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1.
Proc Biol Sci ; 291(2023): 20232439, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38772424

RESUMO

Genetic changes that enabled the evolution of eusociality have long captivated biologists. More recently, attention has focussed on the consequences of eusociality on genome evolution. Studies have reported higher molecular evolutionary rates in eusocial hymenopteran insects compared with their solitary relatives. To investigate the genomic consequences of eusociality in termites, we analysed nine genomes, including newly sequenced genomes from three non-eusocial cockroaches. Using a phylogenomic approach, we found that termite genomes have experienced lower rates of synonymous substitutions than those of cockroaches, possibly as a result of longer generation times. We identified higher rates of non-synonymous substitutions in termite genomes than in cockroach genomes, and identified pervasive relaxed selection in the former (24-31% of the genes analysed) compared with the latter (2-4%). We infer that this is due to reductions in effective population size, rather than gene-specific effects (e.g. indirect selection of caste-biased genes). We found no obvious signature of increased genetic load in termites, and postulate efficient purging of deleterious alleles at the colony level. Additionally, we identified genomic adaptations that may underpin caste differentiation, such as genes involved in post-translational modifications. Our results provide insights into the evolution of termites and the genomic consequences of eusociality more broadly.


Assuntos
Genoma de Inseto , Isópteros , Seleção Genética , Animais , Isópteros/genética , Filogenia , Evolução Molecular , Baratas/genética , Comportamento Social
2.
Insect Sci ; 2024 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-38462506

RESUMO

Microbial symbioses have had profound impacts on the evolution of animals. Conversely, changes in host biology may impact the evolutionary trajectory of symbionts themselves. Blattabacterium cuenoti is present in almost all cockroach species and enables hosts to subsist on a nutrient-poor diet. To investigate if host biology has impacted Blattabacterium at the genomic level, we sequenced and analyzed 25 genomes from Australian soil-burrowing cockroaches (Blaberidae: Panesthiinae), which have undergone at least seven separate subterranean, subsocial transitions from above-ground, wood-feeding ancestors. We find at least three independent instances of genome erosion have occurred in Blattabacterium strains exclusive to Australian soil-burrowing cockroaches. These shrinkages have involved the repeated inactivation of genes involved in amino acid biosynthesis and nitrogen recycling, the core role of Blattabacterium in the host-symbiont relationship. The most drastic of these erosions have occurred in hosts thought to have transitioned underground the earliest relative to other lineages, further suggestive of a link between gene loss in Blattabacterium and the burrowing behavior of hosts. As Blattabacterium is unable to fulfill its core function in certain host lineages, these findings suggest soil-burrowing cockroaches must acquire these nutrients from novel sources. Our study represents one of the first cases, to our knowledge, of parallel host adaptations leading to concomitant parallelism in their mutualistic symbionts, further underscoring the intimate relationship between these two partners.

3.
Small ; 20(26): e2305684, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38247186

RESUMO

Understanding the conformation of proteins in the nanoparticle corona has important implications in how organisms respond to nanoparticle-based drugs. These proteins coat the nanoparticle surface, and their properties will influence the nanoparticle's interaction with cell targets and the immune system. While some coronas are thought to be disordered, two key unanswered questions are the degree of disorder and solvent accessibility. Here, a model is developed for protein corona disorder in polystyrene nanoparticles of varying size. For two different proteins, it is found that binding affinity decreases as nanoparticle size increases. The stoichiometry of binding, along with changes in the hydrodynamic size, supports a highly solvated, disordered protein corona anchored at a small number of attachment sites. The scaling of the stoichiometry versus nanoparticle size is consistent with disordered polymer dimensions. Moreover, it is found that proteins are destabilized less in the presence of larger nanoparticles, and hydrophobic exposure decreases at lower curvatures. The observations hold for proteins on flat polystyrene surfaces, which have the lowest hydrophobic exposure. The model provides an explanation for previous observations of increased amyloid fibrillation rates in the presence of larger nanoparticles, and it may rationalize how cell receptors can recognize protein disorder in therapeutic nanoparticles.


