Twelve weeks of supervised exercise improves self-reported symptom burden and fatigue in chronic kidney disease : a secondary analysis of the ‘ExTra CKD’ trial

Background Chronic kidney disease (CKD) patients experience a high symptom burden including fatigue, sleep difficulties, muscle weakness and pain. These symptoms reduce levels of physical function (PF) and activity, and contribute to poor health-related quality of life (HRQoL). Despite the gathering evidence of positive physiological changes following exercise in CKD, there is limited evidence on its effect on self-reported symptom burden, fatigue, HRQoL and physical activity. Methods Thirty-six patients [mean ± SD 61.6 ± 11.8 years, 22 (61%) females, estimated glomerular filtration rate: 25.5 ± 7.8 mL/min/1.73 m2] not requiring renal replacement therapy underwent 12 weeks (3 times/week) of supervised aerobic exercise (AE), or a combination (CE) of AE plus resistance training. Outcomes included self-reported symptom burden, fatigue, HRQoL and physical activity. Results Exercise reduced the total number of symptoms reported by 17% and had favourable effects on fatigue in both groups. AE reduced the frequency of ‘itching’, ‘impotence’ and ‘shortness of breath’ symptoms, and the intrusiveness for symptoms of ‘sleep disturbance’, ‘loss of muscular strength/power’, ‘muscle spasm/stiffness’ and ‘restless legs’. The addition of resistance exercise in the CE group saw a reduction in ‘loss of muscular strength/power’. No changes were seen in subjective PF or physical activity levels. AE increased self-efficacy for physical activity. Conclusions Supervised exercise had favourable effects on symptom frequency and intrusiveness, including substantial improvements in fatigue. Although the intervention did not improve self-reported physical activity levels, AE increased patients’ self-efficacy for physical activity. These favourable changes in self-reported outcomes support the important role of exercise in CKD

The Gemini NICI Planet-Finding Campaign

Our team is carrying out a multi-year observing program to directly image and characterize young extrasolar planets using the Near-Infrared Coronagraphic Imager (NICI) on the Gemini-South 8.1-meter telescope. NICI is the first instrument on a large telescope designed from the outset for high-contrast imaging, comprising a high-performance curvature adaptive optics system with a simultaneous dual-channel coronagraphic imager. Combined with state-of-the-art observing methods and data processing, NICI typically achieves ~2 magnitudes better contrast compared to previous ground-based or space-based programs, at separations inside of ~2 arcsec. In preparation for the Campaign, we carried out efforts to identify previously unrecognized young stars, to rigorously construct our observing strategy, and to optimize the combination of angular and spectral differential imaging. The Planet-Finding Campaign is in its second year, with first-epoch imaging of 174 stars already obtained out of a total sample of 300 stars. We describe the Campaign's goals, design, implementation, performance, and preliminary results. The NICI Campaign represents the largest and most sensitive imaging survey to date for massive (~1 Mjup) planets around other stars. Upon completion, the Campaign will establish the best measurements to date on the properties of young gas-giant planets at ~5-10 AU separations. Finally, Campaign discoveries will be well-suited to long-term orbital monitoring and detailed spectrophotometric followup with next-generation planet-finding instruments.Comment: Proceedings of the SPIE, vol 7736 (Advances in Adaptive Optics, San Diego, CA, June 2010 meeting), in pres

Parodie et carnavalisation : l’exemple de Hubert Aquin

One of the defining features of patient-centered outcomes research (PCOR) is the emphasis on reporting outcomes that are meaningful to patients. Accelerating progress toward this objective could be achieved through increased development and uptake of core outcome sets (COS), which are intended to represent a standardized minimum set of outcomes that should bemeasured and reported in all clinical trials in a specific condition. The level of activity around COS has increased significantly over recent years, however there are many important clinical conditions for which high quality COS havenot been developed. We believe that meaningful progress toward the goals behind the significant investments in PCOR will depend on sustained attention to the challenges of COS development and uptake

