Inter- and intraobserver reliability of the COFAS end-stage ankle arthritis classification system

End-stage ankle arthritis should have an appropriate classification to assist surgeons in the management of end-stage ankle arthritis. Outcomes research also requires a classification system to stratify patients appropriately.

Icatibant, a new bradykinin-receptor antagonist, in hereditary angioedema

Hereditary angioedema is characterized by recurrent attacks of angioedema of the skin, larynx, and gastrointestinal tract. Bradykinin is the key mediator of symptoms. Icatibant is a selective bradykinin B2 receptor antagonist.

Multiple LRRK2 variants modulate risk of Parkinson disease: a Chinese multicenter study

We and others found two polymorphic LRRK2 (leucine-rich repeat kinase 2) variants (rs34778348:G>A; p.G2385R and rs33949390:G>C; p.R1628P) associated with Parkinson disease (PD) among Chinese patients, but the common worldwide rs34637584:G>A; p.G2019S mutation, was absent. Focusing exclusively on Han Chinese, we first sequenced the coding regions in young onset and familial PD patients and identified 59 variants. We then examined these variants in 250 patients and 250 control subjects. Among the 17 polymorphic variants, five demonstrated different frequency in cases versus controls and were considered in a larger sample of 1,363 patients and 1,251 control subjects. The relative risk of an individual with both p.G2385R and p.R1628P is about 1.9, and this is reduced to 1.5-1.6 if the individual also carries rs7133914:G>C; p.R1398H or rs7308720:C>A: p.N551K. The risk of a carrier with p.R1628P is largely negated if the individual also carries p.R1398H or p.N551K. In dopaminergic neuronal lines, p.R1398H had significantly lower kinase activity, whereas p.G2385R and p.R1628P showed higher kinase activity than wild type. We provided the first evidence that multiple LRRK2 variants exert an individual effect and together modulate the risk of PD among Chinese.

Virus infections and winter losses of honey bee colonies (Apis mellifera)

Apiculturists have recently been confronted with drastic and inexplicable winter losses of colonies, and virus infections may be involved. Here, we surveyed 337 Swiss honey bee colonies in the winter of 2005 and 2006 and categorized their health status as: 1. dead (= no or few live bees left); 2. weak (= dwindling, high mortality of adult bees); or 3. healthy (= normal overwintering colony). From each colony, pooled adult workers were analyzed for deformed wing virus (DWV), acute bee paralysis virus (ABPV), chronic bee paralysis virus (CBPV) and Kashmir bee virus (KBV). Neither KBV nor CBPV were found, but significantly higher ABPV and DWV infections were found in dead vs. weak vs. healthy colonies (except DWV in 2006 between weak and healthy). Moreover, ABPV and DWV loads were positively correlated with each other. This is the first report demonstrating statistically significant correlations between viruses associated with Varroa destructor and winter mortality.

Electrolyte Depletion in White-nose Syndrome Bats

The emerging wildlife disease white-nose syndrome is causing widespread mortality in hibernating North American bats. White-nose syndrome occurs when the fungus Geomyces destructans infects the living skin of bats during hibernation, but links between infection and mortality are underexplored. We analyzed blood from hibernating bats and compared blood electrolyte levels to wing damage caused by the fungus. Sodium and chloride tended to decrease as wing damage increased in severity. Depletion of these electrolytes suggests that infected bats may become hypotonically dehydrated during winter. Although bats regularly arouse from hibernation to drink during winter, water available in hibernacula may not contain sufficient electrolytes to offset winter losses caused by disease. Damage to bat wings from G. destructans may cause life-threatening electrolyte imbalances.

“What Happens When Pollinators Get Sick? Behavioral Impacts of Honeybee Viruses”

Like all organisms on the planet, honeybees (Apis mellifera) are susceptible to infection with a wide variety of viruses. These viruses may produce infections with no visible symptoms or may have devastating consequences on both the individual bee and the entire hive. Deformed Wing Virus, a member of the Iflavirus group of viruses, has an RNA genome and has had a particularly important impact on bee health. It can be spread between bees in a several ways – bees can infect each other during feeding or grooming activities, drones can pass the virus to the queen during mating and queens can lay infected eggs. The primary and most devastating way that these viruses are transmitted within and between hives involves a parasitic mite, an animal known ominously as Varroa destructor. The talk will discuss the effect that viruses have on the health and behavior of honeybees and will outline the collaborative research activities of Drs. Evans and Pizzorno over the last 7 years.

Impact of complications in total ankle replacement and ankle arthrodesis analyzed with a validated outcome measurement

Major modifications in the design and techniques of total ankle replacement have challenged the perception that ankle arthrodesis is the treatment of choice for end-stage ankle arthritis. High complication and revision rates have been reported after both procedures.

