Host jumping onto close relatives and across kingdoms by <i>Tyrannicordyceps</i> (Clavicipitaceae) gen. nov. and <i>Ustilaginoidea</i> _(Clavicipitaceae)

Kepler, Ryan M.,Sung, Gi-Ho,Harada, Yukio,Tanaka, Kazuaki,Tanaka, Eiji,Hosoya, Tsuyoshi,Bischoff, Joseph F.,Spatafora, Joseph W. Wiley (John WileySons) 2012 American journal of botany Vol.99 No.3

<P>This research seeks to advance understanding of conditions allowing movement of fungal pathogens among hosts. The family Clavicipitaceae contains fungal pathogens exploiting hosts across three kingdoms of life in a pattern that features multiple interkingdom host shifts among plants, animals, and fungi. The tribe Ustilaginoideae potentially represents a third origin of plant pathogenesis, although these species remain understudied. Fungal pathogens that cause ergot are linked morphologically with Clavicipitaceae, but are not yet included in phylogenetic studies. The placement of Ustilaginoideae and ergot pathogens will allow differentiation between the host habitat and host relatedness hypotheses as mechanisms of phylogenetic diversification of Clavicipitaceae.</P>

New teleomorph combinations in the entomopathogenic genus <i>Metacordyceps</i>

Kepler, R.M.,Sung, G.-H.,Ban, S.,Nakagiri, A.,Chen, M.-J.,Huang, B.,Li, Z.,Spatafora, J.W. Informa UK (TaylorFrancis) 2012 Mycologia Vol.104 No.1

<P>The genus Metacordyceps contains arthropod pathogens in Clavicipitaceae (Hypocreales) that formerly were classified in Cordyceps sensu Kobayasi et Mains. Of the current arthropod pathogenic genera of Hypocreales, the genus Metacordyceps remains one of the most poorly understood and contains a number of teleomorphic morphologies convergent with species of Cordyceps s.s. (Cordycipitaceae) and Ophiocordyceps (Ophiocordycipitaceae). Of note, the anamorph genera Metarhizium and Pochonia were found to be associated only with Metacordyceps and demonstrated to be phylogenetically informative for the clade. Several species of Cordyceps considered to have uncertain placements (incertae sedis) in the current taxonomic framework of clavicipitoid fungi were collected during field expeditions mostly in eastern Asia. Species reclassified here in Metacordyceps include Cordyceps atrovirens Kobayasi & Shimizu, Cordyceps indigotica Kobayasi & Shimizu, Cordyceps khaoyaiensis Hywel-Jones, Cordyceps kusanagiensis Kobayasi & Shimizu, Cordyceps martialis Speg., Ophiocordyceps owariensis Kobayasi, Cordyceps pseudoatrovirens Kobayasi & Shimizu and Ophicordyceps owariensis f. viridescens (Uchiy. & Udagawa) G.H. Sung, J.M. Sung, Hywel-Jones & Spatafora. Incorporation of these species in a multigene phylogenetic framework of the major clades of clavicipitoid fungi more than doubled the number of species in Metacordyceps and allowed for refinement of morphological concepts for the genus consistent with the phylogenetic structure. Based on these findings we then discuss evolution of this genus, subgeneric relationships, anamorph connections, and suggest additional species that should be confirmed for possible inclusion in Metacordyceps.</P>

The pulsations of PG 1351+489

Redaelli, M.,Kepler, S. O.,Costa, J. E. S.,Winget, D. E.,Handler, G.,Castanheira, B. G.,Kanaan, A.,Fraga, L.,Henrique, P.,Giovannini, O.,Provencal, J. L.,Shipman, H. L.,Dalessio, J.,Thompson, S. E.,Mu Blackwell Publishing Ltd 2011 Monthly notices of the Royal Astronomical Society Vol.415 No.2

