Participant-selected music listening during pulmonary rehabilitation in people with chronic obstructive pulmonary disease: A randomised controlled trial.

To evaluate the impact of participant-selected music listening as an adjunct to pulmonary rehabilitation (PR) in people with COPD. Adults with COPD referred to PR were randomly assigned to participant-selected music listening (intervention group, [IG]) or usual care (control group [CG]) during an 8-weeks PR program. Prior to training, the IG completed an interview with a registered music therapist to identify music preferences. IG participants listened to an individualised playlist; CG participants had usual care. Primary outcomes included end-6-min walk test symptoms (dyspnoea and exertion) and dyspnoea (Multidimensional Dyspnoea Profile [MDP]), measured pre and post PR and 6-months follow-up. 58 participants, FEV1 52.4 (25.9)% pd) were recruited. There were no between-group differences following the intervention (p > .05 for all outcomes at all time points). Within-group differences following PR were significant for MDP sensory quality: IG mean difference [95% CI] -2.2 [-3.3 to -1.2]; CG -1.5 [-2.5 to -0.5] points; MDP emotional response: IG -3.2 [-4.2 to -2.3]; CG -2.2 [-3.2 to -1.3] points). Participant-selected music listening during PR offered no greater benefit to symptoms of dyspnoea or exertion compared to usual care. With the study limited by COVID-19 restrictions, the role of this adjunct remains to be clarified.

Learned Block Iterative Shrinkage Thresholding Algorithm for Photothermal Super Resolution Imaging.

Block-sparse regularization is already well known in active thermal imaging and is used for multiple-measurement-based inverse problems. The main bottleneck of this method is the choice of regularization parameters which differs for each experiment. We show the benefits of using a learned block iterative shrinkage thresholding algorithm (LBISTA) that is able to learn the choice of regularization parameters, without the need to manually select them. In addition, LBISTA enables the determination of a suitable weight matrix to solve the underlying inverse problem. Therefore, in this paper we present LBISTA and compare it with state-of-the-art block iterative shrinkage thresholding using synthetically generated and experimental test data from active thermography for defect reconstruction. Our results show that the use of the learned block-sparse optimization approach provides smaller normalized mean square errors for a small fixed number of iterations. Thus, this allows us to improve the convergence speed and only needs a few iterations to generate accurate defect reconstruction in photothermal super-resolution imaging.

Deep Unfolding of Iteratively Reweighted ADMM for Wireless RF Sensing.

We address the detection of material defects, which are inside a layered material structure using compressive sensing-based multiple-input and multiple-output (MIMO) wireless radar. Here, strong clutter due to the reflection of the layered structure's surface often makes the detection of the defects challenging. Thus, sophisticated signal separation methods are required for improved defect detection. In many scenarios, the number of defects that we are interested in is limited, and the signaling response of the layered structure can be modeled as a low-rank structure. Therefore, we propose joint rank and sparsity minimization for defect detection. In particular, we propose a non-convex approach based on the iteratively reweighted nuclear and ℓ1-norm (a double-reweighted approach) to obtain a higher accuracy compared to the conventional nuclear norm and ℓ1-norm minimization. To this end, an iterative algorithm is designed to estimate the low-rank and sparse contributions. Further, we propose deep learning-based parameter tuning of the algorithm (i.e., algorithm unfolding) to improve the accuracy and the speed of convergence of the algorithm. Our numerical results show that the proposed approach outperforms the conventional approaches in terms of mean squared errors of the recovered low-rank and sparse components and the speed of convergence.

Clutter Suppression for Indoor Self-Localization Systems by Iteratively Reweighted Low-Rank Plus Sparse Recovery.

