Monozygotic twins discordant for schizophrenia differ in maturation and synaptic transmission

Schizophrenia affects approximately 1% of the world population. Genetics, epigenetics, and environmental factors are known to play a role in this psychiatric disorder. While there is a high concordance in monozygotic twins, about half of twin pairs are discordant for schizophrenia. To address the question of how and when concordance in monozygotic twins occur, we have obtained fibroblasts from two pairs of schizophrenia discordant twins (one sibling with schizophrenia while the second one is unaffected by schizophrenia) and three pairs of healthy twins (both of the siblings are healthy). We have prepared iPSC models for these 3 groups of patients with schizophrenia, unaffected co-twins, and the healthy twins. When the study started the co-twins were considered healthy and unaffected but both the co-twins were later diagnosed with a depressive disorder. The reprogrammed iPSCs were differentiated into hippocampal neurons to measure the neurophysiological abnormalities in the patients. We found that the neurons derived from the schizophrenia patients were less arborized, were hypoexcitable with immature spike features, and exhibited a significant reduction in synaptic activity with dysregulation in synapse-related genes. Interestingly, the neurons derived from the co-twin siblings who did not have schizophrenia formed another distinct group that was different from the neurons in the group of the affected twin siblings but also different from the neurons in the group of the control twins. Importantly, their synaptic activity was not affected. Our measurements that were obtained from schizophrenia patients and their monozygotic twin and compared also to control healthy twins point to hippocampal synaptic deficits as a central mechanism in schizophrenia.

Prevalence and drug use correlates of inadvertent fentanyl exposure among individuals misusing drugs in seven U.S. states

Fentanyl has emerged as the leading cause of fatal drug overdoses in the U.S. Individuals misusing drugs may not always be aware of exposure to fentanyl.

To determine the prevalence of fentanyl use and extent of awareness of fentanyl exposure among a national sample of treatment-seeking individuals with opioid use disorder (n = 1098).

Participants provided oral fluid and urine specimens, which were tested for drugs by liquid chromatography/tandem mass spectrometry. Participants also provided self-reports of fentanyl use.

49.5% tested positive for fentanyl in oral fluid, urine, or both. Of those testing positive for fentanyl, 29.8% were unaware that they had been exposed to fentanyl. Participants testing positive for opioids methadone, and specifically 6-monoacetylmorphine (6-MAM), a unique metabolite of heroin, were significantly more likely to be unaware of fentanyl exposure than participants testing negative for these substances, with a similar trend for oxycodone and tramadol.

These findings may be due to fentanyl's effect being difficult to distinguish from that of other opioids, whereas when other types of drugs are adulterated with fentanyl, the differences in effects are likely to be readily discernable. These results support the importance of expanded drug-checking services.

Human iN neuronal model of schizophrenia displays dysregulation of chromogranin B and related neuropeptide transmitter signatures

Schizophrenia (SZ) is a serious mental illness and neuropsychiatric brain disorder with behavioral symptoms that include hallucinations, delusions, disorganized behavior, and cognitive impairment. Regulation of such behaviors requires utilization of neurotransmitters released to mediate cell-cell communication which are essential to brain functions in health and disease. We hypothesized that SZ may involve dysregulation of neurotransmitters secreted from neurons. To gain an understanding of human SZ, induced neurons (iNs) were derived from SZ patients and healthy control subjects to investigate peptide neurotransmitters, known as neuropeptides, which represent the major class of transmitters. The iNs were subjected to depolarization by high KCl in the culture medium and the secreted neuropeptides were identified and quantitated by nano-LC-MS/MS tandem mass spectrometry. Several neuropeptides were identified from schizophrenia patient-derived neurons, including chromogranin B (CHGB), neurotensin, and natriuretic peptide. Focusing on the main secreted CHGB neuropeptides, results revealed differences in SZ iNs compared to control iN neurons. Lower numbers of distinct CHGB peptides were found in the SZ secretion media compared to controls. Mapping of the peptides to the CHGB precursor revealed peptides unique to either SZ or control, and peptides common to both conditions. Also, the iNs secreted neuropeptides under both KCl and basal (no KCl) conditions. These findings are consistent with reports that chromogranin B levels are reduced in the cerebrospinal fluid and specific brain regions of SZ patients. These findings suggest that iNs derived from SZ patients can model the decreased CHGB neuropeptides observed in human SZ.

Genetic correlates of phenotypic heterogeneity in autism

The substantial phenotypic heterogeneity in autism limits our understanding of its genetic etiology. To address this gap, here we investigated genetic differences between autistic individuals (nmax = 12,893) based on core and associated features of autism, co-occurring developmental disabilities and sex. We conducted a comprehensive factor analysis of core autism features in autistic individuals and identified six factors. Common genetic variants were associated with the core factors, but de novo variants were not. We found that higher autism polygenic scores (PGS) were associated with lower likelihood of co-occurring developmental disabilities in autistic individuals. Furthermore, in autistic individuals without co-occurring intellectual disability (ID), autism PGS are overinherited by autistic females compared to males. Finally, we observed higher SNP heritability for autistic males and for autistic individuals without ID. Deeper phenotypic characterization will be critical in determining how the complex underlying genetics shape cognition, behavior and co-occurring conditions in autism.

