Donor-site morbidity after free vascularized autogenous fibular transfer: subjective and quantitative analyses

The purpose of this study was to determine the subjective and quantitative donor-site morbidity after removal of a free vascularized fibula flap for autoreconstruction. Ten patients and six age-matched, healthy control subjects were included in this study. The postoperative periods ranged from 6 to 87 months. Subjective donor-site morbidity was assessed with a patient questionnaire and the Enneking system. For quantification of donor-site morbidity, gait was evaluated during normal walking, walking under visual and cognitive constraints, and walking at a velocity higher than the preferred one. In general, the patient perception of donor-site morbidity was low. Complaints were frequently mentioned, however, including pain (60 percent), dysesthesia (50 percent), a feeling of ankle instability (30 percent), and inability to run (20 percent). Gait analyses revealed that patients walked at a lower preferred velocity, compared with control subjects. Furthermore, they demonstrated significant increases in the coefficients of variation of stride time during walking under visual and cognitive loads and during walking at a velocity higher than the preferred one, compared with normal walking. These increases were not observed for control subjects. These findings suggest that the reautomatization of gait is affected among patients. This study demonstrates that fibula harvesting is associated with low subjective morbidity but frequent complaints. Walking during complex tasks and at high velocities reveals that restoration of gait is not complete after partial fibulectomy.     

A search method for homologs of small proteins. Ubiquitin-like proteins in prokaryotic cells?

The question of protein homology versus analogy arises when proteins share a common function or a common structural fold without any statistically significant amino acid sequence similarity. Even though two or more proteins do not have similar sequences but share a common fold and the same or closely related function, they are assumed to be homologs, descendant from a common ancestor. The problem of homolog identification is compounded in the case of proteins of 100 or less amino acids. This is due to a limited number of basic single domain folds and to a likelihood of identifying by chance sequence similarity. The latter arises from two conditions: first, any search of the currently very large protein database is likely to identify short regions of chance match; secondly, a direct sequence comparison among a small set of short proteins sharing a similar fold can detect many similar patterns of hydrophobicity even if proteins do not descend from a common ancestor. In an effort to identify distant homologs of the many ubiquitin proteins, we have developed a combined structure and sequence similarity approach that attempts to overcome the above limitations of homolog identification. This approach results in the identification of 90 probable ubiquitin-related proteins, including examples from the two prokaryotic domains of life, Archaea and Bacteria.     

Kinetic and mutational analyses of the regulation of phosphoribulokinase by thioredoxins

Despite little supportive data, differential target protein susceptibility to redox regulation by thioredoxin (Trx) f and Trx m has been invoked to account for two distinct Trxs in chloroplasts. However, this postulate has not been rigorously tested with phosphoribulokinase (PRK), a fulcrum for redox regulation of the Calvin cycle. Prerequisite to Trx studies, the activation of spinach PRK by dithiothreitol, 2-mercaptoethanol, and glutathione was examined. Contrary to prior reports, each activated PRK, but only dithiothreitol supported Trx-dependent activation. Comparative kinetics of activation of PRK showed Trx m to be more efficient than Trx f because of its 40% higher V(max) but similar S(0.5). Activations were insensitive to ribulosebisphosphate carboxylase, which may complex with PRK in vivo. To probe the basis for superiority of Trx m, we characterized site-directed mutants of Trx f, in which unique residues in conserved regions were replaced with Trx m counterparts or deleted. These changes generally resulted in V(max) enhancements, the largest (6-fold) of which occurred with T105I, reflective of substitution in a hydrophobic region that opposes the active site. Inclusive of the present study, activation kinetics of several different Trx-regulated enzymes indicate redundancy in the functions of the chloroplastic Trxs.     

Sensory compensation and the detection of predators: the interaction between chemical and visual information

Recent evidence suggests that environmental conditions may affect whether fishes do or do not respond to the presence of chemical alarm cues in water. We present a simple model which suggests that the combination of risk of predation and information from other sources will determine when fishes should react to these chemical cues. We tested this model with a laboratory experiment which manipulated the risk of predation by altering the animals (hungry or well fed), or their environment (presence or absence of cover). We also altered the availability of visual information by manipulating the water clarity. Consistent with our model, fishes were most likely to react to chemical alarm cues in the absence of visual information and when the perceived risk of predation was high. The manipulation of either parameter was able to extinguish this response.     

Contrasting long-term alpine and subalpine precipitation trends in a mid-latitude North American mountain system,Colorado Front Range,USA

Background: Long-term climate trends in mountain systems often vary strongly with elevation.

Aims: To evaluate elevation dependence in long-term precipitation trends in subalpine forest and alpine tundra zones of a mid-continental, mid-latitude North American mountain system and to relate such dependence to atmospheric circulation patterns.

Methods: We contrasted 59-year (1952–2010) precipitation records of two high-elevation climate stations on Niwot Ridge, Colorado Front Range, Rocky Mountains, USA. The sites, one in forest (3022 m a.s.l.) and the other in alpine tundra (3739 m), are closely located (within 7 km horizontally, ca. 700 m vertically), but differ with respect to proximity to the mountain-system crest (the Continental Divide).

Results: The sites exhibited significant differences in annual and seasonal precipitation trends, which depended strongly on their elevation and distance from the Continental Divide. Annual precipitation increased by 60 mm (+6%) per decade at the alpine site, with no significant change at the subalpine site. Seasonally, trends at the alpine site were dominated by increases in winter, which we suggest resulted from an increase in orographically generated precipitation over the Divide, driven by upper-air (700 hPa) north-westerly flow. Such a change was not evident at the subalpine site, which is less affected by orographic precipitation on north-westerly flow.

