Shared Features Underlying Compact Genomes and Extreme Habitat Use in Chironomid Midges.

Nonbiting midges (family Chironomidae) are found throughout the world in a diverse array of aquatic and terrestrial habitats, can often tolerate harsh conditions such as hypoxia or desiccation, and have consistently compact genomes. Yet we know little about the shared molecular basis for these attributes and how they have evolved across the family. Here, we address these questions by first creating high-quality, annotated reference assemblies for Tanytarsus gracilentus (subfamily Chironominae, tribe Tanytarsini) and Parochlus steinenii (subfamily Podonominae). Using these and other publicly available assemblies, we created a time-calibrated phylogenomic tree for family Chironomidae with outgroups from order Diptera. We used this phylogeny to test for features associated with compact genomes, as well as examining patterns of gene family evolution and positive selection that may underlie chironomid habitat tolerances. Our results suggest that compact genomes evolved in the common ancestor of Chironomidae and Ceratopogonidae and that this occurred mainly through reductions in noncoding regions (introns, intergenic sequences, and repeat elements). Significantly expanded gene families in Chironomidae included biological processes that may relate to tolerance of stressful environments, such as temperature homeostasis, carbohydrate transport, melanization defense response, and trehalose transport. We identified several positively selected genes in Chironomidae, notably sulfonylurea receptor, CREB-binding protein, and protein kinase D. Our results improve our understanding of the evolution of small genomes and extreme habitat use in this widely distributed group.

Disentangling the drivers of decadal body size decline in an insect population.

While climate warming is widely predicted to reduce body size of ectotherms, evidence for this trend is mixed. Body size depends not only on temperature but also on other factors, such as food quality and intraspecific competition. Because temperature trends or other long-term environmental factors may affect population size and food sources, attributing trends in average body size to temperature requires the separation of potentially confounding effects. We evaluated trends in the body size of the midge Tanytarsus gracilentus and potential drivers (water temperature, population size, and food quality) between 1977 and 2015 at Lake Mývatn, Iceland. Although temperatures increased at Mývatn over this period, there was only a slight (non-significant) decrease in midge adult body size, contrary to theoretical expectations. Using a state-space model including multiple predictors, body size was negatively associated with both water temperature and midge population abundance, and it was positively associated with 13 C enrichment of midges (an indicator of favorable food conditions). The magnitude of these effects were similar, such that simultaneous changes in temperature, abundance, and carbon stable isotopic signature could counteract each other in the long-term body size trend. Our results illustrate how multiple factors, all of which could be influenced by global change, interact to affect average ectotherm body size.

[Patient satisfaction in oncological aftercare--differential results of gender aspects in doctor-patient dyads]. / Patientenzufriedenheit in der onkologischen Nachsorge--differentielle Befunde zur Geschlechtsspezifik in Arzt-Patient-Dyaden.

OBJECTIVE: The aim of this study was to explore the role of gender of the physician and gender of the patient in explaining differences in patient satisfaction. MATERIAL AND METHODS: Overall, 1,130 patients were assigned to one of 4 possible physician-patient sex dyads and were interviewed with a questionnaire about their patient satisfaction. RESULTS: Female patients in a dyad with a female physician were most satisfied with the overall judgment of practice visit and the inclusion of life situation in comparison to all other dyads. Male patients in a dyad with a male physician were least satisfied. CONCLUSION: In the future, the specific role of patient-physician dyads has to be considered more in the assessment of subdimensions of patient satisfaction.

[Effects of inpatient rehabilitation on long-term health-related quality of life in patients with cancer and rheumatoid arthritis: an analysis based on the classification of therapeutic procedures codes (KTL)]. / Einfluss stationärer Rehabilitationsleistungen auf die langfristige gesundheitsbezogene Lebensqualität von Patienten mit Krebs und rheumatoider Arthritis: eine KTL-Daten-Analyse.

