Τρίτη, 27 Δεκεμβρίου 2016

Effects of gait training with body weight support on a treadmill vs. overground for individuals with stroke

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Gabriela L. Gama, Melissa L. Celestino, José A. Barela, Larry Forrester, Jill Whitall, Ana M.F. Barela
ObjectiveTo investigate the effects of gait training with body weight support on a treadmill vs. overground in individuals with chronic stroke.DesignRandomized controlled trial.SettingUniversity research laboratoryParticipantsTwenty-eight individuals with chronic stroke (> 6 months).InterventionsParticipants were randomly assigned to receive gait training with BWS on a treadmill (n=14) or overground (n=14) three times a week for six weeks.Main Outcome MeasuresOverground gait speed, 6-minute walk test, motor domain of the functional independence measure, lower extremity domain of Fugl-Meyer movement assessment, step length, step-length symmetry ratio and single limb support duration. Measurements were obtained at baseline (T0), immediately after (T1) and six weeks after (T2) the training session.ResultsAt T1, both groups improved in all outcome measures except paretic step-length and step-symmetry, which were only improved in the overground group (p=0.01 and p=0.01 respectively). At T2, all improvements remained and the treadmill group also improved paretic step length (p<0.001) but not step-symmetry (p>0.05).ConclusionsIndividuals with chronic stroke equally improve gait speed and other gait parameters after 18 sessions of BWS gait training on either treadmill or overground. Only the overground group improved step symmetry, suggesting a role for integrating overground walking into BWS interventions post-stroke.



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Validation of the QuickDASH and DASH in Patients with Distal Radius Fractures through Agreement Analysis

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Philemon Tsang, David Walton, Ruby Grewal, Joy MacDermid
ObjectiveTo examine the agreement of scores between the Disability of Arm, Shoulder and Hand (DASH) and QuickDASH Questionnaires in patients with distal radius fractures (DRF) and their score's concurrent validity with PRWE scores.DesignValidity StudySettingHand and upper limb clinicParticipantsOne hundred and seventy-seven patients with Distal Radius Fractures over the age of 18 were included in this study.InterventionsN/AMain Outcome MeasuresMeasurements of the DASH, QuickDASH, and Patient Reported Wrist Evaluation (PRWE) were taken at baseline and 1-year follow-up. QuickDASH scores were extracted from the DASH scores. Agreement analysis of the DASH and QuickDASH were evaluated using Bland-Altman's technique. Item difficultly analysis was performed to examine the distribution of QuickDASH items amongst DASH items. Responsiveness of the DASH, QuickDASH, and PRWE were also evaluated by calculating standardized response means.ResultsQuickDASH scores were higher than DASH scores, particularly at baseline. A mean difference of 3.8 and 1.2 points were observed at baseline and 1-year follow-up, respectively. The limits of agreement (LOA) were wide at baseline with a range of 24.8 points at baseline, but decreased to 12.5 points at 1-year follow-up. Item difficulty analysis revealed that QuickDASH items were not evenly distributed at baseline. Finally, the responsiveness of the DASH, QuickDASH and PRWE were similar from baseline to 1-year follow-up (standardized response mean of 2.13, 2.17, and 2.19, respectively).ConclusionWhen changing from the DASH to the QuickDASH in the context of DRF, a systematic bias of higher scores on the QuickDASH should be considered by the user. However, the QuickDASH still demonstrated good concurrent validity and responsiveness.



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Qualitative Development of a Discrete Choice Experiment for Physical Activity Interventions to Improve Knee Osteoarthritis

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Daniel Pinto, Margaret Danilovich, Paul Hansen, Daniel J. Finn, Rowland W. Chang, Jane L. Holl, Allen W. Heinemann, Ulf Bockenholt
ObjectiveTo describe the qualitative process used to develop attributes and attribute levels for inclusion in a discrete choice experiments (DCE) for older adult physical activity interventions.DesignFive focus groups (a total of 41 participants) were conducted, grounded in the Health Action Process Approach framework. Discussion emphasized identification and prioritization attributes for a DCE on physical activity. Semi-structured interviews (n=6) investigated attribute levels and lay-language for the DCE. A focus group with physical activity researchers and health care providers was the final stakeholder group used to establish a comprehensive approach for the generation of attributes and levels. A DCE pilot test was then conducted with individuals of the target patient population. All transcripts were analyzed using a constant comparative approach.SettingGeneral community and university-based research settingParticipantsVolunteers with age greater than 45 years and knee pain, aches or stiffness for at least one month over the previous 12 months.InterventionsNot applicable.Main outcome measuresInterview guides, attributes, attribute levels, discrete choice experiment.ResultsThe most influential identified attributes for physical activity were time, effort, cost, convenience, enjoyment, and health benefits. Each attribute had three levels that were understandable in the pilot test of the DCE.ConclusionsThe identification of six physical activity attributes that are most salient to adults with knee osteoarthritis resulted from a systematic qualitative process including attribute-ranking exercises. A DCE will provide insight into the relative importance of these attributes for participating in physical activity, which can guide intervention development.



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Relationship between subacromial bursitis on ultrasonography and efficacy of subacromial corticosteroid injection in rotator cuff disease: a prospective comparison study

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Doo-Hyung Lee, Ji Yeon Hong, Michael Young Lee, Kyu-Sung Kwack, Seung-Hyun Yoon
ObjectiveTo evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in rotator cuff disease patients.DesignProspective, longitudinal comparison study.SettingUniversity-affiliated tertiary care hospital.ParticipantsPatients with rotator cuff disease (N=69) were classified into three groups based on ultrasonographic findings; (1) normal bursa group (group 1, n=23): bursa and effusion thickness <1 mm, (2) bursa thickening group (group 2, n=22): bursa thickness >2 mm and effusion thickness <1 mm, (3) bursa effusion group (group 3, n=24): bursa thickness <1 mm and effusion thickness >2 mm.InterventionA single subacromial injection with 20 mg of triamcinolone acetonide.Main Outcome Measures: Visual analog scale (VAS) of the shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre-treatment and post-treatment at week 8.ResultsThere were no significant differences between the 3 groups in demographic characteristics pre-treatment. Groups 2 and 3 showed a significant difference compared to group 1 in changes of VAS and abduction; group 3 showed a significant difference compared to group 1 in changes of SDQ, internal rotation and external rotation; and all groups showed significant differences when compared to each other (1 and 3, 2 and 3, and 1 and 2) in changes of thickness.ConclusionA patient with ultrasonographic observation of subacromial bursitis, instead of normal bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection.



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Physiological limits to endurance exercise performance: influence of sex

This brief review summarizes factors associated with elite endurance performance, trends in distance running training, and participation by men and more recently women. It is framed in the context of key ideas about the physiological determinants of endurance performance but also touches on some historical and sociological factors relevant to the overall topic. Historical trends that served to increase women's participation in elite endurance events are also discussed as is the role of increased volume and intensity of training. The rapid improvement in women's world record marathon times in 1970 s and 80 s are emblematic of these trends and represent a combination of increased training volume and intensity and more competitive opportunities. This occurred as bans on participation by women in endurance events were lifted. For men these same trends evolved over a much longer time frame. The main physiological factor responsible for 10–12% slower times in women compared to men at the elite level are also considered and likely centre around VO2max.

