Moderate preterm birth impacts right ventricular structure and function and pulmonary artery blood flow in adult sheep

Abstract

Preterm birth prematurely exposes the immature heart to the haemodynamic transition at birth, which has the potential to induce abnormal cardiac remodelling. Magnetic resonance imaging studies in young adults born preterm have shown abnormalities in the gross structure of the ventricles (particularly the right ventricle; RV), but the cellular basis of these alterations is unknown. The aim of this study, conducted in sheep, was to determine the effect of moderate preterm birth on RV cellular structure and function in early adulthood. Male singleton lambs were delivered moderately preterm (132 ± 1 days; n = 7) or at term (147 ± 1 days; n = 7). At 14.5 months of age, intra-arterial blood pressure and heart rate were measured. Pulmonary artery diameter and peak systolic blood flow were determined using ultrasound imaging, and RV stroke volume and output calculated. Cardiomyocyte number, size, nuclearity, and levels of cardiac fibrosis were subsequently assessed in perfusion-fixed hearts using image analysis and stereological methods. Blood pressure (systolic, diastolic and mean), heart rate, levels of myocardial fibrosis and RV stroke volume and output were not different between groups. There was, however, a significant reduction in RV wall thickness in preterm sheep, and this was accompanied by a significant reduction in peak systolic blood flow in the pulmonary artery and in RV cardiomyocyte number. Cellular changes in the RV wall and reduced pulmonary artery blood flow following preterm birth have the potential to adversely impact cardiac and respiratory hemodynamics, especially when the cardiovascular system is physiologically or pathologically challenged.

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Researching of tritium speciation in soils of “Balapan” site

Publication date: Available online 5 March 2018
Source:Journal of Environmental Radioactivity
Author(s): Z.B. Serzhanova, A.K. Aidarkhanova, S.N. Lukashenko, O.N. Lyakhova, L.V. Timonova, A.M. Raimkanova
Speciation of tritium (³Н) in soils from the "Balapan" site in Semipalatinsk are presented in this study. Three interrelated objects were chosen for further study: "Atomic" lake, the Shagan River and an external reservoir. The main speciation forms of ³Н in soil were: ³Н in surface-adsorbed water, ³Н in interlayer water, hydroxylic ³Н, organically bound ³Н and crystalline-bound ³Н.Results will allow an estimation of contamination mechanism to be made, and will also allow the potential for migration and bioavailability of ³Н to be assessed.



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A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

Summary

Background

Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior.

Aims

The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures. The reliability of the Pediatric Anesthesia Emergence Delirium scale was also tested.

Methods

One hundred and twenty-two children younger than seven years were observed at postoperative care units during recovery from anesthesia. Two or 3 observers independently assessed the children using the Pediatric Anesthesia Emergence Delirium scale.

Results

The factor analysis clearly revealed a one-factor solution, which accounted for 82% of the variation in the data. Internal consistency, calculated with Cronbach′s alpha, was good (0.96). The Intraclass Correlation Coefficient, which was used to assess interrater reliability for the Pediatric Anesthesia Emergence Delirium scale sum score, was 0.97 (P < .001). The weighted kappa statistics were almost perfect in 4 of 5 items, with substantial agreement in the fifth (P < .001).

Conclusion

The one-factor solution and the satisfactory reliability in terms of internal consistency and stability support the use of the Pediatric Anesthesia Emergence Delirium scale for assessing emergence delirium in children recovering from anesthesia after surgery or diagnostic procedures. The kappa statistics for the Pediatric Anesthesia Emergence Delirium scale items essentially indicated good agreement between independent raters, supporting interrater reliability.

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Understanding cardiac shunts

Summary

Most patients with congenital heart disease have a cardiac shunt whose direction and magnitude can have a major impact on cardiorespiratory physiology and function. The dynamics of the shunt can be significantly altered by anesthetic management and must be understood in order to provide optimal anesthetic care. Given that there are now more adults than children with congenital heart disease and that the majority of nonpediatric patients are cared for in centers without special expertise in congenital heart disease, it is imperative that all anesthesia providers have a general understanding of the subject. This educational review describes a technique to explain this complex subject using simple pictorial diagrams.

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Not just there to fill space: profound observations on interstitial cells of Cajal in the gastric fundus

Abstract

In common with other regions of the gastrointestinal tract, the stomach generates multiple patterns of motility that serve to accommodate, break down and mix food.

