| 1. |
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| 2. |
- Ruilope, LM, et al.
(author)
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Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
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In: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
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Journal article (peer-reviewed)abstract
- <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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| 3. |
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| 4. |
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| 5. |
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| 6. |
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| 7. |
- Tedersoo, Leho, et al.
(author)
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Global patterns in endemicity and vulnerability of soil fungi.
- 2022
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In: Global change biology. - : Wiley. - 1365-2486 .- 1354-1013. ; 28:22, s. 6696-6710
-
Journal article (peer-reviewed)abstract
- Fungi are highly diverse organisms, which provide multiple ecosystem services. However, compared with charismatic animals and plants, the distribution patterns and conservation needs of fungi have been little explored. Here, we examined endemicity patterns, global change vulnerability and conservation priority areas for functional groups of soil fungi based on six global surveys using a high-resolution, long-read metabarcoding approach. We found that the endemicity of all fungi and most functional groups peaks in tropical habitats, including Amazonia, Yucatan, West-Central Africa, Sri Lanka, and New Caledonia, with a negligible island effect compared with plants and animals. We also found that fungi are predominantly vulnerable to drought, heat and land-cover change, particularly in dry tropical regions with high human population density. Fungal conservation areas of highest priority include herbaceous wetlands, tropical forests, and woodlands. We stress that more attention should be focused on the conservation of fungi, especially root symbiotic arbuscular mycorrhizal and ectomycorrhizal fungi in tropical regions as well as unicellular early-diverging groups and macrofungi in general. Given the low overlap between the endemicity of fungi and macroorganisms, but high conservation needs in both groups, detailed analyses on distribution and conservation requirements are warranted for other microorganisms and soil organisms.
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| 8. |
- Abbott, Benjamin W., et al.
(author)
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Biomass offsets little or none of permafrost carbon release from soils, streams, and wildfire : an expert assessment
- 2016
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In: Environmental Research Letters. - : IOP Publishing. - 1748-9326. ; 11:3
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Journal article (peer-reviewed)abstract
- As the permafrost region warms, its large organic carbon pool will be increasingly vulnerable to decomposition, combustion, and hydrologic export. Models predict that some portion of this release will be offset by increased production of Arctic and boreal biomass; however, the lack of robust estimates of net carbon balance increases the risk of further overshooting international emissions targets. Precise empirical or model-based assessments of the critical factors driving carbon balance are unlikely in the near future, so to address this gap, we present estimates from 98 permafrost-region experts of the response of biomass, wildfire, and hydrologic carbon flux to climate change. Results suggest that contrary to model projections, total permafrost-region biomass could decrease due to water stress and disturbance, factors that are not adequately incorporated in current models. Assessments indicate that end-of-the-century organic carbon release from Arctic rivers and collapsing coastlines could increase by 75% while carbon loss via burning could increase four-fold. Experts identified water balance, shifts in vegetation community, and permafrost degradation as the key sources of uncertainty in predicting future system response. In combination with previous findings, results suggest the permafrost region will become a carbon source to the atmosphere by 2100 regardless of warming scenario but that 65%-85% of permafrost carbon release can still be avoided if human emissions are actively reduced.
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| 9. |
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| 10. |
- Plue, Jan, et al.
(author)
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European soil seed bank communities across a climate and land-cover gradient
- 2020
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Other publicationabstract
- This is the data set used for the publication Buffering effects of soil seed banks on plant community composition in response to land use and climate, published in the journal Global Ecology and Biogeography.Aim.Climate and land use are key determinants of biodiversity, with past and ongoing changes posing serious threats to global ecosystems. Unlike most other organism groups, plant species can possess dormant life-history stages such as soil seed banks, which may help plant communities to resist or at least postpone the detrimental impact of global changes. This study investigates the potential for soil seed banks to achieve this.Location. EuropeTime period. 1978 – 2014Major taxa studied. Flowering plantsMethods.Using a space-for-time/warming approach, we study plant species richness and composition in the herb layer and the soil seed bank in 2796 community plots from 54 datasets in managed grasslands, forests and intermediate, successional habitats across a climate gradient.Results.Soil seed banks held more species than the herb layer, being compositionally similar across habitats. Species richness was lower in forests and successional habitats compared to grasslands, with annual temperature range more important than mean annual temperature for determining richness. Climate and land use effects were generally less pronounced when plant community richness included seed bank species richness, while there was no clear effect of land use and climate on compositional similarity between the seed bank and the herb layer.Main conclusions.High seed bank diversity and compositional similarity between the herb layer and seed bank plant communities may provide a potentially important functional buffer against the impact of ongoing environmental changes on plant communities. This capacity could, however, be threatened by climate warming. Dormant life-history stages can therefore be important sources of diversity in changing environments, potentially underpinning already observed time-lags in plant community responses to global change. However, as soil seed banks themselves appear, albeit less, vulnerable to the same changes, their potential to buffer change can only be temporary, and major community shifts may still be expected.MethodsThis dataset is a collection of 41 published and 5 unpublished data sets, consisting of 2796 plots with corresponding seed bank and herb layer community data. Sampling effort varied across data sets, but involved sampling of the soil and subsequent germination trials in a greenhouse to determine seed bank composition. Herb layer communities were determined by the identification of plants in relevés. Please consult the readme file and published paper for further details.Usage NotesPlease contact database or individual data set authors for further information and collaboration when using the data set or any of its component parts. Please also note that some of these data sets have already been published alongside their orginal papers. Finally, please cite data and datasets according to community standards.
