Clinical effect of continuous corrective force delivery in the non-operative treatment of idiopathic scoliosis: a prospective cohort study of the triac-brace

A prospective cohort study of skeletally immature idiopathic scoliotic patients treated with the TriaC brace. To determine if the TriaC brace is effective in preventing curve progression in immature adolescent idiopathic scoliotic patients with a very high risk of curve progression based on reported natural history data. The aim of the newly introduced TriaC brace is to reverse the pathologic transverse force pattern by externally applied and continuously present orthotic forces. In the frontal plane the force system used in the TriaC brace is similar to the force system of the conventional braces. However, in the sagittal plane the force system acts only on the thoracic region. In addition, the brace allows upper trunk flexibility without affecting the corrective forces during body motion. In a preliminary study it is demonstrated that the brace prevents further progression of both the Cobb angle and axial rotation in idiopathic scoliosis. Skeletally immature patients with idiopathic scoliosis with curves between 20 and 40° were studied prospectively. Skeletally immature was defined as a Risser sign 0 or 1 for both boys and girls, or pre-menarche or less than 1-year post-menarche for girls. Curves of less than 30° had to have documented progression before entry. The mean age of the patients at the start of treatment was 11.3 ± 3.1 years. All measurements were collected by a single observer, and all patients were followed up to skeletal maturity. Treatment was complete for all participants when they had reached Risser sign 4 and did not show any further growth at length measurements. This was at a mean age of 15.6 ± 1.1 years, with a mean follow-up of 1.6 years post bracing. In our study a successful outcome was obtained in 76% of patients treated with the TriaC brace. Comparing our data to literature data on natural history of a similar cohort shows that the TriaC brace significantly alters the predicted natural history. The current study demonstrates that treatment with the TriaC brace reduces the scoliosis, and that the achieved correction is maintained in some degree after skeletal maturity is reached and bracing is discontinued. It also prevents further progression of the Cobb angle in idiopathic scoliosis. The new brace does not differ from the conventional braces as far as maintaining the deformity is concerned

Plasticity of the Intrinsic Period of the Human Circadian Timing System

Human expeditions to Mars will require adaptation to the 24.65-h Martian solar day-night cycle (sol), which is outside the range of entrainment of the human circadian pacemaker under lighting intensities to which astronauts are typically exposed. Failure to entrain the circadian time-keeping system to the desired rest-activity cycle disturbs sleep and impairs cognitive function. Furthermore, differences between the intrinsic circadian period and Earth's 24-h light-dark cycle underlie human circadian rhythm sleep disorders, such as advanced sleep phase disorder and non-24-hour sleep-wake disorders. Therefore, first, we tested whether exposure to a model-based lighting regimen would entrain the human circadian pacemaker at a normal phase angle to the 24.65-h Martian sol and to the 23.5-h day length often required of astronauts during short duration space exploration. Second, we tested here whether such prior entrainment to non-24-h light-dark cycles would lead to subsequent modification of the intrinsic period of the human circadian timing system. Here we show that exposure to moderately bright light (∼450 lux; ∼1.2 W/m2) for the second or first half of the scheduled wake episode is effective for entraining individuals to the 24.65-h Martian sol and a 23.5-h day length, respectively. Estimations of the circadian periods of plasma melatonin, plasma cortisol, and core body temperature rhythms collected under forced desynchrony protocols revealed that the intrinsic circadian period of the human circadian pacemaker was significantly longer following entrainment to the Martian sol as compared to following entrainment to the 23.5-h day. The latter finding of after-effects of entrainment reveals for the first time plasticity of the period of the human circadian timing system. Both findings have important implications for the treatment of circadian rhythm sleep disorders and human space exploration

Requirement of Podocalyxin in TGF-Beta Induced Epithelial Mesenchymal Transition

Epithelial mesenchymal transition (EMT) is characterized by the development of mesenchymal properties such as a fibroblast-like morphology with altered cytoskeletal organization and enhanced migratory potential. We report that the expression of podocalyxin (PODXL), a member of the CD34 family, is markedly increased during TGF-β induced EMT. PODXL is enriched on the leading edges of migrating A549 cells. Silencing of podocalyxin expression reduced cell ruffle formation, spreading, migration and affected the expression patterns of several proteins that normally change during EMT (e.g., vimentin, E-cadherin). Cytoskeletion assembly in EMT was also found to be dependent on the production of podocalyin. Compositional analysis of podocalyxin containing immunoprecipitates revealed that collagen type 1 was consistently associated with these isolates. Collagen type 1 was also found to co-localize with podocalyxin on the leading edges of migrating cells. The interactions with collagen may be a critical aspect of podocalyxin function. Podocalyxin is an important regulator of the EMT like process as it regulates the loss of epithelial features and the acquisition of a motile phenotype

