Superior Air-Ground Ambulance Service, Inc. is the largest independent, locally owned and operated Emergency Medical Service provider in Northern Illinois, Michigan and Northwest Indiana. We provide wheelchair transportation, Basic Life Support, Advanced Life Support, and Critical Care Ground Transportation; as well as Critical Care Rotary Air Transportation. Much of our proven success is attributable ...
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Τρίτη 22 Αυγούστου 2017
911 Paramedic - Superior Ambulance
Paramedic - Superior Ambulance
Do you want to make a difference in people's lives" Are you passionate and self-driven" Would you like an opportunity to grow your career in EMS" nd operated Emergency Medical Service provider in Northern Illinois, Michigan and Northwest Indiana. We provide wheelchair transportation, Basic Life Support, Advanced Life Support, and Critical Care Ground Transportation; as well as Critical Care Rotary ...
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Caffeine Increases Work Done above Critical Power, but not Anaerobic Work.
Purpose: The assumption that the curvature constant (W[spacing acute]) of the power-duration relationship represents anaerobic work capacity is a controversial, unresolved question. We investigated if caffeine ingestion could increase total work done above critical power (CP), and if this would be accompanied by greater anaerobic energy expenditure and by an enhanced maintenance of maximal oxidative metabolic rate. Methods: Nine men (26.6 +/- 5.3 years, V[spacing dot above]O2max 40.6 +/- 5.8 mL[middle dot]kg-1[middle dot]min-1) cycled until exhaustion at different exercise intensities on different days to determine the CP and W[spacing acute]. On separated days, participants cycled until exhaustion in the severe-intensity domain (136 +/- 7% of CP) after ingesting either caffeine (5 mg[middle dot]kg-1 body mass) or a placebo. Results Time to exhaustion was 34% longer with caffeine compared to placebo, and this was accompanied by a greater work done above CP (23.7 +/- 5.7 vs 17.5 +/- 3.6 kJ; 130 +/- 30% vs 95 +/- 14% of W[spacing acute], P
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Ischemic Preconditioning Blunts Muscle Damage Responses Induced by Eccentric Exercise.
Purpose: Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion-injury (I/R-Injury) during surgery. Due to similarities between the pathophysiological formation of I/R-injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca2+, an increased production of reactive oxygen species and increased pro-inflammatory signaling, the purpose of the present study was to investigate whether IPC performed prior to eccentric exercise may also protect against EIMD. Methods: Nineteen healthy men were matched to an eccentric only (ECC) (n=9) or eccentric proceeded by IPC group (IPC+ECC) (n=10). The exercise protocol consisted of bilateral biceps curls (3x10 repetitions at 80% of the concentric 1RM). In IPC+ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mmHg) immediately prior to the exercise (3x5 minutes of occlusion, separated by 5 minutes of reperfusion). Creatine Kinase (CK), arm circumference, subjective pain (VAS score) and radial displacement (Tensiomyography, Dm) were assessed before IPC, pre-exercise, post-exercise, 20 minutes-, 2 hours-, 24 hours-, 48 hours- and 72 hours post-exercise. Results: CK differed from baseline only in ECC at 48h (p
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Do Children and Adolescents with Inflammatory Bowel Disease Complete Clinical Disease Indices Similar to Physicians?.
Objective: The degree to which children and adolescents with inflammatory bowel disease (IBD) complete clinical disease activity indices in accordance with their physician is indefinite. Therefore, we investigated the agreement between patient- and physician-based clinical indices in children and adolescents with a previous diagnosis of IBD. Methods: In this cross-sectional study, IBD patients (8-18 years) were included prospectively. Patients completed a patient-based short Pediatric Crohn's Disease Activity Index (shPCDAI) for Crohn's disease or the Pediatric Ulcerative Colitis Activity Index (PUCAI) for ulcerative or indeterminate colitis. Physicians completed the original physician-based shPCDAI or PUCAI. Agreement was calculated with linear weighted kappa. Results: In total, 154 pairs of clinical indices were collected: 89 pairs of shPCDAI's (median age at assessment 15.6 years, 61% male) and 55 pairs of PUCAI's (median age at assessment 14.0 years, 44% male). The shPCDAI disease activity category only fairly agreed between patient- and physician-based indices (kappa: 0.40 [95%CI 0.24-0.55], p
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Spinal deformity changes in children with long-term vertical expandable prosthetic titanium rib (VEPTR) treatment
In several studies, vertical expandable prosthetic titanium rib (VEPTR) implants have shown good scoliosis control in children with the longest reported follow-up (f/u) of 3.6 years. For growing rods, recent studies suggest a decreased efficiency of correction starting just after that time. To our knowledge, no long-term results of children with VEPTR treatment are available.