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| 11. |
- Ronchi, E., et al.
(author)
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The verification of wildland–urban interface fire evacuation models
- 2023
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In: Natural Hazards. - : Springer Science and Business Media LLC. - 0921-030X .- 1573-0840. ; 117:2, s. 1493-1519
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Journal article (peer-reviewed)abstract
- This paper introduces a protocol for the verification of multi-physics wildfire evacuation models, including a set of tests used to ensure that the conceptual modelling representation of each modelling layer is accurately implemented, as well as the interactions between different modelling layers and sub-models (wildfire spread, pedestrian movement, traffic evacuation, and trigger buffers). This work presents a total of 24 verification tests, including (1) 4 tests related to pedestrians, (2) 15 tests for traffic evacuation, (3) 5 tests concerning the interaction between different modelling layers, along with 5 tests for wildfire spread and trigger buffers. The evacuation tests are organized in accordance with different core components related to evacuation modelling, namely Population, Pre-evacuation, Movement, Route/destination selection, Flow constraints, Events, Wildfire spread and Trigger buffers. A reporting template has also been developed to facilitate the application of the verification testing protocol. An example application of the testing protocol has been performed using an open wildfire evacuation modelling platform called WUI-NITY and its associated trigger buffer model k-PERIL. The verification testing protocol is deemed to improve the credibility of wildfire evacuation model results and stimulate future modelling efforts in this domain.
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| 12. |
- Auffret, Alistair G., et al.
(author)
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More warm-adapted species in soil seed banks than in herb layer plant communities across Europe
- 2023
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In: Journal of Ecology. - : John Wiley & Sons. - 0022-0477 .- 1365-2745. ; 111:5, s. 1009-1020
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Journal article (peer-reviewed)abstract
- Responses to climate change have often been found to lag behind the rate of warming that has occurred. In addition to dispersal limitation potentially restricting spread at leading range margins, the persistence of species in new and unsuitable conditions is thought to be responsible for apparent time-lags. Soil seed banks can allow plant communities to temporarily buffer unsuitable environmental conditions, but their potential to slow responses to long-term climate change is largely unknown. As local forest cover can also buffer the effects of a warming climate, it is important to understand how seed banks might interact with land cover to mediate community responses to climate change. We first related species-level seed bank persistence and distribution-derived climatic niches for 840 plant species. We then used a database of plant community data from grasslands, forests and intermediate successional habitats from across Europe to investigate relationships between seed banks and their corresponding herb layers in 2763 plots in the context of climate and land cover. We found that species from warmer climates and with broader distributions are more likely to have a higher seed bank persistence, resulting in seed banks that are composed of species with warmer and broader climatic distributions than their corresponding herb layers. This was consistent across our climatic extent, with larger differences (seed banks from even warmer climates relative to vegetation) found in grasslands. Synthesis. Seed banks have been shown to buffer plant communities through periods of environmental variability, and in a period of climate change might be expected to contain species reflecting past, cooler conditions. Here, we show that persistent seed banks often contain species with relatively warm climatic niches and those with wide climatic ranges. Although these patterns may not be primarily driven by species’ climatic adaptations, the prominence of such species in seed banks might still facilitate climate-driven community shifts. Additionally, seed banks may be related to ongoing trends regarding the spread of widespread generalist species into natural habitats, while cool-associated species may be at risk from both short- and long-term climatic variability and change.
