Additional file 2 of Do chiropractic interns use clinical practice guidelines when managing patients with neck pain in France? A feasibility study

Additional file 2. Enquête nationale stagiaires en centres de soins (PILOTE) - Diagnostic & prise en charge des cervicalgies en chiropraxie

Additional file 1 of Do chiropractic interns use clinical practice guidelines when managing patients with neck pain in France? A feasibility study

Additional file 1. STROBE Statement—Checklist of items that should be included in reports of cross-sectional studies

<i>It might take a village</i>: developing a rehabilitation program of care for degenerative cervical radiculopathy from the patient perspective

The aim of our study is to inform the development of a rehabilitation program of care from the perspectives of those suffering from degenerative cervical radiculopathy (DCR). We conducted a qualitative study, purposefully recruiting individuals with DCR. Transcripts from virtual semi-structured interviews were iteratively analyzed using interpretative phenomenological methods. Eleven participants were recruited and depicted their ideal rehabilitation program of care. Participants described the importance of a patient centered-approach, health care providers who were validating, reassuring and attentive, easier access to health services, a supportive and collaborative team environment, and receiving peer support. Furthermore, participants expressed that they would expect the program of care to result in their symptoms being less intense and intermittent. In consideration of the participant perspectives, the ideal rehabilitation program of care can be conceptualized by the enactive-biopsychosocial model, which provides a theoretical framework for developing and implementing the program of care. We obtained valuable information from individuals living with DCR regarding their preferences and expectations of a rehabilitation program of care. The participant descriptions will provide the groundwork for its development to meet patient needs and expectations. Future research to guide implementation will also be explored. The lives of those suffering from cervical radiculopathy are significantly impacted. Incorporating patient perspectives in the development of care plans can lead to the inclusion of interventions considered patient-centered and may improve implementation, adherence, and outcomes. Participants described their preferences and expectations of a rehabilitation program of care that may assist in its future development to meet patient needs and expectations. From participants’ perspectives, the ideal rehabilitation program of care would be framed by the enactive-biopsychosocial model, thus providing a theoretical context for its development and implementation.</p

HIV exposed seronegative (HESN) compared to HIV infected individuals have higher frequencies of telomeric Killer Immunoglobulin-like Receptor (KIR) B motifs; Contribution of KIR B motif encoded genes to NK cell responsiveness

<div><p>Previously, we showed that Killer Immunoglobulin-like Receptor <i>(KIR)3DS1</i> homozygotes (hmz) are more frequent in HIV exposed seronegative (HESN) than in recently HIV infected (HIV+) individuals. <i>KIR3DS1</i> encodes an activating Natural Killer (NK) cell receptor (NKR). The link between <i>KIR</i> genotype and HIV outcomes likely arises from the function that NK cells acquire through expression of particular NKRs. An initial screen of 97 HESN and 123 HIV+ subjects for the frequency of <i>KIR</i> region gene carriage observed between-group differences for several telomeric <i>KIR</i> region loci. In a larger set of up to 106 HESN and 439 HIV+ individuals, more HESN than HIV+ subjects were <i>KIR3DS1</i> homozygotes, lacked a full length <i>KIR2DS4</i> gene and carried the telomeric group B KIR haplotype motif, <i>TB01</i>. <i>TB01</i> is characterized by the presence of <i>KIR3DS1</i>, <i>KIR2DL5A</i>, <i>KIR2DS3/5</i> and <i>KIR2DS1</i>, in linkage disequilibrium with each other. We assessed which of the <i>TB01</i> encoded KIR gene products contributed to NK cell responsiveness by stimulating NK cells from 8 HIV seronegative <i>KIR3DS1</i> and <i>TB01</i> motif homozygotes with 721.221 HLA null cells and evaluating the frequency of KIR3DS1^+/-KIR2DL5^+/-, KIR3DS1^+/-KIR2DS1^+/-, KIR3DS1^+/-KIR2DS5^+/- NK cells secreting IFN-γ and/or expressing CD107a. A higher frequency of NK cells expressing, versus not, KIR3DS1 responded to 721.221 stimulation. KIR2DL5A⁺, KIR2DS1⁺ and KIR2DS5⁺ NK cells did not contribute to 721.221 responses or modulate those by KIR3DS1⁺ NK cells. Thus, of the <i>TB01</i> KIR gene products, only KIR3DS1 conferred responsiveness to HLA-null stimulation, demonstrating its ligation can activate <i>ex vivo</i> NK cells</p></div

The frequency of NK cells expressing all possible combinations of KIR3DS1 and KIR2DL5 before and after stimulation with 721.221 (221) HLA-null cells.