Self-localization based on passive RFID-based has many potential applications. One of the main challenges it faces is the suppression of the reflected signals from unwanted objects (i.e., clutter). Typically, the clutter echoes are much stronger than the backscattered signals of the passive tag landmarks used in such scenarios. Therefore, successful tag detection can be very challenging. We consider two types of tags, namely low-Q and high-Q tags. The high-Q tag features a sparse frequency response, whereas the low-Q tag presents a broad frequency response. Further, the clutter usually showcases a short-lived response. In this work, we propose an iterative algorithm based on a low-rank plus sparse recovery approach (RPCA) to mitigate clutter and retrieve the landmark response. In addition to that, we compare the proposed approach with the well-known time-gating technique. It turns out that RPCA outperforms significantly time-gating for low-Q tags, achieving clutter suppression and tag identification when clutter encroaches on the time-gating window span, whereas it also increases the backscattered power at resonance by approximately 12 dB at 80 cm for high-Q tags. Altogether, RPCA seems a promising approach to improve the identification of passive indoor self-localization tag landmarks.

Local Acceleration of Neurofilament Transport at Nodes of Ranvier.

Myelinated axons are constricted at nodes of Ranvier. These constrictions are important physiologically because they increase the speed of saltatory nerve conduction, but they also represent potential bottlenecks for the movement of axonally transported cargoes. One type of cargo are neurofilaments, which are abundant space-filling cytoskeletal polymers that function to increase axon caliber. Neurofilaments move bidirectionally along axons, alternating between rapid movements and prolonged pauses. Strikingly, axon constriction at nodes is accompanied by a reduction in neurofilament number that can be as much as 10-fold in the largest axons. To investigate how neurofilaments navigate these constrictions, we developed a transgenic mouse strain that expresses a photoactivatable fluorescent neurofilament protein in neurons. We used the pulse-escape fluorescence photoactivation technique to analyze neurofilament transport in mature myelinated axons of tibial nerves from male and female mice of this strain ex vivo Fluorescent neurofilaments departed the activated region more rapidly in nodes than in flanking internodes, indicating that neurofilament transport is faster in nodes. By computational modeling, we showed that this nodal acceleration can be explained largely by a local increase in the duty cycle of neurofilament transport (i.e., the proportion of the time that the neurofilaments spend moving). We propose that this transient acceleration functions to maintain a constant neurofilament flux across nodal constrictions, much as the current increases where a river narrows its banks. In this way, neurofilaments are prevented from piling up in the flanking internodes, ensuring a stable neurofilament distribution and uniform axonal morphology across these physiologically important axonal domains.SIGNIFICANCE STATEMENT Myelinated axons are constricted at nodes of Ranvier, resulting in a marked local decrease in neurofilament number. These constrictions are important physiologically because they increase the efficiency of saltatory nerve conduction, but they also represent potential bottlenecks for the axonal transport of neurofilaments, which move along axons in a rapid intermittent manner. Imaging of neurofilament transport in mature myelinated axons ex vivo reveals that neurofilament polymers navigate these nodal axonal constrictions by accelerating transiently, much as the current increases where a river narrows its banks. This local acceleration is necessary to ensure a stable axonal morphology across nodal constrictions, which may explain the vulnerability of nodes of Ranvier to neurofilament accumulations in animal models of neurotoxic neuropathies and neurodegenerative diseases.

Wnt-driven LARGE2 mediates laminin-adhesive O-glycosylation in human colonic epithelial cells and colorectal cancer.