Multi-objective optimization of root phenotypes for nutrient capture using evolutionary algorithms

Root phenotypes are avenues to the development of crop cultivars with improved nutrient capture, which is an important goal for global agriculture. The fitness landscape of root phenotypes is highly complex and multidimensional. It is difficult to predict which combinations of traits (phene states) will create the best performing integrated phenotypes in various environments. Brute force methods to map the fitness landscape by simulating millions of phenotypes in multiple environments are computationally challenging. Evolutionary optimization algorithms may provide more efficient avenues to explore high dimensional domains such as the root phenotypic space. We coupled the three-dimensional functional-structural plant model, SimRoot, to the Borg Multi-Objective Evolutionary Algorithm (MOEA) and the evolutionary search over several generations facilitated the identification of optimal root phenotypes balancing trade-offs across nutrient uptake, biomass accumulation, and root carbon costs in environments varying in nutrient availability. Our results show that several combinations of root phenes generate optimal integrated phenotypes where performance in one objective comes at the cost of reduced performance in one or more of the remaining objectives, and such combinations differed for mobile and non-mobile nutrients and for maize (a monocot) and bean (a dicot). Functional-structural plant models can be used with multi-objective optimization to identify optimal root phenotypes under various environments, including future climate scenarios, which will be useful in developing the more resilient, efficient crops urgently needed in global agriculture.

Impacts of irrigation efficiency on water-dependent sectors are heavily controlled by region-specific institutions and infrastructures

Farmers' investment in more efficient irrigation systems represents a primary adaptation strategy when confronting climate change. However, the regional benefits of these investments and their influence on the conflicting demands among different water dependent stakeholders for intensely irrigated regions remains an open question. Using the Pacific Northwest of the United States as an illustrative region of focus, we show that higher irrigation efficiency has diverse effects across stakeholders that are contingent on many local climatic, institutional and infrastructural factors such as the availability of water storage, the location of hydropower generators, and water rights. These complexities limit simple abstractions of irrigation efficiency as broader policy challenge and are central to its inclusion within the class of "wicked problems". Additionally, we argue that the widely used rebound effect concept, which implicitly discourages irrigation efficiency supporting policies, should not be assumed to fully capture the nuances of the complex suite of regional impacts that emerge from irrigation efficiency investments. Consequently, the evaluation of irrigation efficiency investments requires a broader framing across a diversity of perspectives. policies and actions that are pluralistic, context-specific, and closely engage various groups of stakeholders in the policymaking process.

Impact of patient motivation on compliance and outcomes for incontinence

OBJECTIVES

Physiotherapeutic treatment of pelvic floor dysfunction in women has variable outcomes, and identification of the predictors of outcomes is important in developing service provision and treatment planning. This study explored whether patient motivation affects treatment compliance and outcomes of physiotherapeutic treatment in a cohort of patients with pelvic floor dysfunction.

DESIGN, SETTING AND PARTICIPANTS

A prospective observational study of 141 adult female patients referred consecutively to the physiotherapy clinic of an urogynaecological outpatients unit at a UK hospital.

INTERVENTION

A 6-month (one group session per month) pelvic floor muscle training programme, which included a home exercise programme.

MAIN OUTCOME MEASURES

Modified Oxford Grading System and Queensland Pelvic Floor Questionnaire ratings of pelvic floor function were taken pre- and post-intervention, and the University of Rhode Island Change Assessment Scale assessed patient motivation to change pre-intervention.

RESULTS

Motivation to change predicted attendance at the intervention sessions and patient-rated improvements in function. Patients with higher baseline motivation to change also reported greater improvements in pelvic symptoms, given the same pelvic floor muscle strength improvement.

CONCLUSIONS

Patient motivation affects physiotherapeutic treatment adherence and outcomes, and should be considered as part of future assessment/screening procedures.

CLINICAL TRIAL REGISTRATION

NCT02549157.

Evaluating the economic impact of water scarcity in a changing world

Water scarcity is dynamic and complex, emerging from the combined influences of climate change, basin-level water resources, and managed systems’ adaptive capacities. Beyond geophysical stressors and responses, it is critical to also consider how multi-sector, multi-scale economic teleconnections mitigate or exacerbate water shortages. Here, we contribute a global-to-basin-scale exploratory analysis of potential water scarcity impacts by linking a global human-Earth system model, a global hydrologic model, and a metric for the loss of economic surplus due to resource shortages. We find that, dependent on scenario assumptions, major hydrologic basins can experience strongly positive or strongly negative economic impacts due to global trade dynamics and market adaptations to regional scarcity. In many cases, market adaptation profoundly magnifies economic uncertainty relative to hydrologic uncertainty. Our analysis finds that impactful scenarios are often combinations of standard scenarios, showcasing that planners cannot presume drivers of uncertainty in complex adaptive systems.

