Optimum management to prevent recurrent kidney stones is uncertain.
To evaluate the benefits and harms of interventions to prevent recurrent kidney stones.
MEDLINE, Cochrane, and other databases ...through September 2012 and reference lists of systematic reviews and randomized, controlled trials (RCTs).
28 English-language RCTs that studied treatments to prevent recurrent kidney stones and reported stone outcomes.
One reviewer extracted data, a second checked accuracy, and 2 independently rated quality and graded strength of evidence.
In patients with 1 past calcium stone, low-strength evidence showed that increased fluid intake halved recurrent composite stone risk compared with no treatment (relative risk RR, 0.45 95% CI, 0.24 to 0.84). Low-strength evidence showed that reducing soft-drink consumption decreased recurrent symptomatic stone risk (RR, 0.83 CI, 0.71 to 0.98). In patients with multiple past calcium stones, most of whom were receiving increased fluid intake, moderate-strength evidence showed that thiazides (RR, 0.52 CI, 0.39 to 0.69), citrates (RR, 0.25 CI, 0.14 to 0.44), and allopurinol (RR, 0.59 CI, 0.42 to 0.84) each further reduced composite stone recurrence risk compared with placebo or control, although the benefit from allopurinol seemed limited to patients with baseline hyperuricemia or hyperuricosuria. Other baseline biochemistry measures did not allow prediction of treatment efficacy. Low-strength evidence showed that neither citrate nor allopurinol combined with thiazide was superior to thiazide alone. There were few withdrawals among patients with increased fluid intake, many among those with other dietary interventions and more among those who received thiazide and citrate than among control patients. Reporting of adverse events was poor.
Most trial participants had idiopathic calcium stones. Nearly all studies reported a composite (including asymptomatic) stone recurrence outcome.
In patients with 1 past calcium stone, increased fluid intake reduced recurrence risk. In patients with multiple past calcium stones, addition of thiazide, citrate, or allopurinol further reduced risk.
Agency for Healthcare Research and Quality.
Fusarium kernel rot disease starburst symptomatology was characterized fully for the first time. Two maize lines were hand pollinated and inoculated, using a fluorescent protein-expressing ...transformant of the fungal pathogen Fusarium verticillioides, by introduction of a conidial suspension through the silk channel of intact ears. Microscopy was used to identify the infection court and document initial stages of kernel colonization and subsequent manifestation of macroscopic symptoms. The fungus entered kernels of susceptible line AD38 via an open stylar canal and spread extracellularly and over the kernel through the nucellus region, sporadically entering pericarp and filling the long thick-walled mesocarp cells. Hyphae spread within pericarp from cell to cell via pits, colonizing files of host cells by growing both up and down the kernel in a radial pattern that preceded macroscopic symptom development. The starburst symptom developed subsequently, and mirrored colonization exactly, when there was extensive dissolution of the thick walls of pericarp cells. Line HT1 exhibited a closed stylar canal phenotype and was not susceptible—except when the pericarp surface was breached mechanically. We hypothesize the passive movement of conidia along the surface of silks, perhaps via capillarity, as a possible mechanism for pathogen access to the infection court.
Deposition of insoluble protein aggregates is a hallmark of neurodegenerative diseases. The universal presence of β-amyloid and tau in Alzheimer’s disease (AD) has facilitated advancement of the ...amyloid cascade and tau hypotheses that have dominated AD pathogenesis research and therapeutic development. However, the underlying etiology of the disease remains to be fully elucidated. Here we report a comprehensive study of the human brain-insoluble proteome in AD by mass spectrometry. We identify 4,216 proteins, among which 36 proteins accumulate in the disease, including U1-70K and other U1 small nuclear ribonucleoprotein (U1 snRNP) spliceosome components. Similar accumulations in mild cognitive impairment cases indicate that spliceosome changes occur in early stages of AD. Multiple U1 snRNP subunits form cytoplasmic tangle-like structures in AD but not in other examined neurodegenerative disorders, including Parkinson disease and frontotemporal lobar degeneration. Comparison of RNA from AD and control brains reveals dysregulated RNA processing with accumulation of unspliced RNA species in AD, including myc box-dependent-interacting protein 1, clusterin, and presenilin-1 . U1-70K knockdown or antisense oligonucleotide inhibition of U1 snRNP increases the protein level of amyloid precursor protein. Thus, our results demonstrate unique U1 snRNP pathology and implicate abnormal RNA splicing in AD pathogenesis.
