Endothelial mechanical stretch regulates the immunological synapse interface of renal endothelial cells in a sex-dependent manner.

Increased mechanical endothelial cell stretch contributes to the development of numerous cardiovascular and renal pathologies. Recent studies have shone a light on the importance of sex-dependent inflammation in the pathogenesis of renal disease states. The endothelium plays an intimate and critical role in the orchestration of immune cell activation through upregulation of adhesion molecules and secretion of cytokines and chemokines. While endothelial cells are not recognized as professional antigen-presenting cells, in response to cytokine stimulation, endothelial cells can express both major histocompatibility complex (MHC) I and MHC II. MHCs are essential to forming a part of the immunological synapse interface during antigen presentation to adaptive immune cells. Whether MHC I and II are increased under increased mechanical stretch is unknown. Due to hypertension being multifactorial, we hypothesized that increased mechanical endothelial stretch promotes the regulation of MHCs and key costimulatory proteins on mouse renal endothelial cells (MRECs) in a stretch-dependent manner. MRECs derived from both sexes underwent 5%, 10%, or 15% uniaxial cyclical stretch, and immunological synapse interface proteins were determined by immunofluorescence microscopy, immunoblot analysis, and RNA sequencing. We found that increased endothelial mechanical stretch conditions promoted downregulation of MHC I in male MRECs but upregulation in female MRECs. Moreover, MHC II was upregulated by mechanical stretch in both male and female MRECs, whereas CD86 and CD70 were regulated in a sex-dependent manner. By bulk RNA sequencing, we found that increased mechanical endothelial cell stretch promoted differential gene expression of key antigen processing and presentation genes in female MRECs, demonstrating that females have upregulation of key antigen presentation pathways. Taken together, our data demonstrate that mechanical endothelial stretch regulates endothelial activation and immunological synapse interface formation in renal endothelial cells in a sex-dependent manner.NEW & NOTEWORTHY Endothelial cells contribute to the development of renal inflammation and have the unique ability to express antigen presentation proteins. Whether increased endothelial mechanical stretch regulates immunological synapse interface proteins remains unknown. We found that antigen presentation proteins and costimulatory proteins on renal endothelial cells are modulated by mechanical stretch in a sex-dependent manner. Our data provide novel insights into the sex-dependent ability of renal endothelial cells to present antigens in response to endothelial mechanical stimuli.

The SECURE STAIRS Framework: Preliminary Evaluation of Trauma Informed Training Developments Within the Children and Young People's Secure Estate.

The SECURE STAIRS framework promotes trauma informed understanding and training across the workforce to inform work with children and young people. A component of the framework is the 'Trauma Informed Practice with Children and Young People in Secure Settings' (TIPSS) training programme for multidisciplinary staff. Between November 2020 and May 2021, a total of 123 members of multidisciplinary staff from a Secure Children's Home (SCH) in the North East of England attended five-day TIPSS training. A pre-post repeated measures design was adopted. Paired samples t-tests were used to analyse pre- and post- questionnaires regarding self-reported levels of (i) knowledge, (ii) understanding and (iii) confidence across Attachment and Developmental Trauma, Understanding Complex Behaviour and Trauma Informed Care training modules. Staff reported significant (p ≤ .001) post-training improvements in knowledge, understanding, and confidence across all three training modules. Implications of findings are discussed, and further developments outlined.

Extra credit for disruption: trend of disruption in radiology academic journals.

AIM: To identify the most disruptive publications, which are those that are cited more frequently than their own references, in academic radiology journals and their characteristics, such as the number of authors and relative time to publication. MATERIAL AND METHODS: A comprehensive literature search was undertaken to identify the 100 most disruptive publications in the field of radiology. Subsequently, statistical analysis was applied to establish the distribution of disruptive scores of the isolated publications using a non-parametric probability density function. The relation between disruptive scores and citation counts was then determined, with the aid of a correlation coefficient. Finally, data regarding any significant connection between disruption scores and time of publication, number of authors, and study design were examined. RESULTS: Analysing the top 100 papers in increments of 10-year periods showed no significant difference in the distribution of disruption scores over time. No correlation between an article's citation count and disruption score was established. Additionally, no significant relation between the number of authors/study design and disruption scores was identified. CONCLUSION: The disruption score highlights significant impact elements not entirely accounted for by citation count. Its potential benefit in assessing scientific impact should be contemplated.

