Benefits beyond cardiometabolic health: the potential of frequent high intensity 'exercise snacks' to improve outcomes for those living with and beyond cancer.

High intensity interval training (HIIT) has been shown to consistently elicit rapid and significant adaptations in a number of physiological systems, across many different healthy and clinical populations. In addition, there is increasing interest in how some acute, yet transient responses to high intensity exercise potentially reduce the risks of particular diseases. Recent work has shown that discrete, brief bouts of high intensity exercise (termed 'exercise snacks') can improve glucose control and vascular health and thus counter the negative cardiometabolic consequences of prolonged, uninterrupted periods of inactivity. In this brief review, we advance the case, using evidence available from pre-clinical studies in the exercise oncology literature, that brief, frequently completed bouts of high intensity exercise embedded within an individual's overall daily and weekly physical activity schedule, may transiently impact the tumour microenvironment and improve the health outcomes for those who have been diagnosed and treated for cancer.

Monson small-incision lenticule extraction fixation device.

Small-incision lenticule extraction (SMILE) is a stromal based, flapless, minimally invasive form of laser vision correction for the treatment of myopia and myopic astigmatism. SMILE surgery is a more technical procedure compared with other refractive surgeries and generally has a longer skill mastery acquisition period. Thus far, no new stabilization devices or techniques have been proposed. To rectify this, a new distal corneal countertraction device for SMILE surgery, the Monson SMILE Fixation Device, is introduced. This device provides reliable corneal and globe stabilization during delamination and lenticular dissection. It may minimize tissue distortion and manipulation, simplify lenticule dissection, and may decrease operation times and improve cosmesis. Countertraction can also easily be adjusted throughout the procedure.

CD122 signaling in CD8+ memory T cells drives costimulation-independent rejection.

Interrupting T cell costimulatory signals as a strategy to control undesired immune responses, such as occur in autoimmunity or transplantation, has the potential to alleviate many of the unwanted side effects associated with current immunosuppressive therapies. Belatacept, a high-affinity version of CTLA4-Ig that blocks ligand ligation to CD28, has been approved for use in kidney transplant recipients. Despite the long-term benefits associated with its use, such as improved renal function and lower cardiovascular risk, a subset of patients treated with belatacept experience elevated rates of acute T cell-mediated rejection, tempering enthusiasm for its use. Here we demonstrate that costimulation-independent T cell alloreactivity relies on signaling through CD122, the shared IL-2 and IL-15 receptor ß-chain. Combined costimulatory and CD122 blockade improved survival of transplanted tissue in mice and nonhuman primates by controlling proliferation and effector function of CD8+ T cells. The high-affinity IL-2 receptor was dispensable for memory CD8+ T cell responses, whereas signaling through CD122 as a component of the high-affinity IL-15 receptor was critical for costimulation-independent memory CD8+ T cell recall, distinguishing specific roles for IL-2 and IL-15 in T cell activation. These studies outline a novel approach for clinical optimization of costimulatory blockade strategies in transplantation by targeting CD122.

Accelerating chronically unresponsive children to tier 3 instruction: what level of data is necessary to ensure selection accuracy?

Response-to-intervention (RTI) approaches to disability identification are meant to put an end to the so-called wait-to-fail requirement associated with IQ discrepancy. However, in an unfortunate irony, there is a group of children who wait to fail in RTI frameworks. That is, they must fail both general classroom instruction (Tier 1) and small-group intervention (Tier 2) before becoming eligible for the most intensive intervention (Tier 3). The purpose of this article was to determine how to predict accurately which at-risk children will be unresponsive to Tiers 1 and 2, thereby allowing unresponsive children to move directly from Tier 1 to Tier 3. As part of an efficacy study of a multitier RTI approach to prevention and identification of reading disabilities (RD), 129 first-grade children who were unresponsive to classroom reading instruction were randomly assigned to 14 weeks of small-group, Tier 2 intervention. Nonresponders to this instruction (n = 33) were identified using local norms on first-grade word identification fluency growth linked to a distal outcome of RD at the end of second grade. Logistic regression models were used to predict membership in responder and nonresponder groups. Predictors were entered as blocks of data from least to most difficult to obtain: universal screening data, Tier 1 response data, norm referenced tests, and Tier 2 response data. Tier 2 response data were not necessary to classify students as responders and nonresponders to Tier 2 instruction, suggesting that some children can be accurately identified as eligible for Tier 3 intervention using only Tier 1 data, thereby avoiding prolonged periods of failure to instruction.

The relevance of periglomerular fibrosis in the evaluation of routine needle core renal biopsies.