This article is protected by copyright. All rights reserved



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A novel mechanism of tandem activation of ryanodine receptors by cytosolic and SR luminal Ca during excitation-contraction coupling in atrial myocytes

In atrial myocytes Ca release during excitation-contraction coupling (ECC) is strikingly different from ventricular myocytes. In many species atrial myocytes lack a transverse tubule system, dividing the sarcoplasmic reticulum (SR) Ca store into the peripheral subsarcolemmnal junctional (j-SR) and the much more abundant central non-junctional (nj-SR) SR. Action potential (AP)-induced Ca entry activates Ca-induced Ca release (CICR) from j-SR ryanodine receptor (RyR) Ca release channels. Peripheral elevation of [Ca]i initiates CICR from nj-SR and sustains propagation of CICR to the cell centre. Simultaneous confocal measurements of cytosolic ([Ca]i; with the fluorescent Ca indicator rhod-2) and intra-SR ([Ca]SR; fluo-5 N) Ca in rabbit atrial myocytes revealed that Ca release from j-SR resulted in a cytosolic Ca transient of higher amplitude compared to release from nj-SR, however the degree of depletion of j-SR [Ca]SR was smaller than nj-SR [Ca]SR. Similarly, Ca signals from individual release sites of the j-SR showed a larger cytosolic amplitude (Ca sparks) but smaller depletion (Ca blinks) than release from nj-SR. During AP-induced Ca release the rise of [Ca]i detected at individual release sites of the nj-SR preceded the depletion of [Ca]SR, and during this latency period a transient elevation of [Ca]SR occurred. We propose that Ca release from nj-SR is activated by cytosolic and luminal Ca (tandem RyR activation) via a novel 'fire-diffuse-uptake-fire' (FDUF) mechanism. This novel paradigm of atrial ECC predicts that Ca uptake by SERCA at the propagation front elevates local [Ca]SR, leading to luminal RyR sensitization and lowering of the activation threshold for cytosolic CICR.

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A mechanism for sickness sleep: lessons from invertebrates

Abstract

During health, animal sleep is regulated by an internal clock and by the duration of prior wakefulness. During sickness, sleep is regulated by cytokines released from either peripheral cells or from cells within the nervous system. These cytokines regulate central nervous system neurons to induce sleep. Recent research in the invertebrates Caenorhabditis elegans and Drosophila melanogaster has led to new insights into the mechanism of sleep during sickness. Sickness is triggered by exposure to environments such as infection, heat, or ultraviolet light irradiation, all of which cause cellular stress. Epidermal growth factor is released from stressed cells and signals to activate central neuroendocrine cell(s). These neuron(s) release neuropeptides including those containing an amidated arginine(R)-phenylalanine(F) motif at their C-termini (RFamide peptides). Importantly, mechanisms regulating sickness sleep are partially distinct from those regulating healthy sleep. We will here review key findings, which have elucidated the central neuroendocrine mechanism of sleep during sickness. Adaptive mechanisms employed in the control of sickness sleep may play a role in correcting cellular homeostasis after various insults. We speculate that these mechanisms may play a maladaptive role in human pathological conditions such as in the fatigue and anorexia associated with autoimmune diseases, with major depression, and with unexplained chronic fatigue.

This article is protected by copyright. All rights reserved



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From channels to systems: Ca2+-sensitive K+ currents, alternans and cardiac arrhythmia



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qSOFA should replace SIRS as the screening tool for sepsis

No description available

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Disaster Management in the Ottoman Empire

2016-12-27T21-39-24Z
Source: Journal of Contemporary Medicine
Murat Koyuncu, Serhat Koyuncu.
Disaster Management in the Ottoman Empire


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Glomerulopathies and Malignancies; Short Review

2016-12-27T21-39-24Z
Source: Journal of Contemporary Medicine
Ertuğrul Erken, Samed Rahatlı.
Acute kidney injury related to ethiologies such as dehydration, drug toxicities, urate nephropathy and many others is a big concern for patients with maligant diseases. Apart from that, these patients may also develop some renal pathologies which could be defined as glomerular paraneoplastic syndromes associated with malignant diseases. Most common pathologial diagnosis in these secondary glomerulopathies are membranous nephropathy and minimal change disease. On the other hand, immunosupressive medications we used fort he treatment of the primary glomerular diseases might have the way for some malignant diseases in the long run. In this short review we tried to refer to some glomerular diseases associated with malignancies.


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Fine Mapping of Ur-3, a Historically Important Rust Resistance Locus in Common Bean

Bean rust, caused by Uromyces appendiculatus, is a devastating disease of common bean (Phaseolus vulgaris) in the Americas and Africa. The historically important Ur-3 gene confers resistance to many races of the highly variable bean rust pathogen that overcome other rust resistance genes. Existing molecular markers tagging Ur-3 for use in marker assisted selection produce false results. We describe here the fine mapping of the Ur-3 locus for the development of highly accurate markers linked to Ur-3. An F2 population from the cross Pinto 114 (susceptible) x Aurora (resistant with Ur-3) was evaluated for its reaction to four different races of U. appendiculatus. A bulked segregant analysis using the SNP chip BARCBEAN6K_3 placed the approximate location of Ur-3 in the lower arm of chromosome Pv11. Specific SSR and SNP markers and haplotype analysis of 18 sequenced bean lines positioned Ur-3 in a 46.5 Kb genomic region from 46.96 to 47.01 Mb on Pv11. We discovered in this region the SS68 KASP marker that was tightly linked to Ur-3. Validation of SS68 on a panel of 130 diverse common bean lines and cultivars containing all known rust resistance genes revealed that SS68 was highly accurate and produced no false results. The SS68 marker will be of great value in pyramiding Ur-3 with other rust resistance genes. It will also significantly reduce time and labor associated with the current phenotypic detection of Ur-3. This is the first utilization of fine mapping to discover markers linked to a rust resistance in common bean.



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Caenorhabditis elegans Male Copulation Circuitry Incorporates Sex-Shared Defecation Components To Promote Intromission and Sperm Transfer

Sexual dimorphism can be achieved using a variety of mechanisms, including sex-specific circuits and sex-specific function of shared circuits, though how these work together to produce sexually dimorphic behaviors require further investigation. Here, we explore how components of the sex-shared defecation circuitry are incorporated into the sex-specific male mating circuitry in Caenorhabditis elegans to produce successful copulation. Using behavioral studies, calcium imaging, and genetic manipulation, we show that aspects of the defecation system are co-opted by the male copulatory circuitry to facilitate intromission and ejaculation. Similar to hermaphrodites, male defecation is initiated by an intestinal calcium wave, but circuit activity is coordinated differently during mating. In hermaphrodites, the tail neuron DVB promotes expulsion of gut contents through the release of the neurotransmitter GABA onto the anal depressor muscle. However in the male, both neuron and muscle take on modified functions to promote successful copulation. Males require calcium-dependent CAPS/unc-31 dense core vesicle exocytosis activator protein in the DVB to regulate copulatory spicule insertion, while the anal depressor is remodeled to promote release of sperm into the hermaphrodite. This work shows how sex-shared circuitry is modified in multiple ways to contribute to sex-specific mating.



