Developmental Basis of an Anatomical Novelty: Heteroarthrocarpy in Cakile Lanceolata and Erucaria Erucarioides (Brassicaceae)

To understand the developmental basis of a novel anatomical feature, we present a comparative developmental study of an ecologically significant novelty in fruit morphology. Most members of the tribe Brassiceae have heteroarthrocarpic fruits, in contrast to the unsegmented fruits of many Brassicaceae. Heteroarthrocarpy is characterized by a joint that bisects fruits into heteromorphic segments and by partial or complete indehiscence. In order to better understand the development of heteroarthrocarpic characteristics and their relationships to typical siliques, we studied carpel and fruit development in two closely related species of the Brassiceae, Erucaria erucarioides and Cakile lanceolata. Our results indicate that proximal segments of heteroarthrocarpic fruits correspond to valves of typical siliques, regardless of whether these segments are dehiscent. Indehiscent distal segments are composed of both stylar and ovary elements, although the ovary wall of this segment does not differentiate into valve tissue. The joint itself comprises the distal extent of the valve margin and an internal proliferation of the mesocarp. Additionally, Cakile fruits form a transverse dehiscence zone through the joint, allowing the segments to separate. Heteroarthrocarpy entails modifications of lignification patterns and alterations of relationships between valve, style, ovary, and mesocarp. Possible genetic mechanisms underlying these modifications are discussed in reference to what is known about silique development in Arabidopsis.Organismic and Evolutionary Biolog

Developmental Basis of an Anatomical Novelty: Heteroarthrocarpy in Cakile Lanceolata and Erucaria Erucarioides (Brassicaceae)

To understand the developmental basis of a novel anatomical feature, we present a comparative developmental study of an ecologically significant novelty in fruit morphology. Most members of the tribe Brassiceae have heteroarthrocarpic fruits, in contrast to the unsegmented fruits of many Brassicaceae. Heteroarthrocarpy is characterized by a joint that bisects fruits into heteromorphic segments and by partial or complete indehiscence. In order to better understand the development of heteroarthrocarpic characteristics and their relationships to typical siliques, we studied carpel and fruit development in two closely related species of the Brassiceae, Erucaria erucarioides and Cakile lanceolata. Our results indicate that proximal segments of heteroarthrocarpic fruits correspond to valves of typical siliques, regardless of whether these segments are dehiscent. Indehiscent distal segments are composed of both stylar and ovary elements, although the ovary wall of this segment does not differentiate into valve tissue. The joint itself comprises the distal extent of the valve margin and an internal proliferation of the mesocarp. Additionally, Cakile fruits form a transverse dehiscence zone through the joint, allowing the segments to separate. Heteroarthrocarpy entails modifications of lignification patterns and alterations of relationships between valve, style, ovary, and mesocarp. Possible genetic mechanisms underlying these modifications are discussed in reference to what is known about silique development in Arabidopsis.Organismic and Evolutionary Biolog

Health and Nutrition in Vermont Children

Introduction. The AHA (American Heart Association) supports legislation in Ver- mont ensuring that restaurants’ children’s menu meals meet certain nutritional standards. This study investigated Vermont parents’ attitudes towards both dining at restaurants with their children and potential legislation to improve nutritional standards of restaurant food. Methods. An anonymous 21-question survey for parents with children under age 18 was distributed electronically to local organizations via Facebook groups and email, and as paper questionnaires at the Community Health Center of Burlington. Questions probed parents’ overall attitudes surrounding their children’s health, habits pertaining to eating at restaurants, and attitudes towards legislation to ensure healthier options for kids at restaurants. Results were analyzed to look for dominant themes and determine differences between subgroups. Results. 98% of survey participants agreed or strongly agreed that their children’s eating habits are important to them. When asked if they would support legislation to set nutrition standards on children’s menu meals in Vermont, 73% agreed or strongly agreed. Most survey participants eat at a restaurant once per week or less (95%). 53% of survey participants agreed or strongly agreed that there were enough restaurants with healthy kids’ meals in their area. Responses did not differ by county. Conclusion. Vermont parents are concerned about their children’s diets and acknowledge connections between nutrition, obesity, and overall health. Parents favor restaurants providing more nutritional items on children’s menus and support the AHA’s proposed standards. Next steps include investigating any financial impact on restaurants and studying nutritional standards in school cafeterias in Vermont.https://scholarworks.uvm.edu/comphp_gallery/1257/thumbnail.jp