Assuntos
Nanopartículas , Poliestirenos , Ligação Proteica , Coroa de Proteína , Poliestirenos/química , Nanopartículas/química , Coroa de Proteína/química , Solventes/química , Interações Hidrofóbicas e Hidrofílicas , Tamanho da Partícula
4.
bioRxiv ; 2023 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-37461509

RESUMO

Understanding the conformation of proteins in the nanoparticle corona has important implications in how organisms respond to nanoparticle-based drugs. These proteins coat the nanoparticle surface, and their properties will influence the nanoparticle's interaction with cell targets and the immune system. While some coronas are thought to be disordered, two key unanswered questions are the degree of disorder and solvent accessibility. Here, using a comprehensive thermodynamic approach, along with supporting spectroscopic experiments, we develop a model for protein corona disorder in polystyrene nanoparticles of varying size. For two different proteins, we find that binding affinity decreases as nanoparticle size increases. The stoichiometry of binding, along with changes in the hydrodynamic size, support a highly solvated, disordered protein corona anchored at a small number of enthalpically-driven attachment sites. The scaling of the stoichiometry vs. nanoparticle size is consistent disordered polymer dimensions. Moreover, we find that proteins are destabilized less severely in the presence of larger nanoparticles, and this is supported by measurements of hydrophobic exposure, which becomes less pronounced at lower curvatures. Our observations hold for flat polystyrene surfaces, which, when controlled for total surface area, have the lowest hydrophobic exposure of all systems. Our model provides an explanation for previous observations of increased amyloid fibrillation rates in the presence of larger nanoparticles, and it may rationalize how cell receptors can recognize protein disorder in therapeutic nanoparticles.

5.
Front Behav Neurosci ; 17: 1151877, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37324519

RESUMO

Behavioral pattern separation and cognitive flexibility are essential cognitive abilities that are disrupted in many brain disorders. A better understanding of the neural circuitry involved in these abilities will open paths to treatment. In humans and mice, discrimination and adaptation rely on the integrity of the hippocampal dentate gyrus (DG) which receives glutamatergic input from the entorhinal cortex (EC), including the lateral EC (LEC). An inducible increase of EC-DG circuit activity improves simple hippocampal-dependent associative learning and increases DG neurogenesis. Here, we asked if the activity of LEC fan cells that directly project to the DG (LEC → DG neurons) regulates the relatively more complex hippocampal-dependent abilities of behavioral pattern separation or cognitive flexibility. C57BL/6J male mice received bilateral LEC infusions of a virus expressing shRNA TRIP8b, an auxiliary protein of an HCN channel or a control virus (SCR shRNA). Prior work shows that 4 weeks post-surgery, TRIP8b mice have more DG neurogenesis and greater activity of LEC → DG neurons compared to SCR shRNA mice. Here, 4 weeks post-surgery, the mice underwent testing for behavioral pattern separation and reversal learning (touchscreen-based location discrimination reversal [LDR]) and innate fear of open spaces (elevated plus maze [EPM]) followed by quantification of new DG neurons (doublecortin-immunoreactive cells [DCX+] cells). There was no effect of treatment (SCR shRNA vs. TRIP8b) on performance during general touchscreen training, LDR training, or the 1st days of LDR testing. However, in the last days of LDR testing, the TRIP8b shRNA mice had improved pattern separation (reached the first reversal more quickly and had more accurate discrimination) compared to the SCR shRNA mice, specifically when the load on pattern separation was high (lit squares close together or "small separation"). The TRIP8b shRNA mice were also more cognitively flexible (achieved more reversals) compared to the SCR shRNA mice in the last days of LDR testing. Supporting a specific influence on cognitive behavior, the SCR shRNA and TRIP8b shRNA mice did not differ in total distance traveled or in time spent in the closed arms of the EPM. Supporting an inducible increase in LEC-DG activity, DG neurogenesis was increased. These data indicate that the TRIP8b shRNA mice had better pattern separation and reversal learning and more neurogenesis compared to the SCR shRNA mice. This study advances fundamental and translational neuroscience knowledge relevant to two cognitive functions critical for adaptation and survival-behavioral pattern separation and cognitive flexibility-and suggests that the activity of LEC → DG neurons merits exploration as a therapeutic target to normalize dysfunctional DG behavioral output.

