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BackgroundObesity is a leading preventable cause of death and disability and is associated with a lower health-related quality of life. We evaluated the impact of telecoaching conducted by a counselor trained in motivational interviewing paired with a portion control plate for obese patients in a primary care setting.MethodsWe conducted a randomized, clinical trial among patients in a primary care practice in the midwestern United States. Patients were randomized to either usual care or an intervention including telecoaching with a portion control plate. The intervention was provided during a 3-month period with follow-up of all patients through 6 months after randomization. The primary outcomes were weight, body mass index (BMI),waist circumference, and waist to hip ratio measured at baseline, 6, 12, 18, and 24 weeks. Secondary outcomes included measures assessing eating behaviors, self-efficacy, and physical activity at baseline and at 12 and 24 weeks.ResultsA total of 1,101 subjects were pre-screened, and 90 were randomly assigned to telecoaching plus portion control plate (n = 45) or usual care (n = 45). Using last-value carried forward without adjustment for baseline demographics, significant reductions in BMI (estimated treatment effect -0.4 kg/m2, P = .038) and waist to hip ratio (estimated treatment effect -.02, P = .037) at 3 months were observed in the telecoaching plus portion control plate group compared to usual care. These differences were not statistically significant at 6 months. In females, the telecoaching plus portion control plate intervention was associated with significant reductions in weight and BMI at both 3 months (estimated treatment effect -1.6 kg, P = .016 and -0.6 kg/m2, P = .020) and 6 months (estimated treatment effect -2.3 kg, P = .013 and -0.8 kg/m2, P = .025). In males, the telecoaching plus portion control intervention was associated with a significant reduction in waist to hip ratio at 3 months (estimated treatment effect -0.04, P = .017), but failed to show a significant difference in weight and BMI.ConclusionTelecoaching with a portion control plate can produce positive change in body habitus among obese primary care patients; however, changes depend upon sex.Trial registrationClinicalTrials.gov NCT02373878, 13 February 2015. https://clinicaltrials.gov/ct2/show/NCT02373878.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0880-1) contains supplementary material, which is available to authorized users.

Pluripotent bone marrow-derived side population (BM-SP) stem cells have been shown to repopulate the hematopoietic system and to contribute to skeletal and cardiac muscle regeneration after transplantation. We tested BM-SP cells for their ability to regenerate heart and skeletal muscle using a model of cardiomyopathy and muscular dystrophy that lacks δ-sarcoglycan. The absence of δ-sarcoglycan produces microinfarcts in heart and skeletal muscle that should recruit regenerative stem cells. Additionally, sarcoglycan expression after transplantation should mark successful stem cell maturation into cardiac and skeletal muscle lineages. BM-SP cells from normal male mice were transplanted into female δ-sarcoglycan-null mice. We detected engraftment of donor-derived stem cells into skeletal muscle, with the majority of donor-derived cells incorporated within myofibers. In the heart, donor-derived nuclei were detected inside cardiomyocytes. Skeletal muscle myofibers containing donor-derived nuclei generally failed to express sarcoglycan, with only 2 sarcoglycan-positive fibers detected in the quadriceps muscle from all 14 mice analyzed. Moreover, all cardiomyocytes with donor-derived nuclei were sarcoglycan-negative. The absence of sarcoglycan expression in cardiomyocytes and skeletal myofibers after transplantation indicates impaired differentiation and/or maturation of bone marrow-derived stem cells. The inability of BM-SP cells to express this protein severely limits their utility for cardiac and skeletal muscle regeneration.