BACKGROUND: Wnt signaling drives epithelial self-renewal and disease progression in human colonic epithelium and colorectal cancer (CRC). Characterization of Wnt effector pathways is key for our understanding of these processes and for developing therapeutic strategies that aim to preserve tissue homeostasis. O-glycosylated cell surface proteins, such as α-dystroglycan (α-DG), mediate cellular adhesion to extracellular matrix components. We revealed a Wnt/LARGE2/α-DG signaling pathway which triggers this mode of colonic epithelial cell-to-matrix interaction in health and disease. METHODS: Next generation sequencing upon shRNA-mediated silencing of adenomatous polyposis coli (APC), and quantitative chromatin immunoprecipitation (qChIP) combined with CRISPR/Cas9-mediated transcription factor binding site targeting characterized LARGE2 as a Wnt target gene. Quantitative mass spectrometry analysis on size-fractionated, glycoprotein-enriched samples revealed functional O-glycosylation of α-DG by LARGE2 in CRC. The biology of Wnt/LARGE2/α-DG signaling was assessed by affinity-based glycoprotein enrichment, laminin overlay, CRC-to-endothelial cell adhesion, and transwell migration assays. Experiments on primary tissue, human colonic (tumor) organoids, and bioinformatic analysis of CRC cohort data confirmed the biological relevance of our findings. RESULTS: Next generation sequencing identified the LARGE2 O-glycosyltransferase encoding gene as differentially expressed upon Wnt activation in CRC. Silencing of APC, conditional expression of oncogenic ß-catenin and endogenous ß-catenin-sequestration affected LARGE2 expression. The first intron of LARGE2 contained a CTTTGATC motif essential for Wnt-driven LARGE2 expression, showed occupation by the Wnt transcription factor TCF7L2, and Wnt activation triggered LARGE2-dependent α-DG O-glycosylation and laminin-adhesion in CRC cells. Colonic crypts and organoids expressed LARGE2 mainly in stem cell-enriched subpopulations. In human adenoma organoids, activity of the LARGE2/α-DG axis was Wnt-dose dependent. LARGE2 expression was elevated in CRC and correlated with the Wnt-driven molecular subtype and intestinal stem cell features. O-glycosylated α-DG represented a Wnt/LARGE2-dependent feature in CRC cell lines and patient-derived tumor organoids. Modulation of LARGE2/α-DG signaling affected CRC cell migration through laminin-coated membranes and adhesion to endothelial cells. CONCLUSIONS: We conclude that the LARGE2 O-glycosyltransferase-encoding gene represents a direct target of canonical Wnt signaling and mediates functional O-glycosylation of α-dystroglycan (α-DG) in human colonic stem/progenitor cells and Wnt-driven CRC. Our work implies that aberrant Wnt activation augments CRC cell-matrix adhesion by increasing LARGE/α-DG-mediated laminin-adhesiveness. Video abstract.

Stochastic models of polymerization-based axonal actin transport.

Recent advances in live cell imaging of F-actin structures, combined with pulse-chase imaging and computational modeling have suggested that actin is transported along the axon via biased polymerization of metastable actin fibers (actin trails). This mechanism is distinct from motor driven polymer transport, such as for neurofilaments and can be best described as molecular hitchhiking, where G-actin molecules are intermittently incorporated into actin fibers which grow preferentially in the anterograde direction. In this paper, we discuss how various axonal and actin trail parameters like axon diameter, trail nucleation rates, basal G-actin concentration, and trail length influence the transport rate. These predictions can help guide future experiments to verify this novel protein transport mechanism. We introduce a simplified, analytically solvable model of actin transport which relates these parameters to experimentally measurable quantities. We also discuss why a simple diffusion-based transport mechanism cannot explain bulk actin transport in the axon.

Alterations in the epithelial stem cell compartment could contribute to permanent changes in the mucosa of patients with ulcerative colitis.

OBJECTIVE: UC is a chronic inflammatory disease of the colonic mucosa. Growing evidence supports a role for epithelial cell defects in driving pathology. Moreover, long-lasting changes in the epithelial barrier have been reported in quiescent UC. Our aim was to investigate whether epithelial cell defects could originate from changes in the epithelial compartment imprinted by the disease. DESIGN: Epithelial organoid cultures (EpOCs) were expanded ex vivo from the intestinal crypts of non-IBD controls and patients with UC. EpOCs were induced to differentiate (d-EpOCs), and the total RNA was extracted for microarray and quantitative real-time PCR (qPCR) analyses. Whole intestinal samples were used to determine mRNA expression by qPCR, or protein localisation by immunostaining. RESULTS: EpOCs from patients with UC maintained self-renewal potential and the capability to give rise to differentiated epithelial cell lineages comparable with control EpOCs. Nonetheless, a group of genes was differentially regulated in the EpOCs and d-EpOCs of patients with UC, including genes associated with antimicrobial defence (ie, LYZ, PLA2G2A), with secretory (ie, ZG16, CLCA1) and absorptive (ie, AQP8, MUC12) functions, and with a gastric phenotype (ie, ANXA10, CLDN18 and LYZ). A high rate of concordance was found in the expression profiles of the organoid cultures and whole colonic tissues from patients with UC. CONCLUSIONS: Permanent changes in the colonic epithelium of patients with UC could be promoted by alterations imprinted in the stem cell compartment. These changes may contribute to perpetuation of the disease.