<P><B>ABSTRACT</B></P><P>PG 1351+489 is one of the 20 DBVs – pulsating helium‐atmosphere white dwarf stars – known and has the simplest power spectrum for this class of star, making it a good candidate to study cooling rates. We report accurate period determinations for the main peak at 489.334 48 s and two other normal modes using data from the Whole Earth Telescope (WET) observations of 1995 and 2009. In 2009, we detected a new pulsation mode and the main pulsation mode exhibited substantial change in its amplitude compared to all previous observations. We were able to estimate the star's rotation period, of 8.9 h, and discuss a possible determination of the rate of period change of (2.0 ± 0.9) × 10<SUP>−13</SUP> s s <SUP>−1</SUP>, the first such estimate for a DBV.</P>

The pulsation modes of the pre-white dwarf PG 1159-035

Costa, J. E. S.,Kepler, S. O.,Winget, D. E.,O'Brien, M. S.,Kawaler, S. D.,Costa, A. F. M.,Giovannini, O.,Kanaan, A.,Mukadam, A. S.,Mullally, F.,Nitta, A.,Provenç,al, J. L.,Shipman, H.,Wood, M. A EDP Sciences 2008 Astronomy and astrophysics Vol.477 No.2

Comparison of Surgical Outcomes of the Posterior and Combined Approaches for Repair of Cervical Fractures in Ankylosing Spondylitis

Panya Luksanapruksa,Paul William Millhouse,Victor Carlson,Thanase Ariyawatkul,Joshua Heller,Christopher Keppel Kepler 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.3

Study Design: Retrospective cohort study. Purpose: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C). Overview of Literature: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results. Methods: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were enrolled. We analyzed demographic data, radiographic results, perioperative complications, and postoperative results. Results: Thirty-three patients were enrolled (23 in the P group, 10 in the C group). All patients presented with neck pain after a fall. In the P group, mean operative time was 161.1 minutes (100–327 minutes), and mean estimated blood loss (EBL) was 306.4 mL (50–750 mL). In the C group, 90% of patients underwent a staged procedure, typically with posterior surgery first. Mean EBL was 124 mL (25–337 mL). For posterior surgery, mean EBL was 458.3 mL (400–550 mL). EBL of posterior surgery in the C group was higher but this difference was not significant (p=0.16). Postoperative complication rate was higher in the C group but this difference was not significant (50% vs. 17.4%, p=0.09). In the follow-up period, no late reoperations were performed. Patients who underwent C surgery had a higher rate of neurological improvement but this difference was not significant (p=0.57). Conclusions: Both P and C provided good clinical results. P surgery had lower EBL, lower postoperative complication rate, and shorter length of stay than C surgery; none of these differences were statistically significant.

2006 WHOLE EARTH TELESCOPE OBSERVATIONS OF GD358: A NEW LOOK AT THE PROTOTYPE DBV

Provencal, J. L.,Montgomery, M. H.,Kanaan, A.,Shipman, H. L.,Childers, D.,Baran, A.,Kepler, S. O.,Reed, M.,Zhou, A.,Eggen, J.,Watson, T. K.,Winget, D. E.,Thompson, S. E.,Riaz, B.,Nitta, A.,Kleinman, S IOP Publishing 2009 The Astrophysical journal Vol.693 No.1

Use of Bisphosphonates, Calcium and Vitamin D for Bone Demineralization in Patients with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials

Rocha Vinícius Magno da,Mariana Balardino Bogado Faria,Francisco de Assis dos Reis Júnior,Carla Ormundo Gonçalves Ximenes Lima,Rossano Kepler Alvim Fiorelli,Keila Mara Cassiano 대한골대사학회 2020 대한골대사학회지 Vol.27 No.3