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Loss of GABAB-mediated interhemispheric synaptic inhibition in stroke periphery

Abstract

Recovery after stroke is mediated by plastic changes largely occurring in the lesion periphery. However, little is known on the microcircuit changes underlying recovery, at which extent perilesional plasticity occurs at synaptic input vs. spike output level, and on the connectivity behind such synaptic plasticity. We combined intrinsic imaging with extra- and intra-cellular recordings and pharmacological inactivation in a focal stroke in mouse somatosensory cortex (S1). In vivo whole-cell recordings in hindlimb S1 (hS1) showed synaptic responses also to forelimb stimulation in controls, and such responses were abolished by stroke of neighboring forelimb area (fS1), suggesting that in normal conditions they originate via horizontal connections from neighboring fS1. Synaptic and spike responses to forelimb stimulation in hS1 recovered to quasi-normal levels 2 weeks after stroke, without changes in intrinsic excitability and hindlimb-evoked spike responses. Recovered synaptic responses had longer latencies, suggesting a long-range origin of the recovery, prompting us to investigate the role of callosal inputs in the recovery process. Contralesional S1 silencing unmasked significantly larger responses to both limbs in controls, a phenomenon that was not observed when GABA_B receptors were antagonized in the recorded area. Conversely, such GABA_B-mediated interhemispheric inhibition was not detectable after stroke: callosal input silencing failed to change hindlimb responses, whereas it robustly reduced recovered forelimb responses. Thus, recovery of subthreshold responsiveness in the stroke periphery is accompanied by a loss of interhemispheric inhibition and due to a pathway-specific facilitatory action on the affected sensory response from contralateral cortex.

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The “Pectoral-Gap Phenomenon”: A Hypothesis on Origin and Mechanism

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The Molecular Chaperone HSP90 Promotes Notch Signaling in the Germline of Caenorhabditis elegans

In a genetic screen to identify genes that promote GLP-1/Notch signaling in Caenorhabditis elegans germline stem cells, we found a single mutation, om40, defining a gene called ego-3. ego-3(om40) causes several defects in the soma and the germline, including paralysis during larval development, sterility, delayed proliferation of germline stem cells, and ectopic germline stem cell proliferation. Whole genome sequencing identified om40 as an allele of hsp-90, previously known as daf-21, which encodes the C. elegans ortholog of the cytosolic form of HSP90. This protein is a molecular chaperone with a central position in the protein homeostasis network, which is responsible for proper folding, structural maintenance, and degradation of proteins. In addition to its essential role in cellular function, HSP90 plays an important role in stem cell maintenance and renewal. Complementation analysis using a deletion allele of hsp-90 confirmed that ego-3 is the same gene. hsp-90(om40) is an I->N conservative missense mutation of a highly conserved residue in the middle domain of HSP-90. RNA interference-mediated knockdown of hsp-90 expression partially phenocopied hsp-90(om40), confirming the loss-of-function nature of hsp-90(om40). Furthermore, reduced HSP-90 activity enhanced the effect of reduced function of both the GLP-1 receptor and the downstream LAG-1 transcription factor. Taken together, our results provide the first experimental evidence of an essential role for HSP90 in Notch signaling in development.

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The Utility of the Total Neuropathy Score as an Instrument to Assess Neuropathy Severity in Chronic Kidney Disease: A Validation Study

To demonstrate construct validity of the Total Neuropathy Score (TNS) in assessing peripheral neuropathy in subjects with chronic kidney disease (CKD).

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Precision of perceived direction of gravity in partial bilateral vestibulopathy correlates with residual utricular function

Bilateral-vestibular deficiency (BVD) results from functional impairment of both vestibular organs, leading to gait unsteadiness in almost all patients (Zingler et al., 2007) and oscillopsia (illusionary movement of the visual surroundings during head movements) (Hain et al., 2013), which is found less consistently (from 44% (Zingler et al., 2007) to 97% (Black et al., 2004)). These complaints have been linked to a reduced angular vestibulo-ocular reflex (aVOR), which normally stabilizes gaze during head movements, and to impairment of the otolith organs (utriculus, sacculus), which are key for sensing linear acceleration and gravity (Schoene, 1964; Hain et al., 2013).

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Predicting one repetition maximum using hand-held dynamometry

Isometric assessment of muscular function using a hand held dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinician's do not often use 1RM testing, preferring to be cautious with clients who have pre-existing impairments. If strength testing using a HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments.

