Chronic pain self-management support with pain science education and exercise (COMMENCE): Study protocol for a randomized controlled trial

© 2015 Miller et al. Background: Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. Methods/Design: This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control. The primary outcome will be function measured by the Short Musculoskeletal Function Assessment - Dysfunction Index. Secondary outcomes will include pain intensity measured by a numeric pain rating scale, pain interference measured by the eight-item PROMIS pain interference item-bank, how much patients are bothered by functional problems measured by the Short Musculoskeletal Function Assessment - Bother Index, catastrophic thinking measured by the Pain Catastrophizing Scale, fear of movement/re-injury measured by the 11-item Tampa Scale of Kinesiophobia, sense of perceived injustice measured by the Injustice Experience Questionnaire, self-efficacy measured by the Pain Self-Efficacy Questionnaire, pain sensitivity measured by pressure pain threshold and cold sensitivity testing, fatigue measured by a numeric fatigue rating scale, pain neurophysiology knowledge measured by the Neurophysiology of Pain Questionnaire, healthcare utilization measured by number of visits to a healthcare provider, and work status. Assessments will be completed at baseline, 7 and 18 weeks. After the 18-week assessment, the groups will crossover; however, we anticipate carry-over effects with the treatment. Therefore, data from after the crossover will be used to estimate within-group changes and to determine predictors of response that are not for direct between-group comparisons. Mixed effects modelling will be used to determine between-group differences for all primary and secondary outcomes. A series of multiple regression models will be used to determine predictors of treatment response. Discussion: This study has the potential to inform future self-management programming through evaluation of a self-management program that aims to improve function as the primary outcome. Trial registration: ClinicalTrials.gov NCT02422459 , registered on 13 April 2015

Draft Genome Sequence of Antarctic Methanogen Enriched from Dry Valley Permafrost

A genomic reconstruction belonging to the genus Methanosarcina was assembled from metagenomic data from a methane-producing enrichment of Antarctic permafrost. This is the first methanogen genome reported from permafrost of the Dry Valleys and can help shed light on future climate-affected methane dynamics

Brain tissue volume changes following weight gain in adults with anorexia nervosa

Objective: To measure brain volume deficits among underweight patients with anorexia nervosa (AN) compared to control participants and evaluate the reversibility of these deficits with short-term weight restoration. Method: Brain volume changes in gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) were examined in 32 adult women with AN and compared to 21, age and body mass index-range matched control women. Results: Patients with AN had a significant increase in GM (p = .006, η2 = 0.14) and WM volume (p = .001, η2 = 0.19) following weight restoration. Patients on average had lower levels of GM at low weight (647.63 ± 62.07 ml) compared to controls (679.93 ± 53.31 ml), which increased with weight restoration (662.64 ± 69.71 ml), but did not fully normalize. Discussion: This study suggests that underweight adult patients with AN have reduced GM and WM volumes that increase with short-term weight restoration

beta-Hydroxy-beta-methylbutyrate free acid reduces markers of exercise-induced muscle damage and improves recovery in resistance-trained men

The purpose of the present study was to determine the effects of short-term supplementation with the free acid form of beta-hydroxy-beta-methylbutyrate (HMB-FA) on indices of muscle damage, protein breakdown, recovery and hormone status following a high-volume resistance training session in trained athletes. A total of twenty resistance-trained males were recruited to participate in a high-volume resistance training session centred on full squats, bench presses and dead lifts. Subjects were randomly assigned to receive either 3 g/d of HMB-FA or a placebo. Immediately before the exercise session and 48 h post-exercise, serum creatine kinase (CK), urinary 3-methylhistadine (3-MH), testosterone, cortisol and perceived recovery status (PRS) scale measurements were taken. The results showed that CK increased to a greater extent in the placebo (329%) than in the HMB-FA group (104%) (P=0.004, d=1.6). There was also a significant change for PRS, which decreased to a greater extent in the placebo (9.1 (SEM 0.4) to 4.6 (SEM 0.5)) than in the HMB-FA group (9.1 (SEM 0.3) to 6.3 (SEM 0.3)) (P=0.005, d = -0.48). Muscle protein breakdown, measured by 3-MH analysis, numerically decreased with HMB-FA supplementation and approached significance (P=0.08, d = 0.12). There were no acute changes in plasma total or free testosterone, cortisol or C-reactive protein. In conclusion, these results suggest that an HMB-FA supplement given to trained athletes before exercise can blunt increases in muscle damage and prevent declines in perceived readiness to train following a high-volume, muscle-damaging resistance-training session

