Clinical Characteristics and Outcomes Among Individuals With Spinal Implant Infections: A Descriptive Study.

Little is known about the clinical presentation and outcomes associated with spinal implant infections. Here, we describe a single center's experience in a retrospective cohort of 109 individuals with spinal implant infections, including clinical, microbiological, therapeutic, and outcome data

Motor Performance and Quality of Life in a Community Exercise Program for Parkinson Disease

We investigated the effect of a comprehensive community program composed of exercise, mindfulness practice, and education on motor function and quality of life in individuals with Parkinson disease (PD). Thirty-six participants completed physical and quality-of-life assessments independently at baseline and 12 months. Physical assessments showed stability or improvement in functional mobility, integrated strength, and walking ability over the 1-year interval. PDQ-39 measures showed improvement in 6 of 8 indices: mobility, activities of daily living, emotional well-being, stigma reduction, social support, and bodily discomfort. Our results demonstrate the effectiveness of exercise, mindfulness, and education in community and group settings

The why, when, and how of computing in biology classrooms [version 1; peer review: 2 approved]

Many biologists are interested in teaching computing skills or using computing in the classroom, despite not being formally trained in these skills themselves. Thus biologists may find themselves researching how to teach these skills, and therefore many individuals are individually attempting to discover resources and methods to do so. Recent years have seen an expansion of new technologies to assist in delivering course content interactively. Educational research provides insights into how learners absorb and process information during interactive learning. In this review, we discuss the value of teaching foundational computing skills to biologists, and strategies and tools to do so. Additionally, we review the literature on teaching practices to support the development of these skills. We pay special attention to meeting the needs of diverse learners, and consider how different ways of delivering course content can be leveraged to provide a more inclusive classroom experience. Our goal is to enable biologists to teach computational skills and use computing in the classroom successfully

Nontelomeric TRF2-REST Interaction Modulates Neuronal Gene Silencing and Fate of Tumor and Stem Cells

SummaryRemoval of TRF2, a telomere shelterin protein, recapitulates key aspects of telomere attrition including the DNA-damage response and cell-cycle arrest [1]. Distinct from the response of proliferating cells to loss of TRF2 [2, 3], in rodent noncycling cells, TRF2 inhibition promotes differentiation and growth [4, 5]. However, the mechanism that couples telomere gene-silencing features [6–8] to differentiation programs has yet to be elucidated. Here we describe an extratelomeric function of TRF2 in the regulation of neuronal genes mediated by the interaction of TRF2 with repressor element 1-silencing transcription factor (REST), a master repressor of gene networks devoted to neuronal functions [9–12]. TRF2-REST complexes are readily detected by coimmunoprecipitation assays and are localized to aggregated PML-nuclear bodies in undifferentiated pluripotent human NTera2 stem cells. Inhibition of TRF2, either by a dominant-negative mutant or by RNA interference, dissociates TRF2-REST complexes resulting in ubiquitin-proteasomal degradation of REST. Consequentially, REST-targeted neural genes (L1CAM, β3-tubulin, synaptophysin, and others) are derepressed, resulting in acquisition of neuronal phenotypes. Notably, selective damage to telomeres without affecting TRF2 levels causes neither REST degradation nor cell differentiation. Thus, in addition to protecting telomeres, TRF2 possesses a novel role in stabilization of REST thereby controlling neural tumor and stem cell fate

Timing of ibuprofen use and musculoskeletal adaptations to exercise training in older adults