The impacts of water scarcity depend on physical basin characteristics and global economic dynamics. Here, the authors show scenario assumptions can yield either highly positive or negative economic impacts due to water scarcity, and the drivers of these impacts are basin-specific and cannot be determined a priori.

Water rights shape crop yield and revenue volatility tradeoffs for adaptation in snow dependent systems

Irrigated agriculture in snow-dependent regions contributes significantly to global food production. This study quantifies the impacts of climate change on irrigated agriculture in the snow-dependent Yakima River Basin (YRB) in the Pacific Northwest United States. Here we show that increasingly severe droughts and temperature driven reductions in growing season significantly reduces expected annual agricultural productivity. The overall reduction in mean annual productivity also dampens interannual yield variability, limiting yield-driven revenue fluctuations. Our findings show that farmers who adapt to climate change by planting improved crop varieties may potentially increase their expected mean annaul productivity in an altered climate, but remain strongly vulnerable to irrigation water shortages that substantially increase interannual yield variability (i.e., increasing revenue volatility). Our results underscore the importance for crop adaptation strategies to simultaneously capture the biophysical effects of warming as well as the institutional controls on water availability.

De Novo SOX6 Variants Cause a Neurodevelopmental Syndrome Associated with ADHD, Craniosynostosis, and Osteochondromas

SOX6 belongs to a family of 20 SRY-related HMG-box-containing (SOX) genes that encode transcription factors controlling cell fate and differentiation in many developmental and adult processes. For SOX6, these processes include, but are not limited to, neurogenesis and skeletogenesis. Variants in half of the SOX genes have been shown to cause severe developmental and adult syndromes, referred to as SOXopathies. We here provide evidence that SOX6 variants also cause a SOXopathy. Using clinical and genetic data, we identify 19 individuals harboring various types of SOX6 alterations and exhibiting developmental delay and/or intellectual disability; the individuals are from 17 unrelated families. Additional, inconstant features include attention-deficit/hyperactivity disorder (ADHD), autism, mild facial dysmorphism, craniosynostosis, and multiple osteochondromas. All variants are heterozygous. Fourteen are de novo, one is inherited from a mosaic father, and four offspring from two families have a paternally inherited variant. Intragenic microdeletions, balanced structural rearrangements, frameshifts, and nonsense variants are predicted to inactivate the SOX6 variant allele. Four missense variants occur in residues and protein regions highly conserved evolutionarily. These variants are not detected in the gnomAD control cohort, and the amino acid substitutions are predicted to be damaging. Two of these variants are located in the HMG domain and abolish SOX6 transcriptional activity in vitro. No clear genotype-phenotype correlations are found. Taken together, these findings concur that SOX6 haploinsufficiency leads to a neurodevelopmental SOXopathy that often includes ADHD and abnormal skeletal and other features.

Cystoscopic transurethral incision in simplex and duplex ureteroceles-is it the definitive procedure?

OBJECTIVE

The aim of this study is to evaluate the efficacy of primary cystoscopic transurethral incision (CTUI) in the management of paediatric ureteroceles. The secondary aim is to compare the efficacy of CTUI between simplex and duplex systems.

PATIENTS AND METHODS

This is a retrospective review of consecutive paediatric patients requiring surgical intervention for ureterocele. Data collected for analysis included demographics, diagnostic, pre-operative investigations, operative interventions and postoperative variables.

RESULTS

Over a 19-year period, 79 consecutive cases were identified, and 42 were male (53.2%). The mean follow-up was 6.7 years. Seventy-three (92.4%) cases underwent primary CTUI; 50 of these cases (68.5%) required no further procedures during the study period. Sixty-one cases were treated by endoscopic intervention alone (77.2%). Forty-one (51.9%) cases had a simplex system, and 38 (48.1%), a duplex system. There was no statistically significant difference in the efficacy of primary CTUI in simplex vs duplex systems. Of the 20 patients who had pre-operative and postoperative micturating cystourethrograms performed, seven (35%) developed de-novo postoperative vesicoureteric reflux after CTUI.

CONCLUSION

Primary CTUI is a safe, minimally invasive procedure that is definitive in the majority of children presenting with a ureterocele that requires intervention. There was no difference in success of primary CTUI between simplex or duplex systems.

Children with autism spectrum disorder: teaching conversation involving feelings about events

BACKGROUND

Two procedures were developed to teach individuals with Autism Spectrum Disorders labels (tacts) for various private events (emotions): Study 1 attempted to distinguish them from pure tacts and mands (requests); and Study 2 attempted to train initiating a conversation with grammatically correct subject-verb-comment construction.

