Exercise training in childhood-onset systemic lupus erythematosus: a controlled randomized trial

Introduction

Exercise training has emerged as a promising therapeutic strategy to counteract physical dysfunction in adult systemic lupus erythematosus. However, no longitudinal studies have evaluated the effects of an exercise training program in childhood-onset systemic lupus erythematosus (C-SLE) patients. The objective was to evaluate the safety and the efficacy of a supervised aerobic training program in improving the cardiorespiratory capacity in C-SLE patients.

Methods

Nineteen physically inactive C-SLE patients were randomly assigned into two groups: trained (TR, n = 10, supervised moderate-intensity aerobic exercise program) and non-trained (NT, n = 9). Gender-, body mass index (BMI)- and age-matched healthy children were recruited as controls (C, n = 10) for baseline (PRE) measurements only. C-SLE patients were assessed at PRE and after 12 weeks of training (POST). Main measurements included exercise tolerance and cardiorespiratory measurements in response to a maximal exercise (that is, peak VO₂, chronotropic reserve (CR), and the heart rate recovery (ΔHRR) (that is, the difference between HR at peak exercise and at both the first (ΔHRR1) and second (ΔHRR2) minutes of recovery after exercise).

Results

The C-SLE NT patients did not present changes in any of the cardiorespiratory parameters at POST (P > 0.05). In contrast, the exercise training program was effective in promoting significant increases in time-to-exhaustion (P = 0.01; ES = 1.07), peak speed (P = 0.01; ES = 1.08), peak VO₂ (P = 0.04; ES = 0.86), CR (P = 0.06; ES = 0.83), and in ΔHRR1 and ΔHRR2 (P = 0.003; ES = 1.29 and P = 0.0008; ES = 1.36, respectively) in the C-SLE TR when compared with the NT group. Moreover, cardiorespiratory parameters were comparable between C-SLE TR patients and C subjects after the exercise training intervention, as evidenced by the ANOVA analysis (P > 0.05, TR vs. C). SLEDAI-2K scores remained stable throughout the study.

Conclusion

A 3-month aerobic exercise training was safe and capable of ameliorating the cardiorespiratory capacity and the autonomic function in C-SLE patients.

Trial registration

NCT01515163.     

Automated Entire Thrombus Density Measurements for Robust and Comprehensive Thrombus Characterization in Patients with Acute Ischemic Stroke

Background and Purpose

In acute ischemic stroke (AIS) management, CT-based thrombus density has been associated with treatment success. However, currently used thrombus measurements are prone to inter-observer variability and oversimplify the heterogeneous thrombus composition. Our aim was first to introduce an automated method to assess the entire thrombus density and then to compare the measured entire thrombus density with respect to current standard manual measurements.

Materials and Method

In 135 AIS patients, the density distribution of the entire thrombus was determined. Density distributions were described using medians, interquartile ranges (IQR), kurtosis, and skewedness. Differences between the median of entire thrombus measurements and commonly applied manual measurements using 3 regions of interest were determined using linear regression.

Results

Density distributions varied considerably with medians ranging from 20.0 to 62.8 HU and IQRs ranging from 9.3 to 55.8 HU. The average median of the thrombus density distributions (43.5 ± 10.2 HU) was lower than the manual assessment (49.6 ± 8.0 HU) (p<0.05). The difference between manual measurements and median density of entire thrombus decreased with increasing density (r = 0.64; p<0.05), revealing relatively higher manual measurements for low density thrombi such that manual density measurement tend overestimates the real thrombus density.

Conclusions

Automatic measurements of the full thrombus expose a wide variety of thrombi density distribution, which is not grasped with currently used manual measurement. Furthermore, discrimination of low and high density thrombi is improved with the automated method.     

Towards a framework for the evolutionary genomics of Kinetoplastids: what kind of data and how much?

The current status of kinetoplastids phylogeny and evolution is discussed in view of the recent progresses on genomics. Some ideas on a potential framework for the evolutionary genomics of kinetoplastids are presented.     