Increasing athlete knowledge of mental health and intentions to seek help: The State of Mind Ireland (SOMI) Pilot Program

Set statement to accompany deposit "as accepted for publication", Publisher retains copyrightThe present study had three aims, to determine: (a) whether providing a curriculum-based mental health awareness program to athletes increased knowledge of mental health and intentions to offer support; (b) whether the program increased resilience and well-being compared to a control group; and (c) the feasibility of the program. A total of 100 participants (Mage = 20.78; SD = 2.91; male = 59) either attended the program or were part of a control group. Participants completed questionnaires pre-, post-, and 3-months post-intervention, although there was a low participant return rate for the 3-month follow-up (n = 15). Participants were invited to take part in a focus group to explore program relevance. Knowledge of mental health and intentions to offer support increased for the intervention group, compared to the control. The program with some modification could be integrated into university sport courses to promote mental health awareness

A randomized, seven-day study to assess the efficacy and safety of a glycopyrrolate/formoterol fumarate fixed-dose combination metered dose inhaler using novel Co-Suspension™ Delivery Technology in patients with moderate-to-very severe chronic obstructive pulmonary disease

Abstract Background Long-acting muscarinic antagonist/long-acting β 2 -agonist combinations are recommended for patients whose chronic obstructive pulmonary disease (COPD) is not managed with monotherapy. We assessed the efficacy and safety of glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination delivered via a Co-Suspension™ Delivery Technology-based metered dose inhaler (MDI) (GFF MDI). Methods This was a Phase IIb randomized, multicenter, placebo-controlled, double-blind, chronic-dosing (7 days), crossover study in patients with moderate-to-very severe COPD (NCT01085045). Treatments included GFF MDI twice daily (BID) (GP/FF 72/9.6 μg or 36/9.6 μg), GP MDI 36 μg BID, FF MDI 7.2 and 9.6 μg BID, placebo MDI, and open-label formoterol dry powder inhaler (FF DPI) 12 μg BID or tiotropium DPI 18 μg once daily. The primary endpoint was forced expiratory volume in 1 s area under the curve from 0 to 12 h (FEV 1 AUC 0–12 ) on Day 7 relative to baseline FEV 1 . Secondary endpoints included pharmacokinetics and safety. Results GFF MDI 72/9.6 μg or 36/9.6 μg led to statistically significant improvements in FEV 1 AUC 0–12 after 7 days’ treatment versus monocomponent MDIs, placebo MDI, tiotropium, or FF DPI (p ≤ 0.0002). GFF MDI 36/9.6 μg was non-inferior to GFF MDI 72/9.6 μg and monocomponent MDIs were non-inferior to open-label comparators. Pharmacokinetic results showed glycopyrrolate and formoterol exposure were decreased following administration via fixed-dose combination versus monocomponent MDIs; however, this was not clinically meaningful. GFF MDI was well tolerated. Conclusions GFF MDI 72/9.6 μg and 36/9.6 μg BID improve lung function and are well tolerated in patients with moderate-to-very severe COPD. Trial registration ClinicalTrials.gov NCT01085045. Registered 9 March 2010

Antimicrobial-impregnated central venous catheters for preventing neonatal bloodstream infection : the PREVAIL RCT