Australian and New Zealand Pulmonary Rehabilitation Guidelines.

BACKGROUND AND OBJECTIVE: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts. METHODS: The Guideline methodology adhered to the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. Nine key questions were constructed in accordance with the PICO (Population, Intervention, Comparator, Outcome) format and reviewed by a COPD consumer group for appropriateness. Systematic reviews were undertaken for each question and recommendations made with the strength of each recommendation based on the GRADE (Gradings of Recommendations, Assessment, Development and Evaluation) criteria. The Guidelines were externally reviewed by a panel of experts. RESULTS: The Guideline panel recommended that patients with mild-to-severe COPD should undergo PR to improve quality of life and exercise capacity and to reduce hospital admissions; that PR could be offered in hospital gyms, community centres or at home and could be provided irrespective of the availability of a structured education programme; that PR should be offered to patients with bronchiectasis, interstitial lung disease and pulmonary hypertension, with the latter in specialized centres. The Guideline panel was unable to make recommendations relating to PR programme length beyond 8 weeks, the optimal model for maintenance after PR, or the use of supplemental oxygen during exercise training. The strength of each recommendation and the quality of the evidence are presented in the summary. CONCLUSION: The Australian and New Zealand Pulmonary Rehabilitation Guidelines present an evaluation of the evidence for nine PICO questions, with recommendations to provide guidance for clinicians and policymakers.

Local regulation of neurofilament transport by myelinating cells.

Axons in the vertebrate nervous system only expand beyond ∼ 1 µm in diameter if they become myelinated. This expansion is due in large part to the accumulation of space-filling cytoskeletal polymers called neurofilaments, which are cargoes of axonal transport. One possible mechanism for this accumulation is a decrease in the rate of neurofilament transport. To test this hypothesis, we used a fluorescence photoactivation pulse-escape technique to compare the kinetics of neurofilament transport in contiguous myelinated and unmyelinated segments of axons in long-term myelinating cocultures established from the dorsal root ganglia of embryonic rats. The myelinated segments contained more neurofilaments and had a larger cross-sectional area than the contiguous unmyelinated segments, and this correlated with a local slowing of neurofilament transport. By computational modeling of the pulse-escape kinetics, we found that this slowing of neurofilament transport could be explained by an increase in the proportion of the time that the neurofilaments spent pausing and that this increase in pausing was sufficient to explain the observed neurofilament accumulation. Thus we propose that myelinating cells can regulate the neurofilament content and morphology of axons locally by modulating the kinetics of neurofilament transport.

Minimizing the caliber of myelinated axons by means of nodal constrictions.

In myelinated axons, most of the voltage-gated ion channels are concentrated at the nodes of Ranvier, which are short gaps in the myelin sheath. This arrangement leads to saltatory conduction and a larger conduction velocity than in nonmyelinated axons. Intriguingly, axons in the peripheral nervous system that exceed about 2 µm in diameter exhibit a characteristic narrowing of the axon at nodes that results in a local reduction of the axonal cross-sectional area. The extent of constriction increases with increasing internodal axonal caliber, reaching a threefold reduction in diameter for the largest axons. In this paper, we use computational modeling to investigate the effect of nodal constrictions on axonal conduction velocity. For a fixed number of ion channels, we find that there is an optimal extent of nodal constriction which minimizes the internodal axon caliber that is required to achieve a given target conduction velocity, and we show that this is sensitive to the precise geometry of the axon and myelin sheath in the flanking paranodal regions. Thus axonal constrictions at nodes of Ranvier appear to be a biological adaptation to minimize axonal volume, thereby maximizing the spatial and metabolic efficiency of these processes, which can be a significant evolutionary constraint. We show that the optimal nodal morphologies are relatively insensitive to changes in the number of nodal sodium channels.