CONTEXT: Renal interstitial fibrosis and, to a lesser extent, sclerotic glomeruli correlate with poor renal function. However, not all nonfunctional glomeruli are sclerotic. Many or most glomeruli with periglomerular fibrosis, while retaining blood flow, probably do not filter; therefore, they may not contribute to renal function. OBJECTIVE: To examine the relationship of periglomerular fibrosis and the sum of globally sclerotic glomeruli and glomeruli with periglomerular fibrosis (GSG+PF) with interstitial fibrosis and renal function. DESIGN: Native kidney biopsies from 177 patients with chronic renal injury were assessed for interstitial fibrosis, glomerular sclerosis, and GSG+PF. Renal biopsies with active or acute lesions were not included. The percentage of globally sclerotic glomeruli and GSG+PF was correlated with the degree of interstitial fibrosis and serum creatinine levels. RESULTS: The percentage of GSG+PF correlates better with the degree of interstitial fibrosis and renal function than does the percentage of globally sclerotic glomeruli alone. This appears particularly true in chronic renal diseases of patients without diabetes. The number of globally sclerotic glomeruli correlates better with interstitial fibrosis and renal function than does the sum of globally and segmentally sclerotic glomeruli. CONCLUSIONS: The percentage of GSG+PF in a renal biopsy specimen provides a better estimate of chronic renal injury than does the percentage of sclerotic glomeruli alone, probably because many or most glomeruli with periglomerular fibrosis are nonfunctional. Therefore, we recommend that the number of glomeruli with periglomerular fibrosis also be provided in the renal biopsy report.

Configural features of helmet-mounted displays to enhance pilot situation awareness.

BACKGROUND: In the current research, we used configural displays to investigate what design features contribute to the formation of operator situation awareness (SA). Configural displays have been shown to provide better performance for integration tasks, yet the design aspects of these displays which affect the formation of operator SA have not been determined. OBJECTIVE: We compared the design features of three configural attitude head-up displays (HUD) [joint strike fighter (JSF), dual articulated (DA), and arc segment attitude reference (ASAR)] presented on a helmet mounted display (HMD) across four experiments to quantify what aspects of configural displays would affect pilot SA. METHODS: In Experiment 1, nine expert pilots completed recall tasks for briefly-presented aircraft attitude displays to measure Level 1 SA performance. In Experiments 2-4, 10 highly trained pilots (expert group) and 10 flight test engineers (novice group) served as subjects to investigate higher level SA performance in an unusual attitude recovery (UAR) task. Experiments 3 and 4 included off-axis attitude symbology UARs. RESULTS: Experiment 1 results indicated a higher percentage of correct responses for recognition of climb and dive states with the ASAR configural display. Results from Experiments 2-4 indicated no differences in performance. Results also showed that transitioning between dissimilar configural displays conveying attitude does not affect pilot SA. CONCLUSIONS: This research discusses the specific properties of aviation configural displays. The results suggest that using these displays with the full range of aircraft states is sufficient for SA to be established when rapidly transitioning between dissimilar configural displays. Results indicate that differences in performance are diminished when using experts and significant training may overcome differences that exist among the configural displays.

Dermal cysts: a dermatopathological perspective and histological reappraisal.

Dermal cysts constitute an extremely common entity routinely encountered in dermatology and dermatopathology practice. Their ubiquity, overlapping clinical presentation, dermal location, and histologic diversity can engender diagnostic quandary. Though basically defined by the histologic presence of an epithelial lining, cysts derive from a variety of sources including developmental defects, trauma, and tumoral degeneration. Herein, we will discuss the dermatopathologic attributes of the more common dermal cyst entities, updating the most recent and pertinent literature.

Predicting response to early reading intervention from verbal IQ, reading-related language abilities, attention ratings, and verbal IQ-word reading discrepancy: failure to validate discrepancy method.

Additional analyses of a previously published study addressed three questions about growth in word reading during early reading intervention: (1) How well do Verbal IQ, reading-related language abilities (phonological, rapid naming, and orthographic), and attention ratings predict reading growth? (2) How well do language deficits predict reading growth? and (3) How well does Verbal IQ-word reading discrepancy predict reading growth? Univariate analyses showed that Verbal IQ, phonological skills, orthographic skills, rapid automatized naming (RAN), and attention ratings predicted the response to early intervention, but multivariate analyses based on a combination of predictors for real-word reading and pseudoword reading showed that Verbal IQ was not the best unique predictor. Students with double or triple deficits in language skills (RAN, phonological, and orthographic processing) responded more slowly to early intervention than students without language deficits. Verbal IQ-word reading discrepancy did not predict the response to early intervention in reading. Overall results supported the use of reading-related language and attention measures rather than IQ-achievement discrepancy in identifying candidates for early reading intervention.