Structure of a novel P-superfamily spasmodic conotoxin reveals an inhibitory cystine knot motif

Journal ArticleConotoxin gm9a, a putative 27-residue polypeptide encoded by Conus gloriamaris, was recently identified as a homologue of the "spasmodic peptide", tx9a, isolated from the venom of the mollusk-hunting cone shell Conus textile (Lirazan, M. B., Hooper, D., Corpuz, G. P., Ramilo, C. A., Bandyopadhyay, P., Cruz, L. J., and Olivera, B. M. (2000) Biochemistry 39, 1583-1588). The C. gloriamaris spasmodic peptide has been synthesized, and the refolded polypeptide was shown to be biologically active using a mouse bioassay

Variational modelling of wave-structure interactions with an offshore wind-turbine mast

We consider the development of a mathematical model of water waves interacting with the mast of an offshore wind turbine. A variational approach is used for which the starting point is an action functional describing a dual system comprising a potential-flow fluid, a solid structure modelled with nonlinear elasticity, and the coupling between them. We develop a linearized model of the fluid–structure or wave–mast coupling, which is a linearization of the variational principle for the fully coupled nonlinear model. Our numerical results for the linear case indicate that our variational approach yields a stable numerical discretization of a fully coupled model of water waves and an elastic beam. The energy exchange between the subsystems is seen to be in balance, yielding a total energy that shows only small and bounded oscillations amplitude of which tends to zero with the second-order convergence as the timestep approaches zero. Similar second-order convergence is observed for spatial mesh refinement. The linearized model so far developed can be extended to a nonlinear regime

Variational water-wave model with accurate dispersion and vertical vorticity

A new water-wave model has been derived which is based on variational techniques and combines a depth-averaged vertical (component of) vorticity with depth-dependent potential flow. The model facilitates the further restriction of the vertical profile of the velocity potential to n-th order polynomials or a finite-element profile with a small number of elements (say), leading to a framework for efficient modeling of the interaction of steepening and breaking waves near the shore with a large-scale horizontal flow. The equations are derived from a constrained variational formulation which leads to conservation laws for energy, mass, momentum and vertical vorticity. It is shown that the potential-flow water-wave equations and the shallow-water equations are recovered in the relevant limits. Approximate shock relations are provided, which can be used in numerical schemes to model breaking waves

Trastuzumab-associated cardiac events in the Persephone trial.

BACKGROUND: We report cardiac events in the Persephone trial which compares 6-12 months of adjuvant trastuzumab in women with confirmed HER2-positive, early-stage breast cancer. METHODS: Clinical cardiac events were defined as any of the following: symptoms and/or signs of congestive heart failure (CHF) and new or altered CHF medication. In addition, left ventricular ejection fraction (LVEF) was measured at baseline and then 3 monthly for 12 months. RESULTS: A total of 2500 patients, aged 22-82, were included: 1251 randomised to 12 months and 1249 to 6 months of trastuzumab treatment. A total of 93% (2335/2500) received anthracyclines, 49% of these (1136/2335) with taxanes. Cardiotoxicity delayed treatment in 6% of 12-month and 4% of 6-month patients (P=0.01), and stopped treatment early in 8% (96/1214) of 12-month and 4% (45/1216) of 6-month patients (P3 cycles of anthracycline was associated with higher risk of cardiac events only for 12-month patients (OR 1.41 (1.04-1.90)), and not for 6-month patients (OR 1.28 (0.91-1.79)). CONCLUSIONS: We demonstrate significantly fewer cardiac events from 6 months of adjuvant trastuzumab compared with that from 12 months. This cardiac signal adds importance to the question of the optimum duration of adjuvant trastuzumab treatment. If 6 months is proven to have non-inferior outcomes to 12 months treatment, these data would support 6 months as the standard of care.National Institute of Health Research Health Technology Assessment (NIHR HTA) Programme UK. Funding reference number - 06/303/98This is the author accepted manuscript. The final version is available from Nature Publishing Group via https://doi.org/10.1038/bjc.2016.35

Magneto-acoustic waves in a gravitationally stratified magnetized plasma: eigen-solutions and their applications to the solar atmosphere