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Residual force enhancement is regulated by titin in skeletal and cardiac myofibrils

Abstract

When a skeletal muscle contracts isometrically, the muscle produces a force relative to the final isometric sarcomere length (SL). However, when the same final SL is reached by stretching the muscle while it contracts, the muscle produces a relatively higher force: a phenomenon commonly referred to as residual force enhancement. In this study, we investigated residual force enhancement in rabbit skeletal psoas myofibrils and, for the first time, cardiac papillary myofibrils. A custom-built atomic force microscope was used in experiments that stretched myofibrils before and after inhibiting myosin and actin interactions to determine whether the different cardiac and skeletal titin isoforms regulate residual force enhancement. At SLs ranging from 2.24 μm to 3.13 μm, the skeletal myofibrils enhanced the force by an average of 9.0%, and by 29.5% after hindering myosin and actin interactions. At SLs ranging from 1.80 μm to 2.29 μm, the cardiac myofibrils did not enhance the force before or after hindering myosin and actin interactions. We conclude that residual force enhancement is present only in skeletal muscles and is dependent on the titin isoforms.

This article is protected by copyright. All rights reserved



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Rapid frequency-dependent changes in free mitochondrial calcium concentration in rat cardiac myocytes

Calcium ions regulate mitochondrial ATP production and contractile activity and thus play a pivotal role in matching energy supply and demand in cardiac muscle. Little is known about the magnitude and kinetics of the changes in free mitochondrial calcium concentration in cardiomyocytes. Using adenoviral infection, a ratiometric mitochondrially-targeted FRET-based calcium indicator (4 mtD3cpv, MitoCam) was expressed in cultured adult rat cardiomyocytes and the free mitochondrial calcium concentration ([Ca2+]m) was measured at different stimulation frequencies (0.1-4 Hz) and external calcium concentrations (1.8-3.6 mM) at 37°C. Cytosolic calcium concentrations were assessed under the same experimental conditions in separate experiments using Fura-4AM. The increases in [Ca2+]m during electrical stimulation at 0.1 Hz were rapid (rise time = 49 ± 2 ms), while the decreases in [Ca2+]m occurred more slowly (decay half time = 1.17 ± 0.07 s). Model calculations confirmed that this asymmetry caused the rise in [Ca2+]m during diastole observed at elevated stimulation frequencies. Inhibition of the mitochondrial sodium-calcium exchanger (mNCE) resulted in a rise in [Ca2+]m at baseline and -paradoxically- in an acceleration of Ca2+-release. In conclusion: rapid increases in [Ca2+]m allow for fast adjustment of mitochondrial ATP production to increases in myocardial demand on a beat-to-beat basis and mitochondrial calcium release depends on mNCE activity and mitochondrial calcium buffering.

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Neurons as oscillators

Regularly spiking neurons can be described as oscillators. In this article we review some of the insights gained from this conceptualization and their relevance for systems neuroscience. First, we explain how a regularly spiking neuron can be viewed as an oscillator and how the phase-response curve (PRC) describes the response of the neuron's spike times to small perturbations. We then discuss the meaning of the PRC for a single neuron's spiking behavior and review the PRCs measured from a variety of neurons in a range of spiking regimes. Next, we show how the PRC can be related to a number of common measures used to quantify neuronal firing, such as the spike-triggered average and the peristimulus histogram. We further show that the response of a neuron to correlated inputs depends on the shape of the PRC. We then explain how the PRC of single neurons can be used to predict neural network behavior. Given the PRC, conduction delays, and the waveform and time course of the synaptic potentials, it is possible to predict neural population behavior such as synchronization. The PRC also allows us to quantify the robustness of the synchronization to heterogeneity and noise. We finally ask how to combine the measured PRCs and the predictions based on PRC to further the understanding of systems neuroscience. As an example, we discuss how the change of the PRC by the neuromodulator acetylcholine could lead to a destabilization of cortical network dynamics. Although all of these studies are grounded in mathematical abstractions that do not strictly hold in biology, they provide good estimates for the emergence of the brain's network activity from the properties of individual neurons. The study of neurons as oscillators can provide testable hypotheses and mechanistic explanations for systems neuroscience.



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Trial-to-trial adaptation in control of arm reaching and standing posture

Classical theories of motor learning hypothesize that adaptation is driven by sensorimotor error; this is supported by studies of arm and eye movements that have shown that trial-to-trial adaptation increases with error. Studies of postural control have shown that anticipatory postural adjustments increase with the magnitude of a perturbation. However, differences in adaptation have been observed between the two modalities, possibly due to either the inherent instability or sensory uncertainty in standing posture. Therefore, we hypothesized that trial-to-trial adaptation in posture should be driven by error, similar to what is observed in arm reaching, but the nature of the relationship between error and adaptation may differ. Here we investigated trial-to-trial adaptation of arm reaching and postural control concurrently; subjects made reaching movements in a novel dynamic environment of varying strengths, while standing and holding the handle of a force-generating robotic arm. We found that error and adaptation increased with perturbation strength in both arm and posture. Furthermore, in both modalities, adaptation showed a significant correlation with error magnitude. Our results indicate that adaptation scales proportionally with error in the arm and near proportionally in posture. In posture only, adaptation was not sensitive to small error sizes, which were similar in size to errors experienced in unperturbed baseline movements due to inherent variability. This finding may be explained as an effect of uncertainty about the source of small errors. Our findings suggest that in rehabilitation, postural error size should be considered relative to the magnitude of inherent movement variability.



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Effects of protein–carbohydrate supplementation on immunity and resistance training outcomes: a double-blind, randomized, controlled clinical trial

Abstract

Purpose

To examine the impact of ingesting hydrolyzed beef protein, whey protein, and carbohydrate on resistance training outcomes, body composition, muscle thickness, blood indices of health and salivary human neutrophil peptides (HNP1-3), as reference of humoral immunity followed an 8-week resistance training program in college athletes.

Methods

Twenty-seven recreationally physically active males and females (n = 9 per treatment) were randomly assigned to one of the three groups: hydrolyzed beef protein, whey protein, or non-protein isoenergetic carbohydrate. Treatment consisted of ingesting 20 g of supplement, mixed with orange juice, once a day immediately post-workout or before breakfast on non-training days. Measurements were performed pre- and post-intervention on total load (kg) lifted at the first and last workout, body composition (via plethysmography) vastus medialis thickness (mm) (via ultrasonography), and blood indices of health. Salivary HNP1-3 were determined before and after performing the first and last workout.

Results

Salivary concentration and secretion rates of the HNP1-3 decreased in the beef condition only from pre-first-workout (1.90 ± 0.83 μg/mL; 2.95 ± 2.83 μg/min, respectively) to pre-last-workout (0.92 ± 0.63 μg/mL, p = 0.025, d = 1.03; 0.76 ± 0.74 μg/min, p = 0.049, d = 0.95), and post-last-workout (0.95 ± 0.60 μg/mL, p = 0.032, d = 1.00; 0.59 ± 0.52 μg/min, p = 0.027, d = 1.02). No other significant differences between groups were observed.