Deciphering the axonal transport kinetics of neurofilaments using the fluorescence photoactivation pulse-escape method.

Neurofilaments are transported along axons stochastically in a stop-and-go manner, cycling between brief bouts of rapid movement and pauses that can vary from seconds to hours in length. Presently the only way to analyze neurofilament pausing experimentally on both long and short time scales is the pulse-escape method. In this method, fluorescence photoactivation is used to mark a population of axonal neurofilaments and then the loss of fluorescence from the activated region due to neurofilament movement is monitored by time-lapse imaging. Here we develop a mathematical description of the pulse-escape kinetics in terms of the rate constants of a tested mathematical model and we show how this model can be used to characterize neurofilament transport kinetics from fluorescence photoactivation pulse-escape experiments. This combined experimental and computational approach is a powerful tool for the analysis of the moving and pausing behavior of neurofilaments in axons.

Discovery and Characterization of Brigimadlin, a Novel and Highly Potent MDM2-p53 Antagonist Suitable for Intermittent Dose Schedules.

p53 is known as the guardian of the genome and is one of the most important tumor-suppressors. It is inactivated in most tumors, either via tumor protein p53 (TP53) gene mutation or copy number amplification of key negative regulators, e.g., mouse double minute 2 (MDM2). Compounds that bind to the MDM2 protein and disrupt its interaction with p53 restore p53 tumor suppressor activity, thereby promoting cell cycle arrest and apoptosis. Previous clinical experience with MDM2-p53 protein-protein interaction antagonists (MDM2-p53 antagonists) have demonstrated that thrombocytopenia and neutropenia represent on-target dose-limiting toxicities that might restrict their therapeutic utility. Dosing less frequently, while maintaining efficacious exposure, represents an approach to mitigate toxicity and improve the therapeutic window of MDM2-p53 antagonists. However, to achieve this, a molecule possessing excellent potency and ideal pharmacokinetic properties is required. Here, we present the discovery and characterization of brigimadlin (BI 907828), a novel, investigational spiro-oxindole MDM2-p53 antagonist. Brigimadlin exhibited high bioavailability and exposure, as well as dose-linear pharmacokinetics in preclinical models. Brigimadlin treatment restored p53 activity and led to apoptosis induction in preclinical models of TP53 wild-type, MDM2-amplified cancer. Oral administration of brigimadlin in an intermittent dosing schedule induced potent tumor growth inhibition in several TP53 wild-type, MDM2-amplified xenograft models. Exploratory clinical pharmacokinetic studies (NCT03449381) showed high systemic exposure and a long plasma elimination half-life in cancer patients who received oral brigimadlin. These findings support the continued clinical evaluation of brigimadlin in patients with MDM2-amplified cancers, such as dedifferentiated liposarcoma.

Axonal transport of neurofilaments: a single population of intermittently moving polymers.

Studies on mouse optic nerve have led to the controversial proposal that only a small proportion of neurofilaments are transported in axons and that the majority are deposited into a persistently stationary and extensively cross-linked cytoskeletal network that remains fixed in place for months without movement. We have used computational modeling to address this issue, taking advantage of the wealth of published kinetic and morphometric data available for neurofilaments in the mouse visual system. We show that the transport kinetics and distribution of neurofilaments in mouse optic nerve can all be explained fully by a "stop-and-go" model of neurofilament transport, in which axons contain a single population of neurofilaments that all move stochastically in a rapid, intermittent, and bidirectional manner. Importantly, we find that the transport kinetics are not consistent with deposition of neurofilaments into a persistently stationary phase, and that deposition models cannot account for the observed distribution of neurofilaments along mouse optic nerve axons. Finally, we show that the apparent existence of a stationary neurofilament network in mouse optic nerve is most likely an experimental artifact due to contamination of the neurofilament transport kinetics with cytosolic proteins that move at faster rates. Thus, there is no evidence for the deposition of axonally transported neurofilaments into a persistently stationary neurofilament network in optic nerve axons. We conclude that all of the neurofilaments move and that they do so with a single broad and continuous distribution of average rates that is dictated by their intermittent and stochastic motile behavior.

