Alternatives in the treatment of abdominal rectus muscle diastasis : an evaluation

Introduction Abdominal rectus diastasis (ARD) is defined as a widening of the distance between the two rectus muscles located on either side of the Linea Alba (LA). A width of more than 3 cm is, in this thesis, considered as pathological. There are several reasons why ARD occurs, where pregnancy is one of the most common. Genetic variations in collagen composition, massive weight loss, and previous abdominal surgery are others. Patients with ARD usually perceive no pain at rest whereas discomfort, pain, corset instability and bulging of the abdominal wall are symptoms appearing during physical activity. Conclusive data regarding the most appropriate treatment of ARD are sparse, and studies with focus on abdominal wall function and quality of life after repair are lacking. Furthermore, no reliable data exist regarding evaluation of patients with ARD prior to surgery and the relevance of specific symptoms, width of ARD and abdominal wall strength. The overall aim of the present thesis was to evaluate the outcome of two surgical methods with regard to relapse of ARD; repair with a retromuscular mesh or double row self-retaining suture. Quality-of-life, pain and abdominal muscle strength were important secondary endpoints in the outcome of repair. Secondary aims were to evaluate: the effects of a dedicated training programme on symptoms and complaints from ARD; imaging and measurements of the ARD width prior to surgery; and to develop a reliable method for evaluation of abdominal wall strength. Material and methods Study I The validity and reliability of the Biodex System-4, was tested in ten healthy volunteers and ten patients with ARD ≥3 cm. The reliability of isokinetic and isometric muscle strength was assessed by test-retest with one week in between. Validity was tested by IPAQ (International Physical Activity Questionnaire) and VAS-assessment of patient-perceived muscle strength. Study II The width of ARD was evaluated clinically, with CT-scan and intra-operatively in 55 patients. Agreement between these modalities was evaluated to determine the most relevant measurement. Study III Early complications during the initial three postoperative months were monitored in 56 patients of whom 29 were randomised to repair with a retromuscular mesh and 27 to the Quill™ suture technique. All patients presented with an ARD wider than 3 cm. Study IV The same 56 patients randomised to surgery as in Study III were compared to 30 patients assigned to a training programme. Follow-up for the operated patients was at 1 year while training outcome was studied after the stated period of 3 months. Results The reliability of the Biodex System-4 was excellent as shown by ICC (Intra Class Correlation) statistics. The internal validity was excellent when compared to VAS using Spearman’s test. The external validity showed no correlation between IPAQ and isometric muscle strength using the Kendall-Tau test (Study I). Evaluation of the three methods to assess ARD showed a strong agreement (high CCC; Concordance Correlation Coefficient) between the clinical and intraoperative measurements whereas CT-scan and intraoperative measurements did not show agreement (low CCC). CT measurements underestimated the width of the ARD (Study II). Minor complications were observed three months after surgery. No significant difference between the two surgical groups in terms of early complication and perceived pain was observed. Patients in the mesh group experienced greater improvement in abdominal muscle strength (Study III). One year after surgery one recurrence was documented in the Quill group and five encapsulated seromas were distributed with no difference between the two surgical groups. Biodex System-4 showed significant improvement in all muscle strength modalities with the three methods. Quality-of-life (SF-36) domains were all significantly improved one year after surgery (p<0.001) with the exception of bodily pain (BP) in the physiotherapy group after three months of training (Study IV). Conclusions The prospective randomised trial has shown that patients with an ARD wider than 3 cm have physical symptoms and poorer quality of life than an age-matched Swedish population. Surgical intervention improves patient comfort and improves quality of life. There is no difference between the Quill technique and retromuscular mesh in the effect on abdominal wall stability, with a similar complication rate one year after surgery. Dedicated training strengthens abdominal muscles objectively but does not improve perceived muscle strength or pain in the abdominal wal