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Ultrasound Guided Carpal Tunnel Release Using Dynamic Expansion of the Transverse Safe Zone in a Patient with Post-Polio Syndrome: A Case Report

The prevalence of carpal tunnel syndrome(CTS) in patients that suffer from post-polio syndrome occurs at a rate of 22%.[1] Irrespective of those with CTS, 74% of post-polio patients weight bear through their arms for ambulation or transfers.[1] As open carpal tunnel release is performed along the weight bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound guided carpal tunnel release(USCTR) was successfully performed in a patient with post-polio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

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Examination of factors related to the effect of improving gait speed with functional electrical stimulation intervention for patients with stroke

Functional electrical stimulation (FES) for patients with stroke and foot drop is an alternative to ankle foot orthoses. Characteristics of FES responders and non-responders have not been clarified.

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Sonographic Changes Following Ultrasound-guided Release of the Transverse Carpal Ligament- A Case Report

Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy, resulting in 500,000 carpal tunnel release (CTR) surgeries and a total cost of over 2 billion dollars annually in the United States.1,2 Although initially performed via a large (3-5 cm), palmar incision, CTR techniques have continually evolved to reduce recovery times and post-operative pain, and improve cosmesis and clinical outcomes.2,3 More recently, multiple authors have reported excellent results following ultrasound-guided carpal tunnel release (USCTR) using a variety techniques, and one prospective randomized trial reported faster recovery following USCTR compared to traditional mini-open CTR.

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The role of the Oxytocin-Neurophysin I gene in contributing to human personality traits promoting sociality

Publication date: Available online 5 March 2018
Source:International Journal of Psychophysiology
Author(s): Anne Chong, Soo Hong Chew, Poh San Lai, Richard P. Ebstein, Jean-Philippe Gouin
Oxytocin (OT) plays a salient role in contributing to the high levels of human sociality that characterize our species. Across the lifespan this nonapeptide promotes prosocial behaviors and modulates stress responses. Curiously, the OXT-Neurophysin I gene has been little studied despite the fact this is the structural gene for the OT nonapeptide. In a large group of Han Chinese undergraduate students (n = 1593) we examined associations of two single nucleotide polymorphisms of the OXT- Neurophysin I gene with personality traits. Results indicated that the OXT-Neurophysin I rs2770378 was related to extraversion, agreeableness, and neuroticism. AA homozygous individuals reported more prosocial personality traits, compared to participants carrying the G allele. These results indicate that variants of the OXT-Neurophysin-I gene resonate with phenotypes that foster positive social interactions, which may in turn facilitate the social regulation of stress responses.



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Dental topography and the diet of Homo naledi

Publication date: May 2018
Source:Journal of Human Evolution, Volume 118
Author(s): Michael A. Berthaume, Lucas K. Delezene, Kornelius Kupczik
Though late Middle Pleistocene in age, Homo naledi is characterized by a mosaic of Australopithecus-like (e.g., curved fingers, small brains) and Homo-like (e.g., elongated lower limbs) traits, which may suggest it occupied a unique ecological niche. Ecological reconstructions inform on niche occupation, and are particularly successful when using dental material. Tooth shape (via dental topography) and size were quantified for four groups of South African Plio-Pleistocene hominins (specimens of Australopithecus africanus, Paranthropus robustus, H. naledi, and Homo sp.) on relatively unworn M2s to investigate possible ecological differentiation in H. naledi relative to taxa with similar known geographical ranges. H. naledi has smaller, but higher-crowned and more wear resistant teeth than Australopithecus and Paranthropus. These results are found in both lightly and moderately worn teeth. There are no differences in tooth sharpness or complexity. Combined with the high level of dental chipping in H. naledi, this suggests that, relative to Australopithecus and Paranthropus, H. naledi consumed foods with similar fracture mechanics properties but more abrasive particles (e.g., dust, grit), which could be due to a dietary and/or environmental shift(s). The same factors that differentiate H. naledi from Australopithecus and Paranthropus may also differentiate it from Homo sp., which geologically predates it, in the same way. Compared to the great apes, all hominins have sharper teeth, indicating they consumed foods requiring higher shear forces during mastication. Despite some anatomical similarities, H. naledi likely occupied a distinct ecological niche from the South African hominins that predate it.



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Local infiltration analgesia combined with a standardized multimodal approach including an adductor canal block in total knee arthroplasty: a prospective randomized, placebo-controlled, double-blinded clinical trial

Abstract

Purpose

Total knee arthroplasty (TKA) is associated with moderate to severe postoperative pain. This study evaluates the technique of local infiltration analgesia (LIA), by comparing it to saline injections in addition to a standardized multimodal regimen including an adductor canal block.