Termination of Ca²+ release for clustered IP3R channels.

In many cell types, release of calcium ions is controlled by inositol 1,4,5-trisphosphate (IP3) receptor channels. Elevations in Ca²âº concentration after intracellular release through IP3 receptors (IP3R) can either propagate in the form of waves spreading through the entire cell or produce spatially localized puffs. The appearance of waves and puffs is thought to implicate random initial openings of one or a few channels and subsequent activation of neighboring channels because of an "autocatalytic" feedback. It is much less clear, however, what determines the further time course of release, particularly since the lifetime is very different for waves (several seconds) and puffs (around 100 ms). Here we study the lifetime of Ca²âº signals and their dependence on residual Ca²âº microdomains. Our general idea is that Ca²âº microdomains are dynamical and mediate the effect of other physiological processes. Specifically, we focus on the mechanism by which Ca²âº binding proteins (buffers) alter the lifetime of Ca²âº signals. We use stochastic simulations of channel gating coupled to a coarse-grained description for the Ca²âº concentration. To describe the Ca²âº concentration in a phenomenological way, we here introduce a differential equation, which reflects the buffer characteristics by a few effective parameters. This non-stationary model for microdomains gives deep insight into the dynamical differences between puffs and waves. It provides a novel explanation for the different lifetimes of puffs and waves and suggests that puffs are terminated by Ca²âº inhibition while IP3 unbinding is responsible for termination of waves. Thus our analysis hints at an additional role of IP3 and shows how cells can make use of the full complexity in IP3R gating behavior to achieve different signals.

Leadless pacing using induction technology: impact of pulse shape and geometric factors on pacing efficiency.

AIMS: Leadless pacing can be done by transmitting energy by an alternating magnetic field from a subcutaneous transmitter unit (TU) to an endocardial receiver unit (RU). Safety and energy consumption are key issues that determine the clinical feasibility of this new technique. The aims of the study were (i) to evaluate the stimulation characteristics of the non-rectangular pacing pulses induced by the alternating magnetic field, (ii) to determine the extent and impact of RU movement caused by the beating heart, and (iii) to evaluate the influence of the relative position between TU and RU on pacing efficiency and energy consumption. METHODS AND RESULTS: In the first step pacing efficiency and energy consumption for predefined positions were determined by bench testing. Subsequently, in a goat at five different ventricular sites (three in the right ventricle, two in the left ventricle) pacing thresholds using non-rectangular induction pulses were compared with conventional pulses. Relative position, defined by parallel distance, radial distance, and angulation between TU and RU, were determined in vivo by X-ray and an inclination angle measurement system. Bench testing showed that by magnetic induction for every alignment between TU and RU appropriate pulses can be produced up to a distance of 100 mm. In the animal experiment pacing thresholds were similar for non-rectangular pulses as compared with conventional pulse shapes. In all five positions with distances between 62 and 102 mm effective pacing was obtained in vivo. Variations in distance, displacement and angle caused by the beating heart did not cause loss of capture. At pacing threshold energy consumptions between 0.28 and 5.36 mJ were measured. Major determinants of energy consumption were distance and pacing threshold. CONCLUSION: For any given RU position up to a distance of 100 mm reliable pacing using induction can be obtained. In anatomically crucial distances, up to 60 mm energy consumption is within a reasonable range.

Capillaroscopy of toes.

BACKGROUND: Nailfold capillaroscopy of fingers is an important tool for diagnosis and monitoring of collagen-vascular diseases. However, little is known about capillaroscopy of toes. PATIENTS AND METHODS: Capillaroscopy of the first and second toe was performed in 50 healthy volunteers and 67 patients with chronic venous insufficiency (n = 22), peripheral arterial diseases (n = 24) and collagen-vascular diseases (n = 21) with a capillaroscope under oil immersion with non-polarized light and 50-fold magnification. RESULTS: Capillary density of toes (5-9/mm) was reduced compared to fingers (7-11/mm). In contrast to fingers, capillaries of toes show a higher degree of variability. In addition to the classic parallel hairpin form, one may also find tortuous capillaries, ramifications, elongations and capillary bundles. Little difference was noted between patients with vascular and collagen-vascular diseases as compared to volunteers. More ramifications were observed in peripheral arterial diseases and more capillary bundles were seen in collagen-vascular diseases. Pathological patterns such as megacapillaries, avascular areas and hemorrhages were not seen in toes. CONCLUSIONS: The physiological capillary pattern differs between fingers and toes. The detected pathologic alterations in vascular and collagen-vascular diseases have to be confirmed in further studies.