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Duplication and Sub/Neofunctionalization of Malvolio, an Insect Homolog of Nramp, in the Subsocial Beetle Nicrophorus vespilloides
With growing numbers of sequenced genomes, increasing numbers of duplicate genes are uncovered. Here we examine Malvolio, a gene in the natural resistance-associated macrophage protein (Nramp) family, that has been duplicated in the subsocial beetle, Nicrophorus vespilloides, which exhibits advanced parental behavior. There is only one copy of Mvl in honey bees and Drosophila, whereas in vertebrates there are two copies that are subfunctionalized. We first compared amino acid sequences for Drosophila, beetles, mouse and humans. We found a high level of conservation between the different species, though there was greater variation in the C-terminal regions. A phylogenetic analysis across multiple insect orders suggests that Mvl has undergone several independent duplications. To examine the potential for different functions where it has been duplicated, we quantified expression levels of Mvl1 and Mvl2 in eight tissues in N. vespilloides. We found that while Mvl1 was expressed ubiquitously, albeit at varying levels, expression of Mvl2 was limited to brain and midgut. Because Mvl has been implicated in behavior, we examined expression during different behavioral states that reflected differences in opportunity for social interactions and expression of parental care behaviors. We found differing expression patterns for the two copies, with Mvl1 increasing in expression during resource preparation and feeding offspring, and Mvl2 decreasing in these same states. Given these patterns of expression, along with the protein analysis, we suggest that Mvl in N. vespilloides has experienced sub/neofunctionalization following its duplication, and may be evolving differing and tissue-specific roles in behavior and physiology.
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CONE: Community Oriented Network Estimation Is a Versatile Framework for Inferring Population Structure in Large Scale Sequencing Data
Estimation of genetic population structure based on molecular markers is a common task in population genetics and ecology. We apply a generalized linear model with LASSO regularization to infer relationships between individuals and populations from molecular marker data. Specifically, we apply a neighborhood selection algorithm to infer population genetic structure and gene flow between populations. The resulting relationships are used to construct an individual-level population graph. Different network substructures known as communities are then dissociated from each other using a community detection algorithm. Inference of population structure using networks combines the good properties of: (i) network theory (broad collection of tools, including aesthetically pleasing visualization) (ii) principal component analysis (dimension reduction together with simple visual inspection) (iii) model-based methods (e.g. ancestry coefficients estimates). We have named our process as CONE (Community Oriented Network Estimation). CONE has fewer restrictions than conventional assignment methods in that properties such as the number of subpopulations need not be fixed before the analysis, the sample may include close relatives or involve uneven sampling. Applying CONE on simulated data sets resulted in more accurate estimates of the true number of subpopulations and provided comparable ancestry coefficient estimates than model-based methods. Inference of empirical data sets of teosinte single nucleotide polymorphism, bacterial disease outbreak, and human genome diversity panel illustrate that population structures estimated with CONE are consistent with the earlier findings.
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New Kids in the Neighborhood: Biosimilars
No abstract available
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Mineral Intake and Status of Cow's Milk Allergic Infants Consuming an Amino Acid-based Formula
ABSTRACT: Data on the mineral status of infants with cow's milk allergy (CMA) consuming an amino acid-based formula (AAF) have not been published. The present study aims to assess mineral status of term infants age 0 to 8 months diagnosed with CMA receiving an AAF for 16 weeks. Serum concentrations of calcium, phosphorus, chloride, sodium, potassium, magnesium, and ferritin were determined in 82 subjects at baseline and in 66 subjects after 16 weeks on AAF using standard methods and evaluated against age-specific reference ranges. In addition to this, individual estimated energy and mineral intakes were compared to Adequate Intakes defined by the European Food Safety Authority and the US Institute of Medicine. The results of this study show that the AAF was effective in providing an adequate mineral status in infants with CMA. The vast majority of infants aged 0 to 6 months (formula only) and aged 6 to 12 months (formula and complementary foods) had adequate mineral intakes.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v40RIg
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Alas, Who and What Can We Trust? Patients, Parents, Surrogate Markers, or the Specific Carbohydrate Diet
No abstract available
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Dietary Inadequacies in HIV-infected and Uninfected School-aged Children in Johannesburg, South Africa
Objectives: The World Health Organization recommends that human immunodeficiency virus (HIV)-infected children increase energy intake and maintain a balanced macronutrient distribution for optimal growth and nutrition. Few studies have evaluated dietary intake of HIV-infected children in resource-limited settings. Methods: We conducted a cross-sectional analysis of the dietary intake of 220 perinatally HIV-infected children and 220 HIV-uninfected controls ages 5 to 9 years in Johannesburg, South Africa. A standardized 24-hour recall questionnaire and software developed specifically for the South African population were used to estimate intake of energy, macronutrients, and micronutrients. Intake was categorized based on recommendations by the World Health Organization and Acceptable Macronutrient Distribution Ranges established by the IOM. Results: The overall mean age was 6.7 years and 51.8% were boys. Total energy intake was higher in HIV-infected than HIV-uninfected children (1341 vs 1196 kcal/day, P = 0.002), but proportions below the recommended energy requirement were similar in the 2 groups (82.5% vs 85.2%, P = 0.45). Overall, 51.8% of the macronutrient energy intake was from carbohydrates, 13.2% from protein, and 30.8% from fat. The HIV-infected group had a higher percentage of their energy intake from carbohydrates and lower percentage from protein compared with the HIV-uninfected group. Intakes of folate, vitamin A, vitamin D, calcium, iodine, and selenium were suboptimal for both groups. Conclusions: Our findings suggest that the typical diet of HIV-infected children and uninfected children in Johannesburg, South Africa, does not meet energy or micronutrient requirements. There appear to be opportunities for interventions to improve dietary intake for both groups.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2vmTw21
