The effect of exercise training interventions in adult kidney transplant recipients: a systematic review and meta-analysis of randomised control trials

Background: Kidney transplant recipients (KTRs) are characterised by adverse changes in physical fitness and body composition. Post-transplant management involves being physically active, although evidence for the effect of exercise is limited. Objective: To assess the effects of exercise training interventions in KTRs. Methods: NCBI PubMed (MEDLINE) and CENTRAL (EMBASE, WHO ICTRP) databases were searched up to March 2021 to identify eligible randomized controlled trials (RCTs) that studied exercise training in adult KTRs. Outcomes included exercise capacity, strength, blood pressure, body composition, heart rate, markers of dyslipidaemia and renal function, and health-related quality of life (QoL). Results: Sixteen RCTs, containing 827 KTRs, were included. The median intervention length was 14-weeks with participants exercising between 2–7x/week. Most studies used a mixture of aerobic and resistance exercise. Significant improvements were observed in cardiorespiratory function (VO2peak) (3.21 ml/kg/min, p = 0.003), 6MWT (76.3 meters, p = 0.009), physical function (STS-60, 4.8 repetitions, p = 0.04), and high-density lipoprotein (HDL) (0.13 mg/dL, p = 0.03). A moderate increase in maximum heart rate was seen (p = 0.06). A moderate reduction in creatinine was also observed (0.14 mg/dl, p = 0.05). Isolated studies reported improvements in strength, bone health, lean mass, and QoL. Overall, studies had high risk of bias suggestive of publication bias. Conclusions: Exercise training may confer several benefits in adult KTRs, particularly by increasing cardiorespiratory function and exercise capacity, strength, HDL levels, maximum heart rate, and improving QoL. Additional long-term large sampled RCTs, incorporating complex interventions requiring both exercise and dietary behaviour change, are needed to fully understand the effects of exercise in KTRs

Endothelial microparticles: Pathogenic or passive players in endothelial dysfunction in autoimmune rheumatic diseases?

© 2016 Elsevier Inc. Autoimmune rheumatic diseases are characterised by systemic inflammation and complex immunopathology, with an increased risk of cardiovascular disease, initiated by endothelial dysfunction in a chronic inflammatory environment. Endothelial microparticles (EMPs) are released into the circulation from activated endothelial cells and may therefore, reflect disease severity, vascular and endothelial dysfunction, that could influence disease pathogenesis via autocrine/paracrine signalling. The exact function of EMPs in rheumatic disease remains unknown, and this has initiated research to elucidate EMP composition and function, which may be determined by the mode of endothelial activation and the micro environment. To date, EMPs are thought to play a role in angiogenesis, thrombosis and inflammation by transferring specific proteins and microRNAs (miRs) to target cells. Here, we review the mechanisms underlying the generation and composition of EMPs and the clinical and experimental studies describing the involvement of EMPs in rheumatic diseases, since we have previously shown endothelial dysfunction and an elevated risk of cardiovascular disease are characteristics in systemic lupus erythematosus. We will also discuss the potential of EMPs as future biomarkers of cardiovascular risk in these diseases

Practice Coaching model to embed the culture of enhanced recovery: a service evaluation

Poster presented at 'The Future Nurse: enriching people's experience of care' University of Exeter Academy of Nursing, RD&E Hospital, 3rd October 2019

The impact of water on slip system activity in olivine and the formation of bimodal crystallographic preferred orientations

