PAWS1, aka FAM83G) loci, respectively. Using these cells, we demonstrate that the expression of the VHL-aGFP AdPROM system results in near-complete degradation of the endogenous GFP-VPS34 and PAWS1-GFP proteins through the proteasome. Additionally, we show that Tet-inducible destruction of GFP-VPS34 results in the degradation of its associated partner, UVRAG, and reduction in levels of cellular phosphatidylinositol 3-phosphate.
Electrical output of bryophyte microbial fuel cell systems is sufficient to power a radio or an environmental sensor
Authors: Bombelli Paolo , Dennis Ross J. , Felder Fabienne , Cooper Matt B. , Madras Rajaraman Iyer Durgaprasad , Royles Jessica , Harrison Susan T. L. , Smith Alison G. , Harrison C. Jill , Howe Christopher J.
Published: October 2016

Plant microbial fuel cells are a recently developed technology that exploits photosynthesis in vascular plants by harnessing solar energy and generating electrical power. In this study, the model moss species
Physcomitrella patens
, and other environmental samples of mosses, have been used to develop a non-vascular bryophyte microbial fuel cell (bryoMFC). A novel three-dimensional anodic matrix was successfully created and characterized and was further tested in a bryoMFC to determine the capacity of mosses to generate electrical power. The importance of anodophilic microorganisms in the bryoMFC was also determined. It was found that the non-sterile bryoMFCs operated with
P. patens
delivered over an order of magnitude higher peak power output (2.6 ± 0.6 µW m
−2
) than bryoMFCs kept in near-sterile conditions (0.2 ± 0.1 µW m
−2
). These results confirm the importance of the microbial populations for delivering electrons to the anode in a bryoMFC. When the bryoMFCs were operated with environmental samples of moss (non-sterile) the peak power output reached 6.7 ± 0.6 mW m
−2
. The bryoMFCs operated with environmental samples of moss were able to power a commercial radio receiver or an environmental sensor (LCD desktop weather station).
Forest defoliator pests alter carbon and nitrogen cycles
Authors: l-M-Arnold Anne , Grüning Maren , Simon Judy , Reinhardt Annett-Barbara , Lamersdorf Norbert , Thies Carsten
Published: October 2016

Climate change may foster pest epidemics in forests, and thereby the fluxes of elements that are indicators of ecosystem functioning. We examined compounds of carbon (C) and nitrogen (N) in insect faeces, leaf litter, throughfall and analysed the soils of deciduous oak forests (
Quercus petraea
 L.) that were heavily infested by the leaf herbivores winter moth (
Operophtera brumata
 L.) and mottled umber (
Erannis defoliaria
 L.). In infested forests, total net canopy-to-soil fluxes of C and N deriving from insect faeces, leaf litter and throughfall were 30- and 18-fold higher compared with uninfested oak forests, with 4333 kg C ha
−1
and 319 kg N ha
−1
, respectively, during a pest outbreak over 3 years. In infested forests, C and N levels in soil solutions were enhanced and C/N ratios in humus layers were reduced indicating an extended canopy-to-soil element pathway compared with the non-infested forests. In a microcosm incubation experiment, soil treatments with insect faeces showed 16-fold higher fluxes of carbon dioxide and 10-fold higher fluxes of dissolved organic carbon compared with soil treatments without added insect faeces (control). Thus, the deposition of high rates of nitrogen and rapidly decomposable carbon compounds in the course of forest pest epidemics appears to stimulate soil microbial activity (i.e. heterotrophic respiration), and therefore, may represent an important mechanism by which climate change can initiate a carbon cycle feedback.
Rogue waves in multiphase solutions of the focusing nonlinear Schrödinger equation
Authors: Bertola Marco , El Gennady A. , Tovbis Alexander
Published: October 2016

Rogue waves appearing on deep water or in optical fibres are often modelled by certain breather solutions of the focusing nonlinear Schrödinger (fNLS) equation which are referred to as solitons on finite background (SFBs). A more general modelling of rogue waves can be achieved via the consideration of multiphase, or finite-band, fNLS solutions of whom the standard SFBs and the structures forming due to their collisions represent particular, degenerate, cases. A generalized rogue wave notion then naturally enters as a large-amplitude localized coherent structure occurring within a finite-band fNLS solution. In this paper, we use the winding of real tori to show the mechanism of the appearance of such generalized rogue waves and derive an analytical criterion distinguishing finite-band potentials of the fNLS equation that exhibit generalized rogue waves.
Symmetry and reduction in collectives: low-dimensional cyclic pursuit
Authors: Galloway Kevin S. , Justh Eric W. , Krishnaprasad P. S.
Published: October 2016