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| 13. |
- Axelsson, Magnus A. B., et al.
(author)
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Deglycosylation by gaseous hydrogen fluoride of mucus glycoproteins immobilized on nylon membranes and in microtiter wells.
- 1998
-
In: Glycoconjugate journal. - 0282-0080. ; 15:8, s. 749-55
-
Journal article (peer-reviewed)abstract
- Strongly reacting antibodies specific for defined mucin gene products are often directed against the mucin protein backbone of the heavily glycosylated serine/threonine rich regions. A prerequisite for the use of such antibodies is often the complete removal of the oligosaccharides from the protein. This paper describes an efficient one-step deglycosylation method using gaseous hydrogen fluoride on nylon blotting membranes and microtiter wells.
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| 14. |
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| 15. |
- Hagert, E, et al.
(author)
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The role of proprioception and neuromuscular stability in carpal instabilities
- 2016
-
In: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:1, s. 94-101
-
Journal article (peer-reviewed)abstract
- Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities.
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| 16. |
- Kuligowski, E., et al.
(author)
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Evacuation modelling for bushfire : the WUI-NITY simulation platform
- 2022
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In: Australian Journal of Emergency Management. - 1324-1540. ; 37:4, s. 40-43
-
Journal article (peer-reviewed)abstract
- The number of people who live in bushfire-prone areas around the world is growing. In Australia, in the states of Victoria and New South Wales, over 1.5 million people live in areas rated as high to extreme bushfire risk in (SGS Economics and Planning 2019). As effects of climate change increase the size and severity of bushfires, and a greater number of people move into these at-risk areas, there is a growing imperative to understand the likely evacuation outcomes of bushfireprone communities under various fire scenarios. This paper introduces a freely available simulation platform called WUI-NITY that can be used by evacuation planners and decisionmakers to forecast evacuation behaviour within affected areas, and in turn, better prepare for and respond to future bushfire events.
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| 17. |
- Nilsson, R. Henrik, 1976, et al.
(author)
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Improving ITS sequence data for identification of plant pathogenic fungi
- 2014
-
In: Fungal Diversity. - : Springer Science and Business Media LLC. - 1560-2745 .- 1878-9129. ; 67:1, s. 11-19
-
Journal article (peer-reviewed)abstract
- Plant pathogenic fungi are a large and diverse assemblage of eukaryotes with substantial impacts on natural ecosystems and human endeavours. These taxa often have complex and poorly understood life cycles, lack observable, discriminatory morphological characters, and may not be amenable to in vitro culturing. As a result, species identification is frequently difficult. Molecular (DNA sequence) data have emerged as crucial information for the taxonomic identification of plant pathogenic fungi, with the nuclear ribosomal internal transcribed spacer (ITS) region being the most popular marker. However, international nucleotide sequence databases are accumulating numerous sequences of compromised or low-resolution taxonomic annotations and substandard technical quality, making their use in the molecular identification of plant pathogenic fungi problematic. Here we report on a concerted effort to identify high-quality reference sequences for various plant pathogenic fungi and to re-annotate incorrectly or insufficiently annotated public ITS sequences from these fungal lineages. A third objective was to enrich the sequences with geographical and ecological metadata. The results – a total of 31,954 changes – are incorporated in and made available through the UNITE database for molecular identification of fungi (http://unite.ut.ee), including standalone FASTA files of sequence data for local BLAST searches, use in the next-generation sequencing analysis platforms QIIME and mothur, and related applications. The present initiative is just a beginning to cover the wide spectrum of plant pathogenic fungi, and we invite all researchers with pertinent expertise to join the annotation effort.
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| 18. |
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| 19. |
- Plue, Jan, et al.