Methods

Between September 2015 and March 2016, forty patients aged 18 years and older, ASA I–III, undergoing primary unilateral cemented TKA under spinal anesthesia were randomized to receive either LIA (LIA group) or normal saline (sham LIA group). Morphine consumption during the first 24 postoperative hours, time to first IV morphine dose request, pain intensity at rest and passive knee flexion, complication rates, patient satisfaction and duration of hospitalization were documented (Clinicaltrials.gov, identifier: NCT03206554).

Results

Compared with the sham LIA group, the LIA group showed statistically significant lower morphine consumption at all times (6, 12, 18, 24 h—P value: 0.035, 0.008, 0.015 and 0.003, respectively). Time to first IV morphine dose request did not differ significantly between groups (P = 0.902). The intergroup difference in NRS pain scores was statistically significant, with the LIA group showing lower resting and dynamic pain scores in all instances and additionally higher patient satisfaction. The groups did not differ in terms of complication rates and duration of hospitalization.

Conclusions

Performing LIA in addition to a standardized multimodal analgesia regimen results in superior pain control, demonstrated as reduced opioid needs and lower resting and dynamic pain intensity scores on the first postoperative day after TKA. Further studies are needed to establish an LIA protocol that could maximize postoperative pain control.

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Transitions in Smoking Across a Pregnancy: New Information from the Growing Up in New Zealand Longitudinal Study

Abstract

Introduction Maternal smoking remains a modifiable cause of adverse maternal and child health outcomes. This study investigated smoking transitions across pregnancy. Methods Data from the contemporary child cohort study Growing Up in New Zealand (n = 6822) were used to analyse smoking status across three points across a pregnancy: pre-pregnancy, during pregnancy and after pregnancy. Odds-ratios (OR) were calculated for maternal, socio-economic and pregnancy-related factors associated with each transition using multivariate logistic regression. Results The prevalence of smoking pre-pregnancy was 20.3%. The cessation rate during pregnancy was 48.5%, while the postpartum relapse rate was 36.0%. Heavy smokers were less likely to quit during pregnancy (OR 0.13, 95% CI 0.08–0.20), and more likely to relapse at 9 months (OR 2.63, CI 1.60–4.32), relative to light smokers. Women in households with another smoker were less likely to quit during pregnancy (OR 0.35, CI 0.25–0.48), and more likely to relapse postpartum (OR 2.00, CI 1.14–3.51), relative to women in a smoke-free household. Women without high school qualifications were less likely to quit during pregnancy than women with bachelor degrees (OR 0.21, CI 0.11–0.41) but no more likely to relapse. Maori women were less likely to quit during pregnancy than European women (OR 0.35, CI 0.25–0.49) but no more likely to relapse. Conclusion Heavy smokers and those with another smoker in the household are at high risk of smoking during pregnancy or relapsing after pregnancy. Decreasing smoking across a pregnancy therefore requires a focus on cessation in all households with heavy smokers of child-bearing age. The association between smoking and ethnicity may be confounded as it not consistent across the pregnancy.

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Locales of Trust: How Two Forms of Community Trust are Associated with Mothers’ Self-Rated Health in Indonesia

Abstract

Objectives Social trust and access to social capital serve as important mechanisms to offset gender disparities in health in low-middle-income countries (LMICs) such as Indonesia. Indonesian women may have fewer opportunities to create strong social ties outside her social sphere and thus may benefit particularly from individual-level thin trust because generalized trust lowers barriers to gaining social support. We examined the role of thin trust and thick trust, two unique forms of social trust, to better understand the links between individual- and community-level trust and maternal health. Thin trust represents generalized trust in community members while thick trust represents strong and longstanding trusting relationships. Methods We employed nationally representative data from Wave 5 of the Indonesian Family Life Survey collected in 2014–2015 (n = 7276) to identify relationships between social trust and the self-rated health (SRH) of women in Indonesia, net of both individual- and community-level controls. Results We found evidence that both thick and thin trust benefit women's health but operate at different levels. While thick trust decreased likelihoods of poor SRH at the community level, thin trust was associated with lower likelihoods of poor SRH at the individual level. Conclusions for Practice We argue that for women in LMICs, trust provides an important mechanism through which women potentially access both tangible and immaterial resources that positively influence health outcomes.

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Comparative genomics: Blood, guts and vampire bats

Comparative genomics: Blood, guts and vampire bats

Comparative genomics: Blood, guts and vampire bats, Published online: 05 March 2018; doi:10.1038/nrg.2018.14

Comparative genomics: Blood, guts and vampire bats

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