Thromboxane A2 receptors mediate chronic mechanoreflex sensitization in a rat model of simulated peripheral artery disease.

The exercise pressor reflex is a feedback autonomic and cardiovascular control mechanism evoked by mechanical and metabolic signals within contracting skeletal muscles. The mechanically sensitive component of the reflex (the mechanoreflex) is exaggerated in patients with peripheral artery disease (PAD) and in a rat model of simulated PAD in which a femoral artery is chronically ligated. Products of cyclooxygenase enzyme activity have been shown to chronically sensitize the mechanoreflex in PAD, but the identity of the muscle afferent receptors that mediate the sensitization is unclear. We hypothesized that injection of the endoperoxide 4 receptor (EP4-R) antagonist L161982 or the thromboxane A2 receptor (TxA2-R) antagonist daltroban into the arterial supply of the hindlimb would reduce the pressor response to repetitive, dynamic hindlimb skeletal muscle stretch (a model of isolated mechanoreflex activation) in rats with a femoral artery that was ligated ~72 h before the experiment but not in rats with freely perfused femoral arteries. We found that EP4-R blockade had no effect on the pressor response (peak Δmean arterial pressure) to stretch in freely perfused (n = 6, pre: 14 ± 2, post: 15 ± 2 mmHg, P = 0.97) or ligated (n = 8, pre: 29 ± 4, post: 29 ± 6 mmHg, P = 0.98) rats. In contrast, TxA2-R blockade had no effect on the pressor response to stretch in freely perfused rats (n = 6, pre: 16 ± 3, post: 17 ± 4 mmHg, P = 0.99) but significantly reduced the response in ligated rats (n = 11, pre: 29 ± 4, post: 17 ± 5 mmHg, P < 0.01). We conclude that TxA2-Rs contribute to chronic mechanoreflex sensitization in the chronic femoral artery-ligated rat model of simulated PAD.NEW & NOTEWORTHY We demonstrate that thromboxane A2 receptors, but not endoperoxide 4 receptors, on the sensory endings of thin fiber muscle afferents contribute to the chronic sensitization of the muscle mechanoreflex in rats with a ligated femoral artery (a model of simulated peripheral artery disease). The data may have important implications for our understanding of blood pressure control during exercise in patients with peripheral artery disease.

Sibling quality and the haplodiploidy hypothesis.

The 'haplodiploidy hypothesis' argues that haplodiploid inheritance in bees, wasps, and ants generates relatedness asymmetries that promote the evolution of altruism by females, who are less related to their offspring than to their sisters ('supersister' relatedness). However, a consensus holds that relatedness asymmetry can only drive the evolution of eusociality if workers can direct their help preferentially to sisters over brothers, either through sex-ratio biases or a pre-existing ability to discriminate sexes among the brood. We show via a kin selection model that a simple feature of insect biology can promote the origin of workers in haplodiploids without requiring either condition. In insects in which females must found and provision new nests, body quality may have a stronger influence on female fitness than on male fitness. If altruism boosts the quality of all larval siblings, sisters may, therefore, benefit more than brothers from receiving the same amount of help. Accordingly, the benefits of altruism would fall disproportionately on supersisters in haplodiploids. Haplodiploid females should be more prone to altruism than diplodiploid females or males of either ploidy when altruism elevates female fitness especially, and even when altruists are blind to sibling sex.

Investigation of the mechanisms of cyclooxygenase-mediated mechanoreflex sensitization in a rat model of simulated peripheral artery disease.