(author)
-
Buffering effects of soil seed banks on plant community composition in response to land use and climate
- 2020
-
In: Global Ecology and Biogeography. - : Wiley. - 1466-822X .- 1466-8238. ; 30:1, s. 128-139
-
Journal article (peer-reviewed)abstract
- AimClimate and land use are key determinants of biodiversity, with past and ongoing changes posing serious threats to global ecosystems. Unlike most other organism groups, plant species can possess dormant life‐history stages such as soil seed banks, which may help plant communities to resist or at least postpone the detrimental impact of global changes. This study investigates the potential for soil seed banks to achieve this.Location Europe.Time period 1978–2014.Major taxa studied Flowering plantsMethodsUsing a space‐for‐time/warming approach, we study plant species richness and composition in the herb layer and the soil seed bank in 2,796 community plots from 54 datasets in managed grasslands, forests and intermediate, successional habitats across a climate gradient.ResultsSoil seed banks held more species than the herb layer, being compositionally similar across habitats. Species richness was lower in forests and successional habitats compared to grasslands, with annual temperature range more important than mean annual temperature for determining richness. Climate and land‐use effects were generally less pronounced when plant community richness included seed bank species richness, while there was no clear effect of land use and climate on compositional similarity between the seed bank and the herb layer.Main conclusionsHigh seed bank diversity and compositional similarity between the herb layer and seed bank plant communities may provide a potentially important functional buffer against the impact of ongoing environmental changes on plant communities. This capacity could, however, be threatened by climate warming. Dormant life‐history stages can therefore be important sources of diversity in changing environments, potentially underpinning already observed time‐lags in plant community responses to global change. However, as soil seed banks themselves appear, albeit less, vulnerable to the same changes, their potential to buffer change can only be temporary, and major community shifts may still be expected.
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| 20. |
- Posthuma, Rein, et al.
(author)
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Recent advances in bronchoscopic lung volume reduction for severe COPD patients
- 2023
-
In: CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE. - 1751-4258 .- 1751-4266. ; 17:4, s. 296-300
-
Journal article (peer-reviewed)abstract
- Purpose of review Bronchoscopic lung volume reduction (BLVR) is a novel and effective treatment for a specific phenotype of chronic obstructive pulmonary disease (COPD) characterized by advanced emphysema with static lung hyperinflation and severe breathlessness. This review aims to provide an overview of the recent advances made in BLVR.For achieving optimal outcomes with BLVR, patient selection and target lobe identification is crucial. BLVR has recently also been established to improve pulmonary function, exercise capacity and quality of life in COPD patients falling outside the standard treatment criteria, including patients with moderate hyperinflation, chronic hypercapnic failure or with very low diffusion capacity. In a cluster analysis, target lobe characteristics like emphysema destruction, air trapping and perfusion were found to be important discriminators between responders and non-responders. A potential survival benefit has been demonstrated in BLVR-treated patients when compared to non-treated patients. Long-term outcomes showed sustained outcomes of BLVR; however, effects decline over time, probably due to disease progression.BLVR using one-way endobronchial valves has become a guideline treatment offered in specialized intervention centres for a specific subgroup of COPD patients. Recent studies further characterize responders, describe extrapulmonary effects of BLVR and show positive long-term outcomes and a potential survival benefit.R. Posthuma is supported by the Lung Foundation Netherlands, grant number: 5.1.17.171.0.There are no conflicts of interest.Patients with chronic obstructive pulmonary disease (COPD) suffer from respiratory symptoms and reduced quality of life due to destruction and/or inflammation of the airways and alveoli, leading to airflow limitation1. Despite pharmacological and non-pharmacological therapies, patients with advanced COPD often remain highly symptomatic with debilitating breathlessness and reduced exercise capacity. In the last decade, bronchoscopic lung volume reduction (BLVR) emerged as an effective intervention in a carefully selected subgroup of COPD patients characterized by severe emphysema, static lung hyperinflation and breathlessness. In Patel et al.'s2 systematic review and meta-analysis, consistent results on improving pulmonary function, exercise capacity and health-related quality of life were demonstrated. Different techniques exist to reduce hyperinflation bronchoscopically, and while vapour ablation, sealants and coils are available and being researched, the currently most widely implemented are one-way endobronchial valves (EBVs), which have progressed from experimental therapy to standard of care1,3. BLVR is still a relatively novel technique in full development and has only recently been upgraded to the highest level of evidence in the Global Initiative for Chronic Obstructive Lung Disease 2023 report1.In this narrative review, we present the most recent developments in BLVR using EBV, focussing on primary research describing patient selection, (long-term) outcomes and extrapulmonary effects.Purpose of review Bronchoscopic lung volume reduction (BLVR) is a novel and effective treatment for a specific phenotype of chronic obstructive pulmonary disease (COPD) characterized by advanced emphysema with static lung hyperinflation and severe breathlessness. This review aims to provide an overview of the recent advances made in BLVR.For achieving optimal outcomes with BLVR, patient selection and target lobe identification is crucial. BLVR has recently also been established to improve pulmonary function, exercise capacity and quality of life in COPD patients falling