We investigate low-dimensional examples of cyclic pursuit in a collective, wherein each agent employs a constant bearing (CB) steering law relative to exactly one other agent. For the case of three agents in the plane, we characterize relative equilibria and pure shape equilibria of associated closed-loop dynamics. Re-scaling time yields a reduction of phase space to two dimensions and effective tools for stability analysis. Study of bifurcation of a family of collinear equilibria dependent on a single CB control parameter reveals the presence of a rich collection of trajectories that are periodic in shape and undergo precession in physical space. For collectives in three dimensions, with an appropriate notion of CB pursuit strategy and corresponding steering law, the two-agent case proves to be explicitly integrable. These results suggest control schemes for small teams of mobile robotic agents engaged in area coverage tasks such as search and rescue, and raise interesting possibilities for behaviour in biological contexts.
Water adsorption on bimetallic PtRu/Pt(111) surface alloys
Authors: Fischer Julia M. , Mahlberg David , Roman Tanglaw , Groß Axel
Published: October 2016

The adsorption of water on bimetallic PtRu/Pt(111) surface alloys has been studied based on periodic density functional theory calculations including dispersion corrections. The Ru atoms of the PtRu surface alloy interact more strongly with water than Pt atoms, as far as both single water molecules and ice-like hexagonal structures are concerned. Within the surface alloy layer, the lateral ligand effect reducing the local reactivity of the surface atoms with increasing Ru content is more dominant than the opposing geometric effect due to the tensile strain. The structural preference for the Ru atoms also prevails at room temperature, as
ab initio
molecular dynamics simulations show.
Identifying cryptic diversity with predictive phylogeography
Authors: Espíndola Anahí , Ruffley Megan , Smith Megan L. , Carstens Bryan C. , Tank David C. , Sullivan Jack
Published: October 2016

Identifying units of biological diversity is a major goal of organismal biology. An increasing literature has focused on the importance of cryptic diversity, defined as the presence of deeply diverged lineages within a single species. While most discoveries of cryptic lineages proceed on a taxon-by-taxon basis, rapid assessments of biodiversity are needed to inform conservation policy and decision-making. Here, we introduce a predictive framework for phylogeography that allows rapidly identifying cryptic diversity. Our approach proceeds by collecting environmental, taxonomic and genetic data from codistributed taxa with known phylogeographic histories. We define these taxa as a reference set, and categorize them as either harbouring or lacking cryptic diversity. We then build a random forest classifier that allows us to predict which other taxa endemic to the same biome are likely to contain cryptic diversity. We apply this framework to data from two sets of disjunct ecosystems known to harbour taxa with cryptic diversity: the mesic temperate forests of the Pacific Northwest of North America and the arid lands of Southwestern North America. The predictive approach presented here is accurate, with prediction accuracies placed between 65% and 98.79% depending of the ecosystem. This seems to indicate that our method can be successfully used to address ecosystem-level questions about cryptic diversity. Further, our application for the prediction of the cryptic/non-cryptic nature of unknown species is easily applicable and provides results that agree with recent discoveries from those systems. Our results demonstrate that the transition of phylogeography from a descriptive to a predictive discipline is possible and effective.
Social costs enforce honesty of a dynamic signal of motivation
Authors: Ligon Russell A. , McGraw Kevin J.
Published: October 2016

Understanding the processes that promote signal reliability may provide important insights into the evolution of diverse signalling strategies among species. The signals that animals use to communicate must comprise mechanisms that prohibit or punish dishonesty, and social costs of dishonesty have been demonstrated for several fixed morphological signals (e.g. colour badges of birds and wasps). The costs maintaining the honesty of dynamic signals, which are more flexible and potentially cheatable, are unknown. Using an experimental manipulation of the dynamic visual signals used by male veiled chameleons (Chamaeleo calyptratus) during aggressive interactions, we tested the idea that the honesty of rapid colour change signals is maintained by social costs. Our results reveal that social costs are an important mechanism maintaining the honesty of these dynamic colour signals—‘dishonest’ chameleons whose experimentally manipulated coloration was incongruent with their contest behaviour received more physical aggression than ‘honest’ individuals. This is the first demonstration, to the best our knowledge, that the honesty of a dynamic signal of motivation—physiological colour change—can be maintained by the social costliness of dishonesty. Behavioural responses of signal receivers, irrespective of any specific detection mechanisms, therefore prevent chameleon cheaters from prospering.