AbstractProstaglandins (PGs) increase in bone in response to mechanical loading and stimulate bone formation. Inhibition of cyclooxygenase (COX), the enzyme responsible for PG synthesis, by non-steroidal anti-inflammatory drugs (NSAIDs) impairs the bone formation response to loading in animals when administered before, but not after, loading. The aim was to determine whether the timing of ibuprofen use (400mg before versus after exercise sessions) is a significant determinant of the adaptive response of BMD to exercise training in older adults. We hypothesized that taking ibuprofen before exercise would attenuate the improvements in total hip and lumbar spine BMD in response to 36weeks of training when compared with placebo or with ibuprofen use after exercise. Untrained women and men (N=189) aged 60 to 75years were randomly assigned to 1 of 3 treatment arms: placebo before and after exercise (PP); ibuprofen before and placebo after exercise (IP); and placebo before and ibuprofen after exercise (PI).The difference between groups in the change in BMD was not significant when IP was compared with either PP (hip, −0.5% (−1.4, 0.4); spine, 0.1% (−0.9, 1.2)) or PI (hip, 0.3% (−0.6, 1.2); spine, 0.5% (−0.5, 1.5)). Ibuprofen use appeared to have more adverse effects on BMD in women than men. The study demonstrated that ibuprofen use did not significantly alter the BMD adaptations to exercise in older adults, but this finding should be interpreted cautiously. It had been expected that the inhibition of bone formation by ibuprofen would be more robust in men than in women, but this did not appear to be the case and may have limited the power to detect the effects of ibuprofen. Further research is needed to understand whether NSAID use counteracts, in part, the beneficial effects of exercise on bone

An Evaluation of MacArthur's Window of Opportunity: Preserving Affordable Rental Housing Initiative

In this report, we describe the seven strategies by which the MacArthur Foundation sought ambitious changes in the preservation of affordable rental housing. In brief, these strategies were to* support a cadre of large nonprofit owners of affordable rental housing to both preserve rental housing and act as spokespersons for preservation* increase capital for preservation by investing in special-purpose vehicles, such as preservation-themed loan funds* invest in regional interagency partnerships to retain affordable rental housing* develop business practices, tools, and research for or about preservation* provide loans and grants directly to state and local government agencies that themselves fund preservation transactions* promote low-income tenants' rights to remain in and advocate for affordable rental housing* improve the funding, regulatory, and legislative context for preservation through the foundation's combined investments in nonprofit owners, networks of nonprofit owners, special-purpose vehicles, state and local government agencies, and advocates

Survival following parathyroidectomy among United States dialysis patients

Survival following parathyroidectomy among United States dialysis patients.BackgroundSecondary hyperparathyroidism (SHPTH) is highly prevalent among persons with end-stage renal disease (ESRD). SHPTH has been linked to uremic bone disease, vascular calcification, and a higher risk of death. Parathyroidectomy (PTX) can dramatically reduce parathyroid hormone (PTH) and phosphate levels; however, the relationship between PTX and survival is not known.MethodsWe conducted an observational matched cohort study utilizing data from the United States Renal Database System (USRDS) in which 4558 patients undergoing a first PTX while on hemodialysis or peritoneal dialysis were individually matched by age, race, gender, cause of ESRD, dialysis duration, prior transplantation status, and dialysis modality to 4558 control patients who did not undergo PTX. Patients were followed from the date of PTX until they died or were lost to follow-up.ResultsThe 30-day postoperative mortality rate following PTX was 3.1%. Long-term relative risks of death among patients undergoing PTX were estimated to be 10% to 15% lower than those of matched control patients not undergoing surgery. Survival curves between the 2 groups crossed 587 days following PTX. Median survival was 53.4 months (95% CI: 51.2–56.4) in the PTX group, and 46.8 months (95% CI: 44.7–48.9) in the control group.ConclusionPTX was associated with higher short-term, and lower long-term, mortality rates among U.S. patients receiving chronic dialysis. Measures to attenuate SHPTH may play an important role in reducing mortality among patients with end-stage renal disease

Incorporating Breast Cancer Recurrence Events Into Population-Based Cancer Registries Using Medical Claims: Cohort Study.