outside the standard treatment criteria, including patients with moderate hyperinflation, chronic hypercapnic failure or with very low diffusion capacity. In a cluster analysis, target lobe characteristics like emphysema destruction, air trapping and perfusion were found to be important discriminators between responders and non-responders. A potential survival benefit has been demonstrated in BLVR-treated patients when compared to non-treated patients. Long-term outcomes showed sustained outcomes of BLVR; however, effects decline over time, probably due to disease progression.BLVR using one-way endobronchial valves has become a guideline treatment offered in specialized intervention centres for a specific subgroup of COPD patients. Recent studies further characterize responders, describe extrapulmonary effects of BLVR and show positive long-term outcomes and a potential survival benefit.R. Posthuma is supported by the Lung Foundation Netherlands, grant number: 5.1.17.171.0.There are no conflicts of interest.Patients with chronic obstructive pulmonary disease (COPD) suffer from respiratory symptoms and reduced quality of life due to destruction and/or inflammation of the airways and alveoli, leading to airflow limitation1. Despite pharmacological and non-pharmacological therapies, patients with advanced COPD often remain highly symptomatic with debilitating breathlessness and reduced exercise capacity. In the last decade, bronchoscopic lung volume reduction (BLVR) emerged as an effective intervention in a carefully selected subgroup of COPD patients characterized by severe emphysema, static lung hyperinflation and breathlessness. In Patel et al.'s2 systematic review and meta-analysis, consistent results on improving pulmonary function, exercise capacity and health-related quality of life were demonstrated. Different techniques exist to reduce hyperinflation bronchoscopically, and while vapour ablation, sealants and coils are available and being researched, the currently most widely implemented are one-way endobronchial valves (EBVs), which have progressed from experimental therapy to standard of care1,3. BLVR is still a relatively novel technique in full development and has only recently been upgraded to the highest level of evidence in the Global Initiative for Chronic Obstructive Lung Disease 2023 report1.In this narrative review, we present the most recent developments in BLVR using EBV, focussing on primary research describing patient selection, (long-term) outcomes and extrapulmonary effects.Purpose of review Bronchoscopic lung volume reduction (BLVR) is a novel and effective treatment for a specific phenotype of chronic obstructive pulmonary disease (COPD) characterized by advanced emphysema with static lung hyperinflation and severe breathlessness. This review aims to provide an overview of the recent advances made in BLVR.For achieving optimal outcomes with BLVR, patient selection and target lobe identification is crucial. BLVR has recently also been established to improve pulmonary function, exercise capacity and quality of life in COPD patients falling outside the standard treatment criteria, including patients with moderate hyperinflation, chronic hypercapnic failure or with very low diffusion capacity. In a cluster analysis, target lobe characteristics like emphysema destruction, air trapping and perfusion were found to be important discriminators between responders and non-responders. A potential survival benefit has been demonstrated in BLVR-treated patients when compared to non-treated patients. Long-term outcomes showed sustained outcomes of BLVR; however, effects decline over time, probably due to disease progression.BLVR using one-way endobronchial valves has become a guideline treatment offered in specialized intervention centres for a specific subgroup of COPD patients. Recent studies further characterize responders, describe extrapulmonary effects of BLVR and show positive long-term outcomes and a potential survival benefit.R. Posthuma is supported by the Lung Foundation Netherlands, grant number: 5.1.17.171.0.There are no conflicts of interest.Patients with chronic obstructive pulmonary disease (COPD) suffer from respiratory symptoms and reduced quality of life due to destruction and/or inflammation of the airways and alveoli, leading to airflow limitation1. Despite pharmacological and non-pharmacological therapies, patients with advanced COPD often remain highly symptomatic with debilitating breathlessness and reduced exercise capacity. In the last decade, bronchoscopic lung volume reduction (BLVR) emerged as an effective intervention in a carefully selected subgroup of COPD patients characterized by severe emphysema, static lung hyperinflation and breathlessness. In Patel et al.'s2 systematic review and meta-analysis, consistent results on improving pulmonary function, exercise capacity and health-related quality of life were demonstrated. Different techniques exist to reduce hyperinflation bronchoscopically, and while vapour ablation, sealants and coils are available and being researched, the currently most widely implemented are one-way endobronchial valves (EBVs), which have progressed from experimental therapy to standard of care1,3. BLVR is still a relatively novel technique in full development and has only recently been upgraded to the highest level of evidence in the Global Initiative for Chronic Obstructive Lung Disease 2023 report1.In this narrative review, we present the most recent developments in BLVR using EBV, focussing on primary research describing patient selection, (long-term) outcomes and extrapulmonary effects.Purpose of review Bronchoscopic lung volume reduction (BLVR) is a novel and effective treatment for a specific phenotype of chronic obstructive pulmonary disease (COPD) characterized by advanced emphysema with static lung hyperinflation and severe breathlessness. This review aims to provide an overview of the recent advances made in BLVR.For achieving optimal outcomes with BLVR, patient selection and target lobe identification is crucial. BLVR has recently also been established to improve pulmonary function, exercise capacity and quality of life in COPD patients falling outside the standard treatment criteria, including patients wit
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| 21. |
- Posthuma, Rein, et al.
