Establishing a core outcome set for peritoneal dialysis : report of the SONG-PD (standardized outcomes in nephrology-peritoneal dialysis) consensus workshop

Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD

Mitochondrial DNA mutations drive aerobic glycolysis to enhance checkpoint blockade response in melanoma

The mitochondrial genome (mtDNA) encodes essential machinery for oxidative phosphorylation and metabolic homeostasis. Tumor mtDNA is among the most somatically mutated regions of the cancer genome, but whether these mutations impact tumor biology is debated. We engineered truncating mutations of the mtDNA-encoded complex I gene, Mt-Nd5, into several murine models of melanoma. These mutations promoted a Warburg-like metabolic shift that reshaped tumor microenvironments in both mice and humans, consistently eliciting an anti-tumor immune response characterized by loss of resident neutrophils. Tumors bearing mtDNA mutations were sensitized to checkpoint blockade in a neutrophil-dependent manner, with induction of redox imbalance being sufficient to induce this effect in mtDNA wild-type tumors. Patient lesions bearing >50% mtDNA mutation heteroplasmy demonstrated a response rate to checkpoint blockade that was improved by ~2.5-fold over mtDNA wild-type cancer. These data nominate mtDNA mutations as functional regulators of cancer metabolism and tumor biology, with potential for therapeutic exploitation and treatment stratification

Implementing core outcomes in kidney disease: report of the Standardized Outcomes in Nephrology (SONG) implementation workshop

There are an estimated 14,000 randomized trials published in chronic kidney disease. The most frequently reported outcomes are biochemical endpoints, rather than clinical and patient-reported outcomes including cardiovascular disease, mortality, and quality of life. While many trials have focused on optimizing kidney health, the heterogeneity and uncertain relevance of outcomes reported across trials may limit their policy and practice impact. The international Standardized Outcomes in Nephrology (SONG) Initiative was formed to identify core outcomes that are critically important to patients and health professionals, to be reported consistently across trials. We convened a SONG Implementation Workshop to discuss the implementation of core outcomes. Eighty-two patients/caregivers and health professionals participated in plenary and breakout discussions. In this report, we summarize the findings of the workshop in two main themes: socializing the concept of core outcomes, and demonstrating feasibility and usability. We outline implementation strategies and pathways to be established through partnership with stakeholders, which may bolster acceptance and reporting of core outcomes in trials, and encourage their use by end-users such as guideline producers and policymakers to help improve patient-important outcomes

Pre- and post-flood feeding ecology of four species of juvenile fish from the logan-albert estuarine system, moreton bay, queensland

The feeding ecology of the four dominant species of juvenile fish found in the Logan-Albert estuarine system are described in terms of the stomach contents of 675 fish examined over a 7-month period. Ontogenetic dietary changes and spatial, temporal and interspecific differences in diet were determined. Johniops vogleri and Polynemus multiradiatus were predominantly planktonic feeders. At an early stage of development, these fish fed mainly on copepods, which were progressively replaced by larger prey such as mysids and Acetes as the fish grew. Arius graeffei and Aseraggodes macleayanus were mainly benthic feeders. Spatial and temporal differences in diet were also evident for each species. These differences probably reflected changes in prey availability resulting from flood-induced changes to the salinity gradient. The potential for competition between Johniops vogleri and Polynemus multiradiatus was reduced by temporal partitioning of food resources as the fish grew

Gear modifications and alternative baits that reduce bait scavenging and minimize by-catch on baited drum-lines used in the Queensland Shark Control Program

Bycatch minimisation is an important issue for fisheries managers worldwide and is particularly important in the Queensland Shark Control Program (QSCP) since marine turtles, cetaceans and other marine life are incidentally caught along with the targeted shark species. Different hook modifications and baits were trialled on drum-lines used by the QSCP in an effort to reduce the incidental capture of turtles and to deter dolphins from scavenging drum-line baits. Double hook lines did not differ significantly (Wilcoxon matched pairs test T=8.5, n=8, P>0.05) in shark catch compared with single hook lines although they were more likely to catch green turtles ( Chelonia mydas (L.)). Plastic hook guards reduced the turtle bycatch by almost 70% but shark catch also declined significantly ( T=10, n=11, P<0.05) by 30%. Both mesh guards and hook shrouds dramatically reduced scavenging of baits by dolphins in the short-term but they may also increase the turtle catch and their impact on shark catch was inconclusive. None of the baits tested significantly reduced the incidental capture of marine turtles but several baits (particularly frozen shark flesh) reduced scavenging by dolphins. Mullet ( Mugil cephalus (L.)) baits on drum-lines were removed by dolphins within an average of nine seconds of being placed in the water in some areas, with scavenging being more prevalent in southern areas where dolphin/human interactions are more prevalent. Chicken frames and whole chicken were also scavenged by both dolphins and turtles although less intensively than either mullet or carp ( Cyprinus carpio (L.)) baits

Age-based demographics of the pearl perch Glaucosoma scapulare (Ramsay, 1881)

Summary: This research represents the first age-based demographic assessment of pearl perch, Glaucosoma scapulare (Ramsay, 1881), a highly valued species endemic to coastal waters off central eastern Australia. The study was conducted across the species' distribution that encompasses two state jurisdictions (Queensland in the north and New South Wales in the south) using data collected approximately 10 years apart in each state. Estimates of age were made by counting annuli (validated using marginal increment ratios) in sectioned sagittal otoliths. The maximum estimated age was 19 years. Pearl perch attained approx. 12 cm fork length (FL) after one year, 21 cm FL after 2 years and 29 cm FL after 3 years. Fish from the southern end of the species' distribution grew significantly more slowly than those from the northern part of its range. Commercial landings in the north were characterized by greater proportions of larger (>40 cm FL) and older (>6 years) fish than those in the south, with landings mainly of fish between 3 and 6 years of age. The observed variations in age-based demographics of pearl perch highlight the need for a better understanding of patterns of movement and reproduction in developing a model of population dynamics and life-history for this important species. There is a clear need for further, concurrent, age-based studies on pearl perch in the northern and southern parts of its distribution to support the conclusions of the present study based on data collected a decade apart. © 2013 Blackwell Verlag GmbH