Magneto-acoustic gravity (MAG) waves have been studied intensively in the context of astrophysical plasmas. There are three popular choices of analytic modeling using a Cartesian coordinate system: a magnetic field parallel, perpendicular, or at an angle to the gravitational field. Here, we study a gravitationally stratified plasma embedded in a parallel, so called vertical, magnetic field. We find a governing equation for the auxiliary quantity Θ = p 1/ρ 0, and find solutions in terms of hypergeometric functions. With the convenient relationship between Θ and the vertical velocity component, v z , we derive the solution for v z . We show that the four linearly independent functions for v z can also be cast as single hypergeometric functions, rather than the Frobenius series derived by Leroy & Schwartz. We are then able to analyze a case of approximation for a one-layer solution, taking the small wavelength limit. Motivated by solar atmospheric applications, we finally commence study of the eigenmodes of perturbations for a two-layer model using our solutions, solving the dispersion relation numerically. We show that, for a transition between a photospheric and chromospheric plasma embedded in a vertical magnetic field, modes exist that are between the observationally widely investigated three and five minute oscillation periods, interpreted as solar global oscillations in the lower solar atmosphere. It is also shown that, when the density contrast between the layers is large (e.g., applied to photosphere/chromosphere-corona), the global eigenmodes are practically a superposition of the same as in each of the separate one-layer systems

Biophysical basis of filamentous phage tactoid-mediated antibiotic tolerance in P. aeruginosa

Inoviruses are filamentous phages infecting numerous prokaryotic phyla. Inoviruses can self-assemble into mesoscale structures with liquid-crystalline order, termed tactoids, which protect bacterial cells in Pseudomonas aeruginosa biofilms from antibiotics. Here, we investigate the structural, biophysical, and protective properties of tactoids formed by the P. aeruginosa phage Pf4 and Escherichia coli phage fd. A cryo-EM structure of the capsid from fd revealed distinct biochemical properties compared to Pf4. Fd and Pf4 formed tactoids with different morphologies that arise from differing phage geometries and packing densities, which in turn gave rise to different tactoid emergent properties. Finally, we showed that tactoids formed by either phage protect rod-shaped bacteria from antibiotic treatment, and that direct association with a tactoid is required for protection, demonstrating the formation of a diffusion barrier by the tactoid. This study provides insights into how filamentous molecules protect bacteria from extraneous substances in biofilms and in host-associated infections

Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders.

Irritable bowel syndrome (IBS) results from disordered brain-gut interactions. Identifying susceptibility genes could highlight the underlying pathophysiological mechanisms. We designed a digestive health questionnaire for UK Biobank and combined identified cases with IBS with independent cohorts. We conducted a genome-wide association study with 53,400 cases and 433,201 controls and replicated significant associations in a 23andMe panel (205,252 cases and 1,384,055 controls). Our study identified and confirmed six genetic susceptibility loci for IBS. Implicated genes included NCAM1, CADM2, PHF2/FAM120A, DOCK9, CKAP2/TPTE2P3 and BAG6. The first four are associated with mood and anxiety disorders, expressed in the nervous system, or both. Mirroring this, we also found strong genome-wide correlation between the risk of IBS and anxiety, neuroticism and depression (rg > 0.5). Additional analyses suggested this arises due to shared pathogenic pathways rather than, for example, anxiety causing abdominal symptoms. Implicated mechanisms require further exploration to help understand the altered brain-gut interactions underlying IBS

The ViKTORIES trial: a randomised, double-blind, placebo-controlled trial of vitamin K supplementation to improve vascular health in kidney transplant recipients

Premature cardiovascular disease and death with a functioning graft are leading causes of death and graft loss respectively in kidney transplant recipients (KTR). Vascular stiffness and calcification are markers of cardiovascular disease that are prevalent in KTR and associated with subclinical vitamin K deficiency. We performed a single‐centre, phase II, parallel‐group, randomised, double‐blind, placebo‐controlled trial (ISRCTN22012044) to test whether vitamin K supplementation reduced vascular stiffness (MRI‐based aortic distensibility) or calcification (coronary artery calcium score on computed tomography) in KTR over 1 year of treatment. The primary outcome was between‐group difference in vascular stiffness (ascending aortic distensibility). KTR were recruited between September 2017 and June 2018, and randomised 1:1 to vitamin K (Menadiol diphosphate 5mg; n=45) or placebo (n=45) thrice‐weekly. Baseline demographics, clinical history and immunosuppression regimens were similar between groups. There was no impact of vitamin K on vascular stiffness (treatment effect ‐0.23 (95% CI ‐0.75 to 0.29) x10‐3 mmHg‐1; p=0.377), vascular calcification (treatment effect ‐141 (95% CI ‐320 to 38) units; p=0.124), nor any other outcome measure. In this heterogeneous cohort of prevalent KTR, vitamin K supplementation did not reduce vascular stiffness or calcification over 1 year. Improving vascular health in KTR is likely to require a multifaceted approach