Conclusions: Elevation dependence in precipitation trends appears to have arisen from a change in upper-air flow from predominantly south-westerly to north-westerly. Dependence of precipitation trends on topographic position and season has complex implications for the ecology and hydrology of Niwot Ridge and adjacent watersheds, involving interactions among physical processes (e.g. snowpack dynamics) and biotic responses (e.g. in phenologies and ecosystem productivity).     

Anthropometric Characteristics,Physical Fitness and Motor Coordination of 9 to 11 Year Old Children Participating in a Wide Range of Sports

ObjectivesThe aim of this study was to investigate to what extent 9 to 11 year old children participating in a specific sport already exhibit a specific anthropometric, physical fitness and motor coordination profile, in line with the requirements of that particular sport. In addition, the profiles in children with a different training volume were compared and possible differences in training hours per week between children from a low, moderate, and high level of physical fitness and motor coordination were investigated.DiscussionThe study showed that in general, children at a young age do not exhibit sport-specific characteristics, except in children with a high training volume. It is possible that on the one hand, children have not spent enough time yet in their sport to develop sport-specific qualities. On the other hand, it could be possible that they do not take individual qualities into account when choosing a sport.     

A Systematic Review of Hospital-to-School Reintegration Interventions for Children and Youth with Acquired Brain Injury

Objectives

We reviewed the literature on interventions that aimed to improve hospital-to-school reintegration for children and youth with acquired brain injury (ABI). ABI is the leading cause of disability among children and youth. A successful hospital-to-school reintegration process is essential to the rehabilitative process. However, little is known about the effective components of of such interventions.

Methods and findings

Our research team conducted a systematic review, completing comprehensive searches of seven databases and selected reference lists for relevant articles published in a peer-reviewed journal between 1989 and June 2014. We selected articles for inclusion that report on studies involving: a clinical population with ABI; sample had an average age of 20 years or younger; an intentional structured intervention affecting hospital-to-school transitions or related components; an experimental design; and a statistically evaluated health outcome. Two independent reviewers applied our inclusion criteria, extracted data, and rated study quality. A meta-analysis was not feasible due to the heterogeneity of the studies reported. Of the 6933 articles identified in our initial search, 17 articles (reporting on 350 preadolescents and adolescents, aged 4–19, (average age 11.5 years, SD: 2.21) met our inclusion criteria. They reported on interventions varying in number of sessions (one to 119) and session length (20 minutes to 4 hours). The majority of interventions involved multiple one-to-one sessions conducted by a trained clinician or educator, homework activities, and parental involvement. The interventions were delivered through different settings and media, including hospitals, schools, and online. Although outcomes varied (with effect sizes ranging from small to large), 14 of the articles reported at least one significant improvement in cognitive, social, psychological, or behavioral functioning or knowledge of ABI.

Conclusions

Cognitive, behavioral, and problem-solving interventions have the potential to improve school reintegration for youth with ABI. However, more comprehensive interventions are needed to help link rehabilitation clinicians, educators, adolescents, and families.     

High-Throughput Mutation Profiling Changes before and 3 Weeks after Chemotherapy in Newly Diagnosed Breast Cancer Patients

Background

Changes in tumor DNA mutation status during chemotherapy can provide insights into tumor biology and drug resistance. The purpose of this study is to analyse the presence or absence of mutations in cancer-related genes using baseline breast tumor samples and those obtained after exposure to one cycle of chemotherapy to determine if any differences exist, and to correlate these differences with clinical and pathological features.

Methods

Paired breast tumor core biopsies obtained pre- and post-first cycle doxorubicin (n = 18) or docetaxel (n = 22) in treatment-naïve breast cancer patients were analysed for 238 mutations in 19 cancer-related genes by the Sequenom Oncocarta assay.

Results

Median age of patients was 48 years (range 32–64); 55% had estrogen receptor-positive tumors, and 60% had tumor reduction ≥25% after cycle 1. Mutations were detected in 10/40 (25%) pre-treatment and 11/40 (28%) post-treatment samples. Four mutation pattern categories were identified based on tumor mutation status pre- → post-treatment: wildtype (WT)→WT, n = 24; mutant (MT)→MT, n = 5; MT→WT, n = 5; WT→MT, n = 6. Overall, the majority of tumors were WT at baseline (30/40, 75%), of which 6/30 (20%) acquired new mutations after chemotherapy. Pre-treatment mutations were predominantly in PIK3CA (8/10, 80%), while post-treatment mutations were distributed in PIK3CA, EGFR, PDGFRA, ABL1 and MET. All 6 WT→MT cases were treated with docetaxel. Higher mutant allele frequency in baseline MT tumors (n = 10; PIK3CA mutations n = 8) correlated with less tumor reduction after cycle 1 chemotherapy (R = -0.667, p = 0.035). No other associations were observed between mutation pattern category with treatment, clinicopathological features, and tumor response or survival.

Conclusion

Tumor mutational profiles can change as quickly as after one cycle of chemotherapy in breast cancer. Understanding of these changes can provide insights on potential therapeutic options in residual resistant tumors.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00212082","term_id":"NCT00212082"}}NCT00212082     

Parallel synthesis of N-biaryl quinolone carboxylic acids as selective M1 positive allosteric modulators

An iterative analog library synthesis approach was employed in the exploration of a quinolone carboxylic acid series of selective M₁ positive allosteric modulators, and strategies for improving potency and plasma free fraction were identified.