6.
bioRxiv ; 2023 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-36747871

RESUMO

Behavioral pattern separation and cognitive flexibility are essential cognitive abilities which are disrupted in many brain disorders. Better understanding of the neural circuitry involved in these abilities will open paths to treatment. In humans and mice, discrimination and adaptation rely on integrity of the hippocampal dentate gyrus (DG) which both receive glutamatergic input from the entorhinal cortex (EC), including the lateral EC (LEC). Inducible increase of EC-DG circuit activity improves simple hippocampal-dependent associative learning and increases DG neurogenesis. Here we asked if the activity of LEC fan cells that directly project to the DG (LEC➔DG neurons) regulates behavioral pattern separation or cognitive flexibility. C57BL6/J male mice received bilateral LEC infusions of a virus expressing shRNA TRIP8b, an auxiliary protein of an HCN channel or a control virus (SCR shRNA); this approach increases the activity of LEC➔DG neurons. Four weeks later, mice underwent testing for behavioral pattern separation and reversal learning (touchscreen-based Location Discrimination Reversal [LDR] task) and innate fear of open spaces (elevated plus maze [EPM]) followed by counting of new DG neurons (doublecortin-immunoreactive cells [DCX+] cells). TRIP8b and SCR shRNA mice performed similarly in general touchscreen training and LDR training. However, in late LDR testing, TRIP8b shRNA mice reached the first reversal more quickly and had more accurate discrimination vs. SCR shRNA mice, specifically when pattern separation was challenging (lit squares close together or "small separation"). Also, TRIP8b shRNA mice achieved more reversals in late LDR testing vs. SCR shRNA mice. Supporting a specific influence on cognitive behavior, SCR shRNA and TRIP8b shRNA mice did not differ in total distance traveled or in time spent in the closed arms of the EPM. Supporting an inducible increase in LEC-DG activity, DG neurogenesis was increased. These data indicate TRIP8b shRNA mice had better pattern separation and reversal learning and more neurogenesis vs. SCR shRNA mice. This work advances fundamental and translational neuroscience knowledge relevant to two cognitive functions critical for adaptation and survival - behavioral pattern separation and cognitive flexibility - and suggests the activity of LEC➔DG neurons merits exploration as a therapeutic target to normalize dysfunctional DG behavioral output.

7.
Methods Mol Biol ; 2616: 279-326, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36715942

RESUMO

Analyzing cognitive performance is an important aspect of assessing physiological deficits after stroke or other central nervous system (CNS) injuries in both humans and in basic science animal models. Cognitive testing on an automated touchscreen operant platform began in humans but is now increasingly popular in preclinical studies as it enables testing in many cognitive domains in a highly reproducible way while minimizing stress to the laboratory animal. Here, we describe the step-by-step setup and application of four operant touchscreen tests used on adult mice. In brief, mice are trained to touch a graphical image on a lit screen and initiate subsequent trials for a reward. Following initial training, mice can be tested on tasks that probe performance in many cognitive domains and thus infer the integrity of brain circuits and regions. There are already many outstanding published protocols on touchscreen cognitive testing. This chapter is designed to add to the literature in two specific ways. First, this chapter provides in a single location practical, behind-the-scenes tips for setup and testing of mice in four touchscreen tasks that are useful to assess in CNS injury models: Paired Associates Learning (PAL), a task of episodic, associative (object-location) memory; Location Discrimination Reversal (LDR), a test for mnemonic discrimination (also called behavioral pattern separation) and cognitive flexibility; Autoshaping (AUTO), a test of Pavlovian or classical conditioning; and Extinction (EXT), tasks of stimulus-response and response inhibition, respectively. Second, this chapter summarizes issues to consider when performing touchscreen tests in mouse models of CNS injury. Quantifying gross and fine aspects of cognitive function is essential to improved treatment for brain dysfunction after stroke or CNS injury as well as other brain diseases, and touchscreen testing provides a sensitive, reliable, and robust way to achieve this.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Acidente Vascular Cerebral , Humanos , Camundongos , Animais , Sistema Nervoso Central , Cognição
8.
Arthroplast Today ; 11: 64-67, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34471661

RESUMO

BACKGROUND: To increase total knee arthroplasty procedure satisfaction, surgeons are exploring improvements in surgical technique. The impact of gap balancing or measured resection approach on posterior condylar offset (PCO) is not well understood. METHODS: We reviewed the clinical and radiographic results of 498 unilateral posterior stabilized total knee arthroplasties. Radiographs were assessed to measure the primary endpoints of anterior-posterior width, PCO, and anterior condylar offset. Clinical outcome measures were used to assess patient improvement measures. Multiple linear regression analyses were performed to determine the clinical factors related to our primary endpoints. RESULTS: No significant difference was observed between groups in anterior-posterior width (P = .24) and PCO (P = .78). Significant positive correlations were observed between postoperative PCO and knee range of motion (r = 0.12, P = .04) and total Knee Society Scores (r = 0.14, P = .02). CONCLUSION: No impact of surgical technique on PCO was observed. Correlations were observed between postoperative PCO and the functional subscore and total Knee Society Score. All patients reported clinical improvements at 1 year postoperatively.

