Der Verlauf kognitiver Leistungen von Multiple Sklerose-Patienten im ersten Jahr nach Diagnosestellung

Neurokognitive Defizite können sich in beeinträchtigendem Maße im Verlauf einer Multip-len Sklerose entwickeln. In der vorliegenden Studie wurden Patienten, bei denen ein kli-nisch isoliertes Syndrom (CIS) oder eine Multiple Sklerose (MS) neu diagnostiziert wurde, hinsichtlich ihrer kognitiven Leistungsfähigkeit mit gesunden Kontrollindividuen vergli-chen. Es nahmen zur Baseline dreizehn Patienten, zum Testzeitpunkt nach sechs Mona-ten zehn Patienten und nach einem Jahr acht Patienten an den Untersuchungen teil. Der Nachweis von kognitiven Defiziten zu diesem frühen Zeitpunkt kann eine erhebliche Be-deutung bezüglich eines frühen Therapiebeginns mit einer immunmodulatorischen The-rapie haben. Wir konnten nachweisen, dass die semantische Wortflüssigkeit der untersuchten MS-Pa-tienten als einzige spezifische kognitive Leistung zur Baseline und nach einem halben Jahr im Vergleich mit den Kontrollen signifikant schlechter ist, was sich mit bisherigen Studien mit gleicher Fragestellung deckt. Alle anderen mit Hilfe von etablierten neuropsychologischen Testverfahren untersuchten kognitiven Dimensionen sowie die von uns getesteten motorischen Funktionen zeigten keine statistisch signifikante Verschlechterung bei den MS-Patienten. Dies steht auf den ersten Blick im Widerspruch zu anderen Studien, die jedoch sehr heterogene Defizitprofile der MS-Patienten dokumentierten. Zudem waren die Patienten der bisherigen Studien im Krankheitsverlauf fortgeschritten und motorisch mehr beeinträchtigt. Weiterhin ließ sich nach einem Jahr in unserem Patientenkollektiv eine signifikante Zu-nahme der Fatigue-Symptomatik im Vergleich mit den Kontrollen feststellen, obwohl sich das Patientenkollektiv verkleinert hatte. Damit liegt ein Indiz vor, dass Fatigue sich schon früh im Krankheitsverlauf einer Multiplen Sklerose manifestiert. Ein Zusammenhang zwi-schen Depression und Fatigue der Patienten ist hierbei nicht feststellbar gewesen. Einschränkungen dieser Arbeit sind das relativ kleine Patientenkollektiv, das im Verlauf durch eine eher geringe Fortführungscompliance der Patienten geprägt war, und die Sub-jektivität von Fragebögen im Allgemeinen. Stärke dieser Arbeit ist die geringe motorischeKrankheitsbelastung unseres Patientenkollektivs im Vergleich mit anderen Studien glei-cher Konzeption. Insgesamt belegen die vorliegenden Daten die Bedeutung einer frühzeitigen neuropsy-chologischen Testung nach Diagnose einer Multiplen Sklerose. Die Ergebnisse dieser Testung können perspektivisch zur Therapieentscheidung und Unterstützung in der Krankheitsbewältigung eingesetzt werden

Epidemiology of the lymphatic-dwelling filarioid nematode Rumenfilaria andersoni in free-ranging moose (Alces alces) and other cervids of North America

Background: Moose (Alces alces) are a culturally and economically valued species in Minnesota, where the northeast population has decreased by 60 % since 2006. The cause of the decline is currently unclear; however, parasites, predation, and climate change have all been implicated. Nematode parasites are important pathogens in North American moose, potentially causing severe disease and mortality. Recent spread of Rumenfilaria andersoni, a filarioid nematode of moose, has been documented in Finnish cervids; however, little is known about the epidemiology of this parasite in North America. Methods: To investigate the prevalence and distribution of R. andersoni, 584 blood samples were collected from live-captured and dead animals and screened microscopically for the presence of microfilariae using a modified Knott's test. Microfilariae were identified based on morphological characteristics. A subset of Knott's-positive animals was subjected to polymerase chain reaction (PCR) with filarioid-specific primers targeting the first internal transcribed spacer region (ITS-1) of the rRNA gene cluster. Results: Rumenfilaria microfilariae were present in 20.5 % of Minnesota moose (n = 352), with slight fluctuations observed over four years. Minnesota white-tailed deer (Odocoileus virginianus) (n = 2) and moose (n = 44) from Alaska, Montana, Washington, Maine, and New Hampshire also harbored R. andersoni, suggesting this parasite occurs widely throughout North American moose herds, and white-tailed deer can serve as a patent host. Sequence analysis of cervid blood (moose, n = 15; white-tailed deer, n = 1) confirmed the identity of R. andersoni and revealed the existence of two distinct clades. Genetic comparisons of R. andersoni isolates from North America and semi-domesticated Finnish reindeer found the two groups to be closely related, supporting previous hypotheses that R. andersoni was recently introduced into Finland by the importation of deer from the United States. Conclusions: To the best of our knowledge these observations represent the first report of R. andersoni within the contiguous United States and reveal this nematode as a common parasite of North American moose and white-tailed deer. Although the implications of R. andersoni infection on moose health is unclear, increased awareness of this parasite will help prevent unintentional introduction of R. andersoni into naive populations via the translocation of wild and captive cervids.Peer reviewe