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No Need for Routine Endoscopy in Children With Celiac Disease on a Gluten-free Diet
No abstract available
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A Child With Ichthyosis and Liver Failure
No abstract availablefrom Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3VZmI
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Zero, One, or Two Endoscopies to Diagnose and Monitor Pediatric Celiac Disease? The Jury Is Still Out
No abstract available
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Early and Late Factors Impacting Patient and Graft Outcome in Pediatric Liver Transplantation: Summary of an ESPGHAN Monothematic Conference
ABSTRACT: As pediatric liver transplantation comes of age, experts gathered to discuss current paradigms and define gaps in knowledge warranting research to further improve patient and graft outcomes. Identified areas ripe for collaborative research include understanding the molecular and cellular mechanisms of tolerance and the role of donor-specific antibodies, considering ways to expand donor pool, minimizing long-term side effects of immunosuppression, and fine-tuning surgical techniques to minimize biliary and vascular complications.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2vncKEv
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Detection of Sepsis in Preterm Infants by Fecal Volatile Organic Compounds Analysis: A Proof of Principle Study
Objectives: Several studies associated altered gut microbiota composition in preterm infants with late-onset sepsis (LOS), up to days before clinical onset of sepsis. Microbiota analysis as early diagnostic biomarker is, however, in clinical practice currently not feasible because of logistic aspects and high costs. Therefore, we hypothesized that analysis of fecal volatile organic compounds (VOCs) may serve as noninvasive biomarker to predict LOS at a preclinical stage, because VOC reflect the composition and activity of intestinal microbial communities. Methods: In a prospective multicenter study, fecal samples were collected daily from infants with a gestational age offrom Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3rn4O
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Feed-induced Dystonias in Children With Severe Central Nervous System Disorders
ABSTRACT: Dystonias can arise from any painful stimuli in neurologically disabled children. Classically, feed-induced dystonias from mediastinal pain due to severe gastroesophageal reflux disease are described as Sandifer spasm. We report a case series of 12 severely neurologically impaired children with enteral feed–induced dystonias. Intestinal dysmotility was demonstrated in several. Improvements are seen with jejunal feeds or gut rest with total parenteral nutrition. Use of parenteral nutrition in children with severe neurodisability requires thorough discussion with patient groups and commissioners to give clinicians guidelines to standardize care.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3XyRv
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Esomeprazole FDA Approval in Children With GERD: Exposure-Matching and Exposure-Response
Objectives: Food and Drug Administration approval of proton-pump inhibitors for infantile gastroesophageal reflux disease has been limited by intrapatient variability in the clinical assessment of gastroesophageal reflux disease. For children 1 to 17 years old, extrapolating efficacy from adults for IV esomeprazole was accepted. The oral formulation was previously approved in children. Exposure-response and exposure matching analyses were sought to identify approvable pediatric doses. Methods: Intragastric pH biomarker comparisons between children and adults were conducted. Pediatric doses were selected to match exposures in adults and were based on population pharmacokinetic (PK) modeling and simulations with pediatric esomeprazole data. Observed IV or oral esomeprazole PK data were available from 50 and 117 children, between birth and 17 years, respectively, and from 65 adults, between 20 and 48 years. A population PK model developed using these data was used to simulate steady-state esomeprazole exposures for children at different doses to match the observed exposures in adults. Results: Exposure-response relationships of intragastric pH measures were similar between children and adults. The PK simulations identified a dosing regimen for children that results in comparable steady-state area under the curve to that observed after 20 mg in adults. For IV esomeprazole, increasing the infusion duration to 10 to 30 minutes in children achieves matching Cmax values with adults. Conclusions: The exposure-matching analysis permitted approval of an esomeprazole regimen not studied directly in clinical trials. Exposure-response for intragastric pH-permitted approval for the treatment of gastroesophageal reflux disease in children in whom it was not possible to evaluate the adult primary endpoint, mucosal healing assessed by endoscopy.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3VTLS
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Endoscopic Closure of Gastric Leak Following Sleeve Gastrectomy in a Pediatric Patient
No abstract availablefrom Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3VTvm
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Low-impedance Baseline Values Predict Severe Esophagitis
Objectives: The aim of the study was to determine whether esophageal baseline impedance (BI) values in children could be predictive of esophagitis. Materials and Methods: Multichannel intraluminal impedance (MII) tracings of children 3 to 17 years of age suspected of having gastroesophageal reflux and esophagitis, who had also undergone upper endoscopy with multiple esophageal biopsies, were reviewed. Patients with eosinophilic esophagitis were excluded. Esophagitis was assessed by macroscopic and microscopic parameters. Esophageal histology was reported by 2 blinded independent pathologists unaware of the MII results. Mean BI was automatically calculated in the different MII channels (ch) by the specific software without removing any episode of increased/decreased BI. BI results were plotted against macroscopic and histological scores for each channel. Results: Tracings of 87 children, 53 boys, were evaluated. Mean age was 7.4 years: 45 had histologic esophagitis, 8 macroscopic. Histologic mild esophagitis (grade 1) was observed in 30, and 15 had moderate to severe esophagitis (grade 2–3). Ten had grade 3 esophagitis. Eight had macroscopic esophagitis as well. Results: in channel 6 of the MII, all 10 patients with grade 3 esophagitis and the 8 with macroscopic esophagitis had a BIfrom Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v401v2