Probabilistisk säkerhetsverifiering av befintlig vägbro

Rapporten syftar till att jämföra två olika metoder som kan användas för att klassnings- beräkna broar. För att göra detta har en bro som tidigare klassningsberäknats deterministiskt av Reinertsen AB beräknats probabilistiskt. Skillnaden mellan metoderna har utvärderats genom att se vilka laster de olika metoderna tillåter, givet att bron klassningsberäknas i säkerhetsklass 2. Bron som används som referens i arbetet är en plattrambro som leder motorvägen E6 över Lommabanan. Bron är belägen 1,4 kilometer norr om Flädie station. Bron består av två identiska broar som var och en leder norrgående respektive södergående trafik över spåret. Bron är byggd år 1959 i samband med att europavägen E6 byggdes ut

Realizing a 140\ua0GHz Gap Waveguide–Based Array Antenna by Low-Cost Injection Molding and Micromachining

This paper presents a novel micromachining process to fabricate a 140\ua0GHz planar antenna based on gap waveguide technology to be used in the next-generation backhauling links. The 140\ua0GHz planar array antenna consists of three layers, all of which have been fabricated using polymer-based microfabrication and injection molding. The 140\ua0GHz antenna has the potential to be used as an element in a bigger 3D array in a line-of-sight (LOS) multiple input multiple output (MIMO) configuration to boost the network capacity. In this work, we focus on the fabrication of a single antenna array element based on gap waveguide technology. Depending on the complexity of each antenna layer’s design, three different micromachining techniques, SU8 fabrication, polydimethylsiloxane (PDMS) molding, and injection molding of the polymer (OSTEMER), together with gold (Au) coating, have been utilized to fabricate a single 140\ua0GHz planar array antenna. The input reflection coefficient was measured to be below − 11\ua0dB over a 14% bandwidth from 132 to 152\ua0GHz, and the antenna gain was measured to be 31 dBi at 140\ua0GHz, both of which are in good agreement with the simulations

Structural model of dodecameric heat-shock protein Hsp21:Flexible N-terminal arms interact with client proteins while C-terminal tails maintain the dodecamer and chaperone activity

Small heat-shock proteins (sHsps) prevent aggregation of thermosensitive client proteins in a first line of defense against cellular stress. The mechanisms by which they perform this function have been hard to define due to limited structural information; currently, there is only one high-resolution structure of a plant sHsp published, that of the cytosolic Hsp16.9. We took interest in Hsp21, a chloroplast-localized sHsp crucial for plant stress resistance, which has even longer N-terminal arms than Hsp16.9, with a functionally important and conserved methionine-rich motif. To provide a framework for investigating structure-function relationships of Hsp21 and understanding these sequence variations, we developed a structural model of Hsp21 based on homology modeling, cryo-EM, cross-linking mass spectrometry, NMR, and small-angle X-ray scattering. Our data suggest a dodecameric arrangement of two trimer-of-dimer discs stabilized by the C-terminal tails, possibly through tail-to-tail interactions between the discs, mediated through extended IXVXI motifs. Our model further suggests that six N-terminal arms are located on the outside of the dodecamer, accessible for interaction with client proteins, and distinct from previous undefined or inwardly facing arms. To test the importance of the IXVXI motif, we created the point mutant V181A, which, as expected, disrupts the Hsp21 dodecamer and decreases chaperone activity. Finally, our data emphasize that sHsp chaperone efficiency depends on oligomerization and that client interactions can occur both with and without oligomer dissociation. These results provide a generalizable workflow to explore sHsps, expand our understanding of sHsp structural motifs, and provide a testable Hsp21 structure model to inform future investigations

Genome-wide identification of physically clustered genes suggests chromatin-level co-regulation in male reproductive development in Arabidopsis thaliana

