Non-specific mechanisms in orthodox and CAM management of low back pain (MOCAM): theoretical framework and protocol for a prospective cohort study

Introduction

Components other than the active ingredients of treatment can have substantial effects on pain and disability. Such 'non-specific' components include: the therapeutic relationship, the healthcare environment, incidental treatment characteristics, patients' beliefs and practitioners' beliefs. This study aims to: identify the most powerful non-specific treatment components for low back pain (LBP), compare their effects on patient outcomes across orthodox (physiotherapy) and complementary (osteopathy, acupuncture) therapies, test which theoretically derived mechanistic pathways explain the effects of non-specific components and identify similarities and differences between the therapies on patient–practitioner interactions.

Methods and analysis

This research comprises a prospective questionnaire-based cohort study with a nested mixed-methods study. A minimum of 144 practitioners will be recruited from public and private sector settings (48 physiotherapists, 48 osteopaths and 48 acupuncturists). Practitioners are asked to recruit 10–30 patients each, by handing out invitation packs to adult patients presenting with a new episode of LBP. The planned multilevel analysis requires a final sample size of 690 patients to detect correlations between predictors, hypothesised mediators and the primary outcome (self-reported back-related disability on the Roland-Morris Disability Questionnaire). Practitioners and patients complete questionnaires measuring non-specific treatment components, mediators and outcomes at: baseline (time 1: after the first consultation for a new episode of LBP), during treatment (time 2: 2 weeks post-baseline) and short-term outcome (time 3: 3 months post-baseline). A randomly selected subsample of participants in the questionnaire study will be invited to take part in a nested mixed-methods study of patient–practitioner interactions. In the nested study, 63 consultations (21/therapy) will be audio-recorded and analysed quantitatively and qualitatively, to identify communication practices associated with patient outcomes.

Ethics and dissemination

The protocol is approved by the host institution's ethics committee and the NHS Health Research Authority Research Ethics Committee. Results will be disseminated via peer-reviewed journal articles, conferences and a stakeholder workshop.

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The role of financial hardship, mastery and social support in the association between employment status and depression: results from an Australian longitudinal cohort study

Objective

There is robust epidemiological and clinical evidence of the harmful effects of unemployment on psychological well-being, but the mechanisms through which this occurs is still strongly debated. In addition, there is even less evidence on the impact of underemployment on mental health. Using longitudinal data collected from a cohort of 20–24 years old, the present study examines a range of employed states and investigates the role of mastery, financial hardship and social support in the relationship between labour status and depression.

Method

Responses were from the Personality and Total Health (PATH) Through Life Project: A representative, community-based survey conducted in Canberra and Queanbeyan (NSW) in Australia, where respondents (n=2404) in their early twenties were followed for 8 years. Depression was measured using the self-report Goldberg Depression Scale, with the likely presence of depression being indicated by scores 7 or greater.

Results

The analyses identified unemployment and underemployment as significant predictors of depression, compared to their employed counterparts. Both unemployment and underemployment remained significantly correlated with depression even after accounting for sociodemographic, economic and psychological variables. Social support, financial hardship and a sense of personal control (mastery) all emerged as important mediators between unemployment and depression.

Conclusions

Both unemployment and underemployment were associated with increased risk of depression. The strength of this relationship was attenuated but remained significant after accounting for key variables (mastery, financial hardship and social support), and extensive sociodemographic and health covariates, indicating that no or inade­quate employment contributes to poorer mental health over and above these factors.

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Catalysts, Vol. 6, Pages 80: Co-Assembled Supported Catalysts: Synthesis of Nano-Structured Supported Catalysts with Hierarchic Pores through Combined Flow and Radiation Induced Co-Assembled Nano-Reactors

A novel generic method of silica supported catalyst system generation from a fluid state is presented. The technique is based on the combined flow and radiation (such as microwave, thermal or UV) induced co-assembly of the support and catalyst precursors forming nano-reactors, followed by catalyst precursor decomposition. The transformation from the precursor to supported catalyst oxide state can be controlled from a few seconds to several minutes. The resulting nano-structured micro-porous silica supported catalyst system has a surface area approaching 300 m2/g and X-ray Diffraction (XRD)-based catalyst size controlled in the range of 1–10 nm in which the catalyst structure appears as lamellar sheets sandwiched between the catalyst support. These catalyst characteristics are dependent primarily on the processing history as well as the catalyst (Fe, Co and Ni studied) when the catalyst/support molar ratio is typically 0.1–2. In addition, Ca, Mn and Cu were used as co-catalysts with Fe and Co in the evaluation of the mechanism of catalyst generation. Based on extensive XRD, Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) studies, the micro- and nano-structure of the catalyst system were evaluated. It was found that the catalyst and silica support form extensive 0.6–2 nm thick lamellar sheets of 10–100 nm planar dimensions. In these lamellae, the alternate silica support and catalyst layer appear in the form of a bar-code structure. When these lamellae structures pack, they form the walls of a micro-porous catalyst system which typically has a density of 0.2 g/cm3. A tentative mechanism of catalyst nano-structure formation is provided based on the rheology and fluid mechanics of the catalyst/support precursor fluid as well as co-assembly nano-reactor formation during processing. In order to achieve these structures and characteristics, catalyst support must be in the form of silane coated silica nano-particles dispersed in water which also contains the catalyst precursor nitrate salt. This support-catalyst precursor fluid must have a sufficiently low viscosity but high elastic modulus (high extensional viscosity) to form films and bubbles when exposed to processing energy sources such as microwave, thermal, ultra-sound or UV-radiation or their combination. The micro-to-nano structures of the catalyst system are essentially formed at an early stage of energy input. It is shown that the primary particles of silica are transformed to a proto-silica particle state and form lamellar structures with the catalyst precursor. While the nano-structure is forming, water is evaporated leaving a highly porous solid support-catalyst precursor which then undergoes decomposition to form a silica-catalyst oxide system. The final catalyst system is obtained after catalyst oxide reduction. Although the XRD-based catalyst size changes slightly during the subsequent heat treatments, the nano-structure of the catalyst system remains substantially unaltered as evaluated through TEM images. However, if the catalyst preparation is carried out without film formation, the XRD-based catalyst size increases substantially by a factor of 2–8, with no significant alteration in surface area.

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Symmetry, Vol. 8, Pages 38: On Solutions for Linear and Nonlinear Schrödinger Equations with Variable Coefficients: A Computational Approach

In this work, after reviewing two different ways to solve Riccati systems, we are able to present an extensive list of families of integrable nonlinear Schrödinger (NLS) equations with variable coefficients. Using Riccati equations and similarity transformations, we are able to reduce them to the standard NLS models. Consequently, we can construct bright-, dark- and Peregrine-type soliton solutions for NLS with variable coefficients. As an important application of solutions for the Riccati equation with parameters, by means of computer algebra systems, it is shown that the parameters change the dynamics of the solutions. Finally, we test numerical approximations for the inhomogeneous paraxial wave equation by the Crank-Nicolson scheme with analytical solutions found using Riccati systems. These solutions include oscillating laser beams and Laguerre and Gaussian beams.

