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.     

The presence of heterospecific pollen on stigmas of nectariferous and nectarless orchids and its consequences for their reproductive success

Summary The widespread occurrence of nonorchid, heterospecific pollen grains on the stigmatic surfaces of a range of nectariferous and nectarless European orchids (Dactylorhiza. Orchis, Goodyera, andGymnadenia species) is reported for the first time, and the impact of heterospecific pollination on orchid reproductive success is experimentally investigated. There are three main components of stigmatic contamination by heterospecific pollen: the frequency of contamination, the diversity of foreign species present on the stigma, and the amount of pollen deposited. Six out of seven of the species examined have greater than 85% of stigmas contaminated with wind and insect-dispersed pollen. From one to nine insect-dispersed foreign pollen species are present per stigma, including pollen of members of the families Apiaceae, Asteraceae, Caryohpyllaceae, Ericaceae, and Primulaceae. Average loads per stigma vary from 13 to 176 grains, with individual stigma loads ranging from one to 909. Whether or not the orchid provides nectar has a major impact on these three components. Nectarless orchids have the greatest frequencies of contamination, diversity of species, and average load per stigma. Insect-dispersed pollen is deposited both by pollinators and visitors but, in spite of low levels of pollination, nectarless orchids still exhibit higher frequencies of heterospecific pollen contamination. The effect of the presence of heterospecific pollen on the reproductive success of orchids is tested in this study for the first time. Average-to-high, naturally occurring loads of heterospecific pollen derived from a mixture ofArmeria maritima,Caltha palustris,Cochlearia officinalis,Cytisus scoparius, andPrimula vulgaris and consisting of 50–250 grains per load are placed onto stigmas ofDactylorhiza purpurella which are subsequently self-pollinated with half of a pollinium. All pollinations produce capsules indicating that heterospecific pollen does not affect fruit set. Although experimental and control fruits are similar in size, they differ in total seed weight and composition. Total seed weight is reduced and the proportion of seeds with normal embryos decreased while the proportion of unfertilised ovules increased following pollination with heterospecific pollen, indicating a detrimental effect on fertilisation. Lower reproductive success caused by fertilisation failure is likely to be most severe in nectarless species because of their generally higher levels of contaminated stigmas. As nectarless orchids are known to have lower fruit set compared with nectariferous ones, this finding suggests that the reproductive success of nectarless orchids may be even lower than previously realised.Abbreviations RS reproductive success