THE EFFECT OF MEASUREMENT ANGLE ON APPROXIMATIONS OF MAXIMUM JOINT TORQUE

The purpose of this study was to investigate the underestimation of maximum knee joint torque using a single joint-angle position for a variety of realistic torque-angle curves. The maximum force production capability of the knee flexors and knee extensors was modelled using literature-based parameters to define a quadratic torque-angle relationship. Model parameters were varied within a normative range and simulated measured torque was compared to true peak torque (model) for a series of commonly tested joint angles. Measurements furthest from the optimal angle for maximum strength were associated with underestimated torques that were 96% and 80% lower than true peak torque. Therefore, it is essential that knee joint torque is measured as close to the optimal angle as possible when attempting to determine maximum strength capability using a single discrete measurement

Compensatory Neural Reorganization in Tourette Syndrome

Children with neurological disorders may follow unique developmental trajectories whereby they undergo compensatory neuroplastic changes in brain structure and function that help them gain control over their symptoms [1, 2, 3, 4, 5, 6]. We used behavioral and brain imaging techniques to investigate this conjecture in children with Tourette syndrome (TS). Using a behavioral task that induces high levels of intermanual conflict, we show that individuals with TS exhibit enhanced control of motor output. Then, using structural (diffusion-weighted imaging) brain imaging techniques, we demonstrate widespread differences in the white matter (WM) microstructure of the TS brain that include alterations in the corpus callosum and forceps minor (FM) WM that significantly predict tic severity in TS. Most importantly, we show that task performance for the TS group (but not for controls) is strongly predicted by the WM microstructure of the FM pathways that lead to the prefrontal cortex and by the functional magnetic resonance imaging blood oxygen level-dependent response in prefrontal areas connected by these tracts. These results provide evidence for compensatory brain reorganization that may underlie the increased self-regulation mechanisms that have been hypothesized to bring about the control of tics during adolescence

Cognitive control over motor output in Tourette syndrome

Tourette syndrome [TS] is a neurodevelopmental disorder characterised by chronic vocal and motor tics. TS has been associated with dysfunctional cognitive (inhibitory) control of behaviour, however the evidence for this, beyond the occurrence of tics, is scant. Furthermore, in recent studies of uncomplicated TS, it has been shown that adolescents with TS exhibit paradoxically enhanced cognitive control of motor output, consistent with the typical developmental profile of increasing control of tics during adolescence. Here we present arguments, together with new data, that run counter to the widely held view that prefrontal cortex (PFC) is the source of inhibitory task-control signals. Instead, we argue that PFC should be viewed as a source of facilitatory signals that bias competition in brain areas more directly involved in motor execution. Importantly, we argue that in TS, over-activation of PFC may contribute to the hyperexcitability of motor regions and the occurrence of tics; and that compensatory changes, leading to enhanced cognitive control in TS, may primarily be implemented by distributed changes in local cortical excitability

Is telephone health coaching a useful population health strategy for supporting older people with multimorbidity? : An evaluation of reach, effectiveness and cost-effectiveness using a 'trial within a cohort'

BACKGROUND: Innovative ways of delivering care are needed to improve outcomes for older people with multimorbidity. Health coaching involves 'a regular series of phone calls between patient and health professional to provide support and encouragement to promote healthy behaviours'. This intervention is promising, but evidence is insufficient to support a wider role in multimorbidity care. We evaluated health coaching in older people with multimorbidity. METHODS: We used the innovative 'Trials within Cohorts' design. A cohort was recruited, and a trial was conducted using a 'patient-centred' consent model. A randomly selected group within the cohort were offered the intervention and were analysed as the intervention group whether they accepted the offer or not. The intervention sought to improve the skills of patients with multimorbidity to deal with a range of long-term conditions, through health coaching, social prescribing and low-intensity support for low mood. RESULTS: We recruited 4377 older people, and 1306 met the eligibility criteria (two or more long-term conditions and moderate 'patient activation'). We selected 504 for health coaching, and 41% consented. More than 80% of consenters received the defined 'dose' of 4+ sessions. In an intention-to-treat analysis, those selected for health coaching did not improve on any outcome (patient activation, quality of life, depression or self-care) compared to usual care. We examined health care utilisation using hospital administrative and self-report data. Patients selected for health coaching demonstrated lower levels of emergency care use, but an increase in the use of planned services and higher overall costs, as well as a quality-adjusted life year (QALY) gain. The incremental cost per QALY was £8049, with a 70-79% probability of being cost-effective at conventional levels of willingness to pay. CONCLUSIONS: Health coaching did not lead to significant benefits on the primary measures of patient-reported outcome. This is likely related to relatively low levels of uptake amongst those selected for the intervention. Demonstrating effectiveness in this design is challenging, as it estimates the effect of being selected for treatment, regardless of whether treatment is adopted. We argue that the treatment effect estimated is appropriate for health coaching, a proactive model relevant to many patients in the community, not just those seeking care. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number ( ISRCTN12286422 )