4. The School Develops

Between 1947 and 1953, when M.P. Catherwood left the deanship to become New York’s industrial commissioner, the ILR School developed into a full fledged enterprise. These pages attempt to capture some of the excitement of this period of the school’s history, which was characterized by vigor, growth, and innovation. Includes: Alumni Recall Their Lives as Students; The Faculty Were Giants; Alice Cook: Lifelong Scholar, Consummate Teacher; Frances Perkins; Visits and Visitors; Tenth Anniversary: Reflection and Change; The Emergence of Departments at ILR; Development of International Programs and Outreach

Wireless Stimulation of Antennal Muscles in Freely Flying Hawkmoths Leads to Flight Path Changes

Insect antennae are sensory organs involved in a variety of behaviors, sensing many different stimulus modalities. As mechanosensors, they are crucial for flight control in the hawkmoth Manduca sexta. One of their roles is to mediate compensatory reflexes of the abdomen in response to rotations of the body in the pitch axis. Abdominal motions, in turn, are a component of the steering mechanism for flying insects. Using a radio controlled, programmable, miniature stimulator, we show that ultra-low-current electrical stimulation of antennal muscles in freely-flying hawkmoths leads to repeatable, transient changes in the animals' pitch angle, as well as less predictable changes in flight speed and flight altitude. We postulate that by deflecting the antennae we indirectly stimulate mechanoreceptors at the base, which drive compensatory reflexes leading to changes in pitch attitude.United States. Defense Advanced Research Projects Agenc

Stability of Circulating Blood-Based MicroRNAs - Pre-Analytic Methodological Considerations

Background and aim The potential of microRNAs (miRNA) as non-invasive diagnostic, prognostic, and predictive biomarkers, as well as therapeutic targets, has recently been recognized. Previous studies have highlighted the importance of consistency in the methodology used, but to our knowledge, no study has described the methodology of sample preparation and storage systematically with respect to miRNAs as blood biomarkers. The aim of this study was to investigate the stability of miRNAs in blood under various relevant clinical and research conditions: different collection tubes, storage at different temperatures, physical disturbance, as well as serial freeze-thaw cycles. Methods Blood samples were collected from 12 healthy donors into different collection tubes containing anticoagulants, including EDTA, citrate and lithium-heparin, as well as into serum collection tubes. MiRNA stability was evaluated by measuring expression changes of miR-1, miR21 and miR-29b at different conditions: varying processing time of whole blood (up to 72 hours (h)), long-term storage (9 months at -80 degrees C), physical disturbance (1 and 8 h), as well as in a series of freeze/thaw cycles (1 and 4 times). Results Different collection tubes revealed comparable concentrations of miR-1, miR-21 and miR-29b. Tubes with lithium-heparin were found unsuitable for miRNA quantification. MiRNA levels were stable for at least 24 h at room temperature in whole blood, while separated fractions did show alterations within 24 h. There were significant changes in the miR-21 and miR-29b levels after 72 h incubation of whole blood at room temperature (p< 0.01 for both). Both miR-1 and miR-21 showed decreased levels after physical disturbance for 8 h in separated plasma and miR-1 in serum whole blood, while after 1 h of disturbance no changes were observed. Storage of samples at -80 degrees C extended the miRNA stability remarkably, however, miRNA levels in long-term stored (9 months) whole blood samples were significantly changed, which is in contrast to the plasma samples, where miR-21 or miR-29b levels were found to be stable. Repetitive (n = 4) freeze-thaw cycles resulted in a significant reduction of miRNA concentration both in plasma and serum samples. Conclusion This study highlights the importance of proper and systematic sample collection and preparation when measuring circulating miRNAs, e.g., in context of clinical trials. We demonstrated that the type of collection tubes, preparation, handling and storage of samples should be standardized to avoid confounding variables influencing the results

Boundary-Layer Formulation of Dendritic Growth: Existence of a Family of Steady-State Needle Solutions

FWN – Publicaties zonder aanstelling Universiteit Leide

Opposing transcriptional programs of KLF5 and AR emerge during therapy for advanced prostate cancer.