Background: The present study performed a systematic review and meta-analysis of clinical trials using bisphosphonates for bone demineralization in human immunodeficiency virus (HIV) patients. Methods: A comprehensive literature search was performed from January 2004 to January 2020 considering the bone mineral density (BMD) of the lumbar spine (LS) as the main outcome. Out of 214 titles that met criteria, 9 studies fulfilled the selection criteria. Results: A total of 394 patients were identified, and they were allocated into 2 groups: the intervention group (200 patients), to whom a combination of alendronate or zoledronate with calcium and vitamin D was administered; and control group (194 patients), to whom only calcium and vitamin D was administered. Clinical profile and indicators of bone metabolism of the participants were evaluated regarding effect size, homogeneity, and consistency. No substantial heterogeneity between the groups was found for the baseline variables, and there was high consistency to the main outcome. The meta-analysis shows a significant difference in post-treatment BMD, favoring the intervention over the control treatment. The intervention improved LS density up to 0.227 g/cm², raising the average to the levels of general population. Adverse effects related to intervention were fever immediately after zoledronate administration and gastrointestinal complaints during alendronate usage. Other adverse effects were barely reported and poorly connected to intervention by studies’ authors, despite all of them have been successfully resolved. Conclusions: This study provides evidence that BMD post-treatment is better in HIV patients who used bisphosphonates combined with calcium and vitamin D.

Correlation of Early Outcomes and Intradiscal Interleukin-6 Expression in Lumbar Fusion Patients

John D. Koerner,Dessislava Z. Markova,Greg D. Schroeder,Christopher L. Antonacci,Joseph Mendelis,Alexander R. Vaccaro,D. Greg Anderson,Chris K. Kepler 대한척추신경외과학회 2020 Neurospine Vol.17 No.1

Objective: To determine if there is correlation between intradiscal levels of interleukin-6 (IL-6) and early outcome measures in patients undergoing lumbar fusion for painful disc degeneration. Methods: Intervertebral disc tissue was separated into annulus fibrosus/nucleus pulposus and cultured separately in vitro in serum-free medium (Opti-MEM). Conditioned media was collected after 48 hours. The concentration of IL-6 was quantified using enzyme-linked immunosorbent assay. Pearson correlation coefficients quantified relationships between IL-6 levels and pre- and postoperative visual analogue scale (VAS) back pain and Oswestry Disability Index (ODI), as well as change in VAS/ODI. Results: Sixteen discs were harvested from 9 patients undergoing anterior lumbar interbody fusion (mean age, 47.4 years; range, 21–70 years). Mean preoperative and 6-month postoperative VAS were 8.1 and 3.7, respectively. Mean preoperative and postoperative ODI were 56.2 and 25.6, respectively. There were significant positive correlations between IL-6 expression and postoperative VAS (ρ=0.38, p=0.048) and ODI (ρ=0.44, p=0.02). No significant correlations were found between intradiscal IL-6 expression and preoperative VAS (ρ=-0.12, p=0.54). Trends were seen associating IL-6 expression and change in VAS/ODI (ρ=-0.35 p=0.067; ρ=-0.34, p=0.08, respectively). A trend associated IL-6 and preoperative ODI (ρ=0.36, p=0.063). Conclusion: The direct association between IL-6 expression and VAS/ODI suggests patients with elevated intradiscal cytokine expression may have worse early outcomes than those with lower expression of IL-6 after surgery for symptomatic disc degeneration.

Incidence, Risk Factors, and Outcomes of Incidental Durotomy during Lumbar Spine Decompression with or without Fusion

Toci Gregory,Lambrechts Mark James,Issa Tariq,Karamian Brian Abedi,Siegel Nicholas,Antonio Nicholas D’,Canseco Jose,Kurd Mark,Woods Barrett,Kaye Ian David,Hilibrand Alan,Kepler Christopher,Vaccaro Ale 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.4