On the functional anatomy of the urge-for-action

Several common neuropsychiatric disorders (e.g., obsessive-compulsive disorder, Tourette syndrome (TS), autistic spectrum disorder) are associated with unpleasant bodily sensations that are perceived as an urge for action. Similarly, many of our everyday behaviors are also characterized by bodily sensations that we experience as urges for action. Where do these urges originate? In this paper, we consider the nature and the functional anatomy of “urges-for-action,” both in the context of everyday behaviors such as yawning, swallowing, and micturition, and in relation to clinical disorders in which the urge-for-action is considered pathological and substantially interferes with activities of daily living (e.g., TS). We review previous frameworks for thinking about behavioral urges and demonstrate that there is considerable overlap between the functional anatomy of urges associated with everyday behaviors such as swallowing, yawning, and micturition, and those urges associated with the generation of tics in TS. Specifically, we show that the limbic sensory and motor regions—insula and mid-cingulate cortex—are common to all of these behaviors, and we argue that this “motivation-for-action” network should be considered distinct from an “intentional action” network, associated with regions of premotor and parietal cortex, which may be responsible for the perception of “willed intention” during the execution of goal-directed actions

Duration of hydrothermal alteration and mineralization of the Don Manuel porphyry copper system, central Chile

The Don Manuel porphyry copper system, located in the Miocene–Pliocene metallogenic belt of central Chile, contains spatially zoned alteration styles common to other porphyry copper deposits including extensive potassic alteration, propylitic alteration, localized sericite-chlorite alteration and argillic alteration but lacks pervasive hydrolytic alteration typical of some deposits. It is one of the youngest porphyry copper deposits in the Andes. Timing of mineralization and the hydrothermal system at Don Manuel are consistent with emplacement of the associated intrusions (ca. 4 and 3.6 Ma). Two molybdenite samples yielded consistent ages of 3.412 ± 0.037 and 3.425 ± 0.037 Ma. 40Ar/39Ar ages on hydrothermal biotites (3.57 ± 0.02, 3.51 ± 0.02, 3.41 ± 0.01, and 3.37 ± 0.01 Ma) are associated with potassic alteration. These ages are younger than the youngest intrusion by ~300 k.y. recording the cooling of the system below 350 °C. Such a time gap can be explained by fluxing of hot magmatic fluids from deeper magmatic sources

EURO-WABB: an EU rare diseases registry for Wolfram syndrome, Alström syndrome and Bardet-Biedl syndrome

Background: Wolfram, Alström and Bardet-Biedl (WABB) syndromes are rare diseases with overlapping features of multiple sensory and metabolic impairments, including diabetes mellitus, which have caused diagnostic confusion. There are as yet no specific treatments available, little or no access to well characterized cohorts of patients, and limited information on the natural history of the diseases. We aim to establish a Europe-wide registry for these diseases to inform patient care and research. Methods: EURO-WABB is an international multicenter large-scale observational study capturing longitudinal clinical and outcome data for patients with WABB diagnoses. Three hundred participants will be recruited over 3 years from different sites throughout Europe. Comprehensive clinical, genetic and patient experience data will be collated into an anonymized disease registry. Data collection will be web-based, and forms part of the project's Virtual Research and Information Environment (VRIE). Participants who haven't undergone genetic diagnostic testing for their condition will be able to do so via the project. Conclusions: the registry data will be used to increase the understanding of the natural history of WABB diseases, to serve as an evidence base for clinical management, and to aid the identification of opportunities for intervention to stop or delay the progress of the disease. The detailed clinical characterisation will allow inclusion of patients into studies of novel treatment interventions, including targeted interventions in small scale open label studies; and enrolment into multi-national clinical trials. The registry will also support wider access to genetic testing, and encourage international collaborations for patient benefit