The association of physical function and physical activity with all-cause mortality and adverse clinical outcomes in non-dialysis chronic kidney disease : a systematic review

Objective: People with nondialysis-dependent chronic kidney disease (CKD) and renal transplant recipients (RTRs) have compromised physical function and reduced physical activity (PA) levels. Whilst established in healthy older adults and other chronic diseases, this association remains underexplored in CKD. We aimed to review the existing research investigating poor physical function and PA with clinical outcome in nondialysis CKD. Data sources: Electronic databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials) were searched until December 2017 for cohort studies reporting objective or subjective measures of PA and physical function and the associations with adverse clinical outcomes and all-cause mortality in patients with nondialysis CKD stages 1–5 and RTRs. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42016039060). Review methods: Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare and Research Quality (AHRQ) standards. Results: A total of 29 studies were included; 12 reporting on physical function and 17 on PA. Only eight studies were conducted with RTRs. The majority were classified as ‘good’ according to the AHRQ standards. Although not appropriate for meta-analysis due to variance in the outcome measures reported, a coherent pattern was seen with higher mortality rates or prevalence of adverse clinical events associated with lower PA and physical function levels, irrespective of the measurement tool used. Sources of bias included incomplete description of participant flow through the study and over reliance on self-report measures. Conclusions: In nondialysis CKD, survival rates correlate with greater PA and physical function levels. Further trials are required to investigate causality and the effectiveness of physical function and PA interventions in improving outcomes. Future work should identify standard assessment protocols for PA and physical function

The initiator methionine tRNA drives secretion of type II collagen from stromal fibroblasts to promote tumor growth and angiogenesis

Summary: Expression of the initiator methionine tRNA (tRNAi Met) is deregulated in cancer. Despite this fact, it is not currently known how tRNAi Met expression levels influence tumor progression. We have found that tRNAi Met expression is increased in carcinoma-associated fibroblasts, implicating deregulated expression of tRNAi Met in the tumor stroma as a possible contributor to tumor progression. To investigate how elevated stromal tRNAi Met contributes to tumor progression, we generated a mouse expressing additional copies of the tRNAi Met gene (2+tRNAi Met mouse). Growth and vascularization of subcutaneous tumor allografts was enhanced in 2+tRNAi Met mice compared with wild-type littermate controls. Extracellular matrix (ECM) deposited by fibroblasts from 2+tRNAi Met mice supported enhanced endothelial cell and fibroblast migration. SILAC mass spectrometry indicated that elevated expression of tRNAi Met significantly increased synthesis and secretion of certain types of collagen, in particular type II collagen. Suppression of type II collagen opposed the ability of tRNAi Metoverexpressing fibroblasts to deposit pro-migratory ECM. We used the prolyl hydroxylase inhibitor ethyl- 3,4-dihydroxybenzoate (DHB) to determine whether collagen synthesis contributes to the tRNAi Met-driven pro-tumorigenic stroma in vivo. DHB had no effect on the growth of syngeneic allografts in wild-type mice but opposed the ability of 2+tRNAi Met mice to support increased angiogenesis and tumor growth. Finally, collagen II expression predicts poor prognosis in high-grade serous ovarian carcinoma. Taken together, these data indicate that increased tRNAi Met levels contribute to tumor progression by enhancing the ability of stromal fibroblasts to synthesize and secrete a type II collagen-rich ECM that supports endothelial cell migration and angiogenesis