9.
Knee ; 31: 86-96, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34119998

RESUMO

BACKGROUND: The purpose of this study was to compare implant migration and tibiofemoral contact kinematics of a cementless primary total knee arthroplasty (TKA) implanted using either a gap balancing (GB) or measured resection (MR) surgical technique. METHODS: Thirty-nine patients underwent TKA via a GB (n = 19) or a MR (n = 20) surgical technique. Patients received an identical fixed-bearing, cruciate-retaining cementless implant. Patients underwent a baseline radiostereometric analysis (RSA) exam at two weeks post-operation, with follow-up visits at six weeks, three months, six months, and one year post-operation. Migration including maximum total point motion (MTPM) of the femoral and tibial components was calculated over time. At the one year visit patients also underwent a kinematic exam via RSA. RESULTS: Mean MTPM of the tibial component at one year post-operation was not different (mean difference = 0.09 mm, p = 0.980) between the GB group (0.85 ± 0.37 mm) and the MR group (0.94 ± 0.41 mm). Femoral component MTPM at one year post-operation was also not different (mean difference = 0.27 mm, p = 0.463) between the GB group (0.62 ± 0.34 mm) and the MR group (0.89 ± 0.44 mm). Both groups displayed similar kinematic patterns. CONCLUSIONS: There was no difference in implant migration and kinematics of a single-radius, cruciate retaining cementless TKA performed using a GB or MR surgical technique. The magnitude of migration suggests there is low risk of early loosening. The results provide support for using the cementless implant with either a GB or MR technique.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Fenômenos Biomecânicos , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Falha de Prótese
10.
Med Eng Phys ; 89: 14-21, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33608121

RESUMO

Unmet expectations contribute to a high patient dissatisfaction rate following total knee replacement but clinicians currently do not have the tools to confidently adjust expectations. In this study, supervised machine learning was applied to multi-variate wearable sensor data from preoperative timed-up-and-go tests. Participants (n=82) were instrumented three months after surgery and patients showing relevant improvement were designated as "responders" while the remainder were labelled "maintainers". Support vector machine, naïve Bayes, and random forest binary classifiers were developed to distinguish patients using sensor-derived features. Accuracy, sensitivity, specificity, and area under the receiver-operator curve (AUC) were compared between models using ten-fold out-of-sample testing. A high performance using only sensor-derived functional metrics was obtained with a random forest model (accuracy = 0.76 ± 0.11, sensitivity = 0.87 ± 0.08, specificity = 0.57 ± 0.26, AUC = 0.80 ± 0.14) but highly sensitive models were observed using naïve Bayes and SVM models after including patient age, sex, and BMI into the feature set (accuracy = 0.72, 0.73 ± 0.09, 0.12; sensitivity = 0.94, 0.95 ± 0.11, 0.11; specificity = 0.35, 0.37 ± 0.20, 0.18; AUC = 0.80, 0.74 ± 0.07, 0.11; respectfully). Including select patient-reported subjective measures increased the top random forest performance slightly (accuracy = 0.80 ± 0.10, sensitivity = 0.91 ± 0.14, specificity = 0.62 ± 0.23, AUC = 0.86 ± 0.09). The current work has demonstrated that prediction models developed from preoperative sensor-derived functional metrics can reliably predict expected functional recovery following surgery and this can be used by clinicians to help set realistic patient expectations.