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Nutritional Benefit of Recycling of Bowel Content in an Infant With Short Bowel Syndrome
No abstract availablefrom Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3Z3PC
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Diet and Stress in Pediatric Eosinophilic Esophagitis
ABSTRACT: Clinical experiences and recent studies suggest that eosinophilic esophagitis (EoE) has the potential to induce caregiver (CG) and child stress. The specific sources of CG EoE-related stress remain uncertain. To address this, we performed a survey of CGs and youth attending a patient with EoE education symposium that measured potential stressful elements in their daily life. Our results indicated that CGs experienced most stress associated with purchasing, preparation, and completion of meals. We conclude that providers should consider this in choosing therapeutic approaches for children with EoE.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3KlIv
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Oral Cholic Acid Is Efficacious and Well Tolerated in Patients With Bile Acid Synthesis and Zellweger Spectrum Disorders
Objectives: Patients with bile acid synthesis disorders (BASDs) due to single enzyme defects (SEDs) or Zellweger spectrum disorders (ZSDs) accumulate hepatotoxic atypical bile acids resulting in potentially fatal progressive liver disease. We evaluated the efficacy and safety of oral cholic acid in patients with BASD. Methods: In this phase 3, open-label, single-arm, nonrandomized, noncomparative study conducted over 18 years, patients were administered cholic acid orally 10 to 15 mg · kg−1 · day−1. The primary efficacy variables were changes from pre- to post-treatment in atypical urinary bile acids, liver chemistries (serum aspartate aminotransferase, alanine aminotransferase), and height and weight. Additional efficacy variables included changes in serum bilirubin and liver histology. Results: Of the 85 enrolled patients (63 with SED and 22 with ZSD), 79 received at least 1 dose of study medication; 70 patients (50 with SED and 20 with ZSD) were included in the modified intent-to-treat dataset. Cholic acid significantly improved urine bile acid metabolite scores (P from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v3On3r
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Induction Therapy With Biosimilar Infliximab in Children With Crohn Disease
Introduction: In most European countries, an infliximab biosimilar (CT-P13) is currently in common use. In vitro and in vivo studies have proved a high similarity between CT-P13 and the reference infliximab. CT-P13 was licensed for use in patients with Crohn disease (CD) based on the extrapolation of data from preclinical studies and clinical trials in rheumatology indications. The aim of this study was to assess the similarity between CT-P13 and the originator infliximab in induction therapy in CD paediatric patients. Methods: Thirty-six CD paediatric patients from 3 Polish academic centres who started biological therapy with CT-P13 were enrolled in this prospective, observational study. Patients received 3 induction doses (5 mg/kg) of CT-P13 at weeks 0, 2, 6. Assessment was performed before the first infusion and at week 14. Results: Overall 34/36 (94.4%) patients completed induction therapy with CT-P13. A clinical response or remission after 3 initial doses was achieved in 31/36 (86%) and 24/36 (67%) of patients, respectively. Clinically and statistically significant decreases in Paediatric Crohn's Disease Activity Index, C-reactive protein, and erythrocyte sedimentation rate were observed in the responders group. An allergic reaction during infusion, which led to treatment discontinuation, was observed in one case. Conclusions: Induction therapy with CT-P13 in children with CD is effective. The profile appears similar to that reported for the reference infliximab. No unexpected adverse events occurred.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2v4tsgR
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The Malta Childhood National Body Mass Index Study: A Population Study
Objectives: Obesity is a chronic disease that often commences in childhood. More than a quarter of Maltese children are overweight or obese. The present study was carried out to measure height and weight (and body mass index) for all school children in Malta to precisely quantify the extent of the problem. Methods: Schooling in Malta is provided by: free state schools, subsidized Roman Catholic church–run schools, and independent private schools. All were included. Physical education teachers were trained in measurements on identical stadiometers. Bespoke spreadsheets were created using World Health Organization cut-offs for underweight, overweight, and obesity. Results: The present study included more than 46,027 children in more than 145 schools (ages 4.7–17 years). Less than 10% were unmeasured. Approximately 40% of school-aged children in Malta are overweight or obese. The proportion of obese was greater than that of overweight. Levels of overweight and obesity were significantly different: State>Church>Independent schools. Overall, and for both sexes and for school types, there was a trend for overweight and obesity to peak in years 5 to 8, then decline slightly. Overweight and obesity was secondary>primary schools, and boys>girls. The underweight group was small with no significant difference between the school types. Conclusions: The present study has confirmed high levels of overweight and obesity in Maltese children. It also provides proof of concept of scalability by demonstrating the feasibility of undertaking a relatively inexpensive study of an entire childhood population. The modus operandi (utilizing physical education teachers) could relatively easily be up scaled for any country.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2vmPfLJ
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Lack of Mucosal Healing From Modified Specific Carbohydrate Diet in Pediatric Patients With Crohn Disease