Health-related quality of life anticipated with different management strategies for febrile neutropenia in adult cancer patients

PURPOSE: To describe anticipated health-related quality of life (HRQL) for different hypothetical strategies of febrile neutropenia (FN) management in adult cancer patients. METHODS: Seventy-eight adult cancer patients were enrolled. Our study considered four different hypothetical treatment strategies for FN: (1) entire inpatient management with intravenous (IV) antibiotics; (2) oral treatment at home after an initial observation in hospital with IV antibiotics; (3) entire outpatient management with IV antibiotics; and (4) entire outpatient management with oral antibiotics. Initially, patients were asked to rank the different treatment strategies for FN based on their personal preference. Subsequently, HRQL was rated using visual analog scale (VAS), time trade-off (TTO), and willingness-to-pay (WTP). RESULTS: Seventy-five percent of all respondents preferred an outpatient strategy for FN (36% oral, 21% intravenous, 18% early discharge). Further, outpatient strategies were associated with higher mean VAS scores (possible range 0-10) (oral: 6.1 (standard deviation (SD) 3.1); intravenous: 6.2 (SD 2.2); early discharge: 5.7 (SD 2.1)) as compared to inpatient care (5.3 (SD 2.9)). On the aggregate level, patients were willing to give up between 9 and 10 weeks of their life (TTO; corresponding to <1% of remaining life expectancy) and to pay between $255 and $327 Canadian dollars (WTP) to avoid treatment in hospital. CONCLUSIONS: Our study indicates that the majority of adult cancer patients would prefer an outpatient strategy for FN. However, patients' preferences vary substantially at the individual level. Implementation of outpatient strategies into routine clinical practice should consider this variability.

Iron(III)-Pivalate-Based Complexes with Tetranuclear {Fe-4(mu(3)-O)(2)}(8+) Cores and N-Donor Ligands: Formation of Cluster and Polymeric Architectures

Different synthetic routes have been used for the preparation of a new tetranuclear [Fe4O2(O2CCMe3)(8)(bpm)] cluster (1) and a one-dimensional coordination polymer [Fe4O2-(O2CCMe3)(8)(hmta)](n) (2) (bpm = 2,2'-bipyrimidine and hmta = hexamethylenetetramine). For cluster 1, two structural isomers, 1a and 1b center dot 3MeCN, have been found. X-ray crystallographic analysis showed that all complexes consist of a central {Fe-4(mu(3)-O)(2)}(8+) core. In 1a, metal ions in the core are additionally linked by six bridging pivalates as two other pivalates and a bpm ligand are chelated to Fe-III ions, whereas in cluster 1b, metal ions in the {Fe-4(mu(3)-O)(2)}(8+) core are linked by seven bridging pivalates and only one carboxylate as well as bpm are chelated to the iron centers. In coordination polymer 2, [Fe4O2(O2CCMe3)(8)] clusters are bridged by hmta ligands to form zigzag chains. Magnetic measurements have been carried out to characterize these complexes and revealed antiferromagnetic interactions between Fe-III ions with best-fit parameters of J(wb) = -72.2 (1a) and -88.7 cm(-1) (1b) for wing...body interactions.

The postoperative COFAS end-stage ankle arthritis classification system: interobserver and intraobserver reliability

End-stage ankle arthritis is operatively treated with numerous designs of total ankle replacement and different techniques for ankle fusion. For superior comparison of these procedures, outcome research requires a classification system to stratify patients appropriately. A postoperative 4-type classification system was designed by 6 fellowship-trained foot and ankle surgeons. Four surgeons reviewed blinded patient profiles and radiographs on 2 occasions to determine the interobserver and intraobserver reliability of the classification. Excellent interobserver reliability (κ = .89) and intraobserver reproducibility (κ = .87) were demonstrated for the postoperative classification system. In conclusion, the postoperative Canadian Orthopaedic Foot and Ankle Society (COFAS) end-stage ankle arthritis classification system appears to be a valid tool to evaluate the outcome of patients operated for end-stage ankle arthritis.

Physiological Consequences Of White-Nose Syndrome

White-nose syndrome (WNS) is a disease that has caused the mass mortality of hibernating bat species. Since its first discovery in the winter of 2006-2007, an estimated five million bats or more have been killed. Although infection with Pseudogymnoascus destructans (Pd, the causative agent of WNS) does not always result in death, bats that survive Pd infection may experience fitness consequences. To understand the physiological consequences of WNS, I measured reproductive rates of free-ranging hibernating bat species of the Northeastern United States. In addition, captive little brown myotis (Myotis lucifugus) bats that were infected by Pd but survived (¿WNS survivors¿) and uninfected bats were studied in order to understand the potential consequences (e.g., lower reproductive rates, decreased ability to heal wounds, degradation of wing tissue, and altered metabolic rates) of surviving WNS. No differences in reproductive rates were found between WNS-survivors and uninfected bats in either the field or in captivity. In addition, wound healing was not affected by Pd infection. However, wing tissue degradation was worse for little brown myotis 19 days post-hibernation, and mass specific metabolic rate (MSMR) was significantly higher for those infected with Pd 22 days post-hibernation. While it is clear that these consequences are a direct result of Pd infection, further research investigating the long-term consequences for both mothers and pups is necessary.