Terrestrial Planet Occurrence Rates for the Kepler GK Dwarf Sample

We measure planet occurrence rates using the planet candidates discovered by the Q1-Q16 Kepler pipeline search. This study examines planet occurrence rates for the Kepler GK dwarf target sample for planet radii, 0.75<Rp<2.5 Rearth, and orbital periods, 50<Porb<300 days, with an emphasis on a thorough exploration and identification of the most important sources of systematic uncertainties. Integrating over this parameter space, we measure an occurrence rate of F=0.77 planets per star, with an allowed range of 0.3<F<1.9. The allowed range takes into account both statistical and systematic uncertainties, and values of F beyond the allowed range are significantly in disagreement with our analysis. We generally find higher planet occurrence rates and a steeper increase in planet occurrence rates towards small planets than previous studies of the Kepler GK dwarf sample. Through extrapolation, we find that the one year orbital period terrestrial planet occurrence rate, zeta_1=0.1, with an allowed range of 0.01<zeta_1<2, where zeta_1 is defined as the number of planets per star within 20% of the Rp and Porb of Earth. For G dwarf hosts, the zeta_1 parameter space is a subset of the larger eta_earth parameter space, thus zeta_1 places a lower limit on eta_earth for G dwarf hosts. From our analysis, we identify the leading sources of systematics impacting Kepler occurrence rate determinations as: reliability of the planet candidate sample, planet radii, pipeline completeness, and stellar parameters.Comment: 19 Pages, 17 Figures, Submitted ApJ. Python source to support Kepler pipeline completeness estimates available at http://github.com/christopherburke/KeplerPORTs

Aeolian–lacustrine margins: implications for carbon capture and storage within the Rotliegend Group, Southern North Sea

The Southern North Sea Basins of the United Kingdom were renowned for their hydrocarbon resources and exploited extensively from the 1960s to the 1990s. The Permian Leman Sandstone in particular formed an excellent reservoir due to its extensive clean aeolian sediments and was subsequently explored for decades, resulting in a wealth of subsurface data that are now widely accessible. The strata of the Leman Sandstone comprises mixed continental deposits from aeolian, fluvial and lacustrine environments which interfinger with the saline lake deposits of the Silverpit Formation. With the potential reassessment of depleted gas reservoirs in the North Sea for use as sequestration targets for captured carbon dioxide, there is significant renewed interest in the reservoir geology of the Leman Sandstone. A regional study of the sedimentology and petrophysical properties of the Leman Sandstone and Silverpit formations within quadrants 43, 44, 48 and 49 of the Southern North Sea has been conducted. Multiple interactions between the depositional environments are observed, resulting in a complex interplay between aeolian and lacustrine transgressive/regressive events, and migration and expansion/contraction of the fluvial system. In wireline petrophysical data, each depositional environment, along with their transitional environments, form relatively distinct clusters that can be used as a predictive tool for reservoir interpretation in the absence of core, despite extensive sediment recycling between environments

Planetary Candidates Observed by Kepler. VIII. A Fully Automated Catalog with Measured Completeness and Reliability Based on Data Release 25

We present the Kepler Object of Interest (KOI) catalog of transiting exoplanets based on searching 4 yr of Kepler time series photometry (Data Release 25, Q1–Q17). The catalog contains 8054 KOIs, of which 4034 are planet candidates with periods between 0.25 and 632 days. Of these candidates, 219 are new, including two in multiplanet systems (KOI-82.06 and KOI-2926.05) and 10 high-reliability, terrestrial-size, habitable zone candidates. This catalog was created using a tool called the Robovetter, which automatically vets the DR25 threshold crossing events (TCEs). The Robovetter also vetted simulated data sets and measured how well it was able to separate TCEs caused by noise from those caused by low signal-to-noise transits. We discuss the Robovetter and the metrics it uses to sort TCEs. For orbital periods less than 100 days the Robovetter completeness (the fraction of simulated transits that are determined to be planet candidates) across all observed stars is greater than 85%. For the same period range, the catalog reliability (the fraction of candidates that are not due to instrumental or stellar noise) is greater than 98%. However, for low signal-to-noise candidates between 200 and 500 days around FGK-dwarf stars, the Robovetter is 76.7% complete and the catalog is 50.5% reliable. The KOI catalog, the transit fits, and all of the simulated data used to characterize this catalog are available at the NASA Exoplanet Archive