ABSTRACT: Exclusive enteral nutrition is effective in pediatric Crohn disease but challenging as maintenance therapy. There is interest in food-based therapies such as the specific carbohydrate diet (SCD) but paucity of data on efficacy and effect on mucosal healing, an evolving target of IBD therapy. We conducted a retrospective review of the mucosal healing effect of the SCD in pediatric Crohn disease (CD). The endoscopic findings for children younger than 18 years with CD treated exclusively with the SCD or modified SCD (mSCD; SCD + addition of "illegal foods") were reviewed before and after the diet. Ileocolonoscopic examinations were scored according to the Simple Endoscopic Score for CD and findings on upper endoscopy were described. Seven subjects were identified, all on mSCD. The average age at starting the SCD was 11 ± 3.4 years and median duration of SCD/mSCD therapy was 26 months. All subjects reported no active symptoms before repeat endoscopic evaluation on mSCD, the majority had consistently normal C-reactive protein, albumin and hematocrit assessments, and mildly elevated fecal calprotectin (>50 μg/g, median 201, range 65–312) at any point within 3 months before the repeat endoscopy. One patient showed complete ileocolonic healing but persistent upper gastrointestinal tract ulceration. Complete macroscopic mucosal healing of both the ileocolon and upper gastrointestinal tract was not seen in any patient.from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2vmvy74
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Nutritional Assessment and Status of Hospitalized Infants
Objectives: Malnutrition during infancy has long-term adverse consequences for both physical and psychological development. Early detection of malnutrition among hospitalized infants is essential to provide optimal nutrition support. The primary aim of the present study was to investigate the nutritional status of hospitalized infants using 2 methods: the Subjective Global Nutritional Assessment (SGNA) and anthropometric measurement. We also investigated diagnostic category associated with nutritional status, the mean anthropometric z scores, and explored the association between malnutrition and nutrition focused variables. Methods: Nutritional status of 110 hospitalized infants ages 31 days to 12 months was investigated using the SGNA and anthropometric measurements converted to z scores. Results: Utilizing the SGNA, 78 (70.9%) infants were classified as having normal nutritional status, 30 (27.3%) were moderately malnourished, and 2 (1.8%) were severely malnourished. The proportion of infants with acute malnutrition (weight-for-length z scorefrom Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2vmoNlG
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Prevalence of CTX-M-Producing Klebsiella spp. in Broiler, Kuroiler, and Indigenous Poultry in West Bengal State, India
Microbial Drug Resistance , Vol. 0, No. 0.
from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/2xqDOnI
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Child Maltreatment Screening and Anticipatory Guidance: A Description of Pediatric Nurse Practitioner Practice Behaviors
Given the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors.
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S198 Different region-specific networks sustain focal seizures with a fast-activity onset: Evidence from patients and animal models
Focal seizure patterns generated by different cortical networks are not well characterized. I will provide evidence that different seizure patterns are generated by specific brain regions explored with stereo-EEG in patients with drug-resistant focal epilepsy candidate for surgery. Two main patterns typical of temporo-mesial involvement and neocortical involvement are identified. These two patterns were reproduced in an in vitro isolated brain preparation to characterize the network and cellular determinants.
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S200 Paroxyzmal depolarization shift – Is it an interictal phenomenon is humans?
Paroxysmal depolarization shift (PDS) was extensively studied in animal models of acute and subacut epilepsy. Based on the observation that PDS occurred between behavioral seizures it had been complemented by interictal discharges, that can be recorded in humans in the seizure onset zone (SOZ) and around. PDS is characterized by excessive discharge of large number of neurons within a certain area of the cortex. Studying human SOZ with microelectrodes revealed that selective or no neuronal firing increase happen during IIDs.
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P382 Neural mechanisms of attentional switching during distraction analgesia: A single-trial laser evoked potential study
Noxious stimuli capture attention and at the same time, pain is attenuated by a concurrent cognitive task. The present study aimed to elucidate the cortical mechanisms underlying diminution of pain during attentional distraction using single-trial electrocortical and subjective responses.
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P381 Event-related potentials and personality type in patients with multiple sclerosis
The clinical course of multiple sclerosis (MS) can vary significantly among patients and is affected by many factors. Among these, psychoaffective aspects, including the type of personality, have been recently gaining attention. The aim of our study was to investigate the parameters of event-related potentials (ERP) with regards to personality type in MS patients.
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Then and now: EMS practices through the years
By Will Wyatt, EMS1 Contributor When you have engaged in an endeavor for a long time, invariably, noticeable changes occur. The longer you participate in a hobby, activity or career, the more changes time brings. I was reminded of this evolution the other night as I was assisting an old friend teaching a CPR class to a church group. The students were nice people, eager to learn. They of course had the ...
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Phylogenetic relationships of ascomycetes and basidiomycetes based on comparative genomics analysis
Abstract
The relationship between ascomycetes and basidiomycetes, the two main phyla of non-flagellated fungi, has rarely been investigated. In this study, we performed a comparative genomics analysis of genome sequences of 55 ascomycetes and 26 basidiomycetes species and detected 81 universal markers, 875 homologous genes and a conserved contig in the glucose-regulated protein gene. In dendrograms based on simple sequence repeat markers and homologous genes, ascomycetes and basidiomycetes formed distinct clusters, with each set of taxa having a high coefficient of relatedness. Ascomycetes and basidiomycetes also constituted distinct groups in a phylogenetic tree based on a conserved contig in the glucose-regulated protein gene. These results provide evidence that basidiomycetes may be derived from ascomycetes but are definitely genetically differentiated at the genomic level. The phylogenetic relationships of ascomycetes and basidiomycetes uncovered in this study provide new insights for future research related to fungal classification and evolution.