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Left ventricular hypertrophy: A rare cardiac involvement of Becker muscular dystrophy

Publication date: Available online 26 May 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Yu Kang, Yu-Cheng Chen, Qing Zhang




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Selective Detection of RGD-Integrin Binding in Cancer Cells Using Tip Enhanced Raman Scattering Microscopy

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b01344

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Enzyme-Immobilized 3D-Printed Reactors for Online Monitoring of Rat Brain Extracellular Glucose and Lactate

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b00272

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Exosomal miRNA Analysis in Non-small Cell Lung Cancer (NSCLC) Patients' Plasma Through qPCR: A Feasible Liquid Biopsy Tool

This protocol describes the feasibility to perform miRNA profiling in exosomes, released in plasma of NSCLC patients, through a commercial exosome isolation kit with Proteinase K and RNAse treatments, in order to avoid circulating miRNAs contamination and evaluate their biomarker features in NSCLC.

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Alkyne-Modulated Surface-Enhanced Raman Scattering-Palette for Optical Interference-Free and Multiplex Cellular Imaging

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b01374

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Electrochemical Quantifying, Counting, and Sizing Supported Pt Nanoparticles in Real Time

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b00966

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Droit des alternothérapies – Guide juridique pour le praticien et le patient, F. Dessi, A. Leca. LEH (2016)

Publication date: Available online 27 May 2016
Source:Médecine & Droit
Author(s): Guillaume Rousset




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Sauvons notre système de santé et d’assurance maladie – Un enjeu de société, P.H. Bréchat. Presses de l’EHESP (2016)

Publication date: Available online 27 May 2016
Source:Médecine & Droit
Author(s): Guillaume Rousset




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Electrophysiological correlates of face-evoked person knowledge

Publication date: Available online 27 May 2016
Source:Biological Psychology
Author(s): JohnMark Taylor, Zarrar Shehzad, Gregory McCarthy
Face recognition includes identifying a face as perceptually familiar and recollecting biographical information, or person-knowledge, associated with the face. The majority of studies examining the neural basis of face recognition have confounded these stages by comparing brain responses evoked by novel and perceptually familiar famous faces. Here, we recorded EEG in two tasks in which subjects viewed two sets of faces that were equally perceptually familiar, but which had differing levels of associated person-knowledge. Our results dissociated the effects of person-knowledge from perceptual familiarity. Faces with associated biographical information elicited a larger ∼600ms centroparietal positivity in both a passive viewing task in which subjects viewed faces without explicitly responding, and an active question-answering task in which subjects indicated whether or not they knew particular facts about the faces. In the question task only, person-knowledge was associated with a negative ERP difference over right posterior scalp over the 170–450ms interval which appeared again at long latency (>900ms).



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Methods to Discover Alternative Promoter Usage and Transcriptional Regulation of Murine Bcrp1

With the murine ABC transporter Bcrp1 (Abcg2) as an example, in-silico protocols are presented to detect alternative promoter usage in genes expressed in mouse tissues, and to evaluate the functionality of the alternative promoters identified using reporter assays.

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Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model

We present a diffuse optical spectroscopic (DOS) approach that provides quantitative optical biomarkers of skin response to radiation. We describe DOS instrumentation design, optical parameters extraction algorithms and the animal handling procedures required to yield representative data from a pre-clinical mouse model of radiation induced erythema.

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Rhinovirus species and clinical characteristics in the first wheezing episode in children

Abstract

The clinical data on the first wheezing episodes induced by different rhinovirus (RV) species are still limited. We aimed to investigate the prevalence of RV genotypes, sensitization status and clinical characteristics of patients having a respiratory infection caused by either different RV species or other respiratory viruses.

The study enrolled 111 patients (aged 3-23 months, 79% hospitalized, 76% with RV infection) with the first wheezing episode. RV-specific sequences were identified by partial sequencing of VP4/VP2 and 5' non-coding regions with 80% success rate. The investigated clinical and laboratory variables included atopic characteristics and illness severity, parental atopic illnesses, and parental smoking.

Of the study children, 56% percent had >1 atopic characteristic (atopy, eczema and/or blood eosinophil count >0.4 × 10⁹/L) and 23% were sensitised to allergens. RV-C was detected in 58% of RV positive samples, followed by RV-A (20%) and RV-B (1.2%). Children with RV-A and RV-C induced wheezing were older (p = 0.014) and had more atopic characteristics (p = 0.001) than those with non-RV. RV-A and RV-C illnesses had shorter duration of preadmission symptoms and required more bronchodilator use at the ward than non-RV illnesses (both p < 0.05, respectively)

RV-C is the most common cause of severe early wheezing. Atopic and illness severity features are associated with children having RV-A or RV-C induced first wheezing episode rather than with children having a non-RV induced wheezing. This article is protected by copyright. All rights reserved

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miR-29a associates with viro-immunological markers of HIV infection in treatment experienced patients

ABSTRACT

MicroRNAs (miRNAs) are small, non-coding RNA species essential for the post-translational regulation of gene expression. Several miRNA have been proposed to contribute to Human immunodeficiency virus-1 (HIV-1) infection establishment, progression and latency. Among them, miR-29a seems to be of particular interest. The aim of this study was to investigate the association between miR-29a expression and immunologic and virologic markers of HIV infection progression in long-term antiretroviral-treated individuals. In a homogenous group of 165 young adults, with chronic HIV infection, parenterally acquired during childhood, the expression level of miR-29a was found to be inversely correlated with HIV viral load and the degree of immunosuppression, expressed by both CD4 cell count and the CD4/CD8 ratio. There was a significant difference in miR-29a expression according to the patient's response to treatment, with the lowest levels expressed by patients with treatment failure, defined as detectable viremia and CD4 <350 cells/mm³. No significant correlation was found between miRNA level and the nadir CD4 count or zenith HIV viral load.

This study establishes the association between miR-29a expression and markers of HIV infection in long term survivors, treatment-experienced patients, suggesting its potential use as an indicator for the on-treatment disease evolution. This article is protected by copyright. All rights reserved

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Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy

Publication date: June 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 6
Author(s): Birgit Prodinger, Alarcos Cieza, Cornelia Oberhauser, Jerome Bickenbach, Tevfik Bedirhan Üstün, Somnath Chatterji, Gerold Stucki
ObjectiveTo develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Rehabilitation Set and to identify a minimal set of environmental factors (EFs) to be used alongside the ICF Rehabilitation Set when describing disability across individuals and populations with various health conditions.DesignSecondary analysis of existing data sets using regression methods (Random Forests and Group Lasso regression) and expert consultations.SettingAlong the continuum of care, including acute, early postacute, and long-term and community rehabilitation settings.ParticipantsPersons (N=9863) with various health conditions participated in primary studies. The number of respondents for whom the dependent variable data were available and used in this analysis was 9264.InterventionsNot applicable.Main Outcome MeasuresFor regression analyses, self-reported general health was used as a dependent variable. The ICF categories from the functioning component and the EF component were used as independent variables for the development of the ICF Rehabilitation Set and the minimal set of EFs, respectively.ResultsThirty ICF categories to be complemented with 12 EFs were identified as relevant to the identified ICF sets. The ICF Rehabilitation Set constitutes of 9 ICF categories from the component body functions and 21 from the component activities and participation. The minimal set of EFs contains 12 categories spanning all chapters of the EF component of the ICF.ConclusionsThe identified sets proposed serve as minimal generic sets of aspects of functioning in clinical populations for reporting data within and across heath conditions, time, clinical settings including rehabilitation, and countries. These sets present a reference framework for harmonizing existing information on disability across general and clinical populations.