Mechanical and metabolic stimuli within contracting skeletal muscles reflexly increase sympathetic nervous system activity and blood pressure. That reflex, termed the exercise pressor reflex, is exaggerated in patients with peripheral artery disease (PAD) and in a rat PAD model with a chronically ligated femoral artery. The cyclooxygenase (COX) pathway contributes to the exaggerated pressor response during rhythmic skeletal muscle contractions in patients with PAD, but the specific mechanism(s) of the COX-mediated exaggeration are not known. In decerebrate, unanesthetized rats with a chronically ligated femoral artery ("ligated" rats), we hypothesized that hindlimb arterial injection of the COX inhibitor indomethacin would reduce the pressor response during 1-Hz dynamic hindlimb skeletal muscle stretch; a model of the activation of the mechanical component of the exercise pressor reflex (i.e., the mechanoreflex). In ligated rats (n = 7), indomethacin reduced the pressor response during stretch (control: 30 ± 4; indomethacin: 12 ± 3 mmHg; P < 0.01), whereas there was no effect in rats with "freely perfused" femoral arteries (n = 6, control: 18 ± 5; indomethacin: 17 ± 5 mmHg; P = 0.87). In ligated rats (n = 4), systemic indomethacin injection had no effect on the pressor response during stretch. Femoral artery ligation had no effect on skeletal muscle COX protein expression or activity or concentration of the COX metabolite prostaglandin E2. Conversely, femoral artery ligation increased expression of the COX metabolite receptors endoperoxide 4 and thromboxane A2-R in dorsal root ganglia tissue. We conclude that, in ligated rats, the COX pathway sensitizes the peripheral endings of mechanoreflex afferents, which occurs principally as a result of increased expression of COX metabolite receptors.NEW & NOTEWORTHY We demonstrate that the mechanoreflex is sensitized by the cyclooxygenase (COX) pathway within hindlimb skeletal muscles in the rat chronic femoral artery ligation model of simulated peripheral artery disease (PAD). The mechanism of sensitization appears attributable to increased receptors for COX metabolites on sensory neurons and not increased concentration of COX metabolites. Our data may carry important clinical implications for patients with PAD who demonstrate exaggerated increases in blood pressure during exercise compared with healthy counterparts.

Cyclooxygenase inhibition does not impact the pressor response during static or dynamic mechanoreflex activation in healthy decerebrate rats.

Passive limb movement and limb muscle stretch in humans and animals are common experimental strategies used to investigate activation of the muscle mechanoreflex independent of contraction-induced metabolite production. Cyclooxygenase (COX) metabolites, however, are produced by skeletal muscle stretch in vitro and have been found to impact various models of mechanoreflex activation. Whether COX metabolites influence the decerebrate rat triceps surae muscle stretch mechanoreflex model remains unknown. We examined the effect of rat triceps surae muscle stretch on the interstitial concentration of the COX metabolite prostaglandin E2 (PGE2). Interstitial PGE2 concentration was increased above baseline values by 4 min of both static (38% increase, P = 0.01) and dynamic (56% increase, P < 0.01) triceps surae muscle stretch (n = 10). The 4-min protocol was required to collect enough microdialysis fluid for PGE2 detection. The finding that skeletal muscle stretch in vivo was capable of producing COX metabolites prompted the hypothesis that intra-arterial administration of the COX inhibitor indomethacin (1 mg/kg) would reduce the pressor and cardioaccelerator responses evoked during 30 s (the duration most commonly used in the rat mechanoreflex model) of static and dynamic rat triceps surae muscle stretch. We found that indomethacin had no effect (P > 0.05, n = 9) on the pressor or cardioaccelerator response during 30 s of either static or dynamic stretch. We conclude that, despite the possibility of increased COX metabolite concentration, COX metabolites do not activate or sensitize thin-fiber muscle afferents stimulated during 30 s of static or dynamic hindlimb skeletal muscle stretch in healthy rats.

Self-harm and suicide before and after spinal cord injury: a systematic review.

STUDY DESIGN: This is a systematic literature review. OBJECTIVES: The objectives of this study were to investigate, first, the proportion of spinal cord injury (SCI) caused by suicidal behaviour; second, the proportion of deaths in the SCI population caused by suicide; and third, the risk factors associated with suicidal behaviour. SETTING: This study was conducted in the UK. METHODS: AMED, EMBASE, HMIC, BNI, Medline, PsycInfo, CINAHL and HEALTH BUSINESS ELITE were searched between January and February 2016, identifying a total of 404 articles published between 1990 and 2016. Full articles, written in English, looking at suicide before and after SCI were selected. On the basis of the inclusion criteria, 22 relevant articles were included in this literature review. RESULTS: Studies reported that between 0 and 6.8% of individuals with SCI had acquired their injury as a result of attempted suicide. The predominant method used in these attempts was deliberate falling/jumping from buildings and bridges. Suicidal behaviour post SCI was frequently reported as a cause of death; studies reported that between 5.8 and 11% of deaths were a result of suicide. The predominant methods used were gunshot and overdose. Psychiatric diagnoses were identified to be a major risk factor for suicidal behaviour. CONCLUSION: Individuals with SCI are at risk of attempting suicide; this risk is increased by the presence of a psychiatric diagnosis. There is a crucial need for risk assessment and psychological intervention for individuals with mental health issues following SCI.

