Introducing new joint replacements to clinical practice.

Requires collaboration between clinicians and regulators, together with comprehensive surveillance dat

Neural crest migration is driven by a few trailblazer cells with a unique molecular signature narrowly confined to the invasive front

Neural crest (NC) cell migration is crucial to the formation of peripheral tissues during vertebrate development. However, how NC cells respond to different microenvironments to maintain persistence of direction and cohesion in multicellular streams remains unclear. To address this, we profiled eight subregions of a typical cranial NC cell migratory stream. Hierarchical clustering showed significant differences in the expression profiles of the lead three subregions compared with newly emerged cells. Multiplexed imaging of mRNA expression using fluorescent hybridization chain reaction (HCR) quantitatively confirmed the expression profiles of lead cells. Computational modeling predicted that a small fraction of lead cells that detect directional information is optimal for successful stream migration. Single-cell profiling then revealed a unique molecular signature that is consistent and stable over time in a subset of lead cells within the most advanced portion of the migratory front, which we term trailblazers. Model simulations that forced a lead cell behavior in the trailing subpopulation predicted cell bunching near the migratory domain entrance. Misexpression of the trailblazer molecular signature by perturbation of two upstream transcription factors agreed with the in silico prediction and showed alterations to NC cell migration distance and stream shape. These data are the first to characterize the molecular diversity within an NC cell migratory stream and offer insights into how molecular patterns are transduced into cell behaviors

Unusual orbital lymphoma undetectable by magnetic resonance imaging: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report the case of a patient with orbital malignant lymphoma that was not detected by imaging studies when she presented with impaired vision, which lead to her eventual loss of sight.</p> <p>Case presentation</p> <p>A 71-year-old Japanese woman complained of deteriorating vision in her left eye. On examination, papilledema was detected, but magnetic resonance imaging only showed slight thickening and enhancement of the left optic nerve. A diagnosis of idiopathic optic neuritis was made and corticosteroid pulse therapy was administered. During the next four months, the patient received a total of four courses of corticosteroid pulse therapy, but she still suffered from bilateral loss of vision. A second magnetic resonance imaging procedure revealed tumors in both orbits and a biopsy showed diffuse large B-cell malignant lymphoma.</p> <p>Conclusion</p> <p>The possibility of malignant lymphoma should be considered in patients with recurrent optic neuropathy despite administration of corticosteroid pulse therapy, even when there are no abnormalities on cerebrospinal fluid examination or magnetic resonance imaging.</p

Clergy work-related satisfactions in parochial ministry: the influence of personality and churchmanship

The aim of this study was to test several hypotheses that clergy work-related satisfaction could be better explained by a multidimensional rather than a unidimensional model. A sample of 1071 male stipendiary parochial clergy in the Church of England completed the Clergy Role Inventory, together with the short-form Revised Eysenck Personality Questionnaire. Factor analysis of the Clergy Role Inventory identified five separate clergy roles: Religious Instruction, Administration, Statutory Duties (conducting marriages and funerals), Pastoral Care, and Role Extension (including extra-parochial activities). Respondents also provided an indication of their predispositions on the catholic-evangelical and liberal-conservative dimensions. The significant associations of the satisfactions derived from each of the roles with the demographic, personality, and churchmanship variables were numerous, varied, and, with few exceptions, small in magnitude. Separate hierarchical regressions for each of the five roles indicated that the proportion of total variance explained by churchmanship was, in general, at least as great as that explained by personality, and was greater for three roles: Religious Instruction, Statutory Duties, and Role Extension. It was concluded that clergy satisfactions derived from different roles are not uniform and that churchmanship is at least as important as personality in accounting for clergy work satisfaction

The evolution of postpollination reproductive isolation in Costus

Reproductive isolation is critical to the diversification of species. Postpollination barriers may be important in limiting gene flow between closely related species, but they are relatively cryptic and their evolution is poorly understood. Here, we review the role of postpollination reproductive isolation in plants, including the various stages at which it operates and the hypotheses for how it may evolve. We then review empirical studies in the plant genus Costus, evaluating documented postpollination barriers in light of these hypotheses. We summarize isolation due to parental style length differences and present evidence supporting the hypothesis that the differences are in part a by-product of selection on floral morphology. Additionally, we show that reduced pollen adhesion, germination, and tube growth contribute to reproductive isolation between two closely related sympatric species of Costus. Geographic variation in the strength of these crossing barriers supports the hypothesis that they evolved under reinforcement, or direct natural selection to strengthen isolation

Indicators of climate risk in the UK at different levels of warming

Assessments of the impacts of climate change are typically made using climate scenarios based on assumptions about future emissions of greenhouse gases, but policymakers and climate risk communicators are increasingly asking for information on impacts at different levels of warming. This paper provides this information for a set of indicators of climate risks in the UK for levels of warming up to 4 °C above pre-industrial levels. The results show substantial increases in climate risks at 2 °C, which is often inferred in the media to be a 'safe' level of climate change. In a 2 °C world, the chance of a heatwave is doubled, and the frequency of heat stress affecting people, crops and animals can be increased by a factor of five. Cooling degree days more than double, wildfire danger can increase by 40%–70%, the frequency of agricultural and water resources droughts doubles in England, and flood frequency in Wales increases by 50%. At 4 °C the increases in risk are considerably greater: heatwaves occur in virtually every year. The frequency of cold weather extremes reduces, but is not eliminated, with increasing warming. The rate of change in an indicator with warming varies across the UK. For temperature-based indicators this reflects variability in current climate, but for rainfall-based indicators reflects variations in the change in climate. Most indicators show a generally linear increase in risk with level of warming (although the change in risk from now is around 2.4 times higher in a 4 °C world than a 2 °C world because of warming experienced so far). However, some indicators—particularly relating to heat extremes—show a highly non-linear increase with level of warming. The range in change in indicator at a given level of warming is primarily caused by uncertainty in the estimated regional response of to increasing forcing