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Carnosic acid attenuates unilateral ureteral obstruction-induced kidney fibrosis via inhibition of Akt-mediated Nox4 expression

Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Kyong-Jin Jung, Kyoung-jin Min, Jeen-Woo Park, Kwon Moo Park, Taeg Kyu Kwon
Fibrosis represents a common pathway to end-stage renal disease. Transforming growth factor-β (TGF-β) plays a critical role in the progression of kidney fibrosis. In the present study, we explored the effect of carnosic acid (CA) against TGF-β-induced fibroblast activation in vitro and unilateral ureteral obstruction (UUO)-induced kidney fibrosis in vivo. CA attenuated TGF-β-induced up-regulation of profibrogenic proteins, α-smooth muscle actin (α-SMA), collagen I (COLI), fibronectin (FN), and plasminogen activator inhibitor-1 (PAI-1) in kidney fibroblast cells (NRK-49F). CA inhibited TGF-β-induced hydrogen peroxide generation via inhibition of NADPH oxidase 4 (Nox4) expressions. In mice, CA-administration markedly mitigated the UUO-induced interstitial extension, collagen deposition, superoxide anion formation, hydrogen peroxide production, and lipid peroxidation. In addition, CA significantly attenuated the expression of α-SMA, COLI, FN, PAI-1, and Nox4 in UUO-induced kidneys. These results indicated that CA attenuated oxidative stress via inhibition of Nox4 expression in TGF-β-stimulated fibroblasts and UUO operated-kidneys, suggesting that CA may be useful for the treatment of fibrosis-related diseases.



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Impaired Nrf2 regulation of mitochondrial biogenesis in rostral ventrolateral medulla on hypertension induced by systemic inflammation

Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Kay L.H. Wu, Chih-Wei Wu, Yung-Mei Chao, Chun-Ying Hung, Julie Y.H. Chan
Oxidative stress in rostral ventrolateral medulla (RVLM), where sympathetic premotor neurons reside, is involved in the development of hypertension under systemic inflammation. Mitochondrial dysfunction contributes to tissue oxidative stress. In this study, we sought to investigate whether hypertension developed under systemic inflammation is attributable to impaired mitochondrial biogenesis in RVLM. In normotensive Sprague-Dawley rats, intraperitoneal infusion of a low dose Escherichia coli lipopolysaccharide (LPS) for 7 days promoted a pressor response, alongside a decrease in mitochondrial DNA (mtDNA) copy number, reductions in protein expression of nuclear DNA-encoded transcription factors for mitochondrial biogenesis, including mitochondrial transcription factor A (TFAM) and nuclear factor erythroid-derived 2-like 2 (Nrf2), and suppression of nuclear translocation of the phosphorylated Nrf2 (p-Nrf2) in RVLM neurons; all of which were abrogated by treatment with intracisternal infusion of an interleukin-1β (IL-1β) blocker, IL-1Ra, or a mobile mitochondrial electron carrier, coenzyme Q10 (CoQ10). Microinjection into RVLM of IL-1β suppressed the expressions of p-Nrf2 and TFAM, and evoked a pressor response; conversely, the Nrf2 inducer, tert-butylhydroquinone, lessened the LPS-induced suppression of TFAM expression and pressor response. At cellular level, exposure of neuronal N2a cells to IL-1β decreased mtDNA copy number, increased protein interaction of Nrf2 to its negative regulator, kelch-like ECH-associated protein 1 (Keap1), and reduced DNA binding activity of p-Nrf2 to Tfam gene. Together these results indicate that defect mitochondrial biogenesis in RVLM neurons entailing redox-sensitive and IL-1β-dependent suppression of TFAM because of the increase in the formation of Keap1/Nrf2 complex, reductions in nuclear translocation of the activated Nrf2 and its binding to the Tfam gene promoter may underlie hypertension developed under the LPS-induced systemic inflammation.



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Reversible oxidation controls the activity and oligomeric state of the mammalian phosphoglycolate phosphatase AUM

Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Annegrit Seifried, Alexandre Bergeron, Benoit Boivin, Antje Gohla
Redox-dependent switches of enzyme activity are emerging as important fine-tuning mechanisms in cell signaling. For example, protein tyrosine phosphatases employ a conserved cysteine residue for catalysis, which also renders them highly susceptible to reversible inactivation by oxidation. In contrast, haloacid dehalogenase (HAD)-type phosphatases perform catalysis via a phosphoaspartyltransferase reaction. The potential regulation of HAD phosphatases by reversible oxidation has not yet been explored. Here, we investigate the redox-sensitivity of the HAD-type phosphoglycolate phosphatase PGP, also known as AUM or glycerol-3-phosphate phosphatase. We show that recombinant, purified murine PGP is inhibited by oxidation and re-activated by reduction. We identify three reactive cysteine residues in the catalytic core domain of PGP (Cys35, Cys104 and Cys243) that mediate the reversible inhibition of PGP activity and the associated, redox-dependent conformational changes. Structural analysis suggests that Cys35 oxidation weakens van-der-Waals interactions with Thr67, a conserved catalytic residue required for substrate coordination. Cys104 and Cys243 form a redox-dependent disulfide bridge between the PGP catalytic core and cap domains, which may impair the open/close-dynamics of the catalytic cycle. In addition, we demonstrate that Cys297 in the PGP cap domain is essential for redox-dependent PGP oligomerization, and that PGP oxidation/oligomerization occurs in response to stimulation of cells with EGF. Finally, employing a modified cysteinyl-labeling assay, we show that cysteines of cellular PGP are transiently oxidized to sulfenic acids. Taken together, our findings establish that PGP, an aspartate-dependent HAD phosphatase, is transiently inactivated by reversible oxidation in cells.

Graphical abstract

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Simultaneous quantitation of oxidized and reduced glutathione via LC-MS/MS: An insight into the redox state of hematopoietic stem cells

Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Dustin Carroll, Diana Howard, Haining Zhu, Christian M. Paumi, Mary Vore, Subbarao Bondada, Ying Liang, Chi Wang, Daret K. St. Clair
Cellular redox balance plays a significant role in the regulation of hematopoietic stem-progenitor cell (HSC/MPP) self-renewal and differentiation. Unregulated changes in cellular redox homeostasis are associated with the onset of most hematological disorders. However, accurate measurement of the redox state in stem cells is difficult because of the scarcity of HSC/MPPs. Glutathione (GSH) constitutes the most abundant pool of cellular antioxidants. Thus, GSH metabolism may play a critical role in hematological disease onset and progression. A major limitation to studying GSH metabolism in HSC/MPPs has been the inability to measure quantitatively GSH concentrations in small numbers of HSC/MPPs. Current methods used to measure GSH levels not only rely on large numbers of cells, but also rely on the chemical/structural modification or enzymatic recycling of GSH and therefore are likely to measure only total glutathione content accurately. Here, we describe the validation of a sensitive method used for the direct and simultaneous quantitation of both oxidized and reduced GSH via liquid chromatography followed by tandem mass spectrometry (LC-MS/MS) in HSC/MPPs isolated from bone marrow. The lower limit of quantitation (LLOQ) was determined to be 5.0ng/mL for GSH and 1.0ng/mL for GSSG with lower limits of detection at 0.5ng/mL for both glutathione species. Standard addition analysis utilizing mouse bone marrow shows that this method is both sensitive and accurate with reproducible analyte recovery. This method combines a simple extraction with a platform for the high-throughput analysis, allows for efficient determination of GSH/GSSG concentrations within the HSC/MPP populations in mouse, chemotherapeutic treatment conditions within cell culture, and human normal/leukemia patient samples. The data implicate the importance of the modulation of GSH/GSSG redox couple in stem cells related diseases.