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Pluripotent bone marrow-derived side population (BM-SP) stem cells have been shown to repopulate the hematopoietic system and to contribute to skeletal and cardiac muscle regeneration after transplantation. We tested BM-SP cells for their ability to regenerate heart and skeletal muscle using a model of cardiomyopathy and muscular dystrophy that lacks δ-sarcoglycan. The absence of δ-sarcoglycan produces microinfarcts in heart and skeletal muscle that should recruit regenerative stem cells. Additionally, sarcoglycan expression after transplantation should mark successful stem cell maturation into cardiac and skeletal muscle lineages. BM-SP cells from normal male mice were transplanted into female δ-sarcoglycan-null mice. We detected engraftment of donor-derived stem cells into skeletal muscle, with the majority of donor-derived cells incorporated within myofibers. In the heart, donor-derived nuclei were detected inside cardiomyocytes. Skeletal muscle myofibers containing donor-derived nuclei generally failed to express sarcoglycan, with only 2 sarcoglycan-positive fibers detected in the quadriceps muscle from all 14 mice analyzed. Moreover, all cardiomyocytes with donor-derived nuclei were sarcoglycan-negative. The absence of sarcoglycan expression in cardiomyocytes and skeletal myofibers after transplantation indicates impaired differentiation and/or maturation of bone marrow-derived stem cells. The inability of BM-SP cells to express this protein severely limits their utility for cardiac and skeletal muscle regeneration.

BackgroundMutations in the gene encoding the nuclear membrane protein lamin A/C have been associated with at least 7 distinct diseases including autosomal dominant dilated cardiomyopathy with conduction system disease, autosomal dominant and recessive Emery Dreifuss Muscular Dystrophy, limb girdle muscular dystrophy type 1B, autosomal recessive type 2 Charcot Marie Tooth, mandibuloacral dysplasia, familial partial lipodystrophy and Hutchinson-Gilford progeria.MethodsWe used mutation detection to evaluate the lamin A/C gene in a 45 year-old woman with familial dilated cardiomyopathy and conduction system disease whose family has been well characterized for this phenotype [1].ResultsDNA from the proband was analyzed, and a novel 2 base-pair deletion c.908_909delCT in LMNA was identified.ConclusionsMutations in the gene encoding lamin A/C can lead to significant cardiac conduction system disease that can be successfully treated with pacemakers and/or defibrillators. Genetic screening can help assess risk for arrhythmia and need for device implantation.

Phenomenon: Many researchers have difficulty transforming raw data into publishable fulllength manuscripts. Among studies presented at professional meetings, registered as clinical trials, or declined from specific journals, nonpublication rates are estimated to range from 25% to 60%. We aimed to characterize major barriers to manuscript preparation, beyond lack of time, for academics from a broad range of specialties at a tertiary academic medical institution. We explored whether major barriers evolved with increasing publishing experience. Approach:We surveyed registrants of 12 noncompulsory workshops on scientific publishing (April 2009-November 2015. Survey respondents indicated how many of their coauthored papers were accepted for publication in peer-reviewed journals in the past 5 years and stated what they found most difficult about preparing a manuscript, other than lack of time. Two investigators performed a content analysis of the reported barriers; mean agreement between coders was 98% (SD = 2%), and the mean Scott π coefficient for interrater reliability was 0.81 (SD = 0.26). We used a multi-method analytic approach to determine whether the perceived barriers varied with level of publishing experience.Findings: Surveys were returned by 201/256 registrants (79%). Thirty-eight percent of respondents had lower publishing experience (0-4 papers published in peer-reviewed journals in the past 5 years), 26% had medium experience (5-10 papers), and 35% had higher experience (>10 papers). Many respondents (57%) listed multiple barriers, but 5% listed 0 barriers. The content analysis of the 370 reported barrier items identified 8 categories covering 38 concepts. The most common concerns (ie, organization, writing, following journal format, defining the article scope, disliking writing, responding to reviewers) were not affected by author experience level. However, significantly more academics with higher experience expressed concerns about data presentation.

In a survey of 471 patients, we collected self-reported weight and height data and asked about self-perceptions of provider support toward weight loss and other weight management concerns. Multivariable analysis found that respondents with higher body mass index (BMI) were more likely to report that a physician had told them that they were overweight (OR = 3.49, 95% CI 2.06-5.89, P < 0.001). However, this conversation was less likely to change their personal view of their weight (OR = 0.62 per 5 kg/m 2 , 95% CI 0.45-0.86, P = 0.004), or motivate them to lose weight (OR = 0.67 per 5 kg/m 2 , 95% CI 0.50-0.91, P = 0.009). Higher BMI was associated with higher weight-loss goals (P < 0.001), while anticipated time to achieve those goals was increased (P < 0.001). Physician involvement in weight management was important, but the patients' needs and experiences differed by BMI. Approaches to addressing barriers and identifying resources for weight management should be tailored to individuals by considering BMI.