METHODS

A multiple treatment reversal design was used in both studies, followed by a probe to see if the tacts were used across novel settings.

RESULTS

The children were prompted to initiate a series of language exchanges, which resulted in an increased ability to participate in conversations about private events.

CONCLUSIONS

Together, the results of both studies suggest that, by providing an effective and reinforcing means of teaching both the function and the form of these tacts, conversations can be successfully initiated by children with ASD.

Mutations in DDX3X Are a Common Cause of Unexplained Intellectual Disability with Gender-Specific Effects on Wnt Signaling

Intellectual disability (ID) affects approximately 1%-3% of humans with a gender bias toward males. Previous studies have identified mutations in more than 100 genes on the X chromosome in males with ID, but there is less evidence for de novo mutations on the X chromosome causing ID in females. In this study we present 35 unique deleterious de novo mutations in DDX3X identified by whole exome sequencing in 38 females with ID and various other features including hypotonia, movement disorders, behavior problems, corpus callosum hypoplasia, and epilepsy. Based on our findings, mutations in DDX3X are one of the more common causes of ID, accounting for 1%-3% of unexplained ID in females. Although no de novo DDX3X mutations were identified in males, we present three families with segregating missense mutations in DDX3X, suggestive of an X-linked recessive inheritance pattern. In these families, all males with the DDX3X variant had ID, whereas carrier females were unaffected. To explore the pathogenic mechanisms accounting for the differences in disease transmission and phenotype between affected females and affected males with DDX3X missense variants, we used canonical Wnt defects in zebrafish as a surrogate measure of DDX3X function in vivo. We demonstrate a consistent loss-of-function effect of all tested de novo mutations on the Wnt pathway, and we further show a differential effect by gender. The differential activity possibly reflects a dose-dependent effect of DDX3X expression in the context of functional mosaic females versus one-copy males, which reflects the complex biological nature of DDX3X mutations.

The incidence, diagnostic clinical manifestations and severity of juvenile systemic lupus erythematosus in New Zealand Maori and Pacific Island children: The Starship experience (2000−2010)

Objectives

To describe the incidence, diagnostic clinical manifestations and severity of juvenile systemic lupus erythematosus (jSLE) in a cohort of New Zealand Maori and Pacific Island children compared to European children.

Methods

A chart review was conducted of children with jSLE seen by the Starship paediatric rheumatology and/or renal services between January 2000 and November 2010. Diagnostic clinical data and lupus nephritis data at anytime were collated while classic British Isles Lupus Assessment Group (BILAG) and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores were derived retrospectively.

Results

Thirty-two children were diagnosed with jSLE with an annual incidence of 0.52 per 100,000 per year. Compared with European children (0.31 per 100,000 per year) the incidence of jSLE was higher among Maori and Pacific (0.67 per 100,000 per year, p = 0.06) and significantly higher among Asian children (1.17 per 100,000 per year, p = 0.01). Compared with European children, Maori and Pacific children were more frequently diagnosed with lupus nephritis (80% vs 40%, p = 0.09) and severe (WHO class 4 or 5) renal lesions (60% vs 40%, p = 0.43) at presentation. Similarly, at any time during the study, lupus nephritis (100% vs 40%, p = 0.001) and severe (WHO class 4 or 5) renal lesions (73.3% vs 40%, p = 0.12) were more frequent among Maori and Pacific compared with European children. Furthermore, retrospective BILAG assessment of diagnostic disease severity demonstrated that Maori and Pacific children experienced the majority of severe “Category A” disease (56.8% vs 22.7%, p = 0.17) which was predominantly renal (73.3% vs 40%, p = 0.12) in nature.

Conclusions

This is the first description of the incidence and clinical manifestations of jSLE in a cohort of New Zealand children. Although limited by the small numbers involved it confirmed anecdotal suspicions that the incidence of jSLE among Maori, Pacific and Asian children is higher than European children. Lupus nephritis is also more frequent and severe in Maori and Pacific children.

Consideration of the degree of increase in urine metadrenalines provides superior specificity in the diagnosis of phaeochromocytoma than additional urine catecholamine measurement

Background

Measurement of fractionated plasma or urine metadrenalines is the recommended screening test in the diagnosis of phaeochromocytoma, with clinical cut-offs geared towards diagnostic sensitivity. Current practice at Salford Royal Hospital is to add urine catecholamines onto samples with raised urine metadrenalines, with the aim of adding specificity to a diagnosis of phaeochromocytoma.

Methods

This practice was reviewed by identifying a series of patients with raised urine metadrenalines who had catecholamines reflectively added. A total of 358 samples were identified from 242 patients, of which 228 had urine catecholamines measured.