Study Design: Retrospective cohort study.Purpose: The primary objective of this study was to determine the incidence and risk factors for incidental durotomies during lumbar decompression surgeries. In addition, we aimed to determine the changes in patient-reported outcome measures (PROMs) based on incidental durotomy status.Overview of Literature: There is limited literature investigating the affect of incidental durotomy on patient reported outcome measures. While the majority of research does not suggest differences in complications, readmission, or revision rates, many studies rely on public databases, and their sensitivity and specificity for identifying incidental durotomies is unknown.Methods: Patients undergoing lumbar decompression with or without fusion at a single tertiary care center were grouped based on the presence of a durotomy. Multivariate analysis was performed for length of stay (LOS), hospital readmissions, and changes in PROMs. To identify surgical risk factors for durotomy, 3:1 propensity matching was performed using stepwise logistic regression. The sensitivity and specificity of the International Classification of Disease, 10th revision (ICD-10) codes (G96.11 and G97.41) were also assessed.Results: Of the 3,684 consecutive patients who underwent lumbar decompressions, 533 (14.5%) had durotomies, and a complete set of PROMs (preoperative and 1-year postoperative) were available for 737 patients (20.0%). Incidental durotomy was an independent predictor of increased LOS but not hospital readmission or worse PROMs. The durotomy repair method was not associated with hospital readmission or LOS. However, repair with collagen graft and suture predicted reduced improvement in Visual Analog Scale back (<i>β</i> =2.56, <i>p</i>=0.004). Independent risk factors for incidental durotomies included revisions (odds ratio [OR], 1.73; <i>p</i><0.001), levels decompressed (OR, 1.11; <i>p</i>=0.005), and preoperative diagnosis of spondylolisthesis or thoracolumbar kyphosis. The sensitivity and specificity of ICD-10 codes were 5.4% and 99.9%, respectively, for identifying durotomies.Conclusions: The durotomy rate for lumbar decompressions was 14.5%. No differences in outcomes were detected except for increased LOS. Database studies relying on ICD codes should be interpreted with caution due to the limited sensitivity in identifying incidental durotomies.

Serotonin Reuptake Inhibitor Increases Pseudarthrosis Rates in Anterior Cervical Discectomy and Fusions

Lambrechts Mark James,D'Antonio Nicholas,Toci Gregory,Karamian Brian,Pezzulo Josuhu,Farronato Dominic,Canseco Jose,Kaye Ian David,Woods Barrett,Rihn Jeffrey,Kurd Mark,Lee Joseph,Hilibrand Alan,Kepler 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2

Study Design: Retrospective cohort.Purpose: To determine (1) the effects of serotonin reuptake inhibitors in pseudarthrosis rates after anterior cervical decompression and fusion (ACDF) and (2) to identify patient-reported outcome measures in patients taking serotonin reuptake inhibitors. Overview of Literature: Recent literature suggests that selective serotonin reuptake inhibitors (SSRIs) may inhibit fracture healing via downregulation of osteoblast differentiation. Spinal fusion supplementation with osteoblast-rich substances enhances spinal fusion, thus SSRIs may be detrimental.Methods: Patients with 1-year postoperative dynamic cervical spine radiographs following ACDF were grouped into serotonin reuptake inhibitor prescriptions (SSRI, serotonin-norepinephrine reuptake inhibitor [SNRI], or tricyclic antidepressant [TCA]) and no prescription (atypical antidepressant or no antidepressant). Pseudarthrosis was defined as ≥1 mm interspinous process motion on dynamic radiographs. Logistic regression models were controlled for confounding to analyze pseudarthrosis rates. Alpha was set at p - values of <0.05.Results: Of the 523 patients who meet the inclusion criteria, 137 (26.2%) were prescribed an SSRI, SNRI, or TCA. Patients with these prescriptions were more likely to have pseudarthrosis (p =0.008) but not a revision surgery due to pseudarthrosis (p =0.219). Additionally, these patients had worse 1-year postoperative mental component summary (MCS)-12 (p =0.015) and Neck Disability Index (NDI) (p =0.006). The multivariate logistic regression analysis identified SSRI/SNRI/TCA use (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.11–2.99; p =0.018) and construct length (OR, 1.91; 95% CI, 1.50–2.44; p <0.001) as pseudarthrosis predictors. A SSRI/SNRI/TCA prescription was a revision surgery predictor due to adjacent segment disease on univariate analysis (OR, 2.51; p =0.035) but not on multivariate logistic regression analysis (OR, 2.24; p =0.10).Conclusions: Patients taking serotonin reuptake-inhibiting antidepressants are at increased risk of worse postoperative outcome scores, including NDI and MCS-12, likely due to their underlying depression. This may contribute to their greater likelihood of having adjacent segment surgery. Additionally, preoperative use of serotonin reuptake inhibitors in patients undergoing an ACDF is a predictor of radiographic pseudarthrosis but not pseudarthrosis revision.