Assuntos
Artroplastia do Joelho , Dispositivos Eletrônicos Vestíveis , Teorema de Bayes , Humanos , Aprendizado de Máquina , Motivação
11.
J Neurophysiol ; 124(6): 1727-1742, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32997557

RESUMO

The rostral nucleus of the solitary tract (rNST) serves as the first central relay in the gustatory system. In addition to synaptic interactions, central processing is also influenced by the ion channel composition of individual neurons. For example, voltage-gated K+ channels such as outward K+ current (IA) can modify the integrative properties of neurons. IA currents are prevalent in rNST projection cells but are also found to a lesser extent in GABAergic interneurons. However, characterization of the kinetic properties of IA, the molecular basis of these currents, as well as the consequences of IA on spiking properties of identified rNST cells is lacking. Here, we show that IA in rNST GABAergic (G+) and non-GABAergic (G-) neurons share a common molecular basis. In both cell types, there was a reduction in IA following treatment with the specific Kv4 channel blocker AmmTx3. However, the kinetics of activation and inactivation of IA in the two cell types were different with G- neurons having significantly more negative half-maximal activation and inactivation values. Likewise, under current clamp, G- cells had significantly longer delays to spike initiation in response to a depolarizing stimulus preceded by a hyperpolarizing prepulse. Computational modeling and dynamic clamp suggest that differences in the activation half-maximum may account for the differences in delay. We further observed evidence for a window current under both voltage clamp and current clamp protocols. We speculate that the location of Kv4.3 channels on dendrites, together with a window current for IA at rest, serves to regulate excitatory afferent inputs.NEW & NOTEWORTHY Here, we demonstrate that the transient outward K+ current IA occurs in both GABAergic and non-GABAergic neurons via Kv4.3 channels in the rostral (gustatory) solitary nucleus. Although found in both cell types, IA is more prevalent in non-GABAergic cells; a larger conductance at more negative potentials leads to a greater impact on spike initiation compared with GABAergic neurons. An IA window current further suggests that IA can regulate excitatory afferent input to the nucleus.


Assuntos
Fenômenos Eletrofisiológicos/fisiologia , Neurônios GABAérgicos/fisiologia , Interneurônios/fisiologia , Canais de Potássio Shal/metabolismo , Núcleo Solitário/fisiologia , Percepção Gustatória/fisiologia , Animais , Feminino , Neurônios GABAérgicos/metabolismo , Interneurônios/metabolismo , Masculino , Camundongos , Camundongos Transgênicos , Canais de Potássio Shal/antagonistas & inibidores , Núcleo Solitário/metabolismo
12.
Orthopedics ; 43(6): 361-366, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32956472

RESUMO

A variety of surgical approaches are used for total hip arthroplasty (THA). Controversy still exists regarding whether the direct anterior approach truly minimizes muscle damage. The purpose of this study was to determine the effect of surgical approach for THA on muscle atrophy quantified through magnetic resonance imaging (MRI). The study included 25 hips in patients with a mean age of 64.72±8.35 years who underwent a primary unilateral THA for severe osteoarthritis. Patients were grouped according to surgical approach: direct anterior (n=9), direct lateral (n=9), and posterior (n=7). Magnetic resonance images were collected at the 24-week postoperative time point to assess atrophy/fatty infiltration of the hip musculature. All MRIs were assessed by a fellowship-trained radiologist who was blinded to all clinical information. There were no significant differences preoperatively and 1 year postoperatively between the surgical approach groups in terms of patient-reported outcome measures (P>.05). Significant differences in fatty infiltration differences between surgical approaches were observed in the gluteus medius, gluteus minimus, iliacus, obturator externus, obturator internus, pectineus, psoas, quadratus femoris, sartorius, and vastus intermedius (P<.05). The direct anterior approach to THA resulted in less atrophy of the hip musculature compared with a direct lateral or posterior approach; however, there were no differences in patient-reported clinical outcome scores at 1 year between the surgical approaches. [Orthopedics. 2020;43(6):361-366.].


Assuntos
Artroplastia de Quadril/métodos , Articulação do Quadril/cirurgia , Músculo Esquelético/patologia , Atrofia Muscular/etiologia , Idoso , Feminino , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/diagnóstico por imagem , Atrofia Muscular/patologia , Período Pós-Operatório
13.
J Arthroplasty ; 34(10): 2267-2271, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31255408