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Ancient DNA reveals the Arctic origin of Viking Age cod from Haithabu, Germany [Anthropology]
Knowledge of the range and chronology of historic trade and long-distance transport of natural resources is essential for determining the impacts of past human activities on marine environments. However, the specific biological sources of imported fauna are often difficult to identify, in particular if species have a wide spatial distribution...
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Complete overview of protein-inactivating sequence variations in 36 sequenced mouse inbred strains [Genetics]
Mouse inbred strains remain essential in science. We have analyzed the publicly available genome sequences of 36 popular inbred strains and provide lists for each strain of protein-coding genes that acquired sequence variations that cause premature STOP codons, loss of STOP codons and single nucleotide polymorphisms, and short in-frame insertions...
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Patients’ Mental Health Journeys: A Qualitative Case Study with Interactive Computer-Assisted Client Assessment Survey (iCASS)
Abstract
Despite growing concerns about common mental disorders (CMDs), challenges persist in accessing timely and appropriate care, especially for immigrant, refugee, racialized and low-income groups. Partnering with a community health centre serving these populations in Toronto, we examined the Interactive Computer-assisted Client Assessment Survey (iCCAS) that screens for CMDs (depression, generalized anxiety, post-traumatic stress, and alcohol overuse) and related social factors. In this case study design with embedded units, we explored the mental health care journeys of patients who screened positive for a CMD. The analysis identified three major pathways of care: (1) early detection of previously unidentified CMDs; (2) detection of comorbid mental health conditions; and (3) prevention of possible relapse and/or management of existing previously recognized mental health condition. These cases indicate iCCAS holds potential to facilitate more open, tailored, and informed collaborations between patients and clinicians regarding mental health care plans.
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ESO announces 2018 Wave EMS data conference and national user group meeting in Austin, TX, Feb. 1-2, 2018
EMS and fire service leaders, medical directors, and technology and data officers to gather to discuss healthcare trends and share best practices
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How the humble insect brain became a powerful experimental model system
Abstract
In the 21st century, neurobiological studies focused on the insect brain are revealing unprecedented insight into the molecular, cellular, developmental, and circuit aspects of brain organization and function, notably in the genetic model system of Drosophila melanogaster. Underlying this accelerating progress in understanding the insect brain is a century-long history of ground breaking experimental investigation, methodological advance, and conceptual insight catalyzed by the integration of two emerging research fields, neuroscience and genetics. This review traces some of the key early steps in this remarkable historical scientific adventure of exploring the brain of "these apparently humble representatives of life".
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Important role of calcium chloride in preventing carbon monoxide generation during desflurane degradation with alkali hydroxide-free carbon dioxide absorbents
Abstract
We investigated whether calcium chloride (CaCl2), a supplementary additive in carbon dioxide (CO2) absorbents, could affect carbon monoxide (CO) production caused by desflurane degradation, using a Japanese alkali-free CO2 absorbent Yabashi Lime®-f (YL-f), its CaCl2-free and 1% CaCl2-added derivatives, and other commercially available alkali-free absorbents with or without CaCl2. The reaction between 1 L of desflurane gas (3–10%) and 20 g of desiccated specimen was performed in an artificial closed-circuit anesthesia system for 3 min at 20 or 40 °C. The CO concentration was measured using a gas chromatograph equipped with a semiconductor sensor detector. The systems were validated by detecting dose-dependent CO production with an alkali hydroxide-containing CO2 absorbent, Sodasorb®. Compared with YL-f, the CaCl2-free derivative caused the production of significantly more CO, while the 1% CaCl2-added derivative caused the production of a comparable amount of CO. These phenomena were confirmed using commercially available absorbents AMSORB® PLUS, an alkali-free absorbent with CaCl2, and LoFloSorb™, an alkali-free absorbent without CaCl2. These results suggest that CaCl2 plays an important role in preventing CO generation caused by desflurane degradation with alkali hydroxide-free CO2 absorbents like YL-f.
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Skeletal muscle morphology, protein synthesis, and gene expression in Ehlers-Danlos syndrome
Patients with Ehlers-Danlos syndrome (EDS) are known to have genetically impaired connective tissue and skeletal muscle symptoms in form of pain, fatigue, and cramps; however earlier studies have not been able to link these symptoms to morphological muscle changes. We obtained skeletal muscle biopsies in patients with classic EDS [cEDS; n = 5 (Denmark)+ 8 (The Netherlands)] and vascular EDS (vEDS; n = 3) and analyzed muscle fiber morphology and content (Western blotting and muscle fiber type/area distributions) and muscle mRNA expression and protein synthesis rate (RT-PCR and stable isotope technique). The cEDS patients did not differ from healthy controls (n = 7–11) with regard to muscle fiber type/area, myosin/α-actin ratio, muscle protein synthesis rate, or mRNA expression. In contrast, the vEDS patients demonstrated higher expression of matrix proteins compared with cEDS patients (fibronectin and MMP-2). The cEDS patients had surprisingly normal muscle morphology and protein synthesis, whereas vEDS patients demonstrated higher mRNA expression for extracellular matrix remodeling in skeletal musculature compared with cEDS patients.
