Extracellular sheath formation by Sphaeropsis hypodermia and association with its infection in elm trees

Nous avons observé le mode de développement de Sphaeropsis hypodermia (isolé d'une branche d'orme (Ulmus americana) atteinte d'un chancre) dans les milieux suivants : un milieu gélosé (PDA), un tissu essuie-tout (Kimwipes), des blocs de bois d'orme stérilisés à l'autoclave, et des ormes d'Amérique inoculés en serre. Des échantillons de chaque substrat ont été fixés pour les observations en microscopie photonique et en microscopie électronique avec du glutaraldéhyde et du tétroxyde d'osmium. Observés en microscopie électronique, les hyphes accolés au substrat étaient entourés d'une épaisse couche extracellulaire devenant circonscrite par des bandes rigides et contenant des corps opaques simples ou agrégés, ou des masses de matière opaque plus volumineuses dans le cas des blocs de bois d'orme. Sur celui-ci et sur le tissu Kimwipes, la couche extracellulaire s'étendait sur une distance appréciable, loin des cellules fongiques, et avait également pénétré les parois de cellules de parenchyme et des fibres, selon le cas. Dans les ormes inoculés, le champignon a rapidement produit des dommages notables dans les tissus du cambium et colonisé abondamment les régions de l'écorce et du xylème avoisinantes. La pénétration et la dégradation des parois cellulaires de l'écorce étaient marquées, en relation également avec de la matière opaque entourant les cellules du champignon. Cette matière ressemblait à celle liée aux cellules fongiques sur les milieux stérilisés. Bien que les cellules du xylème étaient généralement colonisées, des altérations pariétales n'étaient apparentes que dans les cellules récemment formées. En outre, le passage du champignon d'une cellule à l'autre à travers les parois n'a été observé que dans le cas des éléments de vaisseaux et des cellules de rayon. Concernant les fibres, seule y était visible une bande de matière filamenteuse dans les parois et liant les cellules fongiques présentes dans la lumière de ces fibres. En réponse à la dégradation de parois cellulaires liée à de la matière opaque, l'hypertrophie et l'hyperplasie des cellules du cambium et de l'écorce interne ont été observées, liées possiblement à la formation d'une barrière de protection. On discute du rôle possible de la couche extracellulaire des cellules fongiques in vivo et in vitro.Sphaeropsis hypodermia, isolated from a cankered American elm branch, was grown on agar medium (PDA), on autoclaved wiping paper (Kimwipes), and American elm (Ulmus americana) wood chips, or inoculated into greenhouse-grown American elm saplings. Samples from each treatment were double-fixed with glutaraldehyde and osmium tetroxide and examined with the light and the transmission electron microscopes. Ultrastructurally, the hyphae on PDA and inert substrates appeared surrounded by large extracellular sheaths which were delimited by rigid opaque bands of various thicknesses. The sheaths extended appreciable distances from the fungal cells, as evidenced by their adherence to rigid substrates. Individual or aggregated opaque bodies, even as large masses on elm wood chips, were the main components of the sheath. This opaque material was often associated with penetration and ruptures of the wood cells. Inoculated into elm trees, the fungus rapidly caused pronounced alterations of cambial tissues and colonized the adjoining bark and xylem cells. The prominent penetration and breakdown of the inner and outer bark cells by the fungus were associated with opaque material, particularly in cortical fibres. The material was structurally similar to the sheath formed on the rigid sterilized substrates. In the xylem, only the walls of the recently deposited cells were visibly altered, and although mature fibres were generally colonized, the passage of the fungus from one fibre to another was rarely observed, contrary to the passage from vessel and ray cells to adjoining cells. In that instance, only bands of opaque material present in the walls of fibres were connected with fungal cells in their lumen. In the inner bark and cambial regions, cell hypertrophy and hyperplasia occurred next to host walls that were altered and contained similar opaque material. The extracellular sheath of S. hypodermia under in vitro conditions and the opaque material associated with host wall alterations in vivo are considered to be analogous