RESUMO

BACKGROUND: Wearable sensors permit efficient data collection and unobtrusive systems can be used for instrumenting knee patients for objective assessment. Machine learning can be leveraged to parse the abundant information these systems provide and segment patients into relevant groups without specifying group membership criteria. The objective of this study is to examine functional parameters influencing favorable recovery outcomes by separating patients into functional groups and tracking them through clinical follow-ups. METHODS: Patients undergoing primary unilateral total knee arthroplasty (n = 68) completed instrumented timed-up-and-go tests preoperatively and at their 2-, 6-, and 12-week follow-up appointments. A custom wearable system extracted 55 metrics for analysis and a K-means algorithm separated patients into functionally distinguished groups based on the derived features. These groups were analyzed to determine which metrics differentiated most and how each cluster improved during early recovery. RESULTS: Patients separated into 2 clusters (n = 46 and n = 22) with significantly different test completion times (12.6 s vs 21.6 s, P < .001). Tracking the recovery of both groups to their 12-week follow-ups revealed 64% of one group improved their function while 63% of the other maintained preoperative function. The higher improvement group shortened their test times by 4.94 s, (P = .005) showing faster recovery while the other group did not improve above a minimally important clinical difference (0.87 s, P = .07). Features with the largest effect size between groups were distinguished as important functional parameters. CONCLUSION: This work supports using wearable sensors to instrument functional tests during clinical visits and using machine learning to parse complex patterns to reveal clinically relevant parameters.


Assuntos
Artroplastia do Joelho/reabilitação , Aprendizado de Máquina , Estudos de Tempo e Movimento , Dispositivos Eletrônicos Vestíveis , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Articulação do Joelho/fisiologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Equilíbrio Postural
14.
Int Emerg Nurs ; 43: 106-112, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30733005

RESUMO

AIM: Sepsis is a significant and time-sensitive clinical concern for patients who present to Emergency Departments (EDs). Existing guidelines do not define nurses' roles in managing sepsis. This study explored ED nurses' experiences and perceptions around recognising and responding to patients with sepsis, and their awareness of sepsis screening and prognostic tools. The knowledge and insights gained from this study may be used to inform local and international ED policies, and enrich nursing educational packages that may be used to improve quality of patient care and patient outcomes. METHODS: Qualitative design incorporating semi-structured interviews with 14 ED nurses was undertaken. Thematic and consensus-based content analyses were used to explore transcripts. FINDINGS: Six key themes were identified; (1) contribution of the organisation, (2) appreciation of knowledge, (3) appreciation of clinical urgency, (4) appreciation of importance of staff supervision, (5) awareness of the importance of staff experience, and (6) awareness of the need to seek advice. CONCLUSION: ED nurses' identified deficits in their capacity to recognise and respond to patients with sepsis, despite their vital role within the multidisciplinary team that cares for patients with sepsis. The knowledge and insights gained from this study can be used to inform ED policies, to enrich context-specific educational packages that aim to improve quality of patient care and outcomes and identify areas for further research. Development and implementation of a nurse-inclusive sepsis pathway may address many deficits identified in this study.


Assuntos
Enfermagem em Emergência/normas , Papel do Profissional de Enfermagem/psicologia , Sepse/enfermagem , Adolescente , Adulto , Criança , Pré-Escolar , Competência Clínica/normas , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Lactente , Entrevistas como Assunto/métodos , Masculino , Pesquisa Qualitativa , Queensland
15.
Can Urol Assoc J ; 13(8): 260-265, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30526804

RESUMO

INTRODUCTION: Small cell carcinoma of the bladder (SmCC) is a rare and aggressive genitourinary malignancy. The paucity of clinical trials and outcome data provide no standard treatment guidelines. Accordingly, patient prognosis is poor. Our goal was to present the first comprehensive in-depth analysis of SmCC in a tertiary Canadian centre. METHODS: We retrospectively reviewed all patients diagnosed with primary SmCC at the London Regional Cancer Program between January 1990 and 2016. The primary outcome was overall survival (OS). We examined a number of secondary outcomes and baseline characteristics. RESULTS: We identified 15 men and six women (median age 72 years) with a SmCC diagnosis (median followup 11.33 months). Median Charlson Comorbidity Index score was 7 (interquartile range [IQR] 5-10) and 15 patients had a smoking history. Most common presentation was gross hematuria (18 patients, 86%), and pT2 stage at transurethral resection of the bladder tumour (TURBT) (n= 7/21, 33%), although five patients had cT4 (24%). Pure SmCC was found in nine individuals (43%), whereas 12 had mixed differentiation (57%). From initial staging, 15 patients had extravesical disease (71%), 10 had positive pelvic lymphadenopathy (48%), and distant metastases occurred in six (29%). In our series, five individuals (24%) underwent cystectomy, 18 (86%) received radiation, and 14 (67%) received adjuvant chemotherapy. The median OS was 15 months (two-year OS was 19%). CONCLUSIONS: SmCC is a rare and aggressive form of bladder cancer. Despite multimodal therapy, prognosis remains guarded, with little improvement seen over the study's 25-year duration. An understanding of study limitations is warranted in interpretation of results.

