Methodology of evaluation of morphology of the spine and the trunk in idiopathic scoliosis and other spinal deformities - 6th SOSORT consensus paper

Background

Comprehensive evaluation of the morphology of the spine and of the whole body is essential in order to correctly manage patients suffering from progressive idiopathic scoliosis. Although methodology of clinical and radiological examination is well described in manuals of orthopaedics, there is deficit of data which clinical and radiological parameters are considered in everyday practise. Recently, an increasing tendency to extend scoliosis examination beyond the measure of the Cobb angle can be observed, reflecting a more patient-oriented approach. Such evaluation often involves surface parameters, aesthetics, function and quality of life.

Aim of the study

To investigate current recommendations of experts on methodology of evaluation of the patient with spinal deformity, essentially idiopathic scoliosis.

Methods

Structured Delphi procedure for collecting and processing knowledge from a group of experts with a series of questionnaires and controlled opinion feedback was performed. Experience and opinions of the professionals - physicians and physiotherapists managing scoliosis patients - were studied. According to Delphi method a Meeting Questionnaire (MQ) has been developed, resulting from a preliminary Pre-Meeting Questionnaire (PMQ) which had been previously discussed and approved on line. The MQ was circulated among the SOSORT experts during Consensus Session on "Measurements" which took place at the Annual Meeting of the Society, totally 23 panellists being engaged. Clinical, radiological and surface topography parameters were checked for agreement.

Results

90% agreement or more was reached in 35 items and superior than 75% agreement was reached in further 25 items. An evaluation form was proposed to be used by clinicians and researchers.

Conclusion

The consensus was reached on evaluation of the morphology of the patient with idiopathic scoliosis, comprising clinical, radiological and, to less extend, surface topography assessment. Considering the variety of parameters indicated by the panellists, the Cobb angle, yet the gold standard, can be seen neither as the unique nor the only decisive parameter in the management of patients with idiopathic scoliosis.     

A methodological approach to assess and compare the sustainability level of agricultural plant production systems

A large number of indicators have been developed, in order to assess agricultural sustainability. However, there is no unified theoretical basis for the creation of a scientifically substantiated system of indicators and especially for data collection, analysis, scale and final goal. This paper proposes a methodological approach to assess and to compare the sustainability level of agricultural plant production systems on regional scale combining the three pillars of sustainability environment, economy and society. The combination of 21 individual indicators expressed a unique indicator was realized using the Multiattribute Value Theory (MAVT). The proposed methodology was testified on two geographical regions in Greece, through an empirical study, utilizing questionnaires completed during interviews with farm managers. The questionnaire was designed to gather data on current agricultural practices applied in each particular region and was separated into three broad groups of questions concerning (a) crop management practices, (b) economic performance and (c) social characteristics of each farm. The results of our study demonstrate the overall status of the studied regions, regarding their level of agricultural sustainability. Finally, findings related to the acceptability of the proposed methodological framework were discussed.     

Synthesis and SAR studies of very potent imidazopyridine antiprotozoal agents

Compounds 10a (IC50 110 pM) and 21 (IC50 40 pM) are the most potent inhibitors of Eimeria tenella cGMP-dependent protein kinase activity reported to date and are efficacious in the in vivo antiparasitic assay when administered to chickens at 12.5 and 6.25 ppm levels in the feed. However, both compounds are positive in the Ames microbial mutagenesis assay which precludes them from further development as antiprotozoal agents in the absence of negative lifetime rodent carcinogenicity studies.     

Synthesis and SAR of 2-(4-fluorophenyl)-3-pyrimidin-4-ylimidazo[1,2-a]pyridine derivatives as anticoccidial agents

Compounds 10a-10d and 10i are very potent inhibitors of Eimeria tenella cGMP-dependent protein kinase (0.081-0.32 nM) and are very efficacious antiparasitic agents in vivo when administered to chickens at 12.5-25 ppm levels in the feed.     

Life History,Reproduction, Growth,Population Dynamics and Production of Gammarus aequicauda (Crustacea: Amphipoda) at Extremely Low Salinities in a Mediterranean Lagoon

Aspects of the biology of Gammarus aequicauda were studied at extremely low salinities (0.3–5.7 psu) in Monolimni Lagoon, N. Aegean Sea. Samples were collected monthly from February 1998 to February 1999. Breeding occurred continuously but peaked in late spring, late summer and autumn and three cohorts were produced. The spring and summer cohorts showed fast growth (0.15 mm d^–1), accelerated maturity and life span of about three and seven months respectively, while the overwintering cohort showed a life span of about nine months. The largest individual had a body length of 23.6 mm. Mean brood size was 54.5 early embryos, while the intramarsupial loss was 46%. Population density sharply increased in late spring, summer and autumn. Secondary production calculated by Hynes' method gave a mean annual density of 1077.4 ind. m^–2, a mean annual crop (B) of 2.93 g DW m^–2, an annual production (P) of 35.03 g DW m^–2 and a P: B ratio of 11.96. Gammarus aequicauda showed a life‐history pattern similar to those previously reported for this species at higher salinity environments with comparatively large final body length and high growth rate during summer, brood size and P: B ratio, but with high embryo loss as well. (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