An audit of demographics and rehabilitation outcomes in non-traumatic spinal cord injury.

STUDY DESIGN: Repeated measures, retrospective cohort study. OBJECTIVES: To classify specific causes of injury in a cohort of non-traumatic spinal cord injury (NTSCI) patients, with the aim of exploring whether there are differences in demographics or rehabilitation outcomes depending on the cause of NTSCI. SETTING: Tertiary care, spinal cord injury rehabilitation unit. METHODS: Patients admitted to the unit with a non-traumatic SCI between July 2008 and April 2015 were considered for this study. Demographic information and rehabilitation outcomes were obtained from the Needs Assessment Checklist (NAC). NAC1 is completed within 4 weeks post mobilisation and NAC2 upon the patient moving to the pre-discharge ward. Data were obtained for 265 patients. RESULTS: The most common causes were vertebral column degenerative disorders, infection and vascular disorders, which together accounted for 80% of all NTSCI in this sample. Patients with vertebral column degenerative disorders were less likely to have a complete injury than patients with infections or vascular disorders. There were differences in rehabilitation outcomes on several domains of the NAC. Overall, patients with an SCI caused by an infection have the highest needs (more dependent), and patients with vertebral column degenerative disorders have the lowest needs (more independent). CONCLUSION: The relationship between non-traumatic cause of injury and rehabilitation outcomes may be mediated by severity of injury. Individuals with infection-related NTSCI are more likely to be complete, therefore, present more significant rehab needs, and lower rehabilitation outcomes particularly in physical health, activities of daily living and bowel management domains. This supports previous findings of Kay et al. and provides a possible explanation for the differences. This further informs future interventions.

Return-to-work intentions during spinal cord injury rehabilitation: an audit of employment outcomes.

STUDY DESIGN: Single-centre, retrospective cohort study. OBJECTIVES: To analyse the return-to-work intentions during spinal cord injury (SCI) rehabilitation. SETTING: Tertiary care, spinal cord injury rehabilitation unit, National Spinal Injuries Centre, Stoke Mandeville Hospital, Ayelsbury, UK. METHODS: Employment outcomes were obtained from the Needs Assessment Checklist (NAC), for all patients admitted to the unit between February 2008 and October 2014. NAC1 is completed within 4 weeks post-mobilisation and NAC2 upon the patient moving to the pre-discharge ward. Data from 362 participants were analysed for return-to-work intentions, by gender, age and injury severity. RESULTS: Seventy-six percent of the sample population was employed at the time of their injury. At NAC1, 22.4% of individuals had made plans to return to work, whereas 44.2% had not; at NAC2, 34.3% had made plans to return to work and 31.2% had not. This difference was found to be statistically significant. There were significant differences in return-to-work intentions by injury severity at NAC1 but not NAC2, and by age group at NAC2 but not NAC1. CONCLUSION: Less than half of those employed at the time of their injury had made plans to return to work before their discharge from the unit. The low proportion of individuals with SCI returning to work--just one in three--is concerning in view of the lost health and psychosocial benefits, and requires greater prominence during rehabilitation. Future research into effective employment interventions to improve employment outcomes in this population is required.

Measuring laboratory-based influenza surveillance capacity: development of the 'International Influenza Laboratory Capacity Review' Tool.

