SummaryRecombinant factor Vila (rFVIIa; NovoSeven®) is a recent addition to the hemostatic alternatives for the treatment of hemophiliacs with inhibitors. A drawback in the use of rFVIIa has been its half-life of only about 2 h, which necessitates very frequent and punctual injections. We evaluated the stability of reconstituted, but not further diluted, rFVIIa in 3 infusion systems (WalkMedTM 350 and CADD®-Plus minipumps and Meddex 2001 syringe pump). The factor VII (F VII) activity was maintained for at least 3 days at room temperature with only a minor and clinically insignificant increase in oxidized forms of rFVIIa and minimal leaching of the plastic softeners di-butylphthalate and di-octylphthalate after 24–48 h. Addition of heparin, 5–10 U/ml, to reconstituted rFVIIa caused a loss of about 50% of the activity within 4 h of storage in the infusion system, whereas low molecular weight heparin had no such effect. Repeated samples showed that the infusion systems maintained sterility. Reconstituted rFVIIa did not support bacterial growth when inoculated with Staphylococcus aureus or Escherichia coli to any greater extent than did reconstituted factor VIII, lidocaine in saline or heparin in saline. Two patients were treated with continuous infusion of rFVIIa on 4 occasions (total knee arthroplasty, wound revision, and twice straightening of a 90° contracture of the knee under general anaesthesia). A preoperative pharmacokinetic evaluation was performed, and the clearance was used to calculate the maintenance dose, aiming at a FVII level of 10 U/ml, which proved to be a hemostatic level. The first patient had no change in the clearance during the two treatment episodes. He suffered from repeated thrombophlebitis at the infusion site. The second patient had a progressive decrease of the clearance from 86.4 to 24.7 ml/h/kg. He received during the first treatment a parallel infusion with heparin (≈250 U/24 h) to the same venous access and did not develop thrombophlebitis during 3.5 days of therapy. For the second episode low molecular weight heparin was added directly to the infusion bag, and no adverse effects were observed. Continuous infusion with rFVIIa is thus feasible with the minipumps used by us, eliminates the need for 2 h injections and reduces the total dose of rFVIIa by 50–75%, depending on the behaviour of the clearance.

Hox proteins are well-established developmental regulators that coordinate cell fate and morphogenesis throughout embryogenesis. In contrast, our knowledge of their specific molecular modes of action is limited to the interaction with few cofactors. Here, we show that Hox proteins are able to interact with a wide range of transcription factors in the live Drosophila embryo. In this context, specificity relies on a versatile usage of conserved short linear motifs (SLiMs), which, surprisingly, often restrains the interaction potential of Hox proteins. This novel buffering activity of SLiMs was observed in different tissues and found in Hox proteins from cnidarian to mouse species. Although these interactions remain to be analysed in the context of endogenous Hox regulatory activities, our observations challenge the traditional role assigned to SLiMs and provide an alternative concept to explain how Hox interactome specificity could be achieved during the embryonic development.DOI: http://dx.doi.org/10.7554/eLife.06034.001

Different approaches are necessary when Community Based Participatory Research (CBPR) of environmental illness is initiated after an environmental disaster within a community. Often such events are viewed as golden scientific opportunities to do epidemiological studies. However, we believe that in such circumstances, community engagement and empowerment needs to be integrated into the public health service efforts in order for both those and any science to be successful, with special care being taken to address the immediate health needs of the community first rather than the pressing needs to answer important scientific questions. We will demonstrate how we have simultaneously provided valuable public health service, embedded generalizable scientific knowledge, and built a successful foundation for supplemental CBPR through our on-going recovery work after the chlorine gas disaster in Graniteville, South Carolina.

Prion-like domains (PLDs), defined by their low sequence complexity and intrinsic disorder, are present in hundreds of human proteins. Although gain-of-function mutations in the PLDs of neuronal RNA-binding proteins have been linked to neurodegenerative disease progression, the physiological role of PLDs and their range of molecular functions are still largely unknown. Here, we show that the PLD of Drosophila Imp, a conserved component of neuronal ribonucleoprotein (RNP) granules, is essential for the developmentally-controlled localization of Imp RNP granules to axons and regulates in vivo axonal remodeling. Furthermore, we demonstrate that Imp PLD restricts, rather than promotes, granule assembly, revealing a novel modulatory function for PLDs in RNP granule homeostasis. Swapping the position of Imp PLD compromises RNP granule dynamic assembly but not transport, suggesting that these two functions are uncoupled. Together, our study uncovers a physiological function for PLDs in the spatio-temporal control of neuronal RNP assemblies.

Complications of the pneumatic tourniquet used during limb surgery result from excessive direct pressure. Traditional recommendations suggests parameters for maximum pressure and time limits rather than the minimal effective pressure to achieve a bloodless field. A clinical study was undertaken to evaluate the pneumatic tourniquet setting required for adequate haemostasis in the upper limb. The correlations between several possible influencing parameters (age, sex, arm fat thickness, extremity length, systolic, diastolic, and mean blood pressures) and the minimal pneumatic tourniquet pressure at which the peripheral pulse reappeared were studied in 50 patients undergoing surgery, using a Doppler stethoscope. The average Doppler Opening Pressure was 168.5 +/- 42.7 mmHg and the only significant clinical variable was the mean blood pressure. From these results an equation was derived to predict the minimal effective tourniquet pressure. The mean calculated tourniquet pressure was 202.3 +/- 34.2 mmHg, well below the 250 to 300 mmHg previously recommended. The technique consisted of inflating the tourniquet to a pressure of 300 mmHg, then reducing it to the calculated value. A bloodless field was maintained in all patients.

Patients who were scheduled for surgical release of their trigger fingers underwent an injection of the involved tendon sheath prior to surgery. In thirty-six patients the injection of methylene blue was undertaken in a proximal-distal direction and in forty-three the direction of the injection was reversed. The success rate of the injections was 61 per cent. in the proximal distal group and 37 per cent in the second group. There was no significant statistical difference with regard to age, but duration of the disorder and mode of injection regarding the different fingers did have statistical significance.

Ribonucleoprotein (RNP) granules are dynamic condensates enriched in regulatory RNA binding proteins (RBPs) and RNAs under tight spatiotemporal control. Extensive recent work has investigated the molecular principles underlying RNP granule assembly, unraveling that they form through the self-association of RNP components into dynamic networks of interactions. How endogenous RNP granules respond to external stimuli to regulate RNA fate is still largely unknown. Here, we demonstrate through high-resolution imaging of intact Drosophila brains that Tyramine induces a reversible remodeling of somatic RNP granules characterized by the decondensation of granule-enriched RBPs (e.g. Imp/ZBP1/IGF2BP) and helicases (e.g. Me31B/DDX-6/Rck). Furthermore, our functional analysis reveals that Tyramine signals both through its receptor TyrR and through the calcium-activated kinase CamkII to trigger RNP component decondensation. Finally, we uncover that RNP granule remodeling is accompanied by the rapid and specific translational activation of associated mRNAs. Thus, this work sheds new light on the mechanisms controlling cue-induced rearrangement of physiological RNP condensates.

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