<p>(A) Live singlet lymphocytes were gated on. From this population CD3^-CD56^dim NK cells were examined for the frequency of cells expressing KIR3DS1 and/or KIR2DL5 or neither. (B) The frequency of NK cells on the y-axis expressing all possible combinations of KIR3DS1 (3DS1) and KIR2DL5 (2DL5) on NK cells before and after stimulation with 221 cells (B). Each point represents results from a single individual. Bar heights and error bars represent the median and inter-quartile range of each group.</p

The gating strategy used to determine the frequency of NK cells expressing KIR3DS1, KIR2DS1 and KIR2DS5.

<p>Live singlet lymphocytes were gated on. From this population, CD3^-CD56^dim NK cells were identified from which the frequency of NK cells expressing KIR3DS1 (3DS1) was assessed. CD3^-CD56^dim NK cells were also gated on to determine the frequency of cells expressing KIR2DS1 (2DS1). This was accomplished by using the monoclonal antibody (mAb) REA284 specific for KIR2DL1 (2DL1) only, to bind this KIR making it unavailable for recognition by a second mAb (11PB6) conjugated to a different fluorochrome that was specific for both 2DL1 and 2DS1. This strategy permitted the separation of 2DL1⁺2DS1^- NK cells from 2DL1^-2DS1⁺ cells and 2DL1^-2DS1^- NK cells [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0185160#pone.0185160.ref042" target="_blank">42</a>]. To detect KIR2DS5⁺ NK cells, the CD3^-CD56^dim 2DL1^-2DS1^- NK cells from the previous gate that bound to mAb HP-MA4 specific for 2DL1/2DS1/KIR2DS3 (2DS3)/KIR2DS5 (2DS5) were gated on. Since 2DS3 is not cell surface expressed, this mAb detected only 2DS5⁺ NK cells among those negative for 2DL1 and 2DS1.</p

KIR/HLA information on KIR3DS1 homozygotes providing cells for functional studies.

<p>KIR/HLA information on KIR3DS1 homozygotes providing cells for functional studies.</p

Killer Immunoglobulin-like Receptor (KIR) gene and KIR allele group frequencies in 97 HIV exposed seronegative (HESN) and 123 recently infected HIV positive (HIV+) subjects.

<p>Shown on the y-axis are the percentage of HESN and HIV+ individuals carrying each KIR gene. Percentage refers to the number of subjects positive for each variable divided by the total number of subjects tested for that variable. The framework genes <i>KIR2DL4</i>, <i>KIR3DL2</i>, <i>KIR3DL3</i>, and the pseudogenes <i>KIR3DP1</i> were present in all study subjects and are not shown in this this figure. Each gene shown on the x-axis is named without the “KIR” designation, i.e. 2DS1 = KIR2DS2, etc. ** = p’<0.01. This p-value refers to p-value corrected for multiple comparisons. This p’-value is shown over the bar linking the 2 groups being compared.</p

Killer Immunoglobulin-like Receptor (KIR) generic genotype and allele group frequencies in HIV exposed seronegative (HESN) and recently infected HIV positive (HIV+) subjects.

<p>Shown on the y-axis is the frequency of (A) HESN (n = 106) and HIV+ (n = 439) subjects positive for the three <i>KIR3DL1/S1</i> generic genotypes, (B) HESN (n = 105) and HIV+ (n = 438) subjects positive for a <i>KIR2DS4</i> gene and carrying at least 1 copy of a <i>KIR2DS4*001-</i>like or <i>KIR2DS4*003-</i>like allele (C) <i>KIR2DS4*001-</i>like or <i>KIR2DS4*003-</i>like allele groups among the 210 and 876 KIR haplotypes from HESN (n = 105) and HIV+ (n = 438) subjects, (D) HESN (n = 105) and HIV+ (n = 431) subjects positive for a <i>KIR2DL5</i>, <i>KIR2DL5A</i> and <i>KIR2DL5B</i> gene, (E) HESN (n = 105) and HIV+ (n = 435) positive for a <i>KIR2DS1</i> gene, (F) <i>TB01</i> motifs among the 210 and 846 KIR haplotypes from HESN (n = 105) and HIV+ (n = 423) subjects and (G) HESN (n = 105) and HIV+ (n = 423) subjects positive for a homozygous <i>TB01</i> motif. P’-values over the lines linking groups being compared are corrected for multiple comparisons.</p

Killer Immunoglobulin-like (KIR) haplotypes.

<p>Organization and composition of centromeric and telomeric KIR region genes.</p