Effects of Bovine Plasma and Pharmacological Zinc Level on Nursery Pig Growth Performance and Fecal Characteristics

A total of 300 pigs (241 × 600, DNA; initially 12.9 lb) were used in a 38-d trial to evaluate the effect of Zn level and bovine plasma in nursery pig diets. At the time of placement, pens of pigs were weighed and allotted to 1 of 4 dietary treatments in a randomized complete block design with barn as the blocking factor. There was a total of 60 pens with 5 pigs per pen and 15 replicates per dietary treatment. The treatments were arranged in a 2 × 2 factorial with main effects of Zn level (high and low) and spray-dried bovine plasma inclusion (with or without; APC Inc., Ankeny, IA). Diets with pharmacological levels of Zn had 3,000 and 2,000 ppm of Zn in phase 1 and 2 diets, respectively. Diets with low level of Zn had 110 ppm of Zn in phase 1 and 2 diets. Bovine plasma replaced a portion of a fermented vegetable protein source (MEpro, Prairie Aquatech, Brookings, SD) in diet formulation with bovine plasma included at 5% and 2% in the phase 1 and 2 diets, respectively. Treatment diets were fed in 2 phases (phase 1: d 0 to 9; phase 2: d 9 to 24) with a common diet (110 ppm of Zn without plasma) fed from d 24 to 38. Fecal samples and scores were collected on d 9 and 24 for determination of fecal dry matter. There was no evidence of Zn × plasma interactions (P \u3e 0.10) throughout the trial for any growth criteria. From d 0 to 9, pigs fed bovine plasma tended to have improved ADG (P = 0.066) and had improved (P ≤ 0.035) ADFI and BW, while pigs fed high Zn had improved (P ≤ 0.018) ADG, BW and F/G. From d 9 to 24, pig fed high Zn had improved (P \u3c 0.001) ADG and ADFI. During the common period (d 24 to 38), pigs previously fed high Zn had reduced ADFI (P = 0.046). Overall (d 0 to 38), pigs fed high Zn had improved (P ≤ 0.029) BW, ADG, and F/G. For fecal DM, there was a tendency of plasma × Zn interaction (P = 0.067) where pigs fed high Zn had increased (P \u3c 0.05) fecal DM compared to pigs fed low Zn when bovine plasma was added, while this Zn effect was not significant (P \u3e 0.05) when fed in diets without plasma. For fecal score, pigs fed high Zn had higher (P \u3c 0.001) frequency of firmer feces. In summary, bovine plasma improved growth performance during the first week after weaning. Feeding pharmacological levels of Zn improved growth performance when fed and overall, as well as improved fecal DM and fecal firmness measured by observational scoring

ETV6 germline mutations cause HDAC3/NCOR2 mislocalization and upregulation of interferon response genes

ETV6 is an ETS family transcription factor that plays a key role in hematopoiesis and megakaryocyte development. Our group and others have identified germline mutations in ETV6 resulting in autosomal dominant thrombocytopenia and predisposition to malignancy; however, molecular mechanisms defining the role of ETV6 in megakaryocyte development have not been well established. Using a combination of molecular, biochemical, and sequencing approaches in patient-derived PBMCs, we demonstrate abnormal cytoplasmic localization of ETV6 and the HDAC3/NCOR2 repressor complex that led to overexpression of HDAC3-regulated interferon response genes. This transcriptional dysregulation was also reflected in patient-derived platelet transcripts and drove aberrant proplatelet formation in megakaryocytes. Our results suggest that aberrant transcription may predispose patients with ETV6 mutations to bone marrow inflammation, dysplasia, and megakaryocyte dysfunction