NEW & NOTEWORTHY This study is the first of its kind to systematically investigate muscle biopsies from Ehlers-Danlos patients, focusing on muscle structure and function. These patients suffer from severe muscle symptoms, but in our study they show surprisingly normal muscle findings, which points toward indirect muscle symptoms originating from the surrounding connective tissue. These findings have basal physiological importance and implications for future physiotherapeutic treatment options for these patients.
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Postexercise cold water immersion modulates skeletal muscle PGC-1{alpha} mRNA expression in immersed and nonimmersed limbs: evidence of systemic regulation
Mechanisms mediating postexercise cold-induced increases in PGC-1α gene expression in human skeletal muscle are yet to be fully elucidated but may involve local cooling effects on AMPK and p38 MAPK-related signaling and/or increased systemic β-adrenergic stimulation. Therefore, we aimed to examine whether postexercise cold water immersion enhancement of PGC-1α mRNA is mediated through local or systemic mechanisms. Ten subjects completed acute cycling (8 x 5 min at ~80% peak power output) followed by seated-rest (CON) or single-leg cold water immersion (CWI; 10 min, 8°C). Muscle biopsies were obtained preexercise, postexercise, and 3 h postexercise from a single limb in the CON condition but from both limbs in CWI [thereby providing tissue from a CWI and nonimmersed limb (NOT)]. Muscle temperature decreased up to 2 h postexercise following CWI (–5°C) in the immersed limb, with lesser changes observed in CON and NOT (–3°C, P < 0.05). No differences between limbs were observed in p38 MAPK phosphorylation at any time point (P < 0.05), whereas a significant interaction effect was present for AMPK phosphorylation (P = 0.031). Exercise (CON) increased gene expression of PGC-1α 3 h postexercise (~5-fold, P < 0.001). CWI augmented PGC-1α expression above CON in both the immersed (CWI; ~9-fold, P = 0.003) and NOT limbs (~12-fold, P = 0.001). Plasma normetanephrine concentration was higher in CWI vs. CON immediately postimmersion (860 vs. 665 pmol/l, P = 0.034). We report for the first time that local cooling of the immersed limb evokes transcriptional control of PGC-1α in the nonimmersed limb, suggesting increased systemic β-adrenergic activation of AMPK may mediate, in part, postexercise cold induction of PGC-1α mRNA.
NEW & NOTEWORTHY We report for the first time that postexercise cold water immersion of one limb also enhances PGC-1α expression in a contralateral, nonimmersed limb. We suggest that increased systemic β-adrenergic stimulation, and not localized cooling per se, exerts regulatory effects on local signaling cascades, thereby modulating PGC-1α expression. Therefore, these data have important implications for research designs that adopt contralateral, nonimmersed limbs as a control condition while also increasing our understanding of the potential mechanisms underpinning cold-mediated PGC-1α responses.
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Reflex cardiorespiratory events from esophageal origin are heightened by preterm birth
The involvement of gastroesophageal refluxes in cardiorespiratory events of preterm infants remains controversial. While a few studies in full-term newborn animals have shown that stimulation of esophageal receptors leads to cardiorespiratory reflexes, the latter remain largely unknown, especially after premature birth. The present study aimed to 1) characterize the cardiorespiratory reflexes originating from esophageal receptors in newborn lambs and 2) test the hypotheses that preterm birth enhances reflex cardiorespiratory inhibition and that C-fibers are involved in these reflexes. Eight full-term lambs and 10 lambs born 14 days prematurely were studied. Following surgical instrumentation, a 6-h polysomnography was performed without sedation to record electrocardiogram, respiratory movements, arterial pressure, laryngeal constrictor muscle activity, state of alertness, and hemoglobin oxygen saturation. Five esophageal stimulations of the upper and/or lower esophagus, including rapid balloon inflation and/or HCl injection, were performed in random order. A second recording was performed in full-term lambs 24 h later, after C-fiber blockade by capsaicin. Results confirmed that esophageal stimulations induced inhibitory cardiorespiratory reflexes combined with protective mechanisms, including laryngeal closure, swallowing, coughing, increased arterial pressure, and arousal. Preterm birth heightened cardiorespiratory inhibition. The strongest cardiorespiratory inhibition was observed following simultaneous stimulation of the lower and upper esophagus. Finally, cardiorespiratory inhibition was decreased after C-fiber blockade. In conclusion, esophageal stimulation induces inhibitory cardiorespiratory reflexes, which are partly mediated by C-fibers and more pronounced in preterm lambs. Clinical relevance of these findings requires further studies, especially in conditions associated with increased cardiorespiratory events, e.g., neonatal infection.
NEW & NOTEWORTHY Preterm birth heightens the cardiorespiratory events triggered by esophageal stimulation. The most extensive cardiorespiratory events are induced by simultaneous stimulation of the proximal and distal esophagus.