Endocrine therapies for prostate cancer inhibit the androgen receptor (AR) transcription factor. In most cases, AR activity resumes during therapy and drives progression to castration-resistant prostate cancer (CRPC). However, therapy can also promote lineage plasticity and select for AR-independent phenotypes that are uniformly lethal. Here, we demonstrate the stem cell transcription factor Krüppel-like factor 5 (KLF5) is low or absent in prostate cancers prior to endocrine therapy, but induced in a subset of CRPC, including CRPC displaying lineage plasticity. KLF5 and AR physically interact on chromatin and drive opposing transcriptional programs, with KLF5 promoting cellular migration, anchorage-independent growth, and basal epithelial cell phenotypes. We identify ERBB2 as a point of transcriptional convergence displaying activation by KLF5 and repression by AR. ERBB2 inhibitors preferentially block KLF5-driven oncogenic phenotypes. These findings implicate KLF5 as an oncogene that can be upregulated in CRPC to oppose AR activities and promote lineage plasticity

The National Tumor Association Foundation (ANT): A 30 year old model of home palliative care

<p>Abstract</p> <p>Background</p> <p>Models of palliative care delivery develop within a social, cultural, and political context. This paper describes the 30-year history of the National Tumor Association (ANT), a palliative care organization founded in the Italian province of Bologna, focusing on this model of home care for palliative cancer patients and on its evaluation.</p> <p>Methods</p> <p>Data were collected from the 1986-2008 ANT archives and documents from the Emilia-Romagna Region Health Department, Italy. Outcomes of interest were changed in: number of patients served, performance status at admission (Karnofsky Performance Status score [KPS]), length of participation in the program (days of care provided), place of death (home vs. hospital/hospice), and satisfaction with care. Statistical methods included linear and quadratic regressions. A linear and a quadratic regressions were generated; the independent variable was the year, while the dependent one was the number of patients from 1986 to 2008. Two linear regressions were generated for patients died at home and in the hospital, respectively. For each regression, the R square, the unstandardized and standardized coefficients and related P-values were estimated.</p> <p>Results</p> <p>The number of patients served by ANT has increased continuously from 131 (1986) to a cumulative total of 69,336 patients (2008), at a steady rate of approximately 121 additional patients per year and with no significant gender difference. The annual number of home visits increased from 6,357 (1985) to 904,782 (2008). More ANT patients died at home than in hospice or hospital; this proportion increased from 60% (1987) to 80% (2007). The rate of growth in the number of patients dying in hospital/hospice was approximately 40 patients/year (p < 0.01), vs. approximately 177 patients/year for patients who died at home. The percentage of patients with KPS < 40 at admission decreased from 70% (2003) to 30% (2008); the percentage of patients with KPS > 40 increased. Mean days of care for patients with KPS > 40 exceeded mean days for patients with KPS < 40 (p < 0.001). Patients and caregivers reported high satisfaction with care in each year of assessment; in 2008, among 187 interviewed caregivers, 95% judged the quality of doctors' assistance, and 91% judged the quality of nurses' assistance, to be "optimal."</p> <p>Conclusions</p> <p>The ANT home care model of palliative care delivery has been well-received, with progressively growing numbers of patients served. It has resulted in a greater proportion of home deaths and in patients' accessing palliative care at an earlier point in the disease trajectory. Changes in ANT chronicle palliative care trends in general.</p

NEXMIF encephalopathy:an X-linked disorder with male and female phenotypic patterns

Purpose Pathogenic variants in the X-linked gene NEXMIF (previously KIAA2022) are associated with intellectual disability (ID), autism spectrum disorder, and epilepsy. We aimed to delineate the female and male phenotypic spectrum of NEXMIF encephalopathy. Methods Through an international collaboration, we analyzed the phenotypes and genotypes of 87 patients with NEXMIF encephalopathy. Results Sixty-three females and 24 males (46 new patients) with NEXMIF encephalopathy were studied, with 30 novel variants. Phenotypic features included developmental delay/ID in 86/87 (99%), seizures in 71/86 (83%) and multiple comorbidities. Generalized seizures predominated including myoclonic seizures and absence seizures (both 46/70, 66%), absence with eyelid myoclonia (17/70, 24%), and atonic seizures (30/70, 43%). Males had more severe developmental impairment; females had epilepsy more frequently, and varied from unaffected to severely affected. All NEXMIF pathogenic variants led to a premature stop codon or were deleterious structural variants. Most arose de novo, although X-linked segregation occurred for both sexes. Somatic mosaicism occurred in two males and a family with suspected parental mosaicism. Conclusion NEXMIF encephalopathy is an X-linked, generalized developmental and epileptic encephalopathy characterized by myoclonic-atonic epilepsy overlapping with eyelid myoclonia with absence. Some patients have developmental encephalopathy without epilepsy. Males have more severe developmental impairment. NEXMIF encephalopathy arises due to loss-of-function variants