Results

A diagnosis of ‘phaeochromocytoma‘ (n = 41) or ‘no phaeochromocytoma‘ (n = 90) was obtained in 131 of 228 patients, giving raised urine metadrenalines a positive predictive value for phaeochromocytoma of 31%. The finding of increased urine catecholamines in samples with raised urine metadrenalines increased specificity for phaeochromocytoma to 70%. However, 95% diagnostic specificity for phaeochromocytoma could be achieved by the introduction of a second cut-off for urine metadrenalines geared towards maximizing specificity.

Conclusions

Consideration of the degree of increase in urine metadrenalines is a superior method of determining the likelihood of phaeochromocytoma than measurement of urine catecholamines.

Borg: an auto-adaptive many-objective evolutionary computing framework

This study introduces the Borg multi-objective evolutionary algorithm (MOEA) for many-objective, multimodal optimization. The Borg MOEA combines ε-dominance, a measure of convergence speed named ε-progress, randomized restarts, and auto-adaptive multioperator recombination into a unified optimization framework. A comparative study on 33 instances of 18 test problems from the DTLZ, WFG, and CEC 2009 test suites demonstrates Borg meets or exceeds six state of the art MOEAs on the majority of the tested problems. The performance for each test problem is evaluated using a 1,000 point Latin hypercube sampling of each algorithm's feasible parameterization space. The statistical performance of every sampled MOEA parameterization is evaluated using 50 replicate random seed trials. The Borg MOEA is not a single algorithm; instead it represents a class of algorithms whose operators are adaptively selected based on the problem. The adaptive discovery of key operators is of particular importance for benchmarking how variation operators enhance search for complex many-objective problems.

Diagnostic assessment of search controls and failure modes in many-objective evolutionary optimization

The growing popularity of multiobjective evolutionary algorithms (MOEAs) for solving many-objective problems warrants the careful investigation of their search controls and failure modes. This study contributes a new diagnostic assessment framework for rigorously evaluating the effectiveness, reliability, efficiency, and controllability of MOEAs as well as identifying their search controls and failure modes. The framework is demonstrated using the recently introduced Borg MOEA, [Formula: see text]-NSGA-II, [Formula: see text]-MOEA, IBEA, OMOPSO, GDE3, MOEA/D, SPEA2, and NSGA-II on 33 instances of 18 test problems from the DTLZ, WFG, and CEC 2009 test suites. The diagnostic framework exploits Sobol's variance decomposition to provide guidance on the algorithms' non-separable, multi-parameter controls when performing a many-objective search. This study represents one of the most comprehensive empirical assessments of MOEAs ever completed.

Comparison of conditioning impairments in children with Down syndrome, autistic spectrum disorders and mental age-matched controls

BACKGROUND

This study investigated the relative ease of learning across four tasks suggested by an adaptation of Thomas's hierarchy of learning in children with Down syndrome, autism spectrum disorders and mental age-matched controls.

METHODS

Learning trials were carried out to investigate observational learning, instrumental learning, reversal learning and conditional discrimination.

RESULTS

The sample with autism spectrum disorders performed worse than the other two groups on the observational learning and conditional discrimination tasks, while the Down syndrome sample performed worse on the instrumental learning task.

CONCLUSIONS

These findings are discussed in terms of there implications for reward-based educational intervention programmes.

Multiple determinants of the effects of reinforcement magnitude on free-operant response rates

Four experiments examined the effects of increasing the number of food pellets given to hungry rats for a lever-press response. On a simple variable-interval 60-s schedule, increased number of pellets depressed response rates (Experiment 1). In Experiment 2, the decrease in response rate as a function of increased reinforcement magnitude was demonstrated on a variable-interval 30-s schedule, but enhanced rates of response were obtained with the same increase in reinforcement magnitude on a variable-ratio 30 schedule. In Experiment 3, higher rates of responding were maintained by the component of a concurrent variable-interval 60-s variable-interval 60-s schedule associated with a higher reinforcement magnitude. In Experiment 4, higher rates of response were produced in the component of a multiple variable-interval 60-s variable-interval 60-s schedule associated with the higher reinforcement magnitude. It is suggested that on simple schedules greater reinforcer magnitudes shape the reinforced pattern of responding more effectively than do smaller reinforcement magnitudes. This effect is, however, overridden by another process, such a contrast, when two magnitudes are presented within a single session on two-component schedules.

Effects of magnitude of food reinforcement on free-operant response rates

In Experiment 1 rats were trained to press a lever on a variable-ratio schedule of food presentation and were then exposed to progressively increasing magnitudes of food reinforcement. Response running rates (rates exclusive of the postreinforcement pause) were found to increase as a function of increasing reinforcement magnitudes. The effect of reinforcement magnitude on response rates inclusive of the postreinforcement pause, however, was less pronounced. Increases in the magnitude of reinforcement were also found to increase the length of the postreinforcement pause. Rats in Experiment 2 were trained to respond on a chained differential-reinforcement-of-low-rate variable-ratio schedule, and were exposed to increasing magnitudes of reinforcement as in Experiment 1. Response running rates increased in the variable-ratio component but decreased in the other component of the schedule. The results are discussed with reference to incentive accounts of reinforcement and the action of reinforcement on the response units generated by the operative contingencies.