Conclusions

Supplementation with a carbohydrate–protein beverage may support resistance training outcomes in a comparable way as the ingestion of only carbohydrate. Furthermore, the ingestion of 20 g of hydrolyzed beef protein resulted in a decreased level and secretion rates of the HNP1-3 from baseline with no negative effect on blood indices of health.



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Neuronal insulin receptor mediates a positive feedback regulation of insulin biosynthesis in Drosophila

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Publication date: Available online 27 December 2016
Source:Journal of Genetics and Genomics
Author(s): Jie Ye, Danping Chen, Yue Yu, Liming Wang




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LMM5.1 and LMM5.4, two eukaryotic translation elongation factor 1A-like gene family members, negatively affect cell death and disease resistance in rice

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Publication date: Available online 27 December 2016
Source:Journal of Genetics and Genomics
Author(s): Jiying Zhao, Pengcheng Liu, Chunrong Li, Yanyan Wang, Lequn Guo, Guanghuai Jiang, Wenxue Zhai
Lesion mimic mutant (LMM) genes, stimulating lesion formation in the absence of pathogens, play significant roles in immune response. In this study, we characterized a rice lesion mimic mutant, lmm5, which displayed light-dependent spontaneous lesions. Additionally, lmm5 plants also exhibited enhanced resistance to all of the tested races of Magnaporthe oryzae and Xanthomonas oryzae pv. oryzae (Xoo) by increasing the expression of defense-related genes and the accumulation of hydrogen peroxide. Genetic analysis showed that the lesion mimic phenotype of lmm5 was controlled by two genes, lmm5.1 and lmm5.4, which were isolated with a map-based cloning strategy. Remarkably, LMM5.1 and LMM5.4 share a 97.4% amino acid sequence identity, and they each encode a eukaryotic translation elongation factor 1A (eEF1A)-like protein. Besides, LMM5.1 and LMM5.4 were expressed in a tissue-specific and an indica-specific manner, respectively. In addition, high-throughput mRNA sequencing analysis confirmed that the basal immunity was constitutively activated in the lmm5 mutant. Taken together, these results suggested that the homologous eEF1A-like genes, LMM5.1 and LMM5.4, negatively affect cell death and disease resistance in rice.



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Choline and acetylcholine: what a difference an acetate makes!

Abstract

Choline is a water soluble B-group vitamin, which humans must consume through their diet to remain healthy. Meat, eggs and yeast extract are great sources of choline, an essential component of cell membranes and also the precursor of the neurotransmitter, acetylcholine (ACh).

This article is protected by copyright. All rights reserved



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Family Social Support Modifies the Relationships Between Childhood Maltreatment Severity, Economic Adversity and Postpartum Depressive Symptoms

Abstract

Objectives

This study examines the main and moderating effects of childhood abuse or neglect severity, income, and family social support on the presence of postpartum depressive symptoms (PDS).

Methods

Participants included 183 postpartum mothers who endorsed a history of childhood maltreatment (CM) and enrolled in a longitudinal study of mother and child outcomes. Participants completed questionnaires to assess CM severity, associated societal and maternal characteristics, and depressive symptom severity.

Results

The results confirm previously identified links between CM severity and PDS. Further, hierarchical linear regression analyses indicate the interaction of household income and interpersonal support from the family attenuates the relationship between CM severity and PDS. The final model accounted for 29% of the variance of PDS scores, a large effect size.

Conclusions

This study is the first to demonstrate interrelationships between income and social support on resilience to postpartum psychopathology in childhood trauma-surviving women. Social support appeared to protect against PDS for all mothers in this study while income only conferred a protective effect when accompanied by family support. For clinicians, this implies the need to focus on improving family and other relationships, especially for at-risk mothers.



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The Quality of Care for Gastroesophageal Reflux Disease

Abstract

Improving the quality of healthcare delivery is a cornerstone of modern medical care shared between all stakeholders. However, effectively improving quality requires both an understanding of the tenets of healthcare quality and how they relate to an individual disease process. This is especially important for common diseases, such as gastroesophageal reflux disease (GERD), where wide variations in practice exist. The high prevalence of GERD coupled with wide variation in clinical approach results in significant economic burden and poor quality of care. Thus, GERD serves as a useful framework to highlight the opportunities and current challenges of delivering high-quality care. In this article, we identify quality metrics in GERD and the areas in need of research to improve the quality of the management of GERD. Additionally, we suggest strategies for improvement as it relates to the proper diagnostic testing utilization and the decision-making process.



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Prevalence of Chronic Pancreatitis: Results of a Primary Care Physician-based Population Study

Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies.

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Altered mucosal expression of microRNAs in pediatric patients with inflammatory bowel disease

MicroRNAs (miRs) came recently into focus as promising novel research targets offering new insights into the pathogenesis of inflammatory bowel diseases (IBD).

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Repetitive Peripheral Magnetic Neurostimulation of Multifidus Muscles Combined with Motor Training Influences Spine Motor Control and Chronic Low Back Pain

Chronic low back pain (CLBP) alters the sensorimotor control of the lumbopelvic spine. Patients with CLBP present with impaired activation of lumbopelvic muscle during anticipatory postural adjustments (APA) (Hodges et al., 1996b; Massé-Alarie et al., 2015), as well as during functional activities, such as forward bending (Shirado et al., 1995; Alschuler et al., 2009) and gait (Arendt-Nielsen et al., 1996). Our research group also showed that the activation of remote muscles such as semitendinosus could be delayed during ballistic movement of upper limbs thus reflecting a broad alteration of motor planning that might spread out the painful area (Massé-Alarie et al., 2015).

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Prevalence of Chronic Pancreatitis: Results of a Primary Care Physician-based Population Study

Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies.

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Altered mucosal expression of microRNAs in pediatric patients with inflammatory bowel disease

MicroRNAs (miRs) came recently into focus as promising novel research targets offering new insights into the pathogenesis of inflammatory bowel diseases (IBD).

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A patient with postpolio syndrome developed cauda equina syndrome after neuraxial anesthesia: a case report

Combined spinal anesthesia and postoperative epidural analgesia is widely used in orthopedic surgery. Uncommon but serious neurologic complications of neuraxial anesthesia (NA) include direct trauma during needle or catheter insertion, central nervous system infections, and neurotoxicity of local anesthetics. Cauda equina syndrome (CES) is a rare complication after NA but can result in severe neurologic deterioration that may require surgical intervention. We present a case of a 69-year-old woman with postpolio syndrome who developed CES after combined spinal anesthesia and postoperative epidural analgesia.