A new platform for high-throughput therapy testing on iPSC-derived lung progenitor cells from cystic fibrosis patients

For those people with cystic fibrosis carrying rare CFTR mutations not responding to currently available therapies, there is an unmet need for relevant tissue models for therapy development. Here, we describe a new testing platform that employs patient-specific induced pluripotent stem cells (iPSCs) differentiated to lung progenitor cells that can be studied using a dynamic, high-throughput fluorescence-based assay of CFTR channel activity. Our proof-of-concept studies support the potential use of this platform, together with a Canadian bioresource that contains iPSC lines and matched nasal cultures from people with rare mutations, to advance patient-oriented therapy development. Interventions identified in the high-throughput, stem cell-based model and validated in primary nasal cultures from the same person have the potential to be advanced as therapies

Mutant resources for functional genomics in Dictyostelium discoideum using REMI-seq technology

Background Genomes can be sequenced with relative ease, but ascribing gene function remains a major challenge. Genetically tractable model systems are crucial to meet this challenge. One powerful model is the social amoeba Dictyostelium discoideum, a eukaryotic microbe widely used to study diverse questions in the cell, developmental and evolutionary biology. Results We describe REMI-seq, an adaptation of Tn-seq, which allows high throughput, en masse, and quantitative identification of the genomic site of insertion of a drug resistance marker after restriction enzyme-mediated integration. We use REMI-seq to develop tools which greatly enhance the efficiency with which the sequence, transcriptome or proteome variation can be linked to phenotype in D. discoideum. These comprise (1) a near genome-wide resource of individual mutants and (2) a defined pool of ‘barcoded’ mutants to allow large-scale parallel phenotypic analyses. These resources are freely available and easily accessible through the REMI-seq website that also provides comprehensive guidance and pipelines for data analysis. We demonstrate that integrating these resources allows novel regulators of cell migration, phagocytosis and macropinocytosis to be rapidly identified. Conclusions We present methods and resources, generated using REMI-seq, for high throughput gene function analysis in a key model system

The value of trans-scrotal ultrasonography at Bull Breeding Soundness Evaluation (BBSE):The relationship between testicular parenchymal Pixel Intensity (PI) and semen quality

AbstractBull breeding soundness evaluation (BBSE) is commonly undertaken to identify bulls that are potentially unfit for use as breeding sires. Various studies worldwide have found that approximately 20% of the bulls fail their routine prebreeding BBSE and are therefore considered subfertile. Multiple articles describe the use of testicular ultrasound as a noninvasive aid in the identification of specific testicular and epididymal lesions. Two previous studies have hypothesized a correlation between ultrasonographic testicular parenchymal pixel intensity (PI) and semen quality; however to date, no published studies have specifically examined this link. The aim of this study, therefore, was to assess the relationship between testicular parenchymal PI (measured using trans-scrotal ultrasonography) and semen quality (measured at BBSE), and the usefulness of testicular ultrasonography as an aid in predicting future fertility in bulls, in particular those that are deemed subfertile at the first examination. A total of 162 bulls from 35 farms in the South East of Scotland were submitted to routine BBSE and testicular ultrasonography between March and May 2014, and March and May 2015. Thirty-three animals failed their initial examination (BBSE1) due to poor semen quality, and were re-examined (BBSE2) 6 to 8 weeks later. Computer-aided image analysis and gross visual lesion scoring were performed on all ultrasonograms, and results were compared to semen quality at BBSE1 and BBSE2. The PI measurements were practical and repeatable in a field setting, and although the results of this study did not highlight any biological correlation between semen quality at BBSE1 or BBSE2 and testicular PI, it did identify that gross visual lesion scoring of testicular images is comparable to computer analysis of PI (P < 0.001) in identifying animals suffering from gross testicular fibrosis