OBJECTIVES: The 2005 International Health Regulations (IHR 2005) emphasized the importance of laboratory capacity to detect emerging diseases including novel influenza viruses. To support IHR 2005 requirements and the need to enhance influenza laboratory surveillance capacity, the Association of Public Health Laboratories (APHL) and the Centers for Disease Control and Prevention (CDC) Influenza Division developed the International Influenza Laboratory Capacity Review (Tool). STUDY DESIGN: Data from 37 assessments were reviewed and analyzed to verify that the quantitative analysis results accurately depicted a laboratory's capacity and capabilities. METHODS: Subject matter experts in influenza and laboratory practice used an iterative approach to develop the Tool incorporating feedback and lessons learnt through piloting and implementation. To systematically analyze assessment data, a quantitative framework for analysis was added to the Tool. RESULTS: The review indicated that changes in scores consistently reflected enhanced or decreased capacity. The review process also validated the utility of adding a quantitative analysis component to the assessments and the benefit of establishing a baseline from which to compare future assessments in a standardized way. CONCLUSIONS: Use of the Tool has provided APHL, CDC and each assessed laboratory with a standardized analysis of the laboratory's capacity. The information generated is used to improve laboratory systems for laboratory testing and enhance influenza surveillance globally. We describe the development of the Tool and lessons learnt.

Ethnicity and rehabilitation outcomes: the Needs Assessment Checklist.

STUDY DESIGN: Retrospective cohort study with matched samples. OBJECTIVES: To investigate whether significant differences in rehabilitation outcomes exist between different ethnic groups, using the Needs Assessment Checklist (NAC). SETTINGS: Tertiary care, spinal cord injury rehabilitation unit (National Spinal Injuries Centre), Stoke Mandeville Hospital, UK. METHODS: Rehabilitation outcomes and demographic information were obtained from the NAC. Data on 461 individuals were included in the study. Analysis of variance was employed to investigate differences in rehabilitation outcomes between various ethnic groups, across both the whole cohort and matched samples. RESULTS: Significant differences were evident across the different rehabilitation domains when ethnicity was examined, in particular within the domains of physical healthcare and psychological well-being. Within the unmatched data set, significant differences were found to exist in 3 of the 10 rehabilitation domains, and with the matched data set within 4 of the 10 domains. The results indicated that the cohort as a whole made significant improvements from the first to the second NAC within all rehabilitation domains. CONCLUSION: Results indicate that ethnicity may have an impact on rehabilitation outcomes for individuals with spinal cord injury. Further investigation is needed to explore the nature of this relationship, and the future role of targeted interventions focusing on improving rehabilitation outcomes within the domains of physical and psychological care, in particular for individuals from different ethnic backgrounds.

A sustained hypothalamic-pituitary-adrenal axis response to acute psychosocial stress in irritable bowel syndrome.

BACKGROUND: Despite stress being considered a key factor in the pathophysiology of the functional gastrointestinal (GI) disorder irritable bowel syndrome (IBS), there is a paucity of information regarding the ability of IBS patients to respond to acute experimental stress. Insights into the stress response in IBS could open the way to novel therapeutic interventions. To this end, we assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS. METHOD: Thirteen female patients with IBS and 15 healthy female age-matched control participants underwent a single exposure to the TSST. Salivary cortisol, salivary C-reactive protein (CRP), skin conductance level (SCL), GI symptoms, mood and self-reported stress were measured pre- and post-exposure to the TSST. RESULTS: The hypothalamic-pituitary-adrenal (HPA) axis response to the TSST was sustained in IBS, as shown by a greater total cortisol output throughout (p = 0.035) and higher cortisol levels measured by an area under the curve with respect to ground (AUCG) analysis (p = 0.044). In IBS patients, GI symptoms increased significantly during the recovery period following exposure to the TSST (p = 0.045). Salivary CRP and SCL activity showed significant changes in relation to stress but with no differential effect between experimental groups. CONCLUSIONS: Patients with IBS exhibit sustained HPA axis activity, and an increase in problematic GI symptoms in response to acute experimental psychosocial stress. These data pave the way for future interventional studies aimed at identifying novel therapeutic approaches to modulate the HPA axis and GI symptom response to acute psychosocial stress in IBS.

Cognitive performance in irritable bowel syndrome: evidence of a stress-related impairment in visuospatial memory.