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Primary mesenteric neuroendocrine tumor that changed its internal composition from cystic to solid: a case report

Abstract

Mesenteric neuroendocrine tumors are usually metastases originating from the small intestine; however, primary mesenteric cases are rare. We present an interesting case of a mesenteric neuroendocrine tumor that changed its internal composition from cystic to solid. A 72-year-old male visited our hospital because of epigastralgia 4 years earlier. A 25-mm tumor was recognized around the terminal duodenum on computed tomography and magnetic resonance imaging, and was diagnosed as a cystic lesion. Over the following 2 years, the tumor grew to 40 mm and its internal composition changed from cystic to solid. The lesion showed positive findings on fluorodeoxyglucose positron emission tomography. Upon laparotomy, a solid tumor was detected in the mesentery of the jejunum near the ligament of Treitz. The tumor was extracted without intestinal resection and was diagnosed as a low-grade neuroendocrine tumor after histopathological and immunohistochemical examination. One year has passed since the operation, and there has been no recurrence.



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Married Mont. EMT duo transports patients home for holidays

By EMS1 Staff

EAGLE CLIFF, Mont. — In true holiday spirit, an EMT couple spent their Christmas transporting patients home to spend time with their families. 

As part of AMR's "Home for the Holidays" program, which provides patients a free ride home on Christmas, EMTs Kory and Camille Landwehr spent the day helping patients get home. 

The duo transported two patients Sunday; the agency offers the free service to six patients a year, reported the Billings Gazette

Kory Landwehr said he first began working for the program six years ago when he first became an EMT. He said although he had four patients to transport, he spent most of the day moving them back and forth. 

"People don't know about it [Home for the Holidays]," Landwehr said. "Those assisted living nursing home places are so busy, sometimes they aren't able to get the word out to patients."

The couple isn't normally allowed to work shifts together, but were permitted to do so on Christmas. 

"Getting to help people with the person you love makes it even better," Camille Landwehr said.



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Incidence and clinical outcomes of intestinal Behçet’s disease in Korea, 2011–2014: a nationwide population-based study

Abstract

Background

Intestinal Behçet's disease (BD) is very rare, and epidemiologic data regarding BD are scarce. Moreover, there have been no population-based studies focusing on intestinal BD. We conducted a nationwide population-based study to examine the incidence and clinical course of Korean patients with intestinal BD.

Methods

We collected data on 365 patients diagnosed with intestinal BD from 2011 to 2014 using the Health Insurance Review and Assessment Services claims database. We analyzed the incidence and clinical outcomes, including cumulative rates of bowel resection, hospitalization, and medication use.

Results

During the study period, the average annual incidence for intestinal BD was 0.18 per 105 population, and the proportion of cases with intestinal involvement was 3.9%. At 1 and 4 years after diagnosis, the cumulative rates of surgery were 5.0 and 10.9%, respectively, whereas those of hospitalization were 27.8 and 32.4%, respectively. The 1- and 4-year cumulative rates of requirements for medications were 39.8 and 49.1% for moderate- to high-dose corticosteroids, 33.6 and 42.1% for immunomodulators, and 3.5 and 6.8% for biologics, respectively. The cumulative probability of corticosteroid and immunomodulator use was higher in male than in female patients and in younger (<40 years) than in older (≥40 years) patients. However, there were no significant differences in the cumulative probabilities of surgery, hospitalization, and biologics use according to sex and age group.

Conclusions

The incidence of intestinal BD in Korea is quite low and has been stable in recent years.



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3 injured after car crashes into Ill. ambulance

Officials said the ambulance was on a call and attempting to make a U-turn when it was struck by a Jeep

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Variability of ICA decomposition may impact EEG signals when used to remove eyeblink artifacts

Abstract

Despite the growing use of independent component analysis (ICA) algorithms for isolating and removing eyeblink-related activity from EEG data, we have limited understanding of how variability associated with ICA uncertainty may be influencing the reconstructed EEG signal after removing the eyeblink artifact components. To characterize the magnitude of this ICA uncertainty and to understand the extent to which it may influence findings within ERP and EEG investigations, ICA decompositions of EEG data from 32 college-aged young adults were repeated 30 times for three popular ICA algorithms. Following each decomposition, eyeblink components were identified and removed. The remaining components were back-projected, and the resulting clean EEG data were further used to analyze ERPs. Findings revealed that ICA uncertainty results in variation in P3 amplitude as well as variation across all EEG sampling points, but differs across ICA algorithms as a function of the spatial location of the EEG channel. This investigation highlights the potential of ICA uncertainty to introduce additional sources of variance when the data are back-projected without artifact components. Careful selection of ICA algorithms and parameters can reduce the extent to which ICA uncertainty may introduce an additional source of variance within ERP/EEG studies.



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Heart rate, health, and hurtful behavior

Abstract

Hostility is a risk factor for cardiovascular events. When challenged, individuals high on hostility exhibit a hyperreactive psychophysiological response to stressors, thereby increasing risk for developing cardiovascular disease. However, low resting heart rate (HR) is associated with physical aggression and hostility in children, adolescents, and adults. Based on a community sample of 296 men (mean age = 32.0), we (a) address whether aggression/hostility relates to physical health through relationships with cardiovascular levels at rest and in response to stressors, and (b) determine how relations between aggression and health are altered by including psychophysiological indices in statistical models. The Cook-Medley cynical/hostile attitudes and the Buss-Perry physical aggression and hostility measures assessed aggression. Health was assessed as systolic blood pressure (SBP), report of medical conditions, and a metabolic composite. Reactivity to stressors was assessed with HR, SBP, and diastolic blood pressure. Aggression was negatively related to both resting HR and reactivity. High resting HR and reactivity were, however, positively related to poor health. Thus, the relationship between aggression and HR and reactivity suppressed an overall relationship between high aggression/hostility and poor health. In the presence of covariates for socioeconomic status, race, health behaviors, and medications, the relationship between aggression and health was significantly strengthened when HR level and reactivity were included in models. In sum, at early midlife, low HR among aggressive and hostile individuals is related to less health risk. Aggression and hostility have a deleterious influence on health, but primarily among individuals with higher HR and possibly greater cardiovascular reactivity.



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Early and late brain signatures of emotional prosody among individuals with high versus low power

Abstract

Using ERPs, we explored the relationship between social power and emotional prosody processing. In particular, we investigated differences at early and late processing stages between individuals primed with high or low power. Comparable to previously published findings from nonprimed participants, individuals primed with low power displayed differentially modulated P2 amplitudes in response to different emotional prosodies, whereas participants primed with high power failed to do so. Similarly, participants primed with low power showed differentially modulated amplitudes in response to different emotional prosodies at a later processing stage (late ERP component), whereas participants primed with high power did not. These ERP results suggest that high versus low power leads to emotional prosody processing differences at the early stage associated with emotional salience detection and at a later stage associated with more in-depth processing of emotional stimuli.