16.
Knee ; 25(6): 1278-1282, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30314879

RESUMO

BACKGROUND: Following a total knee arthroplasty (TKA), restoration of the mechanical axis of the lower limb to a neutral position of 0°â€¯±â€¯3° is generally considered the standard of care. Little is known, however, regarding the impact of realignment defined according to the patient's physiologic anatomy on clinical outcome scores. METHODS: The study included 67 knees with a mean age of 65.9 ±â€¯8.3 years with unilateral osteoarthritis (OA) who underwent a primary unilateral TKA for medial end-stage OA. Patients were categorized based on post-operative limb alignment in one of two ways, either based on alignment relative to their contralateral, physiologic side (physiologic), or alignment relative to a neutral axis (neutral). Knee Society Score (KSS), Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC), and the 12-Item Short Form Survey (SF-12) were compared between the two groups. RESULTS: WOMAC Total and subscale scores improved for both groups between the pre- and post-operative time points. SF-12 scores were comparable post-operatively between the groups. WOMAC and KSS total and subscale scores were slightly greater post-operatively in the group not aligned according to their physiologic anatomy (neutral). However, none of these differences reached a level of significance. CONCLUSION: Post-operatively, residual varus and neutral limb alignment lead to comparable clinical outcome scores. In a constitutional varus population with medial end-stage OA, aligning the lower limb during a TKA to a neutral position rather than the patient's native anatomy does not negatively impact self-reported patient outcome scores at the one and two-year time points.


Assuntos
Artroplastia do Joelho/métodos , Genu Varum/cirurgia , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Idoso , Artroplastia do Joelho/efeitos adversos , Feminino , Humanos , Prótese do Joelho/efeitos adversos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente
17.
J Environ Qual ; 46(2): 411-419, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28380572

RESUMO

Biochar has been proposed as an amendment to remediate mine land soils; however, it could be advantageous and novel if feedstocks local to mine land sites were used for biochar production. Two different feedstocks (pine beetle-killed lodgepole pine [] and tamarisk [ spp.]), within close proximity to mine land-affected soils, were used to create biochars to determine if they have the potential to reduce metal bioavailability. Four different mine land soils, contaminated with various amounts of Cd, Cu, Pb, and Zn, received increasing amounts of biochar (0, 5, 10, and 15% by wt). Soil pH and metal bioavailability were determined, and the European Community Bureau of Reference (BCR) sequential extraction procedure was used to identify pools responsible for potential shifts in bioavailability. Increasing biochar application rates caused increases in soil pH (initial, 3.97; final, 7.49) and 55 to 100% (i.e., no longer detectable) decreases in metal bioavailability. The BCR procedure supported the association of Cd with carbonates, Cu and Zn with oxyhydroxides and carbonates, and Pb with oxyhydroxides; these phases were likely responsible for the reduction in heavy metal bioavailability. This study proved that both of these feedstocks local to abandoned mining operations could be used to create biochars and reduce heavy metal bioavailability in mine land soils.


Assuntos
Carvão Vegetal , Metais Pesados/química , Poluentes do Solo/química , Solo
18.
Proc Biol Sci ; 283(1825): 20152869, 2016 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-26888035

RESUMO

Parallel evolution is the independent appearance of similar derived phenotypes from similar ancestral forms. It is of key importance in the debate over whether evolution is stochastic and unpredictable, or subject to constraints that limit available phenotypic options. Nevertheless, its occurrence has rarely been demonstrated above the species level. Climate change on the Australian landmass over the last approximately 20 Myr has provided conditions conducive to parallel evolution, as taxa at the edges of shrinking mesic habitats adapted to drier biomes. Here, we investigate the phylogeny and evolution of Australian soil-burrowing and wood-feeding blaberid cockroaches. Soil burrowers (subfamily Geoscapheinae) are found in relatively dry sclerophyllous and scrubland habits, whereas wood feeders (subfamily Panesthiinae) are found in rainforest and wet sclerophyll. We sequenced and analysed mitochondrial and nuclear markers from 142 specimens, and estimated the evolutionary time scale of the two subfamilies. We found evidence for the parallel evolution of soil-burrowing taxa from wood-feeding ancestors on up to nine occasions. These transitions appear to have been driven by periods of aridification during the Miocene and Pliocene across eastern Australia. Our results provide an illuminating example of climate-driven parallel evolution among species.