MAPKs and NF-κB differentially regulate cytokine expression in the diaphragm in response to resistive breathing: the role of oxidative stress

Inspiratory resistive breathing (IRB) induces cytokine expression in the diaphragm. The mechanism of this cytokine induction remains elusive. The roles of MAPKs and NF-κB and the impact of oxidative stress in IRB-induced cytokine upregulation in the diaphragm were studied. Wistar rats were subjected to IRB (50% of maximal inspiratory pressure) via a two-way nonrebreathing valve for 1, 3, or 6 h. Additional groups of rats subjected to IRB for 6 h were randomly assigned to receive either solvent or N-acetyl-cysteine (NAC) or inhibitors of NF-κB (BAY-11-7082), ERK1/2 (PD98059), and P38 MAPK (SB203580) to study the effect of oxidative stress, NF-κB, and MAPKs in IRB-induced cytokine upregulation in the diaphragm. Quietly breathing animals served as controls. IRB upregulated cytokine (IL-6, TNF-α, IL-10, IL-2, IL-1β) protein levels in the diaphragm and resulted in increased activation of MAPKs (P38, ERK1/2) and NF-κB. Inhibition of NF-κB and ERK1/2 blunted the upregulation of all cytokines except that of IL-6, which was further increased. P38 inhibition attenuated all cytokine (including IL-6) upregulation. Both P38 and ERK1/2 inhibition decreased NF-κB/p65 subunit phosphorylation. NAC pretreatment blunted IRB-induced cytokine upregulation in the diaphragm and resulted in decreased ERK1/2, P38, and NF-κB/p65 phosphorylation. In conclusion, IRB-induced cytokine upregulation in the diaphragm is under the regulatory control of MAPKs and NF-κB. IL-6 is regulated differently from all other cytokines through a P38-dependent and NF-κB independent pathway. Oxidative stress is a stimulus for IRB-induced cytokine upregulation in the diaphragm.     

Distinguishing Closely Related Amyloid Precursors Using an RNA Aptamer

Although amyloid fibrils assembled in vitro commonly involve a single protein, fibrils formed in vivo can contain multiple protein sequences. The amyloidogenic protein human β₂-microglobulin (hβ₂m) can co-polymerize with its N-terminally truncated variant (ΔN6) in vitro to form hetero-polymeric fibrils that differ from their homo-polymeric counterparts. Discrimination between the different assembly precursors, for example by binding of a biomolecule to one species in a mixture of conformers, offers an opportunity to alter the course of co-assembly and the properties of the fibrils formed. Here, using hβ₂m and its amyloidogenic counterpart, ΔΝ6, we describe selection of a 2′F-modified RNA aptamer able to distinguish between these very similar proteins. SELEX with a N30 RNA pool yielded an aptamer (B6) that binds hβ₂m with an EC₅₀ of ∼200 nm. NMR spectroscopy was used to assign the ¹H-¹⁵N HSQC spectrum of the B6-hβ₂m complex, revealing that the aptamer binds to the face of hβ₂m containing the A, B, E, and D β-strands. In contrast, binding of B6 to ΔN6 is weak and less specific. Kinetic analysis of the effect of B6 on co-polymerization of hβ₂m and ΔN6 revealed that the aptamer alters the kinetics of co-polymerization of the two proteins. The results reveal the potential of RNA aptamers as tools for elucidating the mechanisms of co-assembly in amyloid formation and as reagents able to discriminate between very similar protein conformers with different amyloid propensity.     

Population Dynamics,Reproductive Biology and Productivity of Streblospio shrubsolii (Polychaeta: Spionidae) in Different Sediments at Low Salinities in a Mediterranean Lagoon (Monolimni Lagoon,Northern Aegean)

Monthly samples of Streblospio shrubsolii were collected from February 1998 to February 1999 at both parts of Monolimni Lagoon (0.3 psu < Sal. < 6 psu). Streblospio shrubsolii displayed a life cycle of about one year. Reproductive activity occurred from February to October. The worms showed a mean of 14 or 16 gametogenic segments. Reproductive activity, growth and density increased during spring despite the low salinities (∼0.3 psu). Streblospio shrubsolii showed faster growth, larger body size during autumn–winter, more reproductive peaks, a relatively higher mean annual density, mean anual biomass (B) and annual production (P) at the innermost part of the lagoon, in organically richer very fine sand, than those at the outer part in fine sand. Mean annual density was 1,320 individuals m^–2 at the outer part and 1,745 individuals m^–2 at the innermost. Production calculated by Hynes' s method gave a B of 0.20 g DW m^–2 y^–1 and P of 0.45 g DW m^–2 y^–1 at the outer part; the respective values at the innermost part were 0.29 g DW m^–2 y^–1 and 0.61 g DW m^–2 y^–1. (© 2005 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)