BACKGROUND:Clinical trials show that antimicrobial-impregnated central venous catheters reduce catheter-related bloodstream infection in adults and children receiving intensive care, but there is insufficient evidence for use in newborn babies. OBJECTIVES:The objectives were (1) to determine clinical effectiveness by conducting a randomised controlled trial comparing antimicrobial-impregnated peripherally inserted central venous catheters with standard peripherally inserted central venous catheters for reducing bloodstream or cerebrospinal fluid infections (referred to as bloodstream infections); (2) to conduct an economic evaluation of the costs, cost-effectiveness and value of conducting additional research; and (3) to conduct a generalisability analysis of trial findings to neonatal care in the NHS. DESIGN:Three separate studies were undertaken, each addressing one of the three objectives. (1) This was a multicentre, open-label, pragmatic randomised controlled trial; (2) an analysis was undertaken of hospital care costs, lifetime cost-effectiveness and value of information from an NHS perspective; and (3) this was a retrospective cohort study of bloodstream infection rates in neonatal units in England. SETTING:The randomised controlled trial was conducted in 18 neonatal intensive care units in England. PARTICIPANTS:Participants were babies who required a peripherally inserted central venous catheter (of 1 French gauge in size). INTERVENTIONS:The interventions were an antimicrobial-impregnated peripherally inserted central venous catheter (coated with rifampicin-miconazole) or a standard peripherally inserted central venous catheter, allocated randomly (1 : 1) using web randomisation. MAIN OUTCOME MEASURE:Study 1 - time to first bloodstream infection, sampled between 24 hours after randomisation and 48 hours after peripherally inserted central venous catheter removal. Study 2 - cost-effectiveness of the antimicrobial-impregnated peripherally inserted central venous catheter compared with the standard peripherally inserted central venous catheters. Study 3 - risk-adjusted bloodstream rates in the trial compared with those in neonatal units in England. For study 3, the data used were as follows: (1) case report forms and linked death registrations; (2) case report forms and linked death registrations linked to administrative health records with 6-month follow-up; and (3) neonatal health records linked to infection surveillance data. RESULTS:Study 1, clinical effectiveness - 861 babies were randomised (antimicrobial-impregnated peripherally inserted central venous catheter, n = 430; standard peripherally inserted central venous catheter, n = 431). Bloodstream infections occurred in 46 babies (10.7%) randomised to antimicrobial-impregnated peripherally inserted central venous catheters and in 44 (10.2%) babies randomised to standard peripherally inserted central venous catheters. No difference in time to bloodstream infection was detected (hazard ratio 1.11, 95% confidence interval 0.73 to 1.67; p = 0.63). Secondary outcomes of rifampicin resistance in positive blood/cerebrospinal fluid cultures, mortality, clinical outcomes at neonatal unit discharge and time to peripherally inserted central venous catheter removal were similar in both groups. Rifampicin resistance in positive peripherally inserted central venous catheter tip cultures was higher in the antimicrobial-impregnated peripherally inserted central venous catheter group (relative risk 3.51, 95% confidence interval 1.16 to 10.57; p = 0.02) than in the standard peripherally inserted central venous catheter group. Adverse events were similar in both groups. Study 2, economic evaluation - the mean cost of babies' hospital care was £83,473. Antimicrobial-impregnated peripherally inserted central venous catheters were not cost-effective. Given the increased price, compared with standard peripherally inserted central venous catheters, the minimum reduction in risk of bloodstream infection for antimicrobial-impregnated peripherally inserted central venous catheters to be cost-effective was 3% and 15% for babies born at 23-27 and 28-32 weeks' gestation, respectively. Study 3, generalisability analysis - risk-adjusted bloodstream infection rates per 1000 peripherally inserted central venous catheter days were similar among babies in the trial and in all neonatal units. Of all bloodstream infections in babies receiving intensive or high-dependency care in neonatal units, 46% occurred during peripherally inserted central venous catheter days. LIMITATIONS:The trial was open label as antimicrobial-impregnated and standard peripherally inserted central venous catheters are different colours. There was insufficient power to determine differences in rifampicin resistance. CONCLUSIONS:No evidence of benefit or harm was found of peripherally inserted central venous catheters impregnated with rifampicin-miconazole during neonatal care. Interventions with small effects on bloodstream infections could be cost-effective over a child's life course. Findings were generalisable to neonatal units in England. Future research should focus on other types of antimicrobial impregnation of peripherally inserted central venous catheters and alternative approaches for preventing bloodstream infections in neonatal care. TRIAL REGISTRATION:Current Controlled Trials ISRCTN81931394. FUNDING:This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 57. See the NIHR Journals Library website for further project information

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common