Exploration Of Survival Traits In The White-Nose Syndrome-Affected Big Brown Bat (Eptesicus Fuscus)

The widespread mortality of hibernating bats is associated with the emerging infectious disease white-nose syndrome (WNS), and has provoked a strong interest in understanding which bats will survive, and why? The ability of infected bats to resist WNS may depend upon variation in the expression of different characteristics. In a captive colony of big brown bats, I sought to characterize the phenotypic variability, repeatability, and survivability for several key ¿survival¿ traits, including: torpor patterns, microclimate preferences, and wound healing capacity. Torpor patterns were profiled using temperature sensitive dataloggers throughout the hibernation season, while microclimate preferences were quantified by using temperature-graded boxes and thermal imaging. In order to assess wound healing capacity, small wing biopsies were obtained from each bat and healing progress was tracked for one month. Individuals exhibited a wide range of phenotypes that were significantly influenced by sex and body condition. Repeatability estimates suggest that there is not a strong genetic basis for the observed variation in torpor patterns or microclimate preferences. Certain phenotypes (e.g., BMI) were associated with an increased probability of overwinter survivorship, which suggests a basis for intra-species differences in WNS susceptibility. The results from this project provide novel insight into what we know about ¿who will survive,¿ and will influence the direction and implementation of future conservation and mitigation strategies.

Personality and Current Political Beliefs | Comparative Study of Polish and Belgian Samples)"

This project had a threefold aim and sought to provide answers to several different questions. Kossowska first focused on the relationship between Openness to Experience and ideological variables such as authoritarianism and conservatism. The main questions here were (1) whether there are differences between the Polish and Belgian samples studied with respect to the relationship between political ideology and Openness to Experience, and (2) whether this relationship applies to all facets of Openness to Experience. The study showed significant negative correlations between Openness and right-wing ideology in both adult samples, and that Fantasy and Actions were the most robust correlates of political ideology. A second problem examined concerned the relationship between ideology and cognitive functioning. The important questions here were about the conceptualisation and measurement of cognitive variables such as rigidity, intolerance of ambiguity, or the need for closure, which determine individuals' attitudes to politics. The results confirmed the significance of the need for closure construct in both samples for understanding the process of formulating and holding political beliefs. The last aspect of the study was the differences in political beliefs between the Polish and Belgian samples in relation to the social, political and economic situation in the two countries. The most important question here was the changes in the political mentality of Poles during the period of system transition. Kossowska expected to find differences between Poles and Belgians with respect to the level of conservatism and authoritarianism, but in fact both samples showed comparable levels of right-wing political beliefs.

The Institutional Framework around Successful Art Forms in Communist Czechoslovakia

Mr. Michl posed the question of how the institutional framework that the former communist regime set up around art production contributed to the success of Czech applied arts. In his theoretical review of the question he discussed the reasons for the lack of success of socialist industrial design as opposed to what he terms pre-industrial arts (such as art glass), and also for the current lack of interest into art institutions of the past regime. His findings in the second, historical section of his work were based largely on interviews with artists and other insiders, as an initial attempt to use questionnaires was unsuccessful. His original assumption that the institutional framework was imposed on artists against their will in fact proved mistaken, as it turned out to have been proposed by the artists themselves. The basic blueprint for communist art institutions was the Memorandum document published on behalf of Czechoslovak visual artists in March 1947, i.e. before the communist coup of February 1948. Thus, while the communist state provided a beneficial institutional framework for artists' work, it was the artists themselves who designed this framework. Mr. Michl concludes that the text of the memorandum appealed to the general left-wing and anti-market sentiments of the immediate post-war period and by this and by later working through the administrative channels of the new state, the artists succeeded in gaining all of their demands over the next 15 years. The one exception was artistic freedom, although this they came to enjoy, if only by default and for a short time, during the ideological thaw of the 1960s. Mr. Michl also examined the art-related legislative framework in detail and looked at the main features of key art institutions in the field, such as the Czech Fund for Visual Arts and the 1960s art export enterprise Art Centrum, which opened the doors into foreign markets for artists.

Pontocerebellar hypoplasia type 2: variability in clinical and imaging findings

We report 24 children (14 girls) who presented with the typical neuroimaging findings of pontocerebellar hypoplasia (PCH) to describe the clinical spectrum of type 2. Twenty-one presented with the classical form described by Barth; characteristic features (15/21) were breathing and/or sucking problems during neonatal period and early onset hyperkinetic movement disorder. Eighteen were normocephalic at birth, but all developed microcephaly during infancy. Development was severely affected with none of the children being capable of sitting, walking, or talking. Social contact and visual fixation were persistently poor. Dyskinetic movement disorder was present in all, in some together with mild spasticity. Seizures occurred in 14 (in 7 as neonates). Eight children died (age 1 day-6 years). Neuroimaging showed an absent or severely flattened pons, different degrees of vermian hypoplasia, with cerebellar hemispheres (wing-like structures) being equally or more affected. Three (all girls) were less severely affected clinically and did not develop the dyskinetic movement disorder, motor and cognitive development were somewhat better. Microcephaly was also a prominent sign. Severity of pontocerebellar neuroimaging findings did not differentiate between the typical and atypical clinical group and did not correlate with clinical outcome.