Sarcolemmal reorganization in facioscapulohumeral muscular dystrophy

OBJECTIVE

We examined the sarcolemma of skeletal muscle from patients with facioscapulohumeral muscular dystrophy (FSHD1A) to learn if, as in other murine and human muscular dystrophies, its organization and relationship to nearby contractile structures are altered.

METHODS

Unfixed biopsies of control and FSHD deltoid and biceps muscles, snap-frozen at resting length, were cryosectioned, indirectly immunolabeled with fluorescent antibodies to sarcolemmal and myofibrillar markers, and examined with confocal microscopy to localize the immunolabeled proteins. Glutaraldehyde-fixed samples were stained with heavy metals, embedded, thin-sectioned, and examined with electron microscopy to determine the relationship between the sarcolemma and the underlying myofibrils.

RESULTS

Confocal microscopy showed that some of the structures at the sarcolemma in FSHD samples were misaligned with respect to the underlying contractile apparatus. Electron microscopy showed a significant increase in the distance between the sarcolemma and the nearest myofibrils, from less than 100 nm in controls to values as high as 550 nm in FSHD.

INTERPRETATION

Our results show that the pathophysiology of FSHD includes novel changes in the organization of the sarcolemma and its association with nearby contractile structures and suggest that, as in other muscular dystrophies, the integrity of the sarcolemma may be compromised in FSHD.

Postnatal changes in sarcolemmal organization in the mdx mouse

The tibialis anterior muscles of mdx mice degenerate between 3 and 4 weeks after birth and then partially recover. We show that the membrane cytoskeleton at the mdx sarcolemma is disorganized at 18-days postnatal, and becomes more disorganized at 4 weeks compared to earlier or later times. Mdx muscle at 18 days have few central nuclei, suggesting that it has not yet sustained significant damage. The variance of myofiber diameter confirms that the mdx pathology is greatest at 4 weeks, when the sarcolemma is most disorganized. Sarcolemmal disorganization in the mdx does not involve contractile structures, nor is it seen in age-matched controls. In revertant mdx fibers expressing dystrophin, sarcolemmal organization is similar to controls. Our results suggest that the absence of dystrophin results in the disorganization of the sarcolemma, even in 18-day-old mice, and that the extent of disorganization is greater when the myopathy is most severe.

Solutions to stabilisation issues

Proteins employed as diagnostic agents must be kept stable to maintain their structure and viability. Multiple strategies to address stabilisation issues are presented here.

Anti-Vpr activity of a yeast chaperone protein

Human immunodeficiency virus type 1 (HIV-1) viral protein R (Vpr) exerts multiple effects on viral and host cellular activities during viral infection, including nuclear transport of the proviral integration complex, induction of cell cycle G(2) arrest, and cell death. In this report, we show that a fission yeast chaperone protein Hsp16 inhibits HIV-1 by suppressing these Vpr activities. This protein was identified through three independent genome-wide screens for multicopy suppressors of each of the three Vpr activities. Consistent with the properties of a heat shock protein, heat shock-induced elevation or overproduction of Hsp16 suppressed Vpr activities through direct protein-protein interaction. Even though Hsp16 shows a stronger suppressive effect on Vpr in fission yeast than in mammalian cells, similar effects were also observed in human cells when fission yeast hsp16 was expressed either in vpr-expressing cells or during HIV-1 infection, indicating a possible highly conserved Vpr suppressing activity. Furthermore, stable expression of hsp16 prior to HIV-1 infection inhibits viral replication in a Vpr-dependent manner. Together, these data suggest that Hsp16 inhibits HIV-1 by suppressing Vpr-specific activities. This finding could potentially provide a new approach to studying the contribution of Vpr to viral pathogenesis and to reducing Vpr-mediated detrimental effects in HIV-infected patients.

Adrenocorticotropic hormone directly stimulates testosterone production by the fetal and neonatal mouse testis