The role of intravascular ultrasound imaging in vascular brachytherapy

Intracoronary brachytherapy has recently emerged as a new therapy to prevent restenosis. Initial experimental work was achieved in animal models and the results were assessed by histomorphometry. Initial clinical trials used angiography to guide dosimetry and to assess efficacy. Intravascular ultrasound (IVUS) permits tomographic examination of the vessel wall, elucidating the true morphology of the lumen and transmural components, which cannot be investigated on the lumenogram obtained by angiography. This paper reviews the use of IVUS in the clinical studies of brachytherapy conducted to date. IVUS allows clinicians to make a thorough assessment of the remodeling of the vessel and appears to have a major role to play in facilitating understanding of the underlying mechanisms of action in this emerging field. The authors propose that state-of-the-art IVUS techniques should be employed to further knowledge of the mechanisms of action of brachytherapy in atherosclerotic human coronary arteries.     

Improving model construction of profile HMMs for remote homology detection through structural alignment

Background  

Remote homology detection is a challenging problem in Bioinformatics. Arguably, profile Hidden Markov Models (pHMMs) are one of the most successful approaches in addressing this important problem. pHMM packages present a relatively small computational cost, and perform particularly well at recognizing remote homologies. This raises the question of whether structural alignments could impact the performance of pHMMs trained from proteins in the Twilight Zone, as structural alignments are often more accurate than sequence alignments at identifying motifs and functional residues. Next, we assess the impact of using structural alignments in pHMM performance.     

Synthesis and Secretion of Hypoxyproline-containing Macromolecules in Carrots: III. Metabolic Requirements for Secretion

Using pulse-chase experiments with radioactive proline, it is possible to study the rapid transfer from the cytoplasm to the cell wall of the hydroxyproline-rich protein found in the cell walls of higher plants. The secretion of this protein is not obligatorily coupled to protein synthesis. Secretion is completely inhibited by uncouplers of oxidative phosphorylation and strongly inhibited by the inhibitors of electron transport, cyanide and azide. It is concluded that the transfer of proteins from the cytoplasm to the cell wall is an energy-requiring step.     

Studies of dotted,a regulatory element in maize

Summary Dotted (Dt) is the regulatory element of a two-unit controlling system in maize. Dt causes the inherited change from the recessive a ₁ (colorless) to its dominant allele, A ₁ (anthocyanin production), during the development of the stalk, leaves, and endosperm. The mutation events are observed as sectors of color in an anthocyaninless background.One of the most puzzling, but perhaps significant, aspects of controlling elements in maize is that they originate in conjunction with chromosome or chromatid breaks. This fact invokes a requirement that either an existing regulatory mechanism is disturbed by the breakage or that a foreign element is incorporated before fusion of the broken chromatids.Experimental crosses were made between Dt tester stocks and a pollen parent, a large proportion of whose chromosomes 9 were undergoing the chromatid type of bridge-breakage-fusion cycle. New Dt's were induced in endosperm sectors of 250 of 154,422 kernels tested (1/600); among these, two germinal Dt's (Dt ^crown ₄ and Dt ₅) were recovered, presumably due to chromatid breaks during meiosis or the first microspore division. Dt ₅ produces a mutation pattern very similar to the original Dt ₁ and is located 0.33 crossover units away from the yg ₂ locus. This is close to the known location of Dt ₁ (7 crossover units distal to the yg ₂ locus) and is suggestive of a specific site for Dt inductive breaks. Dt ^crown ₄, on the other hand, is inherited independently of the yg ₂ locus and does not support this contention. Dt ^crown ₄ represents a new state causing a high concentration of fine dots in the crown of the kernel, with little or no dotting at the base.The phase variation of Dt ^crown ₄ is discussed together with the tissue-dependent expression of Dt ^in-ac ₁ (Dotted, inactive-active). Dt ^in-ac ₁ is a new state of Dt ₁ and shows inactive (no a ₁ to A ₁ mutations) and active (a ₁ to A ₁ mutations) phases in the endosperm, whereas it is only in the active phase in the diploid scutellum. The observed phase variation was shown to be a property of the regulatory elements, Dt, responding to differences in the cellular environment.In appreciation of his help and guidance, I dedicate this article to Professor Marcus M. Rhoades on his birthday.Journal Paper No. J-7454 of the Iowa Agriculture and Home Economics Experiment Station, Ames, Iowa. Project No. 1880.