OBJECTIVES: This explorative study investigated associations among the amount of different rehabilitative interventions, based on the classification of therapeutic procedures codes (KTL), and long-term health-related quality of life in patients with cancer or rheumatoid arthritis. METHODS: 3 therapeutic modules of rehabilitative interventions were defined on the basis of KTL codes: (i) somatic interventions, (ii) psychological interventions, and (iii) medical counselling. Based on a median-split, patients were classified in 2 groups with low vs. high amount of rehabilitative interventions. Health-related quality of life was assessed on admission, at discharge from rehabilitative stay, as well as 3 and 12 months after discharge using the SF-12 health survey. RESULTS: 166 patients with chronic arthritis and 159 patients with cancer undergoing inpatient rehabilitation were included in the analysis. Arthritis patients who received a high amount of somatic interventions showed a significant improvement in the SF-12 mental health component summary score up to 12 months after discharge (p<0.05). Cancer patients who received a high amount of psychological interventions showed higher SF-12 physical health component summary scores at 3 and 12 months follow-up (p<0.05). CONCLUSION: The results suggest differential relationships between amount of rehabilitative interventions and long-term rehabilitation outcome in 2 different disease groups. Routine classification of rehabilitative procedures (KTL) codes can be used for analysing dose-response relationships, although open questions remain concerning the validity of KTL codes.

[The role of psycho-oncology in orthopedic tumor centers]. / Stellenwert der Psychoonkologie und ihre Versorgungslage an Zentren für Tumororthopädie.

INTRODUCTION: Psychosocial screening has not been implemented into diagnosis-related guidelines for the treatment of orthopedic tumor patients. The aim of the study was to evaluate the significance of psycho-oncology in orthopedic institutions specialized in musculoskeletal tumors as well as the opinion and clinical experience of the treating physicians. METHODS: In total 60 orthopedic institutions were recruited. Data were assessed and analyzed by a newly developed, standardized questionnaire. To detect specific, demographic differences results were additionally analyzed according to gender, age and professional experience. RESULTS: A total of 118 physicians from 47 institutions participated. Significant differences between professional experience groups were obtained regarding the wish for psychosocial treatment in cases of own illness (p=0.032) and the difficulty of addressing patient feelings (p=0.05). CONCLUSIONS: The majority of orthopedic physicians deemed psycho-oncology important. To ensure a holistic approach to the treatment of orthopedic tumor patients, psycho-oncological aspects should be implemented in diagnosis-related guidelines.

Routine psychosocial distress screening in radiotherapy: implementation and evaluation of a computerised procedure.

BACKGROUND: To implement distress screening in routine radiotherapy practice and to compare computerised and paper-and-pencil screening in terms of acceptability and utility. METHODS: We used the Stress Index RadioOncology (SIRO) for screening. In phase 1, 177 patients answered both a computerised and a paper version, and in phase 2, 273 patients filled out either the computerised or the paper assessment. Physicians received immediate feedback of the psycho-oncological results. Patients, nurses/radiographers (n=27) and physicians (n=15) evaluated the screening procedure. RESULTS: The agreement between the computerised and the paper assessment was high (intra-class correlation=0.92). Patients' satisfaction did not differ between the two administration modes. Nurses/radiographers rated the computerised assessment less time consuming (3.7 vs 18.5%), although the objective data did not reveal a difference in time demand. Physicians valued the psycho-oncological results as interesting and informative (46.7%). Patients and staff agreed that the distress screening did not lead to an increase in the discussion of psychosocial issues in clinician-patient encounters. CONCLUSION: The implementation of a distress screening was feasible and highly accepted, regardless of the administration mode. Communication trainings should be offered in order to increase the discussion of psychosocial topics in clinician-patient encounters.

Psychological distress in cancer patients assessed with an expert rating scale.

The purpose of this study was to investigate psychosocial stress in a large sample of cancer patients using an expert rating scale. Specific aims were to analyse the relevance of setting variables (type of clinic, contact initiative, therapy) and gender. A total of 6365 patients were assessed in 105 institutions. Univariate and multivariate statistical analysis of setting variables indicated that patients treated in palliative care settings showed highest distress scores compared to patients recruited from hospitals and outpatient clinics (P<0.001). Significant differences were also found for contact initiative (P<0.001); lowest distress was found in patients who were recruited by routine contact. Patients who asked for psychosocial support or who were recruited by the medical staff showed the highest distress scores. The analysis of therapy groups showed that patients receiving radiotherapy or surgery were not more distressed than patients without therapy. The most distressing treatment was chemotherapy. Gender had differential effects on clinic type (P<0.001) and contact initiative (P<0.001) but not on treatment and diagnosis. Expert rating scales are an important complement for self-assessment questionnaires to evaluate psychological distress of cancer patients in psychosocial studies as well as in routine medical care.