(author)
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Treatable traits in advanced emphysema patients eligible for bronchoscopic lung volume reduction with endobronchial valves
- 2024
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In: RESPIRATORY MEDICINE. - 0954-6111 .- 1532-3064. ; 224
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Journal article (peer-reviewed)abstract
- Introduction: Patients with advanced emphysema eligible for bronchoscopic lung volume reduction (BLVR) using endobronchial valves (EBV) are characterized by severe static lung hyperinflation, which can be considered a treatable trait. Other treatable traits (TTs), which are assumed to be present in this highly selected patient group, have not been studied in detail nor how they may affect health-related quality of life (HRQL). Aims: We aimed to evaluate a spectrum of TTs in COPD patients eligible for EBV treatment and their association with HRQL. Methods: The SoLVE study (NCT03474471) was a prospective multicenter randomized controlled trial to examine the impact of pulmonary rehabilitation in COPD patients receiving EBV. The presence/absence of 16 TTs was based on pre-defined thresholds. HRQL was assessed with the St. George's Respiratory Questionnaire (SGRQ). Subjects were stratified into two groups, using the median split method, into higher or lower SGRQ total score. Logistic regression assessed the odds ratio (OR) of having a higher SGRQ total score per TT. Results: Ninety-seven subjects were included, the mean number of TTs per patient was 8.1 +/- 2.5. Low physical activity (95%), poor exercise capacity (94%) and severe fatigue (75%) were the most prevalent TTs. The sum of TTs present in a subject was associated with the SGRQ total score (r = 0.53; p < 0.001). Severe fatigue, depression, and anxiety were predictors of having a higher SGRQ total score. Conclusions: A high prevalence and co-occurrence of multiple TTs were identified in emphysema patients eligible for EBV. Patients with a higher number of TTs were more likely to have worse HRQL.
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| 22. |
- Rein, S, et al.
(author)
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Comparative analysis of inter- and intraligamentous distribution of sensory nerve endings in ankle ligaments: a cadaver study
- 2013
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In: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 34:7, s. 1017-1024
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Journal article (peer-reviewed)abstract
- The aim of this study was to analyze the inter-, intraligamentous, and side-related patterns of sensory nerve endings in ankle ligaments. Methods: A total of 140 ligaments from 10 cadaver feet were harvested. Lateral: calcaneofibular, anterior-, posterior talofibular; sinus tarsi: lateral- (IERL), intermediate-, medial-roots inferior extensor retinaculum, talocalcaneal oblique and canalis tarsi (CTL); medial: tibionavicular (TNL), tibiocalcaneal (TCL), superficial tibiotalar, anterior/posterior tibiotalar portions; syndesmosis: anterior tibiofibular. Following immunohistochemical staining, the innervation and vascularity was analyzed between ligaments of each anatomical complex, left/right feet, and within the 5 levels of each ligament. Results: Significantly more free nerve endings were seen in all ligaments as compared to Ruffini, Pacini, Golgi-like, and unclassifiable corpuscles ( P ≤ .005). The IERL had significantly more free nerve endings and blood vessels than the CTL ( P ≤ .001). No significant differences were seen in the side-related distribution, except for Ruffini endings in right TCL ( P = .016) and unclassifiable corpuscles in left TNL ( P = .008). The intraligamentous analysis in general revealed no significant differences in mechanoreceptor distribution. Conclusions: The IERL at the entrance of the sinus tarsi contained more free nerve endings and blood vessels, as compared to the deeper situated CTL. Despite different biomechanical functions in the medial and lateral ligaments, the interligamentous distribution of sensory nerve endings was equal. Clinical Relevance: The intrinsic innervation patterns of the ankle ligaments provides an understanding of their innate healing capacities following injury as well as the proprioception properties in postoperative rehabilitation.
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| 23. |
- Rein, S, et al.