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Correction for Colman et al., Genome-Wide Analysis of Host mRNA Translation during Hepatitis C Virus Infection [Author Corrections]

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Articles of Significant Interest Selected from This Issue by the Editors [Spotlight]

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Novel Structure and Unexpected RNA-Binding Ability of the C-Terminal Domain of Herpes Simplex Virus 1 Tegument Protein UL21 [Structure and Assembly]

Proteins forming the tegument layers of herpesviral virions mediate many essential processes in the viral replication cycle, yet few have been characterized in detail. UL21 is one such multifunctional tegument protein and is conserved among alphaherpesviruses. While UL21 has been implicated in many processes in viral replication, ranging from nuclear egress to virion morphogenesis to cell-cell spread, its precise roles remain unclear. Here we report the 2.7-Å crystal structure of the C-terminal domain of herpes simplex virus 1 (HSV-1) UL21 (UL21C), which has a unique α-helical fold resembling a dragonfly. Analysis of evolutionary conservation patterns and surface electrostatics pinpointed four regions of potential functional importance on the surface of UL21C to be pursued by mutagenesis. In combination with the previously determined structure of the N-terminal domain of UL21, the structure of UL21C provides a 3-dimensional framework for targeted exploration of the multiple roles of UL21 in the replication and pathogenesis of alphaherpesviruses. Additionally, we describe an unanticipated ability of UL21 to bind RNA, which may hint at a yet unexplored function.

IMPORTANCE Due to the limited genomic coding capacity of viruses, viral proteins are often multifunctional, which makes them attractive antiviral targets. Such multifunctionality, however, complicates their study, which often involves constructing and characterizing null mutant viruses. Systematic exploration of these multifunctional proteins requires detailed road maps in the form of 3-dimensional structures. In this work, we determined the crystal structure of the C-terminal domain of UL21, a multifunctional tegument protein that is conserved among alphaherpesviruses. Structural analysis pinpointed surface areas of potential functional importance that provide a starting point for mutagenesis. In addition, the unexpected RNA-binding ability of UL21 may expand its functional repertoire. The structure of UL21C and the observation of its RNA-binding ability are the latest additions to the navigational chart that can guide the exploration of the multiple functions of UL21.

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Coinfections: Another Variable in the Herpesvirus Latency-Reactivation Dynamic [Gems]

Chronic viruses, such as herpesviruses, shape host physiology. These viruses modulate the inflammatory state of the immune system and have evolved to harness inflammation as a mechanism to regulate viral latency and reactivation. In this review, I examine some of the recent work demonstrating the important role of inflammation in the regulation of the herpesvirus life cycle and discuss recent work that implicates coinfection in the regulation of herpesvirus latency.

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Evaluation of Sexual Dysfunction in Men With Spinal Cord Injury Using the Male Sexual Quotient

Publication date: June 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 6
Author(s): Eduardo P. Miranda, Cristiano Mendes Gomes, José de Bessa, Carmita Helena Najjar Abdo, Carlos Henrique Suzuki Bellucci, Jose Everton de Castro Filho, Fabrício Leite de Carvalho, Daniel Rubio de Souza, Linamara Rizzo Battistella, Márcia Scazufca, Homero Bruschini, Tarcisio Barros Filho, Miguel Srougi
ObjectiveTo assess different aspects of sexual function in men with spinal cord injury (SCI) using the Male Sexual Quotient (MSQ), a newly developed tool to assess sexual function and satisfaction.DesignCross-sectional study.SettingTertiary rehabilitation center.ParticipantsPatients (N=295) older than 18 years (mean age ± SD, 40.7±14.5y) with SCI for more than 1 year (median time since SCI, 3.6y; range, 1.6–7.0y) were assessed from February to August 2012. Patients completed the MSQ questionnaire and the Sexual Health Inventory for Men (SHIM).InterventionsNot applicable.Main Outcome MeasuresPerformance in various domains of sexual function was evaluated using the MSQ and SHIM questionnaires.ResultsErectile function, ejaculation, and orgasm were the most severely affected domains. The median MSQ score was 40 (range, 8–66), and the median SHIM score was 5 (range, 0–16). The diagnostic properties of the 2 instruments were similar in the discrimination of sexually active subjects. The area under the receiver operating characteristic curve was .950 (95% confidence interval [CI], .923–.979) for the MSQ and .942 (95% CI, .915–.968) for the SHIM. There was a strong correlation between the 2 instruments (r=.826; 95% CI, .802–.878).ConclusionsDifferent domains of sexual function are severely impaired in men with SCI, although their sexual interest remains high. The MSQ and SHIM scores strongly correlate, but the MSQ provides a more comprehensive assessment of sexual dysfunction in male patients with SCI.



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Structural considerations on the selectivity of an immunoassay for sulfamethoxazole

Publication date: 1 September 2016
Source:Talanta, Volume 158
Author(s): Holger Hoffmann, Stefanie Baldofski, Kristin Hoffmann, Sabine Flemig, Carla Patrícia Silva, Valdemar I. Esteves, Franziska Emmerling, Ulrich Panne, Rudolf J. Schneider
Sulfamethoxazole (SMX), a sulfonamide, is a widely used bacteriostatic antibiotic and therefore a promising marker for the entry of anthropogenic pollution in the environment. SMX is frequently found in wastewater and surface water. This study presents the production of high affinity and selective polyclonal antibodies for SMX and the development and evaluation of a direct competitive enzyme-linked immunosorbent assay (ELISA) for the quantification of SMX in environmental water samples. The crystal structures of the cross-reacting compounds sulfamethizole, N⁴-acetyl-SMX and succinimidyl-SMX were determined by x-ray diffraction aiming to explain their high cross-reactivity. These crystal structures are described for the first time. The quantification range of the ELISA is 0.82–63µg/L. To verify our results, the SMX concentration in 20 environmental samples, including wastewater and surface water, was determined by ELISA and tandem mass spectrometry (MS/MS). A good agreement of the measured SMX concentrations was found with average recoveries of 97–113% for the results of ELISA compared to LC-MS/MS.

Graphical abstract

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Determination of halogens and sulfur in high-purity polyimide by IC after digestion by MIC

Publication date: 1 September 2016
Source:Talanta, Volume 158
Author(s): Sindy R. Krzyzaniak, Rafael F. Santos, Flavia M. Dalla Nora, Sandra M. Cruz, Erico M.M. Flores, Paola A. Mello
In this work, a method for sample preparation of high-purity polyimide was proposed for halogens and sulfur determination by ion chromatography (IC) with conductivity detection and, alternatively, by inductively coupled plasma mass spectrometry (ICP-MS). A relatively high polyimide mass (600mg) was completely digested by microwave-induced combustion (MIC) using 20bar of O2 and 50mmolL⁻¹ NH4OH as absorbing solution. These conditions allowed final solutions with low carbon content (<10mgL⁻¹) and suitable pH for analysis by both IC and ICP-MS. The accuracy was evaluated using a certified reference material of polymer for Cl, Br and S and spike recovery experiments for all analytes. No statistical difference (t-test, 95% of confidence level) was observed between the results obtained for Cl, Br and S by IC after MIC and the certified values. In addition, spike recoveries obtained for F, Cl, Br, I and S ranged from 94% to 101%. The proposed method was suitable for polyimide decomposition for further determination of halogens and sulfur by IC and by ICP-MS (Br and I only). Taking into account the lack of methods and the difficulty of bringing this material into solution, MIC can be considered as a suitable alternative for the decomposition of polyimide for routine quality control of halogens and sulfur using IC or ICP-MS.