BACKGROUND: There is a need for automated approaches to incorporate information on cancer recurrence events into population-based cancer registries. OBJECTIVE: The aim of this study is to determine the accuracy of a novel data mining algorithm to extract information from linked registry and medical claims data on the occurrence and timing of second breast cancer events (SBCE). METHODS: We used supervised data from 3092 stage I and II breast cancer cases (with 394 recurrences), diagnosed between 1993 and 2006 inclusive, of patients at Kaiser Permanente Washington and cases in the Puget Sound Cancer Surveillance System. Our goal was to classify each month after primary treatment as pre- versus post-SBCE. The prediction feature set for a given month consisted of registry variables on disease and patient characteristics related to the primary breast cancer event, as well as features based on monthly counts of diagnosis and procedure codes for the current, prior, and future months. A month was classified as post-SBCE if the predicted probability exceeded a probability threshold (PT); the predicted time of the SBCE was taken to be the month of maximum increase in the predicted probability between adjacent months. RESULTS: The Kaplan-Meier net probability of SBCE was 0.25 at 14 years. The month-level receiver operating characteristic curve on test data (20% of the data set) had an area under the curve of 0.986. The person-level predictions (at a monthly PT of 0.5) had a sensitivity of 0.89, a specificity of 0.98, a positive predictive value of 0.85, and a negative predictive value of 0.98. The corresponding median difference between the observed and predicted months of recurrence was 0 and the mean difference was 0.04 months. CONCLUSIONS: Data mining of medical claims holds promise for the streamlining of cancer registry operations to feasibly collect information about second breast cancer events

Impact of genomic testing and patient-reported outcomes on receipt of adjuvant chemotherapy

Practice guidelines incorporate genomic tumor profiling, using results such as the Oncotype DX Recurrence Score (RS), to refine recurrence risk estimates for the large proportion of breast cancer patients with early-stage, estrogen receptor-positive disease. We sought to understand the impact of receiving genomic recurrence risk estimates on breast cancer patients’ well-being and the impact of these patient-reported outcomes on receipt of adjuvant chemotherapy. Participants were 193 women (mean age 57) newly diagnosed with early-stage breast cancer. Women were interviewed before and 2–3 weeks after receiving the RS result between 2011 and 2015. We assessed subsequent receipt of chemotherapy from chart review. After receiving their RS, perceived pros (t = 4.27, P < .001) and cons (t = 8.54, P <.001) of chemotherapy increased from pre-test to post-test, while perceived risk of breast cancer recurrence decreased (t = 2.90, P = .004). Women with high RS tumors were more likely to receive chemotherapy than women with low RS tumors (88 vs. 5 %, OR 0.01, 0.00–0.02, P < .001). Higher distress (OR 2.19, 95 % CI 1.05–4.57, P < .05) and lower perceived cons of chemotherapy (OR 0.50, 95 % CI 0.26–0.97, P < .05) also predicted receipt of chemotherapy. Distressed patients who saw few downsides of chemotherapy received this treatment. Clinicians should consider these factors when discussing chemotherapy with breast cancer patients

Predicting Chandra CCD Degradation with the Chandra Radiation Model

Not long after launch of the Chandra X-Ray Observatory, it was discovered that the Advanced CCD Imaging Spectrometer (ACIS) detector was rapidly degrading due to radiation. Analysis by Chandra personnel showed that this degradation was due to 10w energy protons (100 - 200 keV) that scattered down the optical path onto the focal plane. In response to this unexpected problem, the Chandra Team developed a radiation-protection program that has been used to manage the radiation damage to the CCDs. This program consists of multiple approaches - scheduled sating of the ACIS detector from the radiation environment during passage through radiation belts, real-time monitoring of space weather conditions, on-board monitoring of radiation environment levels, and the creation of a radiation environment model for use in computing proton flux and fluence at energies that damage the ACIS detector. This radiation mitigation program has been very successful. The initial precipitous increase in the CCDs' charge transfer inefficiency (CTI) resulting from proton damage has been slowed dramatically, with the front-illuminated CCDS having an increase in CTI of only 2.3% per year, allowing the ASIS detector's expected lifetime to exceed requirements. This paper concentrates on one aspect of the Chandra radiation mitigation program, the creation of the Chandra Radiation Model (CRM). Because of Chandra's highly elliptical orbit, the spacecraft spends most of its time outside of the trapped radiation belts that present the severest risks to the ACIS detector. However, there is still a proton flux environment that must be accounted for in all parts of Chandra's orbit. At the time of Chandra's launch there was no engineering model of the radiation environment that could be used in the outer regions of the spacecraft's orbit, so the CRM was developed to provide the flux environment of 100 - 200 keV protons in the outer magnetosphere, magnetosheath, and solar wind regions of geospace. This presentation describes CRM, its role in Chandra operations, and its prediction of the ACIS CTI increase