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Stroke-like onset of brain stem degeneration presents with unique MRI sign and heterozygous NMNAT2 variant: a case report

Background: Acute-onset neurodegenerative diseases in older patients are rare clinical cases, especially when the degeneration only affects specific regions of the nervous system. Several neurological disorders have been described in which the degeneration of brain parenchyma originates from and/or primarily affects the brain stem. Clinical diagnosis in these patients, however, is often complicated due to a poor understanding of these diseases and their underlying mechanisms.Case presentationIn this manuscript we report on a 73-year-old female who had experienced a sudden onset of complex neurological symptoms that progressively worsened over a period of 2 years. Original evaluation had suggested a MRI-negative stroke as underlying pathogenesis. The combination of patient's medical history, clinical examination and exceptional pattern of brain stem degeneration presenting as "kissing swan sign" in MR imaging was strongly suggestive of acute onset of Alexander's disease. This leukoencephalopathy is caused by GFAP (glial fibrilary acidic protein) gene mutations and may present with brain stem atrophy and stroke-like onset of symptoms in elderly individuals. However, a pathognomonic GFAP gene mutation could not be identified by Sanger sequencing. Conclusions: After an extended differential diagnosis and exclusion of other diseases, a definite diagnosis of the patient's condition presently remains elusive. However, whole-exome sequencing performed from patient's blood revealed 12 potentially disease-causative heterozygous variants, amongst which several have been associated with neurological disorders in vitro and in vivo – in particular the axon degeneration-related NMNAT2 gene.

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Degeneracy in the regulation of short-term plasticity and synaptic filtering by presynaptic mechanisms

Abstract

Information processing in neurons is known to emerge as a gestalt of pre- and post-synaptic filtering. However, the impact of presynaptic mechanisms on synaptic filters has not been quantitatively assessed. Here, we developed a biophysically-rooted, conductance-based model synapse that was endowed with six different voltage-gated ion channels, calcium pumps, calcium buffer and neurotransmitter-replenishment mechanisms in the presynaptic terminal. We tuned our model to match the short-term plasticity profile and band-pass structure of Schaffer collateral synapses, and performed sensitivity analyses to demonstrate that presynaptic voltage-gated ion channels regulated synaptic filters through changes in excitability and associated calcium influx. These sensitivity analyses also revealed that calcium- and release-control mechanisms were effective regulators of synaptic filters, but accomplished this without changes in terminal excitability or calcium influx. Next, to perform global sensitivity analysis, we generated 7000 randomized models spanning 15 presynaptic parameters, and computed eight different physiological measurements in each of these models. We validated these models by applying experimentally obtained bounds on their measurements, and found 104 (∼1.5%) models to match the validation criteria for all eight measurements. Analyzing these valid models, we demonstrate that analogous synaptic filters emerge from disparate combinations of presynaptic parameters exhibiting weak pairwise correlations. Finally, employing virtual knockout models, we establish the variable and differential impact of different presynaptic channels on synaptic filters, underscoring the critical importance of interactions among different presynaptic components in defining synaptic physiology. Our results have significant implications for protein-localization strategies required for physiological robustness and for degeneracy in long-term synaptic

This article is protected by copyright. All rights reserved



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The Perception Of Facial Profile Attractiveness By Changing The Lower Facial Vertical And Antero-Posterior Proportion

2016-12-27T06-11-57Z
Source: National Journal of Integrated Research in Medicine
Pratik Gandhi*, Kalpesh Patel**, Padmaja Sharma Arora***, Nikunj Patel****.
Introduction: This study aimed to investigate the influence of changing the antero-posterior and vertical facial proportions on attractiveness rankings and to determine if these rankings would be influenced by gender and profession of the evaluators. Facial profile images were used as a mean of stimulus presentation. It has been shown that photographs provide valid, reproducible and representative ratings of dental and facial appearance. Objective: This study was to determine what Indian society considers optimal for facial attractiveness and whether this preference is affected by gender and profession. Method: Total 500 evaluators were selected for this study, from which 250 evaluators were dentist and 250 evaluators were non-dentist. Conclusion: At the end of the study it was concluded that the male and female profile images with average lower facial height consider as a most attractive by the both the groups. The class II profile image of male and female profiles consider as a more attractive than class- III profile images. [Pratik G NJIRM 2016; 7(6): 59-68]


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Nasal Unit Transplantation

http://otorhinolarygology.blogspot.com/2016/12/nasal-unit-transplantation.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Reliability of neutrophilic nuclear appendages in morphological sex differentiation

2016-12-27T04-51-02Z
Source: International Journal of Medical Science and Public Health
Rashmi Verma, Manjula Adinarayan.
Background: The inactive X-chromosome in neutrophils appears in one of the three forms. They are drumsticks, racquet forms, and sessile nodules. Objective: A correlative study based on the presence of drumstick and other nuclear appendages in polymorphonuclear neutrophils to determine the morphological sex. Materials and Methods: Sixty-eight randomly selected blood smears (34 males and 34 females) were stained with Leishmans stain. One hundred well-stained neutrophils were double-blindly studied in the tail-end of the smears and classified into four groups based on Kosenows formula as drumstick (Form A), sessile nodule (Form B), and other pedunculated nuclear projections such as tag and hooks (Form C). Results: Significant correlation of neutrophilic nuclear appendage of Form A (P = 0.00001) and Form C (P = 0.00016) was obtained for females and males, respectively. Difference of A-C gives a positive value in females and a negative value in males. Conclusion: Neutrophilic nuclear appendages which include true drumsticks, sessile nodules, and racket structures form a useful tool for morphological sex differentiation.


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Unraveling the dynamic interplay between family functioning and substance use among adolescents: An Indian perspective

2016-12-27T04-51-02Z
Source: International Journal of Medical Science and Public Health
Anuj Khandelwal, Sonal Khandelwal, Avinash Desousa.
Substance abuse is a common problem seen in adolescents all over the world. It has been noted that the early antecedents of substance abuse in adolescents include dysfunctional family environments and broken or disrupted families. The family systems theory is reviewed to elucidate the optimal and abnormal functioning of a family and the difference between normal and postdivorce and single parent families are considered. There is a theory built based on available literature regarding the process that causes a transition from broken families and single parent families to substance abuse in adolescence. Adolescence is a period of stress and along with hormonal and physical changes any other turmoil during the middle years of life shall serve to push the adolescent into either internalizing behavior leading to anxiety and depression or externalizing behavior manifesting as conduct problems and aggression which may soon progress to substance abuse and other forms of dangerous behavior. This trajectory for the development of substance abuse in adolescents must be considered when planning out the long-term treatment and management of such patients.


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Knowledge, attitude, and practice of family planning among Muslim women of North India

2016-12-27T04-51-02Z
Source: International Journal of Medical Science and Public Health
Saifi Shumayla, Satwanti Kapoor.
Background: Muslims are the second largest minority group in India. Research has shown that Muslim population have higher fertility rate which favor larger family size. Various sociodemographic factors play important role in choosing any kind of family planning method. Objectives: To study the knowledge and beliefs of Muslim women in North India regarding family planning and to examine their contraceptive practices. Materials and Methods: A cross-sectional study was done by multistage and snowball technique among Muslim women aged 15-49 years living in Delhi. Results: A majority of women (87%) had knowledge about family planning, but only 47% of the ever-married women are currently using any kind of family planning method. Age of marriage, education level, socioeconomic status, parity, and sex of the first child are significantly associated with the current use of family planning methods. Most of the women are not using family planning methods because of religious constraints (34.5%) followed by lack of knowledge (27.7%) and fear of side effects (19.2%). Conclusion: Muslim women despite having adequate knowledge about family planning methods tend to avoid using it. Higher age of marriage, improved education level and better standard of living will help the Muslim women to have sound reproductive health.