(author)
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Histological analysis of the structural composition of ankle ligaments
- 2015
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In: Foot & ankle international. - : SAGE Publications. - 1944-7876 .- 1071-1007. ; 36:2, s. 211-224
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Journal article (peer-reviewed)abstract
- Various ankle ligaments have different structural composition. The aim of this study was to analyze the morphological structure of ankle ligaments to further understand their function in ankle stability. Methods: One hundred forty ligaments from 10 fresh-frozen cadaver ankle joints were dissected: the calcaneofibular, anterior, and posterior talofibular ligaments; the inferior extensor retinaculum, the talocalcaneal oblique ligament, the canalis tarsi ligament; the deltoid ligament; and the anterior tibiofibular ligament. Hematoxylin-eosin and Elastica van Gieson stains were used for determination of tissue morphology. Results: Three different morphological compositions were identified: dense, mixed, and interlaced compositions. Densely packed ligaments, characterized by parallel bundles of collagen, were primarily seen in the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments. Ligaments with mixed tight and loose parallel bundles of collagenous connective tissue were mainly found in the inferior extensor retinaculum and talocalcaneal oblique ligament. Densely packed and fiber-rich interlacing collagen was primarily seen in the areas of ligament insertion into bone of the deltoid ligament. Conclusions: Ligaments of the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments have tightly packed, parallel collagen bundles and thus can resist high tensile forces. The mixed tight and loose, parallel oriented collagenous connective tissue of the inferior extensor retinaculum and the talocalcaneal oblique ligament support the dynamic positioning of the foot on the ground. The interlacing collagen bundles seen at the insertion of the deltoid ligament suggest that these insertion areas are susceptible to tension in a multitude of directions. Clinical Relevance: The morphology and mechanical properties of ankle ligaments may provide an understanding of their response to the loads to which they are subjected.
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| 24. |
- Rein, S, et al.
(author)
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Histopathological analysis of the synovium in trapeziometacarpal osteoarthritis
- 2019
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In: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 44:10, s. 1079-1088
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Journal article (peer-reviewed)abstract
- Dorsoradial and anterior oblique ligaments were harvested during surgery in 13 patients with symptomatic trapeziometacarpal osteoarthritis, which had been graded preoperatively by a modified Eaton-Littler radiographic grading. Ligaments, including the periligamentous synovium, were stained with S100 protein, neurotrophic receptor p75, protein gene product 9.5, calcitonin gene related peptide, acetylcholine, substance P, neuropeptide Y, noradrenaline, N-methyl-D-aspartate-receptor and Met/Leu-enkephalin. The synovium was classified as showing no, low-grade or high-grade synovitis. Free nerve endings had higher immunoreactivity for substance P than for N-methyl-D-aspartate-receptor, enkephalin and noradrenaline. The synovial stroma had less immunoreactivity for N-methyl-D-aspartate-receptor than for noradrenaline, substance P and calcitonin gene related peptide. There was no relation between the grade of osteoarthritis and the visual pain analogue scale, synovitis score, immunoreactivity of all antibodies and quantity of free nerve endings or blood vessels. Synovium in trapeziometacarpal joint osteoarthritis produces several neuromediators causing a polymodal neurogenic inflammation and which may serve as biomarkers for osteoarthritis or therapeutic targets.
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| 25. |
- Rein, S, et al.
(author)
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Immunohistochemical analysis of sensory nerve endings in ankle ligaments: a cadaver study
- 2013
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In: Cells, tissues, organs. - : S. Karger AG. - 1422-6421 .- 1422-6405. ; 197:1, s. 64-76
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Journal article (peer-reviewed)abstract
- <b><i>Background:</i></b> The aim of this study was to analyze the pattern and types of sensory nerve endings in ankle ligaments using immunohistochemical techniques, in order to gain more insight into functional ankle stability. <b><i>Methods:</i></b> One hundred forty ligaments from 10 cadaver feet were included: the calcaneofibular and anterior/posterior talofibular ligaments from the lateral complex; inferior extensor retinaculum complex, talocalcaneal oblique and canalis tarsi ligaments from the sinus tarsi; deltoid ligament with its individual portions from the medial complex, and anterior tibiofibular ligament (ATiFL) from the syndesmosis. Mechanoreceptors were classified according to Freeman and Wyke [Acta Anat (Basel) 1967;68:321–333] after staining with hematoxylin-eosin, low-affinity neurotrophin receptor p75, protein gene product 9.5, and S-100 protein. <b><i>Results:</i></b> Free nerve endings were the predominant sensory endings in all four complexes, with the greatest density in the lateral and medial complexes; followed by Ruffini endings, unclassifiable corpuscles, Pacini corpuscles, and Golgi-like endings. Ruffini endings were significantly more prevalent in the ATiFL than in the medial complex, and more common than Pacini corpuscles and Golgi-like endings in the lateral, medial, and sinus tarsi complexes. A greater number of blood vessels correlated with a greater number of free nerve endings. There was a negative correlation between the number of Ruffini endings, unclassifiable corpuscles, and age. <b><i>Conclusions:</i></b> Free nerve endings are the dominant mechanoreceptor type in the ankle ligaments, followed by Ruffini endings. The ligaments of the lateral and medial ankle complexes are more innervated than the sinus tarsi ligaments.