Capillaroscopy.

Microscopy of the nailfold capillaries has found increasing use in dermatology, rheumatology and angiology particularly as an important tool to distinguish between primary and secondary Raynaud disease. The best evidence is available in systemic sclerosis where specific capillaroscopic patterns have a high positive predictive value for the development of the disease. Conversely, a regular capillary pattern rules out systemic sclerosis with high degree of probability. PRINCE (prognostic index for nailfold capillaroscopic examination) was developed to identify patients at high risk of developing systemic sclerosis. CSURI (capillaroscopic skin ulcer risk index) should predict the risk of developing digital ulcers in patients with systemic sclerosis with high specificity and sensitivity. As a consequence of recent results a pathologic capillary pattern was integrated by the EULAR Scleroderma Trials and Research Group (EUSTAR) in the diagnostic algorithm of the VEDOSS-Project (very early diagnosis of systemic sclerosis). Capillary patterns may correlate with visceral involvement and capillaroscopy thus has the potential as a screening tool to enable early diagnosis of organ involvement in systemic sclerosis.

The role of neurofilament transport in the radial growth of myelinated axons.

The cross-sectional area of myelinated axons increases greatly during postnatal development in mammals and is an important influence on axonal conduction velocity. This radial growth is driven primarily by an accumulation of neurofilaments, which are cytoskeletal polymers that serve a space-filling function in axons. Neurofilaments are assembled in the neuronal cell body and transported into axons along microtubule tracks. The maturation of myelinated axons is accompanied by an increase in neurofilament gene expression and a decrease in neurofilament transport velocity, but the relative contributions of these processes to the radial growth are not known. Here, we address this question by computational modeling of the radial growth of myelinated motor axons during postnatal development in rats. We show that a single model can explain the radial growth of these axons in a manner consistent with published data on axon caliber, neurofilament and microtubule densities, and neurofilament transport kinetics in vivo. We find that the increase in the cross-sectional area of these axons is driven primarily by an increase in the influx of neurofilaments at early times and by a slowing of neurofilament transport at later times. We show that the slowing can be explained by a decline in the microtubule density.

The Mobility of Neurofilaments in Mature Myelinated Axons of Adult Mice.

Studies in cultured neurons have shown that neurofilaments are cargoes of axonal transport that move rapidly but intermittently along microtubule tracks. However, the extent to which axonal neurofilaments move in vivo has been controversial. Some researchers have proposed that most axonally transported neurofilaments are deposited into a persistently stationary network and that only a small proportion of axonal neurofilaments are transported in mature axons. Here we use the fluorescence photoactivation pulse-escape technique to test this hypothesis in intact peripheral nerves of adult male hThy1-paGFP-NFM mice, which express low levels of mouse neurofilament protein M tagged with photoactivatable GFP. Neurofilaments were photoactivated in short segments of large, myelinated axons, and the mobility of these fluorescently tagged polymers was determined by analyzing the kinetics of their departure. Our results show that >80% of the fluorescence departed the window within 3 h after activation, indicating a highly mobile neurofilament population. The movement was blocked by glycolytic inhibitors, confirming that it was an active transport process. Thus, we find no evidence for a substantial stationary neurofilament population. By extrapolation of the decay kinetics, we predict that 99% of the neurofilaments would have exited the activation window after 10 h. These data support a dynamic view of the neuronal cytoskeleton in which neurofilaments cycle repeatedly between moving and pausing states throughout their journey along the axon, even in mature myelinated axons. The filaments spend a large proportion of their time pausing, but on a timescale of hours, most of them move.