This research was conducted to examine the influence of parental involvement, in the form of parent conversations, on mathematics achievement for high school girls. Data from the High School ...Longitudinal Study of 2009 (HSLS:09) public-use file provided a sample of 13,694 students, including 6,592 girls for our analyses. A scale for measuring parent conversations was developed and regression analyses were conducted to examine whether this scale variable predicted mathematics achievement. Results indicated that conversational parental involvement was a significant predictor of mathematics achievement for Black and White girls, but not Hispanic and Asian. Implications for research and policy initiatives are discussed.
We examined the relationships between high school CTE participation and indicators of career and college readiness using 2009 High School Longitudinal Study restricted-use data. Regression analyses ...of 2009–2018 data revealed significantly lower dropout rates for CTE participants, but only White CTE participants experienced better employment likelihood. CTE participants were mostly employed in service or manual labor occupations with below average wages and were significantly less likely to attend a 4-year college. CTE benefits were disproportionate by race and gender, and participation may have a “cooling out” effect on the aspirations of some students. Advising and urban education implications are discussed.
Many individuals who experience a stroke exhibit reduced modulation of their mediolateral foot placement, an important gait stabilization strategy. One factor that may contribute to this deficit is ...altered somatosensory processing, which can be probed by applying vibration to the involved muscles (e.g., the hip abductors). The purpose of this study was to investigate whether appropriately controlled hip abductor vibration can increase foot placement modulation among people with chronic stroke. 40 people with chronic stroke performed a series of treadmill walking trials without vibration and with vibration of either the hip abductors or lateral trunk (a control condition) that scaled with their real-time mediolateral motion. To assess participants’ vibration sensitivity, we also measured vibration detection threshold and lateral sway evoked by abductor vibration during quiet standing. As a group, foot placement modulation increased significantly with either hip or trunk vibration, compared to without vibration. However, these changes were quite variable across participants, and were not predicted by either vibration detection threshold or the lateral sway evoked by hip vibration during standing. Overall, we found that somatosensory stimulation had small, positive effects on post-stroke foot placement modulation. Unexpectedly, these effects were observed with both hip abductor and lateral trunk vibration, perhaps indicating that the trunk can also provide useful somatosensory feedback during walking. Future work is needed to determine whether repeated application of such somatosensory stimulation can produce sustained effects on this important gait stabilization strategy.
Genes involved in cell number regulation may affect plant growth and organ size and, ultimately, crop yield. The tomato (genus Solanum) fruit weight gene fw2.2, for instance, governs a quantitative ...trait locus that accounts for 30% of fruit size variation, with increased fruit size chiefly due to increased carpel ovary cell number. To expand investigation of how related genes may impact other crop plant or organ sizes, we identified the maize (Zea mays) gene family of putative fw2.2 orthologs, naming them Cell Number Regulator (CNR) genes. This family represents an ancient eukaryotic family of Cys-rich proteins containing the PLAC8 or DUF614 conserved motif. We focused on native expression and transgene analysis of the two maize members closest to Le-fw2.2, namely, CNR1 and CNR2. We show that CNR1 reduced overall plant size when ectopically overexpressed and that plant and organ size increased when its expression was cosuppressed or silenced. Leaf epidermal cell counts showed that the increased or decreased transgenic plant and organ size was due to changes in cell number, not cell size. CNR2 expression was found to be negatively correlated with tissue growth activity and hybrid seedling vigor. The effects of CNR1 on plant size and cell number are reminiscent of heterosis, which also increases plant size primarily through increased cell number. Regardless of whether CNRs and other cell number-influencing genes directly contribute to, or merely mimic, heterosis, they may aid generation of more vigorous and productive crop plants.