Dynamic contrast-enhanced CT compared with positron emission tomography CT to characterise solitary pulmonary nodules: the SPUtNIk diagnostic accuracy study and economic modelling

BACKGROUND: Current pathways recommend positron emission tomography-computerised tomography for the characterisation of solitary pulmonary nodules. Dynamic contrast-enhanced computerised tomography may be a more cost-effective approach. OBJECTIVES: To determine the diagnostic performances of dynamic contrast-enhanced computerised tomography and positron emission tomography-computerised tomography in the NHS for solitary pulmonary nodules. Systematic reviews and a health economic evaluation contributed to the decision-analytic modelling to assess the likely costs and health outcomes resulting from incorporation of dynamic contrast-enhanced computerised tomography into management strategies. DESIGN: Multicentre comparative accuracy trial. SETTING: Secondary or tertiary outpatient settings at 16 hospitals in the UK. PARTICIPANTS: Participants with solitary pulmonary nodules of ≥ 8 mm and of ≤ 30 mm in size with no malignancy in the previous 2 years were included. INTERVENTIONS: Baseline positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography with 2 years' follow-up. MAIN OUTCOME MEASURES: Primary outcome measures were sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computerised tomography. Incremental cost-effectiveness ratios compared management strategies that used dynamic contrast-enhanced computerised tomography with management strategies that did not use dynamic contrast-enhanced computerised tomography. RESULTS: A total of 380 patients were recruited (median age 69 years). Of 312 patients with matched dynamic contrast-enhanced computer tomography and positron emission tomography-computerised tomography examinations, 191 (61%) were cancer patients. The sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography were 72.8% (95% confidence interval 66.1% to 78.6%), 81.8% (95% confidence interval 74.0% to 87.7%), 76.3% (95% confidence interval 71.3% to 80.7%) and 95.3% (95% confidence interval 91.3% to 97.5%), 29.8% (95% confidence interval 22.3% to 38.4%) and 69.9% (95% confidence interval 64.6% to 74.7%), respectively. Exploratory modelling showed that maximum standardised uptake values had the best diagnostic accuracy, with an area under the curve of 0.87, which increased to 0.90 if combined with dynamic contrast-enhanced computerised tomography peak enhancement. The economic analysis showed that, over 24 months, dynamic contrast-enhanced computerised tomography was less costly (£3305, 95% confidence interval £2952 to £3746) than positron emission tomography-computerised tomography (£4013, 95% confidence interval £3673 to £4498) or a strategy combining the two tests (£4058, 95% confidence interval £3702 to £4547). Positron emission tomography-computerised tomography led to more patients with malignant nodules being correctly managed, 0.44 on average (95% confidence interval 0.39 to 0.49), compared with 0.40 (95% confidence interval 0.35 to 0.45); using both tests further increased this (0.47, 95% confidence interval 0.42 to 0.51). LIMITATIONS: The high prevalence of malignancy in nodules observed in this trial, compared with that observed in nodules identified within screening programmes, limits the generalisation of the current results to nodules identified by screening. CONCLUSIONS: Findings from this research indicate that positron emission tomography-computerised tomography is more accurate than dynamic contrast-enhanced computerised tomography for the characterisation of solitary pulmonary nodules. A combination of maximum standardised uptake value and peak enhancement had the highest accuracy with a small increase in costs. Findings from this research also indicate that a combined positron emission tomography-dynamic contrast-enhanced computerised tomography approach with a slightly higher willingness to pay to avoid missing small cancers or to avoid a 'watch and wait' policy may be an approach to consider. FUTURE WORK: Integration of the dynamic contrast-enhanced component into the positron emission tomography-computerised tomography examination and the feasibility of dynamic contrast-enhanced computerised tomography at lung screening for the characterisation of solitary pulmonary nodules should be explored, together with a lower radiation dose protocol