Infantile myofibromatosis of the ovary presenting with ascites.

We report the first case of ovarian infantile myofibromatosis (IM) presenting with gross ascites in a 2-month-old girl. There was no evidence of recurrence of ascites or tumour 5 years after complete excision. IM has to be considered in the differential diagnosis of ovarian tumours in infants. Despite having the alarming histologic features of high cellularity, brisk mitotic activity, vascular invasion and necrosis, the tumour responded well to surgery alone without aggressive adjuvant therapy. The case is reported to expand the spectrum of 1) ovarian tumour pathology; 2) infantile myofibromatosis distribution; 3) causes of infantile ascites.

Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla.

The aim of this investigation was to evaluate the use of resonance frequency measurements in the clinical measurement of implant stability. Resonance frequency measurements are undertaken by measuring the response of a small transducer attached to an implant fixture or abutment. Two groups of patients were selected for study. Group A comprised 9 patients who had a total of 56 implants placed. Resonance frequency measurements were made at fixture installation and repeated 8 months later at abutment connection. The resonance frequency of the implant/transducer system increased for 50 out of the 56 implants from a mean value of 7473 Hz +/- 127 Hz (P < 0.05) to a mean of 7915 Hz +/- 112 Hz (P < 0.05). Two implants had failed to integrate and the resonance frequency of these had fallen. Group B comprised 9 patients who had been provided with fixed prostheses and had a total of 52 implants placed. They were examined 5 years after fixture placement and the prostheses removed. All implants were judged clinically to be osseointegrated. The level of the marginal bone around each implant was calculated by measuring the number of exposed threads on intraoral periapical radiographs and added to the length of each abutment to give a value termed the effective implant length (EIL). Measurements indicated a correlation (R = -0.78, P < 0.01) between EIL and resonance frequency. The results support the hypothesis that the resonance frequency of an implant/transducer system is related to the height of the implant not surrounded by bone and the stability of the implant/tissue interface as determined by the absence of clinical mobility.

Prosthesis misfit and marginal bone loss in edentulous implant patients.

The objective of this study was to statistically correlate in vivo measurements of prosthesis misfit and change of marginal bone level in implants placed in the edentulous maxilla. Two groups, each comprising seven patients, were followed up either prospectively for 1 year or retrospectively for the last 4 years of the 5-year period after second-stage surgery. Measurements of prosthesis misfit were performed by means of a three-dimensional photogrammetric technique, and marginal bone levels were measured from standard intraoral radiographs. Results showed that none of the prostheses presented a completely passive fit to the implants in vivo. Furthermore, similar distortions of the prostheses were found in the two groups, indicating that the implants seemed to be stable and did not move, even after several years in function. The maximal range of three-dimensional distortion of cylinder center points was about 275 microns for both groups. Mean center point misfit was 111 (SD 59) and 91 (SD 51) microns for the 1-year and 5-year groups, respectively. The corresponding mean marginal bone loss was 0.5 and 0.2 mm for the two follow-up groups. No statistical correlations (P > .05) between change of marginal bone levels and different parameters of prosthesis misfit were observed in the two groups. The study indicated that a certain biologic tolerance for misfit may be present. The degree of misfit reported in the study was clinically acceptable with regard to observed marginal bone loss.

Mucosal topography around implants in edentulous upper jaws. Photogrammetric three-dimensional measurements of the effect of replacement of a removable prosthesis with a fixed prosthesis.

A photogrammetric technique was tested to measure the topography of the mucosa around implants, placed in edentulous upper jaws. Photographs were taken of casts from 6 patients, who all had used a removable overdenture for one year. Another series of photographs was taken on new casts after the use of a fixed prosthesis for a second year. The 6 pairs of photographs were measured and compared in an analytical stereo plotter for surface contour and implant positions. The results from the measurements indicated a trend of general recession of the mucosa after one year with fixed prosthesis, both on the buccal as well as on the palatal side. The mean volume of recession was 222.4 mm3, corresponding to an average of 0.4 mm3/mm2 of mucosa. More recession was generally observed on the palatal side, but obvious variations between the patients were present. In conclusion, the photogrammetric technique was considered to be well suited for analysing tissue contours in various dental situations.