A higher dietary diversity score (DDS) and a lower energy-adjusted dietary inflammatory index (E-DII) may be associated with lower risks of type 2 diabetes (T2D) and mortality. This cohort study ...aimed to investigate the associations of DDS and E-DII with all-cause mortality, incidence of T2D, and mortality of T2D, as well as the joint effects of these two dietary factors. A total of 181,360 participants without all types of diabetes at baseline from the UK Biobank and 42,139 participants from the US NHANES were included. Cox proportional hazards models were used to assess the associations of DDS and E-DII with outcomes. In the UK Biobank data, 8338 deaths, 3416 incident T2D cases, and 353 T2D deaths occurred during a median follow-up of 12.5 years. In the US NHANES data, 6803 all-cause deaths and 248 T2D-specific deaths were recorded during a median follow-up of 9.6 years. We observed that higher DDS and lower E-DII were significantly associated with lower risks of total mortality and incident T2D. Compared with low DDS, the hazard ratios (HRs) and 95% confidence intervals (CIs) of high DDS were 0.69 (0.64, 0.74) for all-cause mortality, 0.79 (0.70, 0.88) for incident T2D in the UK Biobank, and 0.69 (0.61, 0.78) for all-cause mortality in the US NHANES. Compared with participants in tertile 3 of E-DII, those in tertile 1 had a lower risk of overall death HR 0.86 (95% CI: 0.81, 0.91) in UK Biobank; 0.83 (0.77, 0.88) in US NHANES and incident T2D 0.86 (0.79, 0.94) in UK Biobank. No evidence was observed of the interactive effects of DDS and E-DII on either all-cause mortality or the incidence and mortality of T2D. There was no significant association found between any exposure and T2D mortality in this study. In conclusion, our results revealed that higher DDS and lower E-DII were associated with both total mortality and incident T2D in UK and US adults.
Many people with chronic stroke (PwCS) exhibit walking balance deficits linked to increased fall risk and decreased balance confidence. One potential contributor to these balance deficits is a ...decreased ability to modulate mediolateral stepping behavior based on pelvis motion. This behavior, hereby termed mediolateral step modulation, is thought to be an important balance strategy but can be disrupted in PwCS.
Are biomechanical metrics of mediolateral step modulation related to common clinical balance measures among PwCS?
In this cross-sectional study, 93 PwCS walked on a treadmill at their self-selected speed for 3-minutes. We quantified mediolateral step modulation for both paretic and non-paretic steps by calculating partial correlations between mediolateral pelvis displacement at the start of each step and step width (ρSW), mediolateral foot placement relative to the pelvis (ρFP), and final mediolateral location of the pelvis (ρPD) at the end of the step. We also assessed several common clinical balance measures (Functional Gait Assessment FGA, Activities-specific Balance Confidence scale ABC, self-reported fear of falling and fall history). We performed Spearman correlations to relate each biomechanical metric of step modulation to FGA and ABC scores. We performed Wilcoxon rank sum tests to compare each biomechanical metric between individuals with and without a fear of falling and a history of falls.
Only ρFP for paretic steps was significantly related to all four clinical balance measures; higher paretic ρFP values tended to be observed in participants with higher FGA scores, with higher ABC scores, without a fear of falling and without a history of falls. However, the strength of each of these relationships was only weak to moderate.
While the present results do not provide insight into causality, they justify future work investigating whether interventions designed to increase ρFP can improve clinical measures of post-stroke balance in parallel.
•Many people with chronic stroke have reduced walking balance and confidence.•Modulation of mediolateral foot placement may be an important balance strategy.•Paretic foot placement modulation was related to clinical balance measures.
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