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Microbial profile and antibiotic susceptibility pattern of orthopedic infections in a tertiary care hospital: A study from South India

2016-12-27T04-51-02Z
Source: International Journal of Medical Science and Public Health
Vasundhara Devi P, Sreenivasulu Reddy P, Shabnum M.
Background: Orthopedic wound infections are one of the most important causes of morbidity and are difficult to treat. Changes in pathogenic microbial flora and the emergence of bacterial resistance are another problem in the management of orthopedic infections. Objectives: In this regard, an attempt was made to know the bacteriological profile and their antibiotic susceptibility pattern in our hospital. Materials and Methods: This study was conducted in the Department of Microbiology, Narayana Medical College & Hospital, Nellore, over a period of 1-year from June 2015 to May 2016. A total of 100 pus samples were collected and processed during the mentioned period. Results: Out of the samples processed, 68 (68%) of specimens showed culture positivity. Pseudomonas aeruginosa 18 (26.4%) was the predominant isolate followed by Staphylococcus aureus 17 (25%). All Gram-positive cocci were susceptible to vancomycin and linezolid. Pseudomonas isolates were susceptible to polymyxin B, piperacillin-tazobactam, and meropenem. Conclusion: Microbial analysis and their antibiogram of clinical samples are mandatory since it is deep seated infections with more pathogenic bacteria for optimal management of orthopedic infections.


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Diastolic dysfunction in apparently healthy individuals: A single center experience based on echocardiography

2016-12-27T04-51-02Z
Source: International Journal of Medical Science and Public Health
Swapan Saha, Pravin Kumar Jha, Tony Ete, Gaurav Kavi, Rinchin Dorjee Megeji, Rondeep Kumar Nath Sivam, Manish Kapoor, Amit Malviya, Animesh Mishra.
Background: As the process of myocardial remodeling starts before the onset of symptoms, detection of subclinical left ventricular diastolic dysfunction is of paramount importance. This will help in the early implementation of interventions to reverse the functional and structural abnormalities. Objectives: This study was conducted to assess the diastolic function of apparently healthy individuals who presented with exertional chest discomfort and shortness of breath (New York Heart Association Class I) with effort tolerance more than 9 metabolic equivalents on treadmill. Materials and Methods: A total of 141 patients, fulfilling the inclusion criteria, were analyzed to look for diastolic dysfunction using two-dimensional and Doppler echocardiography. Peak velocities of early (E) and late (A) diastolic filling, deceleration time and Doppler tissue imaging for early (E), and late (A) diastolic peak velocities were measured. Subsequently, mitral E/E ratio was calculated. Results: Mean age of patients examined was 46.46 ± 4.27 years and 86.5% of the patients were male. Overall, the prevalence of diastolic dysfunction in the patients analyzed was 14.9%. Diastolic dysfunction in patients more than 50 years of age was 21.6%, whereas it was 12.5% in patients


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Low pHo boosts burst firing and catecholamine release by blocking TASK-1 and BK channels while preserving Cav1 channels in mouse chromaffin cells

Abstract

Mouse chromaffin cells (MCCs) generate action potential (AP) firing that regulates the Ca2+-dependent release of catecholamines (CAs). Recent findings indicate that MCCs possess a variety of spontaneous firing modes that span from the common "tonic-irregular" to the less frequent "burst" firing. This latter is evident in a small fraction of MCCs but occurs regularly when Nav1.3/1.7 channels are made less available or when the Slo1β2-subunit responsible for BK channel inactivation is deleted. Burst firing causes massive increases of Ca2+-entry and potentiates CA release ∼3.5-fold and, thus, may be a key mechanism to regulate MCC function. With the purpose of uncovering a physiological role for burst firing in CCs, we studied the effects of acidosis on MCCs activity. We found that lowering extracellular pH (pHo) from 7.4 to 7.0 and 6.6 induces 10–15 mV cell depolarizations that generate repeated bursts. Bursts at pHo 6.6 lasted ∼330 ms, occurred at 1–2 Hz and caused ∼7-fold increase of CA cumulative release. Burst firing originates from the inhibition of the pH-sensitive TASK-1/TASK-3 channels and from a 40% BK channel conductance reduction at pHo 7.0. The same pHo had little or no effect on Nav, Cav, Kv and SK channels that support AP firing in MCCs. Burst firing of pHo 6.6 could be mimicked by mixtures of the TASK-1 blocker A1899 (300 nM) and BK blocker paxilline (300 nM) and could be prevented by blocking L-type channels by adding 3 μm nifedipine. Mixtures of the two blockers raised cumulative CA-secretion even more than low-pHo (∼12-fold), showing that the action of protons on vesicle release is mainly due to the ionic conductance changes that increase Ca2+-entry during bursts. Our data furnish direct evidence that MCCs respond to low-pHo with sustained depolarization, burst firing and enhanced CA-secretion, thus mimicking the physiological response of CCs to acute acidosis and hyperkalemia generated during heavy exercise and muscle fatigue.

This article is protected by copyright. All rights reserved



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Pre Operative Investigations: Should We Adopt Health Technology Assessment Guidelines In Developing Country? - A Retrospective Study

2016-12-27T04-13-53Z
Source: National Journal of Integrated Research in Medicine
Dr. Kamla Mehta*, Dr. Sheetal Shah**, Dr. Nupoor Contractor***.
Background and aims: Preoperative assessment and preoperative investigations are compulsory before elective surgery. Preoperative routine testing was begun before 40 years and has expanded to include many of routine diagnostic tests performed today. Many guidelines are developed by various countries for these preoperative investigations to prevent the unnecessary investigations and overburden to the hospital. The aim was to find out unnecessary investigations carried out in elective general surgical patients during the period of March to August 2013 in our hospital. Methods: A retrospective study of 802 patients from their preoperative assessment forms was done. Various blood investigations, Chest X ray and Electrocardiogram were evaluated. The Data was collected and analyzed using SPSS software. Results: CXR was abnormal in 30.04% of patients in less than 40 years of age and 53.25% of patients in more than 40 years of age though only 5.73% of patients aged more than 40 years of age were needed treatment for that before operation. ECG was done in 454patients only. Out of them 13.46% of patients had abnormal finding in younger age group(less than 40 years of age) while 47.97% of patients in older age group (more than 40 years of age). Blood investigations were normal in more than 90% of patients. Conclusion: The hypothesis of unnecessary investigations was true with the biochemical investigations except Haemoglobin level which was low in majority of patients but for Chest X ray and Electrocardiogram the p value was not significant. [Kamla M NJIRM 2016; 7(5): 55-58]


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Perceptions Of First M.B.B.S Students Regarding Audiovisual Teaching Aids In Physiology