Co-expression of physically linked genes occurs surprisingly frequently in eukaryotes. Such chromosomal clustering may confer a selective advantage as it enables coordinated gene regulation at the chromatin level. We studied the chromosomal organization of genes involved in male reproductive development in Arabidopsis thaliana. We developed an in-silico tool to identify physical clusters of co-regulated genes from gene expression data. We identified 17 clusters (96 genes) involved in stamen development and acting downstream of the transcriptional activator MS1 (MALE STERILITY 1), which contains a PHD domain associated with chromatin re-organization. The clusters exhibited little gene homology or promoter element similarity, and largely overlapped with reported repressive histone marks. Experiments on a subset of the clusters suggested a link between expression activation and chromatin conformation: qRT-PCR and mRNA in situ hybridization showed that the clustered genes were up-regulated within 48 h after MS1 induction; out of 14 chromatin-remodeling mutants studied, expression of clustered genes was consistently down-regulated only in hta9/hta11, previously associated with metabolic cluster activation; DNA fluorescence in situ hybridization confirmed that transcriptional activation of the clustered genes was correlated with open chromatin conformation. Stamen development thus appears to involve transcriptional activation of physically clustered genes through chromatin de-condensation.QC 20170320</p

A functional analysis of the pyrimidine catabolic pathway in Arabidopsis

Reductive catabolism of pyrimidine nucleotides occurs via a three-step pathway in which uracil is degraded to β-alanine, CO2 and NH3 through sequential activities of dihydropyrimidine dehydrogenase (EC 1.3.1.2, PYD1), dihydropyrimidinase (EC 3.5.2.2, PYD2) and β-ureidopropionase (EC 3.5.1.6, PYD3).A proposed function of this pathway, in addition to the maintenance of pyrimidine homeostasis, is the recycling of pyrimidine nitrogen to general nitrogen metabolism. PYD expression and catabolism of [2-14C]-uracil are markedly elevated in response to nitrogen limitation in plants, which can utilize uracil as a nitrogen source.PYD1, PYD2 and PYD3 knockout mutants were used for functional analysis of this pathway in Arabidopsis. pyd mutants exhibited no obvious phenotype under optimal growing conditions. pyd2 and pyd3 mutants were unable to catabolize [2-14C]-uracil or to grow on uracil as the sole nitrogen source. By contrast, catabolism of uracil was reduced by only 40% in pyd1 mutants, and pyd1 seedlings grew nearly as well as wild-type seedlings with a uracil nitrogen source. These results confirm PYD1 function and suggest the possible existence of another, as yet unknown, activity for uracil degradation to dihydrouracil in this plant.The localization of PYD-green fluorescent protein fusions in the plastid (PYD1), secretory system (PYD2) and cytosol (PYD3) suggests potentially complex metabolic regulation

Genomics of Aerobic Cellulose Utilization Systems in Actinobacteria

Cellulose degrading enzymes have important functions in the biotechnology industry, including the production of biofuels from lignocellulosic biomass. Anaerobes including Clostridium species organize cellulases and other glycosyl hydrolases into large complexes known as cellulosomes. In contrast, aerobic actinobacteria utilize systems comprised of independently acting enzymes, often with carbohydrate binding domains. Numerous actinobacterial genomes have become available through the Genomic Encyclopedia of Bacteria and Archaea (GEBA) project. We identified putative cellulose-degrading enzymes belonging to families GH5, GH6, GH8, GH9, GH12, GH48, and GH51 in the genomes of eleven members of the actinobacteria. The eleven organisms were tested in several assays for cellulose degradation, and eight of the organisms showed evidence of cellulase activity. The three with the highest cellulase activity were Actinosynnema mirum, Cellulomonas flavigena, and Xylanimonas cellulosilytica. Cellobiose is known to induce cellulolytic enzymes in the model organism Thermobifida fusca, but only Nocardiopsis dassonvillei showed higher cellulolytic activity in the presence of cellobiose. In T. fusca, cellulases and a putative cellobiose ABC transporter are regulated by the transcriptional regulator CelR. Nine organisms appear to use the CelR site or a closely related binding site to regulate an ABC transporter. In some, CelR also regulates cellulases, while cellulases are controlled by different regulatory sites in three organisms. Mining of genome data for cellulose degradative enzymes followed by experimental verification successfully identified several actinobacteria species which were not previously known to degrade cellulose as cellulolytic organisms