Graphical abstract

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WITHDRAWN: Wet effluent diffusion denuder: The tool for determination of monoterpenes in forest

Publication date: 1 September 2016
Source:Talanta, Volume 158
Author(s): Kamil Křůmal, Pavel Mikuška, Kristýna Večeřová, Otmar Urban, Emanuele Pallozzi, Zbyněk Večeřa
The Publisher regrets that this article is an accidental duplication of an article that has already been published, 10.1016/j.talanta.2016.03.032. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at http://ift.tt/1poHqya.



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Bistability of mitotic entry and exit switches during open mitosis in mammalian cells

Mitotic entry and exit are switch-like transitions that are driven by the activation and inactivation of Cdk1 and mitotic cyclins. This simple on/off reaction turns out to be a complex interplay of various reversible reactions, feedback loops, and thresholds that involve both the direct regulators of Cdk1 and its counteracting phosphatases. In this review, we summarize the interplay of the major components of the system and discuss how they work together to generate robustness, bistability, and irreversibility. We propose that it may be beneficial to regard the entry and exit reactions as two separate reversible switches that are distinguished by differences in the state of phosphatase activity, mitotic proteolysis, and a dramatic rearrangement of cellular components after nuclear envelope breakdown, and discuss how the major Cdk1 activity thresholds could be determined for these transitions.

A complex cell cycle control network is responsible for mitotic entry and exit. This system is based on Cdk1 activation and inactivation and behaves like a bistable switch. We are discussing the various control elements in this system and their contribution to the thresholds that ultimately determine bistability.

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Lineage-specific genomics: Frequent birth and death in the human genome

Frequent evolutionary birth and death events have created a large quantity of biologically important, lineage-specific DNA within mammalian genomes. The birth and death of DNA sequences is so frequent that the total number of these insertions and deletions in the human population remains unknown, although there are differences between these groups, e.g. transposable elements contribute predominantly to sequence insertion. Functional turnover – where the activity of a locus is specific to one lineage, but the underlying DNA remains conserved – can also drive birth and death. However, this does not appear to be a major driver of divergent transcriptional regulation. Both sequence and functional turnover have contributed to the birth and death of thousands of functional promoters in the human and mouse genomes. These findings reveal the pervasive nature of evolutionary birth and death and suggest that lineage-specific regions may play an important but previously underappreciated role in human biology and disease.

Lineage-specific elements within mammalian genomes have been created by evolutionary birth and death events, which are driven by frequent sequence and functional turnover. Regulatory elements, such as promoters and enhancers, are particularly evolutionarily volatile but their association with divergent transcription and human biology and disease is as yet unclear.

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Dynamic PET simulator via tomographic emission projection for kinetic modeling and parametric image studies

Purpose:

To develop and evaluate a fast and simple tool called dpetstep (Dynamic PET Simulator of Tracers via Emission Projection), for dynamic PET simulations as an alternative to Monte Carlo (MC), useful for educational purposes and evaluation of the effects of the clinical environment, postprocessing choices, etc., on dynamic and parametric images.

Methods:

The tool was developed in matlab using both new and previously reported modules of petstep (PET Simulator of Tracers via Emission Projection). Time activity curves are generated for each voxel of the input parametric image, whereby effects of imaging system blurring, counting noise, scatters, randoms, and attenuation are simulated for each frame. Each frame is then reconstructed into images according to the user specified method, settings, and corrections. Reconstructed images were compared to MC data, and simple Gaussian noised time activity curves (GAUSS).

Results:

dpetstep was 8000 times faster than MC. Dynamic images from dpetstep had a root mean square error that was within 4% on average of that of MC images, whereas the GAUSS images were within 11%. The average bias in dpetstep and MC images was the same, while GAUSS differed by 3% points. Noise profiles in dpetstep images conformed well to MC images, confirmed visually by scatter plot histograms, and statistically by tumor region of interest histogram comparisons that showed no significant differences (p petstep images and noise properties agreed better with MC.

Conclusions:

The authors have developed a fast and easy one-stop solution for simulations of dynamic PET and parametric images, and demonstrated that it generates both images and subsequent parametric images with very similar noise properties to those of MC images, in a fraction of the time. They believe dpetstep to be very useful for generating fast, simple, and realistic results, however since it uses simple scatter and random models it may not be suitable for studies investigating these phenomena. dpetstep can be downloaded free of cost from http://ift.tt/1UaqIyF.

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Segmentation of prostate from ultrasound images using level sets on active band and intensity variation across edges

Purpose:

In this paper, the authors propose a novel efficient method to segment ultrasound images of the prostate with weak boundaries. Segmentation of the prostate from ultrasound images with weak boundaries widely exists in clinical applications. One of the most typical examples is the diagnosis and treatment of prostate cancer. Accurate segmentation of the prostate boundaries from ultrasound images plays an important role in many prostate-related applications such as the accurate placement of the biopsy needles, the assignment of the appropriate therapy in cancer treatment, and the measurement of the prostate volume.

Methods:

Ultrasound images of the prostate are usually corrupted with intensity inhomogeneities, weak boundaries, and unwanted edges, which make the segmentation of the prostate an inherently difficult task. Regarding to these difficulties, the authors introduce an active band term and an edge descriptor term in the modified level set energy functional. The active band term is to deal with intensity inhomogeneities and the edge descriptor term is to capture the weak boundaries or to rule out unwanted boundaries. The level set function of the proposed model is updated in a band region around the zero level set which the authors call it an active band. The active band restricts the authors' method to utilize the local image information in a banded region around the prostate contour. Compared to traditional level set methods, the average intensities inside∖outside the zero level set are only computed in this banded region. Thus, only pixels in the active band have influence on the evolution of the level set. For weak boundaries, they are hard to be distinguished by human eyes, but in local patches in the band region around prostate boundaries, they are easier to be detected. The authors incorporate an edge descriptor to calculate the total intensity variation in a local patch paralleled to the normal direction of the zero level set, which can detect weak boundaries and avoid unwanted edges in the ultrasound images.

Results:

The efficiency of the proposed model is demonstrated by experiments on real 3D volume images and 2D ultrasound images and comparisons with other approaches. Validation results on real 3D TRUS prostate images show that the authors' model can obtain a Dice similarity coefficient (DSC) of 94.03% ± 1.50% and a sensitivity of 93.16% ± 2.30%. Experiments on 100 typical 2D ultrasound images show that the authors' method can obtain a sensitivity of 94.87% ± 1.85% and a DSC of 95.82% ± 2.23%. A reproducibility experiment is done to evaluate the robustness of the proposed model.

Conclusions:

As far as the authors know, prostate segmentation from ultrasound images with weak boundaries and unwanted edges is a difficult task. A novel method using level sets with active band and the intensity variation across edges is proposed in this paper. Extensive experimental results demonstrate that the proposed method is more efficient and accurate.

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Multilayered tissue mimicking skin and vessel phantoms with tunable mechanical, optical, and acoustic properties

Purpose:

This paper describes the design, fabrication, and characterization of multilayered tissue mimicking skin and vessel phantoms with tunable mechanical, optical, and acoustic properties. The phantoms comprise epidermis, dermis, and hypodermis skin layers, blood vessels, and blood mimicking fluid. Each tissue component may be individually tailored to a range of physiological and demographic conditions.