Flipping quantum coins

Coin flipping is a cryptographic primitive in which two distrustful parties wish to generate a random bit in order to choose between two alternatives. This task is impossible to realize when it relies solely on the asynchronous exchange of classical bits: one dishonest player has complete control over the final outcome. It is only when coin flipping is supplemented with quantum communication that this problem can be alleviated, although partial bias remains. Unfortunately, practical systems are subject to loss of quantum data, which restores complete or nearly complete bias in previous protocols. We report herein on the first implementation of a quantum coin-flipping protocol that is impervious to loss. Moreover, in the presence of unavoidable experimental noise, we propose to use this protocol sequentially to implement many coin flips, which guarantees that a cheater unwillingly reveals asymptotically, through an increased error rate, how many outcomes have been fixed. Hence, we demonstrate for the first time the possibility of flipping coins in a realistic setting. Flipping quantum coins thereby joins quantum key distribution as one of the few currently practical applications of quantum communication. We anticipate our findings to be useful for various cryptographic protocols and other applications, such as an online casino, in which a possibly unlimited number of coin flips has to be performed and where each player is free to decide at any time whether to continue playing or not.Comment: 17 pages, 3 figure

Fair Loss-Tolerant Quantum Coin Flipping

Coin flipping is a cryptographic primitive in which two spatially separated players, who in principle do not trust each other, wish to establish a common random bit. If we limit ourselves to classical communication, this task requires either assumptions on the computational power of the players or it requires them to send messages to each other with sufficient simultaneity to force their complete independence. Without such assumptions, all classical protocols are so that one dishonest player has complete control over the outcome. If we use quantum communication, on the other hand, protocols have been introduced that limit the maximal bias that dishonest players can produce. However, those protocols would be very difficult to implement in practice because they are susceptible to realistic losses on the quantum channel between the players or in their quantum memory and measurement apparatus. In this paper, we introduce a novel quantum protocol and we prove that it is completely impervious to loss. The protocol is fair in the sense that either player has the same probability of success in cheating attempts at biasing the outcome of the coin flip. We also give explicit and optimal cheating strategies for both players.Comment: 12 pages, 1 figure; various minor typos corrected in version

Historical influence on the practice of chiropractic radiology: Part I - a survey of Diplomates of the American Chiropractic College of Radiology

Background It is known that not all chiropractors follow mainstream guidelines on the use of diagnostic ionising radiation. Various reasons have been discussed in the literature, including using radiography to screen for congenital anomalies, to perform postural analysis, to search for contraindications to spinal manipulation, and to document chiropractic subluxations, i.e., tiny anatomical displacements of vertebrae thought to affect nerves and health. The visualisation of subluxations was the reason chiropractic first adopted the x-ray in 1910. There has never been a study of the influence of this historical paradigm of radiography on the practices of chiropractic radiologists (DACBRs or Diplomates of the American Chiropractic College of Radiology). Methods A survey was administered with a modified Dillman method using SurveyMonkey and supplemented by hard copies distributed at a professional conference. The target population was all active DACBRs. There were 34 items, which consisted of multiple choice and open-ended interrogatives on all three areas in which chiropractic radiologists work: education, clinical practice, and radiology practice. Results The response rate was 38% (73 of 190 DACBRs). Respondents reported that the historical paradigm of radiography was found in all areas of practice, but not as a major aspect. The majority of respondents did not condone that historical paradigm, but many tolerated it, particularly from referring chiropractors. Radiographic subluxation analysis was reportedly perpetuated by private clinical practitioners as well as technique instructors and supervising clinicians in the teaching institutions. Conclusions Within the chiropractic profession, there is a continuing belief in radiographically visible subluxations as a cause of suboptimal health. This situation is sustained in part due to the reticence of other chiropractors to report these practices to licensing and registration boards. Investigation into other structures supporting a vitalistic belief system over science in chiropractic is recommended. In addition, it may be useful to explore remunerative systems that move beyond the inherently conflicted fee-for-service model

Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework

Background: The Theoretical Domains Framework (TDF) was developed to investigate determinants of specific clinical behaviors and inform the design of interventions to change professional behavior. This framework was used to explore the beliefs of chiropractors in an American Provider Network and two Canadian provinces about their adherence to evidence-based recommendations for spine radiography for uncomplicated back pain. The primary objective of the study was to identify chiropractors’ beliefs about managing uncomplicated back pain without xrays and to explore barriers and facilitators to implementing evidence-based recommendations on lumbar spine xrays. A secondary objective was to compare chiropractors in the United States and Canada on their beliefs regarding the use of spine x-rays. Methods: Six focus groups exploring beliefs about managing back pain without x-rays were conducted with a purposive sample. The interview guide was based upon the TDF. Focus groups were digitally recorded, transcribed verbatim, and analyzed by two independent assessors using thematic content analysis based on the TDF. Results: Five domains were identified as likely relevant. Key beliefs within these domains included the following: conflicting comments about the potential consequences of not ordering x-rays (risk of missing a pathology, avoiding adverse treatment effects, risks of litigation, determining the treatment plan, and using x-ray-driven techniques contrasted with perceived benefits of minimizing patient radiation exposure and reducing costs; beliefs about consequences); beliefs regarding professional autonomy, professional credibility, lack of standardization, and agreement with guidelines widely varied (social/professional role & identity); the influence of formal training, colleagues, and patients also appeared to be important factors (social influences); conflicting comments regarding levels of confidence and comfort in managing patients without x-rays (belief about capabilities); and guideline awareness and agreements (knowledge). Conclusions: Chiropractors’ use of diagnostic imaging appears to be influenced by a number of factors. Five key domains may be important considering the presence of conflicting beliefs, evidence of strong beliefs likely to impact the behavior of interest, and high frequency of beliefs. The results will inform the development of a theorybased survey to help identify potential targets for behavioral-change strategies

Vision evaluation tools for adults with acquired brain injury: A scoping review = Outils d’évaluation de la vision pour les adultes atteints de lésions cérébrales acquises : une revue de portée

Background. Unrecognized visual deficits (VDs) following an acquired brain injury (ABI) may impact clients? rehabilitation. Little is known about evaluation tools used in vision rehabilitation. Purpose. To systematically explore the literature describing evaluation tools used for VD on adults with ABI. Method. Using a scoping review methodology, we searched in MEDLINE(Ovid), Embase, CINAHL, PsycINFO, and the grey literature from inception to 2020. Quantitative and thematic analyses were performed. Findings. Of the 83 studies reporting on 86 evaluation tools, 47% used multiple tools to assess VD. Tools were mostly used by occupational therapists and psychologists to evaluate intermediate, intermediate to high, and high-level visual skills. Clinicians tend to select specific tools that focus on different levels of the hierarchy of visual skills. Implications. Future research should investigate the optimal timeframe for assessment of VD and the psychometric properties of tools to ensure comprehensive VD evaluation

Intra-Host Evolution Analyses in an Immunosuppressed Patient Supports SARS-CoV-2 Viral Reservoir Hypothesis.

Throughout the SARS-CoV-2 pandemic, several variants of concern (VOCs) have been identified, many of which share recurrent mutations in the spike glycoprotein's receptor-binding domain (RBD). This region coincides with known epitopes and can therefore have an impact on immune escape. Protracted infections in immunosuppressed patients have been hypothesized to lead to an enrichment of such mutations and therefore drive evolution towards VOCs. Here, we present the case of an immunosuppressed patient that developed distinct populations with immune escape mutations throughout the course of their infection. Notably, by investigating the co-occurrence of substitutions on individual sequencing reads in the RBD, we found quasispecies harboring mutations that confer resistance to known monoclonal antibodies (mAbs) such as S:E484K and S:E484A. These mutations were acquired without the patient being treated with mAbs nor convalescent sera and without them developing a detectable immune response to the virus. We also provide additional evidence for a viral reservoir based on intra-host phylogenetics, which led to a viral substrain that evolved elsewhere in the patient's body, colonizing their upper respiratory tract (URT). The presence of SARS-CoV-2 viral reservoirs can shed light on protracted infections interspersed with periods where the virus is undetectable, and potential explanations for long-COVID cases