Assuntos
Evolução Biológica , Mudança Climática , Baratas/genética , Animais , Austrália , DNA Espaçador Ribossômico/genética , Proteínas de Insetos/genética , Dados de Sequência Molecular , Filogenia , Análise de Sequência de DNA
19.
Clin Epigenetics ; 7: 59, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26221190

RESUMO

BACKGROUND: Recent developments in genomic sequencing have advanced our understanding of the mutations underlying human malignancy. Melanoma is a prototype of an aggressive, genetically heterogeneous cancer notorious for its biologic plasticity and predilection towards developing resistance to targeted therapies. Evidence is rapidly accumulating that dysregulated epigenetic mechanisms (DNA methylation/demethylation, histone modification, non-coding RNAs) may play a central role in the pathogenesis of melanoma. Therefore, we sought to characterize the frequency and nature of mutations in epigenetic regulators in clinical, treatment-naïve, patient melanoma specimens obtained from one academic institution. RESULTS: Targeted next-generation sequencing for 275 known and investigative cancer genes (of which 41 genes, or 14.9 %, encoded an epigenetic regulator) of 38 treatment-naïve patient melanoma samples revealed that 22.3 % (165 of 740) of all non-silent mutations affected an epigenetic regulator. The most frequently mutated genes were BRAF, MECOM, NRAS, TP53, MLL2, and CDKN2A. Of the 40 most commonly mutated genes, 12 (30.0 %) encoded epigenetic regulators, including genes encoding enzymes involved in histone modification (MECOM, MLL2, SETD2), chromatin remodeling (ARID1B, ARID2), and DNA methylation and demethylation (TET2, IDH1). Among the 38 patient melanoma samples, 35 (92.1 %) harbored at least one mutation in an epigenetic regulator. The genes with the highest number of total UVB-signature mutations encoded epigenetic regulators, including MLL2 (100 %, 16 of 16) and MECOM (82.6 %, 19 of 23). Moreover, on average, epigenetic genes harbored a significantly greater number of UVB-signature mutations per gene than non-epigenetic genes (3.7 versus 2.4, respectively; p = 0.01). Bioinformatics analysis of The Cancer Genome Atlas (TCGA) melanoma mutation dataset also revealed a frequency of mutations in the 41 epigenetic genes comparable to that found within our cohort of patient melanoma samples. CONCLUSIONS: Our study identified a high prevalence of somatic mutations in genes encoding epigenetic regulators, including those involved in DNA demethylation, histone modification, chromatin remodeling, and microRNA processing. Moreover, UVB-signature mutations were found more commonly among epigenetic genes than in non-epigenetic genes. Taken together, these findings further implicate epigenetic mechanisms, particularly those involving the chromatin-remodeling enzyme MECOM/EVI1 and histone-modifying enzyme MLL2, in the pathobiology of melanoma.

20.
J Phys Chem B ; 118(51): 14929-41, 2014 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-25495473

RESUMO

Photolysis of nitrate plays an important role in the emission of nitrogen oxides from snow and ice, which affects the composition of the overlying atmosphere. In order to quantify these reactions, it is necessary to know how much nitrate is available for photolysis near the surfaces of snow and ice. The concentration of nitrate excluded from frozen solutions of nitric acid, sodium nitrate, and magnesium nitrate was measured with attenuated total reflection infrared spectroscopy. Liquid water and nitrate were observed at and near the bottom surface of frozen aqueous solutions during annealing from -18 to -2 °C. At -2 °C, the nitrate concentration was determined to be ∼1.0 mol/L for frozen NaNO(3) and Mg(NO(3))(2) solutions and ∼0.8 mol/L for frozen HNO(3) solutions. At lower temperatures, nitrate concentration ranged from 1.6 to 3.7 mol/L. Ideal thermodynamics overestimates nitrate concentration at colder temperatures where the brine is highly concentrated for all solutions. The nitrate concentration at ice surfaces is well described by bulk freezing point depression data close to the melting point of ice and for nitric acid at colder temperatures. Effects of temperature and counterions and implications for modeling snow chemistry are discussed.

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