Methods:

The skin layers were constructed from varying concentrations of gelatin and agar. Synthetic melanin, India ink, absorbing dyes, and Intralipid were added to provide optical absorption and scattering in the skin layers. Bovine serum albumin was used to increase acoustic attenuation, and 40 μm diameter silica microspheres were used to induce acoustic backscatter. Phantom vessels consisting of thin-walled polydimethylsiloxane tubing were embedded at depths of 2–6 mm beneath the skin, and blood mimicking fluid was passed through the vessels. The phantoms were characterized through uniaxial compression and tension experiments, rheological frequency sweep studies, diffuse reflectance spectroscopy, and ultrasonic pulse-echo measurements. Results were then compared to in vivo and ex vivo literature data.

Results:

The elastic and dynamic shear behavior of the phantom skin layers and vessel wall closely approximated the behavior of porcine skin tissues and human vessels. Similarly, the optical properties of the phantom tissue components in the wavelength range of 400–1100 nm, as well as the acoustic properties in the frequency range of 2–9 MHz, were comparable to human tissue data. Normalized root mean square percent errors between the phantom results and the literature reference values ranged from 1.06% to 9.82%, which for many measurements were less than the sample variability. Finally, the mechanical and imaging characteristics of the phantoms were found to remain stable after 30 days of storage at 21 °C.

Conclusions:

The phantoms described in this work simulate the mechanical, optical, and acoustic properties of human skin tissues, vessel tissue, and blood. In this way, the phantoms are uniquely suited to serve as test models for multimodal imaging techniques and image-guided interventions.

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Intensity-dependent timing and precision of startle response latency in larval zebrafish

Abstract

Vertebrates rely on fast sensory encoding for rapid and precise initiation of startle responses. In afferent sensory neurons, trains of action potentials (spikes) encode stimulus intensity within the onset time of the first evoked spike (first spike latency; FSL) and the number of evoked spikes. For speed of initiation of startle responses, FSL would be the more advantageous mechanism to encode the intensity of a threat. However, the intensity dependence of FSL and spike number and whether either determines the precision of startle response initiation is not known. Here, we examined short-latency startle responses (SLCs) in larval zebrafish and tested the hypothesis that first spike latencies and their precision (jitter) determine the onset time and precision of SLCs. We evoked startle responses via activation of Channelrhodopsin (ChR2) expressed in ear and lateral-line hair cells and acquired high-speed videos of head-fixed larvae while simultaneously recording underlying field potentials. This method allowed for discrimination between primary SLCs and less frequent, long-latency startle responses (LLCs). Quantification of SLC kinematics and field potential parameters revealed that, apart their latencies, they were intensity independent. We found that increasing stimulus intensity decreased SLC latencies while increasing their precision, which was significantly correlated with corresponding changes in field potential latencies and their precision. Single afferent neuron recordings from the lateral line revealed a similar intensity-dependent decrease in first spike latencies and their jitter, which could account for the intensity-dependent changes in timing and precision of startle response latencies.

This article is protected by copyright. All rights reserved

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Dynamin-1deletion enhances post-tetanic potentiation and quantal size after tetanic stimulation at the calyx of held

High frequency stimulation leads to post-tetanic potentiation (PTP) at many types of synapses. Previous studies suggest that PTP results primarily from a protein kinase C (PKC) dependent increase in release probability (P_r) and/or readily-releasable pool (RRP) of synaptic vesicles (SVs), but the role of SV endocytosis in this process is unknown. Using the mature calyx of Held (P16-20), we reported that the tissue-specific deletion of dynamin-1 (cKO), an endocytic protein crucial for SV regeneration, enhanced PTP compared to control. To explore the mechanism of this enhancement, we estimated the changes of paired-pulse ratios (PPRs) and RRP size during PTP. RRP was estimated by the back extrapolation of cumulative EPSC amplitudes during a train of 30 action potentials at 100 Hz (termed RRP_train). We found an increase in RRP_train during PTP in both control and cKO, but no significant changes in the PPR. Moreover, the amplitude and frequency of spontaneous excitatory postsynaptic currents (spEPSCs) were increased during PTP in both control and cKO; however, the spEPSC amplitude in cKO during PTP was significantly larger than in control. The actin depolymerization reagent Latrunculin-B (Lat-B) abolished the activity-dependent increase in spEPSC amplitude in both control and cKO, but selectively blocked the enhancement of PTP in cKOs without affecting PTP in controls. The PKC inhibitor GF109203X nearly abolished PTP in both control and cKO. These data suggest that the quantal size increase contributes to the enhancement of PTP in dynamin-1 cKO, and this change depends on strong synaptic activity and actin polymerization.

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Glutamate transporter activity promotes enhanced Na+/K+-ATPase-mediated extracellular K+ management during neuronal activity

Abstract

Neuronal activity is associated with transient [K⁺]_o increases. The excess K⁺ is cleared by surrounding astrocytes, partly by the Na⁺/K⁺-ATPase of which several subunit isoform combinations exist. The astrocytic Na⁺/K⁺-ATPase α2β2 isoform constellation responds directly to increased [K⁺]_o but Na⁺/K⁺-ATPase-mediated K⁺ clearance could, in addition, be governed by astrocytic [Na⁺]_i. During most neuronal activity, glutamate is released in the synaptic cleft and is re-absorbed by astrocytic Na⁺-coupled glutamate transporters, thereby elevating [Na⁺]_i. It thus remains unresolved whether the different Na⁺/K⁺-ATPase isoforms are controlled by [K⁺]_o or [Na⁺]_i during neuronal activity. Hippocampal slice recordings of stimulus-induced [K⁺]_o transients with ion-sensitive microelectrodes revealed reduced Na⁺/K⁺-ATPase-mediated K⁺ management upon parallel inhibition of the glutamate transporter. The apparent intracellular Na⁺ affinity of isoform constellations involving the astrocytic β2 has remained elusive due to inherent expression of β1 in most cell systems as well as technical challenges in measuring intracellular affinity in intact cells. We therefore expressed the different astrocytic isoform constellations in Xenopus oocytes and determined their apparent Na⁺ affinity in intact oocytes and isolated membranes. The Na⁺/K⁺-ATPase was not fully saturated at basal astrocytic [Na⁺]_i, irrespective of isoform constellation, although the β1 subunit conferred lower apparent Na⁺ affinity to the α1 and α2 isoforms than the β2 isoform. In summary, enhanced astrocytic Na⁺/K⁺-ATPase-dependent K⁺ clearance was obtained with parallel glutamate transport activity. The astrocytic Na⁺/K⁺-ATPase isoform constellation α2β1 appeared specifically geared to respond to the [Na⁺]_i transients associated with activity-induced glutamate transporter activity.

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Cav1.2 and Cav1.3 l-type calcium channels independently control short- and long-term sensitization to pain

Short-term central sensitization to pain temporarily increases the responsiveness of nociceptive pathways after peripheral injury. In dorsal horn neurons (DHNs), short term sensitization can be monitored through the study of windup. Windup, a progressive increase in DHNs response following repetitive peripheral stimulations, depends on the post-synaptic L-type calcium channels (LTCs). In the dorsal horn of the spinal cord, two LTCs are present, Cav1.2 and Cav1.3, each displaying specific kinetics and spatial distribution. We used here a mathematical model of DHNs in which we integrated the specific patterns of expression of each Cav subunits. This mathematical approach reveals that Cav1.3 is necessary for the onset of windup while Cav1.2 is not and that synaptically triggered windup requires NMDA receptor activation. We then switched to a biological preparation in which we knocked down Cav subunits, we confirmed the prominent role of Cav1.3 in both naive and spinal nerve ligation model of neuropathy (SNL). Interestingly, while a clear mechanical allodynia dependant on Cav1.2 expression was observed after SNL, the amplitude of windup was decreased. These results were confirmed with our model when adapting Cav1.3 conductance to the changes observed after SNL. Finally, our mathematical approach predicts that although windup amplitude is decreased in SNL, plateau potentials are not altered, suggesting that plateau and windup are not fully equivalent. Windup and long-term hyperexcitability of DHNs are differentially controlled by Cav1.2 and Cav1.3, therefore, confirming that short-term and long-term sensitization are two different phenomena triggered by distinct mechanisms.