BACKGROUND: Central nervous system (CNS) dysfunction is a prominent feature of the functional gastrointestinal (GI) disorder, irritable bowel syndrome (IBS). However, the neurobiological and cognitive consequences of key pathophysiological features of IBS, such as stress-induced changes in hypothalamic-pituitary-adrenal (HPA)-axis functioning, is unknown. Our aim was to determine whether IBS is associated with cognitive impairment, independently of psychiatric co-morbidity, and whether cognitive performance is related to HPA-axis function. METHOD: A cross-sectional sample of 39 patients with IBS, a disease control group of 18 patients with Crohn's disease (CD) in clinical remission and 40 healthy age- and IQ-matched control participants were assessed using the Paired Associates Learning (PAL), Intra-Extra Dimensional Set Shift (IED) and Spatial Working Memory (SWM) tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and a computerized Stroop test. HPA-axis function was determined by measuring the cortisol awakening response (CAR). RESULTS: IBS patients exhibited a subtle visuospatial memory deficit at the PAL six- pattern stage (p = 0.03), which remained after psychiatric co-morbidity was controlled for (p = 0.04). Morning cortisol levels were lower in IBS (p = 0.04) and significantly associated with visuospatial memory performance within IBS only (p = 0.02). CONCLUSIONS: For the first time, altered cognitive function on a hippocampal-mediated test of visuospatial memory, which was related to cortisol levels and independent of psychiatric co-morbidity, has been identified in IBS. Visuospatial memory impairment may be a common, but currently neglected, component of IBS. Further elucidation of the nature of this impairment may lead to a greater understanding of the underlying pathophysiology of IBS, and may provide novel therapeutic approaches.

Are ant supercolonies crucibles of a new major transition in evolution?

The biological hierarchy of genes, cells, organisms and societies is a fundamental reality in the living world. This hierarchy of entities did not arise ex nihilo at the origin of life, but rather has been serially generated by a succession of critical events known as 'evolutionary transitions in individuality' (ETIs). Given the sequential nature of ETIs, it is natural to look for candidates to form the next hierarchical tier. We analyse claims that these candidates are found among 'supercolonies', ant populations in which discrete nests cooperate as part of a wider collective, in ways redolent of cells in a multicellular organism. Examining earlier empirical work and new data within the recently proposed 'Darwinian space' framework, we offer a novel analysis of the evolutionary status of supercolonies and show how certain key conditions might be satisfied in any future process transforming these collaborative networks into true Darwinian individuals.

Systematic review of leisure therapy and its effectiveness in managing functional outcomes in stroke rehabilitation.

BACKGROUND: Evidence suggests that the incorporation of leisure activities in adult stroke rehabilitation can contribute to improved physical, cognitive, and psychological outcomes. However, differences in study design and treatment delivery may affect these findings. Furthermore, the magnitude of therapeutic change associated with leisure therapy is unclear, with few quantitative reviews available. OBJECTIVE: To synthesize and evaluate the empirical evidence examining leisure therapy in stroke rehabilitation. METHODS: Eight independent studies (N = 615 participants) were identified from a comprehensive database search. Study quality was evaluated using the Oxford Levels of Evidence. Pre- and posttreatment data for participants who received leisure therapy, in comparison with peers who received standard care or no treatment, were evaluated by calculating Cohen's d effect sizes and 95% confidence intervals. RESULTS: No studies met the criteria for the highest level of methodological rigor, although all used randomization procedures. Leisure therapy contributed to significant short-term improvements in psychological outcomes, namely quality of life and mood (d range, 2.10 to 0.54), in addition to leisure-specific outcomes, including increased participation in and satisfaction with leisure activities (d range, 0.81 to 1.23). Longer term effects of treatment could not be determined, with one study providing data and reporting nonsignificant effects (d range, -0.07 to 0.17). CONCLUSIONS: There is some evidence that leisure therapy offers an opportunity to enhance short-term treatment gains in community-based stroke rehabilitation. Further controlled research is needed to establish its longer term effects and assist the development of evidence-based guidelines for this treatment.

Quality of life in and after spinal cord injury rehabilitation: a longitudinal multicenter study.

PURPOSE: To investigate the changes in quality of life (QOL) in persons with spinal cord injury (SCI) and their close persons during the first 2 years post injury. METHOD: Longitudinal multiple sample multiple wave panel design. Data included 292 patients recruited from Austrian British German Irish and Swiss specialist SCI rehabilitation centers and 55 of their close persons. Questionnaire booklets were administered at 6 weeks 12 weeks 1 year and 2 years after injury to both samples. RESULTS: Study 1 investigated the WHOQOL-BREF domains in individuals with SCI and found differences mostly in the physical domain indicating that QOL increases for persons with SCI from onset. An effect of the culture was observed in the psychological and environmental domains with higher QOL scores in the German-speaking sample. Study 2 compared individuals with SCI to their close persons and found differences in the physical environmental and social domains over time. The scores on the psychological dimension did not significantly differ between the persons with SCI and their close persons over time. CONCLUSION: QOL measured by the WHOQOL-BREF shows that QOL changes during rehabilitation and after discharge. Apart from the physical dimension the persons with SCI and their close persons seem to experience a similar change in QOL. Further longitudinal research is suggested to clarify the mutual adjustment process of people with SCI and their close persons and to explore cultural differences in QOL between English-and German-speaking countries.