Transnational regulation of temporary agency work compromised partnership between Private Employment Agencies and Global Union Federations

This article critically assesses the potential for the international regulation of temporary agency work (TAW) through building partnership between the Global Union Federations (GUFs) and major Private Employment Agencies (PrEAs). Given the limits of existing national and international regulation of TAW, particularly in developing countries, and the current deadlock in dialogue through the International Labour Organization, the argument of this article is that Transnational Private Labour Regulation (TPLR) offers a unique opportunity to establish a basis for minimum standards for temporary agency workers. This article goes on to propose three potential TPLR frameworks that, although compromised, are transparent, fair and sufficiently elastic to accommodate the distributive and political risks associated with partnership. They also offer important gains, namely increasing the competitive advantage of the PrEAs involved, minimum standards for agency workers and ‘field enlarging’ strategies for the GUFs and their affiliates

Detrended Fluctuation Analysis in the prediction of type 2 diabetes mellitus in patients at risk: Model optimization and comparison with other metrics

[EN] Complexity analysis of glucose time series with Detrended Fluctuation Analysis (DFA) has been proved to be useful for the prediction of type 2 diabetes mellitus (T2DM) development. We propose a modified DFA algorithm, review some of its characteristics and compare it with other metrics derived from continuous glucose monitorization in this setting. Several issues of the DFA algorithm were evaluated: (1) Time windowing: the best predictive value was obtained including all time-windows from 15 minutes to 24 hours. (2) Influence of circadian rhythms: for 48-hour glucometries, DFA alpha scaling exponent was calculated on 24hour sliding segments (1-hour gap, 23-hour overlap), with a median coefficient of variation of 3.2%, which suggests that analysing time series of at least 24-hour length avoids the influence of circadian rhythms. (3) Influence of pretreatment of the time series through integration: DFA without integration was more sensitive to the introduction of white noise and it showed significant predictive power to forecast the development of T2DM, while the pretreated time series did not. (4) Robustness of an interpolation algorithm for missing values: The modified DFA algorithm evaluates the percentage of missing values in a time series. Establishing a 2% error threshold, we estimated the number and length of missing segments that could be admitted to consider a time series as suitable for DFA analysis. For comparison with other metrics, a Principal Component Analysis was performed and the results neatly tease out four different components. The first vector carries information concerned with variability, the second represents mainly DFA alpha exponent, while the third and fourth vectors carry essentially information related to the two "pre-diabetic behaviours" (impaired fasting glucose and impaired glucose tolerance). The scaling exponent obtained with the modified DFA algorithm proposed has significant predictive power for the development of T2DM in a high-risk population compared with other variability metrics or with the standard DFA algorithm.This study has been funded by Instituto de Salud Carlos III through the project PI17/00856 (Co-funded by the European Regional Development Fund, A way to make Europe). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Colás, A.; Vigil, L.; Vargas, B.; Cuesta Frau, D.; Varela, M. (2019). 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Altered Complexity and Correlation Properties of R-R Interval Dynamics Before the Spontaneous Onset of Paroxysmal Atrial Fibrillation. Circulation, 100(20), 2079-2084. doi:10.1161/01.cir.100.20.2079Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., … Coates, M. M. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1459-1544. doi:10.1016/s0140-6736(16)31012-1Saudek, C. D., Derr, R. L., & Kalyani, R. R. (2006). Assessing Glycemia in Diabetes Using Self-monitoring Blood Glucose and Hemoglobin A1c. JAMA, 295(14), 1688. doi:10.1001/jama.295.14.1688Monnier, L., Colette, C., & Owens, D. R. (2008). Glycemic Variability: The Third Component of the Dysglycemia in Diabetes. Is it Important? How to Measure it? 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Diabetologia, 53(3), 435-445. doi:10.1007/s00125-009-1614-2Nathan, D. M., Davidson, M. B., DeFronzo, R. A., Heine, R. J., Henry, R. R., Pratley, R., & Zinman, B. (2007). Impaired Fasting Glucose and Impaired Glucose Tolerance: Implications for care. Diabetes Care, 30(3), 753-759. doi:10.2337/dc07-9920Ogata, H., Tokuyama, K., Nagasaka, S., Tsuchita, T., Kusaka, I., Ishibashi, S., … Yamamoto, Y. (2012). The lack of long-range negative correlations in glucose dynamics is associated with worse glucose control in patients with diabetes mellitus. Metabolism, 61(7), 1041-1050. doi:10.1016/j.metabol.2011.12.007Kohnert, K.-D. (2015). Utility of different glycemic control metrics for optimizing management of diabetes. World Journal of Diabetes, 6(1), 17. doi:10.4239/wjd.v6.i1.17García Maset, L., González, L. B., Furquet, G. L., Suay, F. M., & Marco, R. H. (2016). Study of Glycemic Variability Through Time Series Analyses (Detrended Fluctuation Analysis and Poincaré Plot) in Children and Adolescents with Type 1 Diabetes. Diabetes Technology & Therapeutics, 18(11), 719-724. doi:10.1089/dia.2016.0208Service, F. J., O’Brien, P. C., & Rizza, R. A. (1987). Measurements of Glucose Control. Diabetes Care, 10(2), 225-237. doi:10.2337/diacare.10.2.225Goldberger, A. L., Amaral, L. A. N., Hausdorff, J. M., Ivanov, P. C., Peng, C.-K., & Stanley, H. E. (2002). Fractal dynamics in physiology: Alterations with disease and aging. Proceedings of the National Academy of Sciences, 99(Supplement 1), 2466-2472. doi:10.1073/pnas.012579499Crenier, L., Lytrivi, M., Van Dalem, A., Keymeulen, B., & Corvilain, B. (2016). Glucose Complexity Estimates Insulin Resistance in Either Nondiabetic Individuals or in Type 1 Diabetes. 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Matricellular Proteins Produced by Melanocytes and Melanomas: In Search for Functions