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Systemic leukotriene b4 receptor antagonism lowers arterial blood pressure and improves autonomic function in the spontaneously hypertensive rat

Accumulating evidence indicates an association between hypertension and chronic systemic inflammation in both human hypertension and experimental animal models. Previous studies in the spontaneously hypertensive rat (SHR) supports a role for leukotriene B4 (LTB₄), a potent chemoattractant involved in the inflammatory response. However the mechanism for LTB₄ mediated inflammation in hypertension is poorly understood. Here we report in the SHR, increased brainstem infiltration of T cells and macrophages plus gene expression profiling data showing that LTB₄ production, degradation and downstream signalling in the brainstem of the SHR are dynamically regulated during hypertension. Chronic blockade of the LTB₄ receptor 1 (BLT1) receptor with CP-105,696, reduced arterial pressure in the SHR compared to the normotensive control and this reduction was associated with a significant decrease in low and high frequency spectra of systolic blood pressure, and an increase in spontaneous baroreceptor reflex gain (sBRG). These data provide new evidence for the role of LTB₄ as an important neuroimmune pathway in the development of hypertension and therefore may serve as a novel therapeutic target for the treatment of neurogenic hypertension.

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Dynamic cerebral autoregulation is unrelated to decrease in external carotid artery blood flow during acute hypotension in healthy young men

External carotid artery (ECA) vasoconstriction may defend internal carotid artery (ICA) blood flow during acute hypotension. We hypothesized that α₁-receptor blockade-induced delay in ICA recovery to the baseline level from acute hypo-perfusion is related to attenuated ECA vasoconstriction. ICA and ECA blood flow were determined by duplex ultrasound during thigh-cuff release induced acute hypotension while the α₁-receptor blocker prazosin (1 mg/20 kg⁻¹) was administered to nine seated young healthy males. Both ICA (mean ± SD; 17 ± 8%, P = 0.005) and ECA (37 ± 15%, P < 0.001) blood flow decreased immediately following occluded thigh-cuff release with a more rapid ICA blood flow recovery to the baseline level (9 ± 5 s) than for the ECA blood flow (17 ± 5 s; P = 0.019). ICA blood flow recovery from hypo-perfusion was delayed with prazosin (17 ± 4 s vs. CONTROL 9 ± 5 s, P = 0.006) whereas ECA recovery remained unchanged (P = 0.313) despite a similar reduction in mean arterial pressure (−20 ± 4 mmHg vs. CONTROL −23 ± 7 mmHg, P = 0.148). These findings suggest that α₁-receptor blockade-induced attenuation of the ICA blood flow response to acute hypotension is unrelated to the reduction in ECA blood flow. Sympathetic nervous system via the ECA vascular bed does not contribute to dynamic CA during acute hypotension.

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Influence of attention on bimodal integration during emotional change decoding: ERP evidence

Publication date: Available online 26 May 2016
Source:International Journal of Psychophysiology
Author(s): Xuhai Chen, Lingzi Han, Zhihui Pan, Yangmei Luo, Ping Wang
Recent findings on audiovisual emotional interactions suggest that selective attention affects cross-sensory interaction from an early processing stage. However, the influence of attention manipulation on facial-vocal integration during emotional change perception is still elusive at this point. To address this issue, we asked participants to detect emotional changes conveyed by prosodies (vocal task) or facial expressions (facial task) while facial, vocal, and facial-vocal expressions were presented. At the same time, behavioral responses and electroencephalogram (EEG) were recorded. Behavioral results showed that bimodal emotional changes were detected with shorter response latencies compared to each unimodal condition, suggesting that bimodal emotional cues facilitated emotional change detection. Moreover, while the P3 amplitudes were larger for the bimodal change condition than for the sum of the two unimodal conditions regardless of attention direction, the N1 amplitudes were larger for the bimodal emotional change condition than for the sum of the two unimodal conditions under the attend-voice condition, but not under the attend-face condition. These findings suggest that selective attention modulates facial-vocal integration during emotional change perception in early sensory processing, but not in late cognitive processing stages.



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Distinction in EEG slow oscillations between chronic mild traumatic brain injury and PTSD

Publication date: Available online 27 May 2016
Source:International Journal of Psychophysiology
Author(s): Laura M. Franke, William C. Walker, Kathy W. Hoke, Joanna R. Wares
Spectral information from resting state EEG is altered in acute mild traumatic brain injury (mTBI) and in disorders of consciousness, but there is disagreement about whether mTBI can elicit long term changes in the spectral profile. Even when identified, any long-term changes attributed to TBI can be confounded by psychiatric comorbidities such as PTSD, particularly for combat-related mTBI where postdeployment distress is commonplace. To address this question, we measured spectral power during the resting state in a large sample of service members and Veterans varying in mTBI history and active PTSD diagnosis but matched for having had combat blast exposure. We found that PTSD was associated with decreases in low frequency power, especially in the right temporoparietal region, while conversely, blast-related mTBI was associated with increases in low frequency power, especially in prefrontal and right temporal areas. Results support the idea that long-term neurophysiological effects of mTBI share some features with states of reduced arousal and cognitive dysfunction, suggesting a role for EEG in tracking the trajectory of recovery and persisting vulnerabilities to injury. Additionally, results suggest that EEG power reflects distinct pathophysiologies for current PTSD and chronic mTBI.



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Muscle mechanical properties of strength and endurance athletes and changes after one week of intensive training

Publication date: Available online 26 May 2016
Source:Journal of Electromyography and Kinesiology
Author(s): Rauno Á.P. Simola, Christian Raeder, Thimo Wiewelhove, Michael Kellmann, Tim Meyer, Mark Pfeiffer, Alexander Ferrauti
The study investigates whether tensiomyography (TMG) is sensitive to differentiate between strength and endurance athletes, and to monitor fatigue after either one week of intensive strength (ST) or endurance (END) training. Fourteen strength (24.1 ± 2.0 years) and eleven endurance athletes (25.5 ± 4.8 years) performed an intensive training period of 6 days of ST or END, respectively. ST and END groups completed specific performance tests as well as TMG measurements of maximal radial deformation of the muscle belly (Dm), deformation time between 10% and 90% Dm (Tc), rate of deformation development until 10% Dm (V10) and 90% Dm (V90) before (baseline), after training period (post1), and after 72 hours of recovery (post2). Specific performance of both groups decreased from baseline to post1 (P < 0.05) and returned to baseline values at post2 (P < 0.05). The ST group showed higher countermovement jump (P < 0.05) and shorter Tc (P < 0.05) at baseline. After training, Dm, V10, and V90 were reduced in the ST (P < 0.05) while TMG changes were less pronounced in the END. TMG could be a useful tool to differentiate between strength and endurance athletes, and to monitor fatigue and recovery especially in strength training.