Food texture and vitamin D influence mouse mandible form and molar roots.

Industrialization influenced several facets of lifestyle, including softer nutrient-poor diets that contributed to vitamin D deficiency in post-industrzialized populations, with concomitantly increased dental problems. Here we simulated a post-industrialized diet in a mouse model to test the effects of diet texture and vitamin D level on mandible and third molar (M3) forms. Mice were raised on a soft diet with vitamin D (VitD) or without it (NoD), or on a hard diet with vitamin D. We hypothesized that a VitD/hard diet is optimal for normal mandible and tooth root form, as well as for timely M3 initiation. Subsets of adult NoD/soft and VitD/soft groups were bred to produce embryos that were micro-computed tomography (µCT) scanned to stage M3 development. M3 stage did not differ between embryos from mothers fed VitD and NoD diets, indicating that vitamin D does not affect timing of M3 onset. Sacrificed adult mice were µCT-scanned, their mandibles 3D-landmarked and M3 roots were measured. Principal component (PC) analysis described the largest proportion of mandible shape variance (PC1, 30.1%) related to diet texture, and nominal shape variance (PC2, 13.8%) related to vitamin D. Mice fed a soft diet had shorter, relatively narrower, and somewhat differently shaped mandibles that recapitulated findings in human populations. ANOVA and other multivariate tests found significantly wider M3 roots and larger root canals in mice fed a soft diet, with vitamin D having little effect. Altogether our experiments using a mouse model contribute new insights about how a post-industrial diet may influence human craniodental variation.

Microbiome assembly and stability during start-up of a full-scale, two-phase anaerobic digester fed cow manure and mixed organic feedstocks.

Carbon transformations during anaerobic digestion are mediated by complex microbiomes, but their assembly is poorly understood, especially in full-scale digesters. Gene-centric metagenomics combining functional and taxonomic classification was performed for an on-farm digester during start-up. Cow manure and organic waste pre-treated in a hydrolysis tank were fed to the methane-producing digester and the volatile solids loading rate was slowly increased from 0 to 3.5 kg volatile solids m-3 d-1 over one year. The microbial community in the anaerobic digester exhibited a high ratio of archaea, which were dominated by hydrogenotrophic methanogens. Bacteria in the anaerobic digester had a high abundance of genes for ferredoxin cycling, H2 generation, and more metabolically complex fermentations than in the hydrolysis tank. In total, the results show that a functionally stable microbiome was achieved quickly during start-up and that the microbiome created in the low-pH hydrolysis tank did not persist in the downstream anaerobic digester.

Spinal cord injuries as a consequence of falls: are there differential rehabilitation outcomes?

STUDY DESIGN: Case series, consecutive sample, survey. OBJECTIVES: To examine the incidence of spinal cord injuries sustained as a result of falls compared with other causes, and to investigate rehabilitation outcomes between these two groups. SETTINGS: Tertiary care, spinal cord injury rehabilitation unit (National Spinal Injuries Center), Stoke Mandeville Hospital, UK. METHODS: Demographic information and descriptive statistics were examined for individuals sustaining their injury via falls vs non-falls. Statistical analysis investigated rehabilitation outcomes between the groups. RESULTS: The etiology of spinal cord injury (SCI) reported is similar to previous findings. Individuals who sustained their SCI as a result of falls and other causes made equal improvements from the start to end of rehabilitation, according to the Needs Assessment Checklist, a clinical measure of individual rehabilitation needs in 10 domains. However, those in the falls group achieved less overall throughout rehabilitation, and this was significant at pre-discharge for the areas of bladder management, mobility and discharge. CONCLUSION: Results highlight the need for specific consideration to be made of the rehabilitation needs of individuals who sustain SCI as a result of a fall, and for these to be addressed in rehabilitation programming.