Matricellular proteins are modulators of cell-matrix interactions and cellular functions. The group includes thrombospondin, osteopontin, osteonectin/SPARC, tenascin, disintegrins, galectins and CCN proteins. The production of matricellular proteins such as osteopontin, SPARC or tenascin is highly upregulated in melanoma and other tumors but little is known about their functions in tumor growth, survival, and metastasis. The distribution pattern of CCN3 differs from most other matricellular proteins, such that it is produced abundantly by normal melanocytes, but is not significantly expressed in melanoma cells. CCN3 is known to inhibit melanocyte proliferation and stimulate adhesion to collagen type IV, the main component of the basement membrane. CCN3 has a unique role in securing adhesion of melanocytes to the basement membrane distinct from other melanoma-produced matricellular proteins which act as de-adhesive molecules and antagonists of focal adhesion. Qualitative and quantitative changes in matricellular protein expression contribute to melanoma progression similar to the E-cadherin to N-cadherin class switch, allowing melanoma cells to escape from keratinocyte control

Factors affecting glomerular filtration rate, as measured by iohexol disappearance, in men with or at risk for HIV infection

Objective: Formulae used to estimate glomerular filtration rate (GFR) underestimate higher GFRs and have not been well-studied in HIV-infected (HIV(+)) people; we evaluated the relationships of HIV infection and known or potential risk factors for kidney disease with directly measured GFR and the presence of chronic kidney disease (CKD). Design: Cross-sectional measurement of iohexol-based GFR (iGFR) in HIV(+) men (n = 455) receiving antiretroviral therapy, and HIV-uninfected (HIV(-)) men (n = 258) in the Multicenter AIDS Cohort Study. Methods: iGFR was calculated from disappearance of infused iohexol from plasma. Determinants of GFR and the presence of CKD were compared using iGFR and GFR estimated by the CKD-Epi equation (eGFR). Results: Median iGFR was higher among HIV(+) than HIV(-) men (109 vs. 106 ml/min/1.73 m2, respectively, p = .046), and was 7 ml/min higher than median eGFR. Mean iGFR was lower in men who were older, had chronic hepatitis C virus (HCV) infection, or had a history of AIDS. Low iGFR (≤90 ml/min/1.73 m2) was associated with these factors and with black race. Other than age, factors associated with low iGFR were not observed with low eGFR. CKD was more common in HIV(+) than HIV(-) men; predictors of CKD were similar using iGFR and eGFR. Conclusions: iGFR was higher than eGFR in this population of HIV-infected and -uninfected men who have sex with men. Presence of CKD was predicted equally well by iGFR and eGFR, but associations of chronic HCV infection and history of clinically-defined AIDS with mildly decreased GFR were seen only with iGFR. © 2014 Margolick et al