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Towards a National Initiative in Cancer Rehabilitation: Recommendations from a Subject Matter Expert Group

Publication date: Available online 27 May 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Nicole L. Stout, Julie K. Silver, Vishwa S. Raj, Julia Rowland, Lynn Gerber, Andrea Cheville, Kirsten K. Ness, Mary Radomski, Ralph Nitkin, Michael D. Stubblefield, G. Stephen Morris, Ana Acevedo, Zavera Brandon, Brent Braveman, Schuyler Cunningham, Laura Gilchrist, Lee Jones, Lynne Padgett, Timothy Wolf, Kerri Winters-Stone, Grace Campbell, Jennifer Hendricks, Karen Perkins, Leighton Chan
The health care delivery system in the United States is challenged to meet the needs of a growing population of cancer survivors. A pressing need is to optimize overall function and reduce disability in these individuals. Functional impairments and disability impact a majority of patients during and after disease treatment. Rehabilitation health care providers can "diagnose and treat patients' physical, psychological, and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence and improve quality of life in this medically complex population." However, few care delivery models integrate comprehensive cancer rehabilitation services into the oncology care continuum.The Rehabilitation Medicine Department of the Clinical Center at the National Institutes of Health with support from the National Cancer Institute and the National Center for Medical Rehabilitation Research convened a subject matter expert group to review current literature and practice patterns, identify opportunities and gaps regarding cancer rehabilitation and its support of oncology care, and to make recommendations for future efforts that promote quality cancer rehabilitation care. The recommendations suggest stronger efforts towards integrating cancer rehabilitation care models into oncology care from the point of diagnosis, incorporating evidence-based rehabilitation clinical assessment tools, and including rehabilitation professionals in shared decision making in order to provide comprehensive cancer care and maximize the functional capabilities of cancer survivors. These recommendations aim to enable future collaborations among a variety of stakeholders to improve the delivery of high quality cancer care.



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How storytelling can help scientists to write better abstracts

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Using the Consumer Experience with Pharmacy Services Survey as a quality metric for ambulatory care pharmacies: older adults' perspectives

Objectives

To describe older adults' perceptions of evaluating and comparing pharmacies based on the Consumer Experience with Pharmacy Services Survey (CEPSS), describe older adults' perceived importance of the CEPSS and its specific domains, and explore older adults' perceptions of the influence of specific CEPSS domains in choosing/switching pharmacies.

Design

Focus group methodology was combined with the administration of a questionnaire. The focus groups explored participants' perceived importance of the CEPSS and their perception of using the CEPSS to choose and/or switch pharmacies. Then, using the questionnaire, participants rated their perceived importance of each CEPSS domain in evaluating a pharmacy, and the likelihood of using CEPSS to switch pharmacies if their current pharmacy had low ratings. Descriptive and thematic analyses were done.

Setting

6 semistructured focus groups were conducted in a private meeting room in a Mid-Western state in the USA.

Participants

60 English-speaking adults who were at least 65 years, and had filled a prescription at a retail pharmacy within 90 days.

Results

During the focus groups, the older adults perceived the CEPSS to have advantages and disadvantages in evaluating and comparing pharmacies. Older adults thought the CEPSS was important in choosing the best pharmacies and avoiding the worst pharmacies. The perceived influence of the CEPSS in switching pharmacies varied depending on the older adult's personal experience or trust of other consumers' experience. Questionnaire results showed that participants perceived health/medication-focused communication as very important or extremely important (n=47, 82.5%) in evaluating pharmacies and would be extremely likely (n=21, 36.8%) to switch pharmacies if their pharmacy had low ratings in this domain.

Conclusions

The older adults in this study are interested in using patient experiences as a quality metric for avoiding the worst pharmacies. Pharmacists' communication about health and medicines is perceived important and likely to influence older adults' pharmacy selection.

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Efficacy and safety of acupuncture for chemotherapy-induced leucopoenia: protocol for a systematic review

Introduction

Many cancer patients experience leucopoenia during chemotherapy. Granulocyte- colony-stimulating factor (G-CSF) is used to treat chemotherapy-induced leucopoenia (CIL) but has various limitations. Clinical trials have indicated that acupuncture may prevent bone marrow suppression and increase leucocyte counts after chemotherapy. The objective of this review is to assess the efficacy and safety of acupuncture for treating CIL.

Methods and analysis

This systematic review will electronically search the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, Medline, EMBASE, the China National Knowledge Infrastructure Database (CNKI), the Chinese Biomedical Literature Database (CBM), the Chinese Scientific Journal Database (VIP Database) and the Wanfang database from their inception to 1 January 2016. Other sources will also be searched including potential grey literature, conference proceedings and the reference lists of identified publications and existing systematic reviews. Two reviewers will independently search the databases, perform data extraction and assess the quality of studies. Data will be synthesised by either the fixed-effects or the random-effects model according to a heterogeneity test. White blood cell counts will be assessed as the primary outcome. Adverse effects, incidence of leucopoenia, quality of life and physical condition will be evaluated as secondary outcomes. RevMan V.5.3 will be employed for data analysis. The results will be expressed as risk ratios for dichotomous data and mean differences for continuous data.

Ethics and dissemination

The protocol does not need ethics approval because individuals cannot be identified. The review will be reported in a peer-reviewed publication or at a relevant conference.

Trial registration number

CRD42015027594.

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Bayesian spatiotemporal modelling for identifying unusual and unstable trends in mammography utilisation

Objectives

To compare two Bayesian models capable of identifying unusual and unstable temporal patterns in spatiotemporal data.

Setting

Annual counts of mammography screening users from each statistical local area (SLA) in Brisbane, Australia, recorded between 1997 and 2008 inclusive.

Primary outcome measures

Mammography screening counts.

Results

The temporal trends of 91 SLAs (58%) were dissimilar from the overall common temporal trend. SLAs that followed the common temporal trend also tended to have stable temporal trends. SLAs with unstable temporal trends tended to be situated farther from the city and farther from mammography screening facilities.

Conclusions

This paper demonstrates the usefulness of the two models in identifying unusual and unstable temporal trends, and the synergy obtained when both models are applied to the same data set. An analysis of these models has provided interesting insights into the temporal trends of mammography screening counts and has shown several possible avenues for further research, such as extending the models to allow for multiple common temporal trends and accounting for additional spatiotemporal heterogeneity.

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Retrospective hepatitis C seroprevalence screening in the antenatal setting--should we be screening antenatal women?

Objectives

An unlinked anonymous seroprevalence study was conducted to estimate the prevalence of hepatitis C virus (HCV) infection in samples derived from antenatal clinic attendees at 2 East London Hospitals. An unexpectedly high HCV seroprevalence of 2.6% (1.2% viraemic) had been revealed during an unlinked study of the emergency department at 1 of these hospitals.

Design

1000 stored residual samples were tested for HCV antibody (anti-HCV) and reactive samples were further tested for HCV RNA. The study was reviewed by the East Midland NRES ethics committee project ID 181154, approval number 15/WS/0125.

Results

The anti-HCV reactivity rate was 0.5% (5/1000) with 0.1% (1/1000) confirmed viraemic. Prevalence for the other blood-borne viruses was higher: 1% (10/1000) were hepatitis B surface antigen positive and 0.3% were HIV antigen/antibody positive (3/1000). There were no co-infections.

Conclusions

More data to establish the prevalence of HCV in the antenatal population is needed. The addition of anti-HCV testing to the well-established antenatal screening programme provides a unique opportunity to impact on the health of pregnant women, their children, partners and future pregnancies in this new era of treatment for hepatitis C.

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