Importance of fisheries for food security across three climate change vulnerable deltas

Deltas are home to a large and growing proportion of the world's population, often living in conditions of extreme poverty. Deltaic ecosystems are ecologically significant as they support high biodiversity and a variety of fisheries, however these coastal environments are extremely vulnerable to climate change. The Ganges-Brahmaputra-Meghna (Bangladesh/India), the Mahanadi (India), and the Volta (Ghana) are among the most important and populous delta regions in the world and they are all considered at risk of food insecurity and climate change. The fisheries sector is vital for populations that live in the three deltas, as a source of animal protein (in Bangladesh and Ghana around 50–60% of animal protein is supplied by fish while in India this is about 12%) through subsistence fishing, as a source of employment and for the wider economy. The aquaculture sector shows a rapid growth in Bangladesh and India while in Ghana this is just starting to expand. The main exported species differ across countries with Ghana and India dominated by marine fish species, whereas Bangladesh exports shrimps and prawns. Fisheries play a more important part in the economy of Bangladesh and Ghana than for India, both men and women work in fisheries, with a higher proportion of women in the Volta then in the Asian deltas. Economic and integrated modelling using future scenarios suggest that changes in temperature and primary production could reduce fish productivity and fisheries income especially in the Volta and Bangladesh deltas, however these losses could be mitigated by reducing overfishing and improving management. The analysis provided in this paper highlights the importance of applying plans for fisheries management at regional level. Minimizing the impacts of climate change while increasing marine ecosystems resilience must be a priority for scientists and governments before these have dramatic impacts on millions of people's lives

Recent progress in understanding climate thresholds: ice sheets, the Atlantic meridional overturning circulation, tropical forests and responses to ocean acidification

This article reviews recent scientific progress, relating to four major systems that could exhibit threshold behaviour: ice sheets, the Atlantic meridional overturning circulation (AMOC), tropical forests and ecosystem responses to ocean acidification. The focus is on advances since the Intergovernmental Panel on Climate Change Fifth Assessment Report (IPCC AR5). The most significant developments in each component are identified by synthesizing input from multiple experts from each field. For ice sheets, some degree of irreversible loss (timescales of millennia) of part of the West Antarctic Ice Sheet (WAIS) may have already begun, but the rate and eventual magnitude of this irreversible loss is uncertain. The observed AMOC overturning has decreased from 2004–2014, but it is unclear at this stage whether this is forced or is internal variability. New evidence from experimental and natural droughts has given greater confidence that tropical forests are adversely affected by drought. The ecological and socio-economic impacts of ocean acidification are expected to greatly increase over the range from today’s annual value of around 400, up to 650 ppm CO2 in the atmosphere (reached around 2070 under RCP8.5), with the rapid development of aragonite undersaturation at high latitudes affecting calcifying organisms. Tropical coral reefs are vulnerable to the interaction of ocean acidification and temperature rise, and the rapidity of those changes, with severe losses and risks to survival at 2 °C warming above pre-industrial levels. Across the four systems studied, however, quantitative evidence for a difference in risk between 1.5 and 2 °C warming above pre-industrial levels is limited

Recommendations for exercise adherence measures in musculoskeletal settings : a systematic review and consensus meeting (protocol)

Background: Exercise programmes are frequently advocated for the management of musculoskeletal disorders; however, adherence is an important pre-requisite for their success. The assessment of exercise adherence requires the use of relevant and appropriate measures, but guidance for appropriate assessment does not exist. This research will identify and evaluate the quality and acceptability of all measures used to assess exercise adherence within a musculoskeletal setting, seeking to reach consensus for the most relevant and appropriate measures for application in research and/or clinical practice settings. Methods/design: There are two key stages to the proposed research. First, a systematic review of the quality and acceptability of measures used to assess exercise adherence in musculoskeletal disorders; second, a consensus meeting. The systematic review will be conducted in two phases and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure a robust methodology. Phase one will identify all measures that have been used to assess exercise adherence in a musculoskeletal setting. Phase two will seek to identify published and unpublished evidence of the measurement and practical properties of identified measures. Study quality will be assessed against the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. A shortlist of best quality measures will be produced for consideration during stage two: a meeting of relevant stakeholders in the United Kingdom during which consensus on the most relevant and appropriate measures of exercise adherence for application in research and/or clinical practice settings will be sought. Discussion: This study will benefit clinicians who seek to evaluate patients’ levels of exercise adherence and those intending to undertake research, service evaluation, or audit relating to exercise adherence in the musculoskeletal field. The findings will impact upon new research studies which aim to understand the factors that predict adherence with exercise and which test different adherence-enhancing interventions. PROSPERO reference: CRD4201300621