2016-12-27T04-13-53Z
Source: National Journal of Integrated Research in Medicine
Shilpa S. Gupta*, Ashok H Kale**.
Introduction: Use of teaching aid in didactic lectures plays an important role in the overall impact of the lecture in terms of student interest and learning. It is always recommended, not to get carried away with the use of ever changing technology. Technology always appears fancier, but student preferences and the impact that it makes on learning, should be evaluated before over using it. Aim :- To know I MBBS student preferences regarding use of audio-visual aids in teaching various components of Human Physiology. Methodology: This is an observational study conducted by administering a questionnaire regarding student preferences about various teaching aids used by Physiology faculty during teaching sessions, in SVN. GMC, Yavatmal, from September 2015 to December 2015 on total 181 I(119) & II(62) MBBS students. Results: For teaching aid best suited and understanding of Physiology, 43.10% of the students preferred L.C.D. i.e. 106(58.56%) of the students, opined that traditional Chalk & Board provides maximum interaction with the teacher while 76(41.99%) felt that it induces more sleep than other teaching aids. 118(65.19%) opined that traditional chalk & talk method was best suited for taking down running notes during lectures and 108(59.67%) of the students preferred it tobe combined with LCD. Majority of the students in this study preferred LCD for better understanding of diagrams (41.44%) and flowcharts (43.1%). Conclusion: Senior students are more inclined towards conventional mode of learning through the use of Chalk & Board while the junior batch preferred LCD, which appears fancier to them, initially. This study was conducted on one batch size of students. For better interpretation and results that could be applied at university, state or national level, we recommend a wide spread multi-centric study in medical colleges all over the country, having representation from all strata of students, faculty and policy makers. [Shilpa G NJIRM 2016; 7(6): 51-54]


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The Study Of The Relation Between Intellectual Intelligence And Quality Of Working Life And Occupational Maturity In Employed Nurses

2016-12-27T04-13-53Z
Source: National Journal of Integrated Research in Medicine
Nasibe Anvari*, Nooshin Abbasi Abyaneh**, Sedigheh Maleki***.
Introduction: Recognize the spiritual patterns and adjust behavior of employees are the core of spiritual intelligence And this despite the fact that spirituality and job satisfaction on the quality of people's working lives have followed effectiveness. This study was conducted with the aim of Survey relationship between spiritual intelligence with quality of work life and job maturity in nurses who work in selected hospitals of Alborz University of Medical Sciences. Methods: In these study correlations 200 nurses in 10 hospitals Tehran University of Medical Sciences were selected using random cluster sampling. Spiritual intelligence questionnaire, quality of work life and career maturity were distributed. For data analysis SPSS/18 was used. Results: Based on the findings, the majority of participants had moderate quality of life (200-219) and the maturity of their career was at a low level (178-209). The results of Spearman correlation between spiritual intelligence and maturity of the quality of work life among nurses (r=0.452), showed a significant relationship. The majority of women had spiritual intelligence and spiritual intelligence score average (110-128) and in men, the majority of the lower spiritual intelligence (94-110).Conclusion: Considering that the nursing profession in the country is among the most vital, Special attention of practitioner seems very important to nurture spiritual intelligence nurses, raising the level of their maturityand creating a favorable business environment to improve the quality of working life.[Nasibe ANJIRM 2016; 7(6): 45-50]


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Hysteroscopic Evaluation Of Menorrhagia And Its Correlation With Saline Infusion Sonography

2016-12-27T04-13-53Z
Source: National Journal of Integrated Research in Medicine
Neelam Tejwani*, Rahul Padval**, P.K. Roy***, Roopam Jain****.
Background: In India Menorrhagia is becoming an increasingly frequent problem of women seeking gynaec consultation and has become a major reason for hysterectomy without any uterine pathology. Woman work 2/3rd of world's working hours and produce 1/2 of worlds food and earn 10% of worlds income but menorrhagia leads to loss of working hours significantly hence to treat properly a correct diagnosis is a must. Aim: The purpose of this study is to know best way of diagnosis cause of menorrhagia with minimum invasion and more accuracy[1]. Method: A prospective observational study on 97 women attending gynaec OPD in R.D. Gardi Medical College between 01-09-2011 to 01-03-2013 was done. Complete clinical examination with saline infusion sonography and hysteroscopy was done in each patient here we compare results of two diagnostic methods. Result: Out of 97 patients (n=97), by Hysteroscopy 44% had normal findings and 55.6% had abnormal findings. Out of 97 patients (n=97), by SIS 42% had normal findings and 57.7% had abnormal findings. Conclusion: (Saline infusion sonography) SIS an easy diagnostic modality being widely available, can be used in the same sitting of ultrasound scan of the pelvis and if a structural lesion is detected plan for definitive management may be taken early in a poor country like India. Hysteroscopy is the gold standard in evaluation of AUB and besides diagnostic accuracy offers definitive management in cases like small endometrial polyp, sepsis, small fibroid, indometrial hyperplasia. [Neelam T NJIRM 2016; 7(6):40-44]


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The Safety and Effectiveness of Ledipasvir-Sofosbuvir in Adolescents 12 to 17 Years Old With Hepatitis C Virus Genotype 1 Infection

Hepatology

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Infliximab vs. adalimumab in Crohn's disease: Results from 327 patients in an Australian and New Zealand observational cohort study

Alimentary Pharmacology and Therapeutics

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Evaluation of the Correlation Between the Pre-Test Probability for Clostridium difficile infection and Clostridium difficile Enzyme Immunoassay Results

Journal of Clinical Microbiology

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Systematic review with meta-analysis: Recurrence of Crohn's disease after total colectomy with permanent ileostomy

Alimentary Pharmacology and Therapeutics

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Validation of intimate correlation between visceral fat and hepatic steatosis: Quantitative measurement techniques using CT for area of fat and MR for hepatic steatosis

Clinical Nutrition

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Comparison of long-term survival and immediate postoperative liver function after laparoscopic and open distal gastrectomy for early gastric cancer patients with liver cirrhosis

Gastric Cancer

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Placental transport and metabolism of energy substrates in maternal obesity and diabetes

Placenta

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Association between cachexia, chemotherapy and outcomes in older cancer patients: A systematic review

Clinical Nutrition

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Long-term outcome in liver Transplantation candidates with portopulmonary hypertension

Hepatology

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The lipid droplet associated protein perilipin 3 facilitates hepatitis C virus-driven hepatic steatosis [

Journal of Lipid Research

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Associations of serum fibroblast growth factor 23 levels with obesity and visceral fat accumulation

Clinical Nutrition

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The core domain of hepatitis C virus glycoprotein E2 generates potent cross-neutralizing antibodies

Hepatology

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Validity of a population-specific BMR predictive equation for adults from an urban tropical setting

Clinical Nutrition

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Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: The sportdiet study

Hepatology

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Association between weight status and men’s positive mental health: The influence of marital status

Obesity Research & Clinical Practice

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ENOXAPARIN INDUCED RETROPERITONEAL BLEEDING AFTER ISCHEMIC STROKE

2016-12-27T03-40-49Z
Source: Journal of Contemporary Medicine
Elif Börekci, Hasan Börekci, Zeynep Tuğba Özdemir, Asuman Çelikbilek, Sebahattin Albayrak, Tekin Yıldırım.
The enoxaparin is a low molecular weight heparin with antithrombotic effect . Increasing use of enoxaparin in the therapy and prophylaxis of thromboembolic disorders causes an increase in the incidence of these potential anticoagulant-related complications . Retroperitoneal bleeding is one of those complications. This is a rare case report of spontaneous retroperitoneal hematoma as a result of ischemic stroke due to the use of enoxaparin.


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