Adult Leydig cell steroidogenesis is dependent on LH but fetal Leydig cells can function independently of gonadotropin stimulation. To identify factors that may be involved in regulation of fetal Leydig cells expressed sequence tag libraries from fetal and adult testes were compared, and fetal-specific genes identified. The ACTH receptor [melanocortin type 2 receptor (Mc2r)] was identified within this fetal-specific group. Subsequent real-time PCR studies confirmed that Mc2r was expressed in the fetal testis at 100-fold higher levels than in the adult testis. Incubation of fetal or neonatal testes with ACTH in vitro stimulated testosterone production more than 10-fold, although ACTH had no effect on testes from animals aged 20 d or older. The steroidogenic response of fetal and neonatal testes to a maximally stimulating dose of human chorionic gonadotropin was similar to the response shown to ACTH. The ED(50) for ACTH, measured in isolated fetal and neonatal testicular cells, was 5 x 10(-10) M and the lowest dose of ACTH eliciting a response was 2 x 10(-11) M. Circulating ACTH levels in fetal mice were around 8 x 10(-11) M. Neither alpha-MSH nor gamma-MSH had any effect on androgen production in vitro at any age. Fetal testosterone levels were normal in mice that lack circulating ACTH (proopiomelanocortin-null) indicating that ACTH is not essential for fetal Leydig cell function. Results show that both LH and ACTH can regulate testicular steroidogenesis during fetal development in the mouse and suggest that fetal Leydig cells, but not adult Leydig cells, are sensitive to ACTH stimulation.

Novel association suggests multiple independent QTLs within chromosome 5q21-33 region control variation in total humans IgE levels

Asthma is a common, heterogeneous, complex disease accompanied by raised total and specific immunoglobulin-E (IgE) antibody levels. Despite numerous previous reports of linkage and association of asthma, atopy and serum IgE levels to genes within the 5q21-33 region, definitive, replicable results are still not available. We used the classical twin design to (i) estimate the relative contributions of genes and environment to variation in total IgE levels, (ii) assess genetic linkage, and (iii) examine allelic association of 11 microsatellite markers spanning the 5q21-33 region to total IgE. Variation in total IgE level was shown to be highly heritable (65%). Although evidence for linkage of the 11 microsatellites to IgE was not observed, the omnibus test of association, not confounded by population substructure, showed positive association of D5S393 and D5S673 to IgE. Genes in the vicinity of D5S673 include hepatitis A virus receptor (HAVCR-1) and IL-12B. Recently, the mouse orthologue of HAVCR-1, the T-cell membrane family of proteins, have been shown to be in strong association with expression of airway hyperactivity in a mouse model of human asthma and atopy. IL-12B subserves many proinflammatory functions and also induces B cells proliferation.

Costameres: repeating structures at the sarcolemma of skeletal muscle

Costameres, structures at the plasma membrane of skeletal muscle, are present in a rectilinear array that parallels the organization of the underlying contractile apparatus. Costameres have three major functions: to keep the plasma membrane, or sarcolemma, aligned and in register with nearby contractile structures; to protect the sarcolemma against contraction-induced damage; and to transmit some of the forces of contraction laterally, to the extracellular matrix. These functions require that costameres link the contractile apparatus through the membrane to the extracellular matrix. Mutations to key components of costameres cause these structures to lose their rectilinear organization and can result in muscle weakness or death. This article summarizes the evidence that costameres are composed of large complexes of integral and peripheral membrane proteins that are linked to the contractile apparatus by intermediate filaments and to the extracellular matrix by laminin. They also present evidence that costameres are altered when key costameric components are missing, as in a murine form of muscular dystrophy.

Linkage and association for bone mineral density and heel ultrasound measurements with a simple tandem repeat polymorphism near the osteocalcin gene in female dizygotic twins

In this confirmatory candidate gene study, we investigated possible linkage and association for bone density, heel ultrasound and bone turnover with the osteocalcin gene using the nearby (50-180kb) microsatellite marker D1S3737. Non-identical twin sisters aged 18-75 years at first interview were recruited for the study from the St Thomas' UK Adult Twin Registry with 1366 women being genotyped for marker D1S3737. Linkage, allelic association and joint linkage and association tests were carried out using quantitative transmission disequilibrium tests (QTDT), along with post-hoc multivariate tests of linkage and association. Phenotypes tested were bone mineral density (BMD) at the spine, left forearm and left total hip; quantitative ultrasound measurements of the heel including velocity of ultrasound (VOS) and broadband ultrasound attenuation (BUA); and bone turnover markers, urine deoxypyridinoline (DPD), serum osteocalcin, bone specific and total alkaline phosphatase (ALP). BMD and ultrasound variables showed evidence of pleiotropic linkage ( p = 0.05) and association ( p = 0.02) with the marker in postmenopausal women. Bone markers showed little or no evidence of linkage and association for any age group. Evidence for pleiotropic linkage appeared to be strongest for BUA and spine BMD in postmenopausal women. The univariate test statistic for BUA was chi(2)(1)=12.8 ( p = 0.0003), equivalent to a LOD score of 2.8. DPD showed borderline evidence of linkage to the marker for women of all ages. Multivariate model-fitting showed allele 10 to be negatively associated with BMD, VOS and BUA via a common pathway, suggesting the putative functional polymorphism affects both bone content and structure through shared underlying metabolic pathways. It is likely that the alleles are in linkage disequilibrium with functional polymorphism(s) in or nearby the osteocalcin gene, which may contribute to the onset of osteoporosis.