Crystallographic preferred orientations (CPOs) in olivine are widely used to infer the mechanisms, conditions, and kinematics of deformation of mantle rocks. Recent experiments on water-saturated olivine were the first to produce a complex CPO characterised by bimodal orientation distributions of both [100] and [001] axes and inferred to form by combined activity of (001)[100], (100)[001], and (010)[100] slip. This result potentially provides a new microstructural indicator of deformation in the presence of elevated concentrations of intracrystalline hydrous point defects and has implications for the interpretation of seismic anisotropy. Here, we document a previously unexplained natural example of this CPO type in a xenolith from Lesotho and demonstrate that it too may be explained by elevated concentrations of hydrous point defects. We test and confirm the hypothesis that combined (001)[100], (100)[001], and (010)[100] slip were responsible for formation of this CPO by (1) using high-angular resolution electron backscatter diffraction to precisely characterise the dislocation types present in both the experimental and natural samples and (2) employing visco-plastic self-consistent simulations of CPO evolution to assess the ability of these slip systems to generate the observed CPO. Finally, we utilise calculations based on effective-medium theory to predict the anisotropy of seismic wave velocities arising from the CPO of the xenolith. Maxima in S-wave velocities and anisotropy are parallel to both the shear direction and shear plane normal, whereas maxima in P-wave velocities are oblique to both, adding complexity to interpretation of deformation kinematics from seismic anisotropy.D. Wallis, L.N. Hansen, and A.J. Wilkinson acknowledge support from the Natural Environment Research Council Grant NE/M000966/1. M. Tasaka acknowledges support through a JSPS Research Fellowship for Young Scientists (26-4879) and the Japan Society for the Promotion of Science (16K17832). D.L. Kohlstedt acknowledges support through NASA Grant NNX15AL53G. K.M. Kumamoto acknowledges support through NSF Division of Earth Science grants 1255620 and 1625032

Genome-wide polyadenylation site mapping datasets in the rice blast fungus Magnaporthe oryzae

Polyadenylation plays an important role in gene regulation, thus affecting a wide variety of biological processes. In the rice blast fungus Magnaporthe oryzae the cleavage factor I protein Rpb35 is required for pre-mRNA polyadenylation and fungal virulence. Here we present the bioinformatic approach and output data related to a global survey of polyadenylation site usage in M. oryzae wild-type and Delta rbp35 strains under a variety of nutrient conditions, some of which simulate the conditions experienced by the fungus during part of its infection cycle

Integrated sports and respiratory medicine in the aftermath of COVID-19.

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Molecular Characterization of the Gastrula in the Turtle Emys orbicularis: An Evolutionary Perspective on Gastrulation

Due to the presence of a blastopore as in amphibians, the turtle has been suggested to exemplify a transition form from an amphibian- to an avian-type gastrulation pattern. In order to test this hypothesis and gain insight into the emergence of the unique characteristics of amniotes during gastrulation, we have performed the first molecular characterization of the gastrula in a reptile, the turtle Emys orbicularis. The study of Brachyury, Lim1, Otx2 and Otx5 expression patterns points to a highly conserved dynamic of expression with amniote model organisms and makes it possible to identify the site of mesoderm internalization, which is a long-standing issue in reptiles. Analysis of Brachyury expression also highlights the presence of two distinct phases, less easily recognizable in model organisms and respectively characterized by an early ring-shaped and a later bilateral symmetrical territory. Systematic comparisons with tetrapod model organisms lead to new insights into the relationships of the blastopore/blastoporal plate system shared by all reptiles, with the blastopore of amphibians and the primitive streak of birds and mammals. The biphasic Brachyury expression pattern is also consistent with recent models of emergence of bilateral symmetry, which raises the question of its evolutionary significance

Vocabulary Learning in a Yorkshire Terrier: Slow Mapping of Spoken Words

Rapid vocabulary learning in children has been attributed to “fast mapping”, with new words often claimed to be learned through a single presentation. As reported in 2004 in Science a border collie (Rico) not only learned to identify more than 200 words, but fast mapped the new words, remembering meanings after just one presentation. Our research tests the fast mapping interpretation of the Science paper based on Rico's results, while extending the demonstration of large vocabulary recognition to a lap dog. We tested a Yorkshire terrier (Bailey) with the same procedures as Rico, illustrating that Bailey accurately retrieved randomly selected toys from a set of 117 on voice command of the owner. Second we tested her retrieval based on two additional voices, one male, one female, with different accents that had never been involved in her training, again showing she was capable of recognition by voice command. Third, we did both exclusion-based training of new items (toys she had never seen before with names she had never heard before) embedded in a set of known items, with subsequent retention tests designed as in the Rico experiment. After Bailey succeeded on exclusion and retention tests, a crucial evaluation of true mapping tested items previously successfully retrieved in exclusion and retention, but now pitted against each other in a two-choice task. Bailey failed on the true mapping task repeatedly, illustrating that the claim of fast mapping in Rico had not been proven, because no true mapping task had ever been conducted with him. It appears that the task called retention in the Rico study only demonstrated success in retrieval by a process of extended exclusion