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| 26. |
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| 27. |
- Semisch, M, et al.
(author)
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Histological assessment of the triangular fibrocartilage complex
- 2016
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In: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:5, s. 527-533
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Journal article (peer-reviewed)abstract
- The morphological structure of the seven components of triangular fibrocartilage complexes of 11 cadaver wrists of elderly people was assessed microscopically, after staining with Hematoxylin-Eosin and Elastica van Gieson. The articular disc consisted of tight interlaced fibrocartilage without blood vessels except in its ulnar part. Volar and dorsal radioulnar ligaments showed densely parallel collagen bundles. The subsheath of the extensor carpi ulnaris muscle, the ulnotriquetral and ulnolunate ligament showed mainly mixed tight and loose parallel tissue. The ulnolunate ligament contained tighter parallel collagen bundles and clearly less elastic fibres than the ulnotriquetral ligament. The ulnocarpal meniscoid had an irregular morphological composition and loose connective tissue predominated. The structure of the articular disc indicates a buffering function. The tight structure of radioulnar and ulnolunate ligaments reflects a central stabilizing role, whereas the ulnotriquetral ligament and ulnocarpal meniscoid have less stabilizing functions.
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| 28. |
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| 29. |
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| 30. |
- van der Molen, Marieke C., et al.
(author)
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Impact and timing of pulmonary rehabilitation in patients undergoing bronchoscopic lung volume reduction with endobronchial valves: A multicentre randomized controlled trial in patients with severe emphysema
- 2024
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In: RESPIROLOGY. - 1323-7799 .- 1440-1843.
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Journal article (peer-reviewed)abstract
- Background and ObjectiveBoth bronchoscopic lung volume reduction with endobronchial valves (BLVR-EBV) and pulmonary rehabilitation (PR) are effective treatments for improving exercise capacity and patient-reported outcomes in patients with severe Chronic Obstructive Pulmonary Disease (COPD). According to current recommendations, all BLVR-EBV patients should have undergone PR first. Our aim was to study the effects of PR both before and after BLVR-EBV compared to BLVR-EBV alone.MethodsWe included patients with severe COPD who were eligible for BLVR-EBV and PR. Participants were randomized into three groups: PR before BLVR-EBV, PR after BLVR-EBV or BLVR-EBV without PR. The primary outcome was change in constant work rate cycle test (CWRT) endurance time at 6-month follow-up of the PR groups compared to BLVR-EBV alone. Secondary endpoints included changes in 6-minute walking test, daily step count, dyspnoea and health-related quality of life.ResultsNinety-seven participants were included. At 6-month follow-up, there was no difference in change in CWRT endurance time between the PR before BLVR-EBV and BLVR-EBV alone groups (median: 421 [IQR: 44; 1304] vs. 787 [123; 1024] seconds, p = 0.82) or in any of the secondary endpoints, but the PR after BLVR-EBV group exhibited a smaller improvement in CWRT endurance time (median: 107 [IQR: 2; 573], p = 0.04) and health-related quality of life compared to BLVR-EBV alone.ConclusionThe addition of PR to BLVR-EBV did not result in increased exercise capacity, daily step count or improved patient-reported outcomes compared to BLVR-EBV alone, neither when PR was administered before BLVR-EBV nor when PR was administered after BLVR-EBV. Our findings suggest that a combination of pulmonary rehabilitation and bronchoscopic lung volume reduction with endobronchial valves (BLVR-EBV) may not provide additional benefits compared to BLVR-EBV alone at a group-level. Future challenges lie in selecting patients for whom a combined rehabilitation trajectory would be beneficial.
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