IBD sharing around the PPARG locus is not increased in dizygotic twins or their mothers

Busjahn et al reported finding linkage between PPARG (3p25) and being a dizygotic (DZ) twin. We differentiate, as do the authors, between the conception of DZ twins, and being the viable result of such a conception.

Schedules of reinforcement as determinants of human causality judgments and response rates

Experiments examined the effect of relationships between a response and an outcome on human judgments of causal effectiveness. In Experiment 1, the time between outcomes obtained on a variable ratio (VR) schedule became the intervals for a yoked variable interval (VI) schedule. Response rates were higher on the VR than on the VI schedule. In Experiment 2, the number of responses required per outcome on a VR schedule were matched to that on a master VI 20-s schedule. Both ratings of causal effectiveness and response rates were higher in the VR schedule. In Experiment 3, tandem VI fixed-ratio (FR) schedules produced higher rates and judgments than equivalent conjunctive VI FR schedule. In Experiment 4, a VI schedule with a reinforcement requirement for a short interresponse time (IRT) produced higher rates and judgments than a simple VI schedule. These results corroborate the view that schedules are a determinant of both response rates and causal judgments. Few current theories of causal judgment predict this pattern of results.

Treatment of newly-diagnosed acute promyelocytic leukemia with liposomal all-trans retinoic acid

It has been postulated that recurrence of disease in some patients with newly-diagnosed APL induced into CR, and subsequently maintained, with single agent oral ATRA results from the decline in ATRA levels that occurs with repeated dosing. Administration of liposomal ATRA (lipoATRA) circumvents, for perhaps several months, the decrease in ATRA levels and produces CRs in patients with relapsed APL. These findings led us to administer lipoATRA "monotherapy" to patients with newly-diagnosed APL. Patients received lipoATRA (90 mg/m2) for induction and continued to receive the drug, by itself, for 9 months unless 2 PCR tests done within 2-4 weeks of each other at a sensitivity level of 10(-4) were positive at 3 or 6 months from CR date, in which case idarubicin was added to lipoATRA. If the PCR test was negative 9 months from CR date, treatment stopped. 34 patients were enrolled, of whom 79% entered CR. The PCR test at time of CR was positive in 23/24 patients, but was negative in 24/26 (92%) 3 months later. Of most interest 11 of the 26 evaluable responding patients have remained PCR negative (tested Q 3 months) with a median follow-up of 18 months (range up to 34 months). It is generally believed that this type of result would be unlikely with oral ATRA monotherapy. Recurrence of morphologic APL has occurred in 4 patients, at 5, 6, 12, and 12 months, with a median follow-up time of 18 months in the patients remaining alive in CR. Comparison of this lipoATRA +/- idarubicin trial with oral ATRA + idarubicin induction and idarubicin + POMP maintenance, our previous trial, indicates similar survival, CR, and DFS in CR rates, with a suggestion that lipoATRA may produce lower CR rates and hence shorter survival in patients with high-risk disease (wbc count > 10,000/microliter. Nonetheless, the rates and duration of PCR negativity produced by lipoATRA monotherapy suggest that lipoATRA is a superior anti-APL agent than oral ATRA.

Development and validation of the pharmaceutical care satisfaction questionnaire

The development and validation of a survey instrument to assess consumer satisfaction with pharmacy services is discussed. The Pharmaceutical Care Satisfaction Questionnaire (PCSQ) is a 30-item instrument administered by someone other than the pharmacist that uses a Likert scale to score respondents' answers. The PCSQ is written approximately at a seventh grade reading level. Following initial development, the PCSQ was administered to 360 consumers in ambulatory pharmacies and to 311 patients in a multicenter hyperlipidemia outcomes study. The Cronbach coefficient alpha was .94 for the consumer data, with a 64.8% variance accounted for by the 4-factor solution. A coefficient alpha of .84 was found on all 30 items in the hyperlipidemia study, with a variance of 63.78% in control patients and 60.16% in treatment patients. The PCSQ is easy to administer and score, with minimal cost. Unlike other satisfaction surveys, the PCSQ contains patient evaluations regarding outcomes of care. A primary limitation of the PCSQ is that it is a newly developed instrument that needs to be used in more studies to strengthen its validity.

Interference with judgements of control and learning as a result of prior exposure to controllable and uncontrollable feedback during concept-learning tasks

Two experiments examined whether exposure to an uncontrollable relationship between an action and its outcome during a nonaversive pretreatment phase would attenuate subsequent ratings of control given to actions emitted by subjects. In Experiment 1, such an interference effect was demonstrated relative to a group that received prior training with a controllable action-outcome relationship, and relative to a group not exposed to any prior relationship. In Experiment 2, these effects were replicated, and interference was also found to occur when learning a maze task. Thus, the effects of helplessness were shown to be quite general, to be produced by a nonaversive induction procedure, and to occur most readily when the current contingency between action and outcome was weakest.