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults

PURPOSE Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. METHODS We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE. RESULTS We screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = - 0.33, 95% CI - 0.58 to - 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = - 0.31, 95% CI - 0.57 to - 0.05) (moderate certainty evidence). CONCLUSIONS With moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP

The development of a stakeholder-endorsed national strategic plan for advancing pain education across Canadian physiotherapy programs

Abstract Background The Canadian Pain Task Force recently advanced an action plan calling for improved entry-level health professional pain education. However, there is little research to inform the collaboration and coordination across stakeholders that is needed for its implementation. Aims This manuscript reports on the development of a stakeholder-generated strategic plan to improve pain education across all Canadian physiotherapy (PT) programs. Methods Participants included representatives from the following stakeholder groups: people living with pain (n = 1); PT students and recent graduates (n = 2); educators and directors from every Canadian PT program (n = 24); and leaders of Canada?s national PT professional association (n = 2). Strategic priorities were developed through three steps (1) stakeholder-generated data was collected and analyzed; (2) a draft strategic plan was developed and refined; and (2) stakeholder endorsement of the final plan was assessed. The project was primarily implemented online, between 2016 and 2018. Results The plan was developed through five iterative versions. Stakeholders unanimously endorsed a plan that included five priorities focusing on uptake of best evidence across (1) national PT governance groups and (2) within individual PT programs; (3) partnering with people living with pain in pain education; (4) advocacy for the PT role in pain management; and (5) advancing pain education research. Conclusion This plan is expected to help Canadian stakeholders work toward national improvements in PT pain education and to serve as a useful template for informing collaboration on entry-level pain education within other professions and across different geographic regions

Childhood craniopharyngioma: greater hypothalamic involvement before surgery is associated with higher homeostasis model insulin resistance index

<p>Abstract</p> <p>Background</p> <p>Obesity seems to be linked to the hypothalamic involvement in craniopharyngioma. We evaluated the pre-surgery relationship between the degree of this involvement on magnetic resonance imaging and insulin resistance, as evaluated by the homeostasis model insulin resistance index (HOMA). As insulin-like growth factor 1, leptin, soluble leptin receptor (sOB-R) and ghrelin may also be involved, we compared their plasma concentrations and their link to weight change.</p> <p>Methods</p> <p>27 children with craniopharyngioma were classified as either grade 0 (n = 7, no hypothalamic involvement), grade 1 (n = 8, compression without involvement), or grade 2 (n = 12, severe involvement).</p> <p>Results</p> <p>Despite having similar body mass indexes (BMI), the grade 2 patients had higher glucose, insulin and HOMA before surgery than the grade 0 (P = 0.02, <0.05 and 0.02 respectively) and 1 patients (P < 0.02 and <0.03 for both insulin and HOMA). The grade 0 (5.8 ± 4.9) and 1 (7.2 ± 5.3) patients gained significantly less weight (kg) during the year after surgery than did the grade 2 (16.3 ± 7.4) patients. The pre-surgery HOMA was positively correlated with these weight changes (P < 0.03).</p> <p>The data for the whole population before and 6–18 months after surgery showed increases in BMI (P < 0.0001), insulin (P < 0.005), and leptin (P = 0.0005), and decreases in sOB-R (P < 0.04) and ghrelin (P < 0.03).</p> <p>Conclusion</p> <p>The hypothalamic involvement by the craniopharyngioma before surgery seems to determine the degree of insulin resistance, regardless of the BMI. The pre-surgery HOMA values were correlated with the post-surgery weight gain. This suggests that obesity should be prevented by reducing inn secretion in those cases with hypothalamic involvement.</p