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Exercise: Teaching myocytes new tricks
Endurance exercise training promotes numerous cellular adaptations in both cardiac myocytes and skeletal muscle fibers. For example, exercise training fosters changes in mitochondrial function due to increased mitochondrial protein expression and accelerated mitochondrial turnover. Additionally, endurance exercise training alters the abundance of numerous cytosolic and mitochondrial proteins in both cardiac and skeletal muscle myocytes, resulting in a protective phenotype in the active fibers; this exercise-induced protection of cardiac and skeletal muscle fibers is often referred to as "exercise preconditioning." As few as 3–5 consecutive days of endurance exercise training result in a preconditioned cardiac phenotype that is sheltered against ischemia-reperfusion-induced injury. Similarly, endurance exercise training results in preconditioned skeletal muscle fibers that are resistant to a variety of stresses (e.g., heat stress, exercise-induced oxidative stress, and inactivity-induced atrophy). Many studies have probed the mechanisms responsible for exercise-induced preconditioning of cardiac and skeletal muscle fibers; these studies are important, because they provide an improved understanding of the biochemical mechanisms responsible for exercise-induced preconditioning, which has the potential to lead to innovative pharmacological therapies aimed at minimizing stress-induced injury to cardiac and skeletal muscle. This review summarizes the development of exercise-induced protection of cardiac myocytes and skeletal muscle fibers and highlights the putative mechanisms responsible for exercise-induced protection in the heart and skeletal muscles.
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Application of Euclidean distance mapping for assessment of basement membrane thickness distribution in asthma
Abnormal thickening of the airway basement membrane is one of the hallmarks of airway remodeling in asthma. The present protocols for measuring the basement membrane involve the use of stained tissue sections and measurements of the basement membrane thickness at certain intervals, followed by the calculation of the geometric mean thickness for each airway. This report describes an automated, unbiased approach which uses color segmentation to identify structures of interest on stained sections and Euclidean distance mapping to measure the thickness distribution of airway structures. This method was applied to study the thickness distribution of the basement membrane and airway epithelium in lungs donated for research from seven nonasthmatic and eight asthmatic age- and sex-matched donors. A total of 60 airways were assessed. We report that the thickness and thickness distribution of the basement membrane and airway epithelium are increased in large and small airways of asthmatics compared with nonasthmatics. Using this method we were able to demonstrate the heterogeneity in the thickness of the basement membrane and airway epithelium within individual airways of asthmatic subjects. This new computational method enables comprehensive and objective quantification of airway structures, which can be used to quantify heterogeneity of airway remodeling in obstructive lung diseases such as asthma and chronic obstructive pulmonary disease.
NEW & NOTEWORTHY The described application of Euclidean distance mapping provides an unbiased approach to study the extent and thickness distribution of changes in tissue structures. This approach will enable researchers to use computer-aided analysis of structural changes within lung tissue to understand the heterogeneity of airway remodeling in lung diseases.
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Postmeal exercise blunts postprandial glucose excursions in people on metformin monotherapy
Metformin is used clinically to reduce fasting glucose with minimal effects on postprandial glucose. Postmeal exercise reduces postprandial glucose and may offer additional glucose-lowering benefit beyond that of metformin alone, yet controversy exists surrounding exercise and metformin interactions. It is currently unknown how postmeal exercise and metformin monotherapy in combination will affect postprandial glucose. Thus, we examined the independent and combined effects of postmeal exercise and metformin monotherapy on postprandial glucose. A randomized crossover design was used to assess the influence of postmeal exercise on postprandial glucose excursions in 10 people treated with metformin monotherapy (57 ± 10 yr, HbA1C = 6.3 ± 0.6%). Each participant completed the following four conditions: sedentary and postmeal exercise (5 x 10-min bouts of treadmill walking at 60% Vo2max) with metformin and sedentary and postmeal exercise without metformin. Peak postprandial glucose within a 2-h time window and 2-h total area under the curve was assessed after a standardized breakfast meal, using continuous glucose monitoring. Postmeal exercise significantly blunted 2-h peak (P = 0.001) and 2-h area under the curve (P = 0.006), with the lowest peak postprandial glucose excursion observed with postmeal exercise and metformin combined (P < 0.05 vs. all other conditions: metformin/sedentary: 12 ± 3.4, metformin/exercise: 9.7 ± 2.3, washout/sedentary: 13.3 ± 3.2, washout/exercise: 11.1 ± 3.4 mmol/l). Postmeal exercise and metformin in combination resulted in the lowest peak postprandial glucose excursion compared with either treatment modality alone. Exercise timed to the postprandial phase may be important for optimizing glucose control during metformin monotherapy.
NEW & NOTEWORTHY The interactive effects of metformin and exercise on key physiological outcomes remain an area of controversy. Findings from this study show that the combination of metformin monotherapy and moderate-intensity postmeal exercise led to beneficial reductions in postprandial glucose excursions. Postmeal exercise may be a useful strategy for the management of postprandial glucose in people on metformin.
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The Kindlin-2 double act
Abstract
A restricted and controlled ability of circulating ions, molecules and cells to pass through the endothelium lining all blood vessels is crucial for maintaining the correct balance of fluid within our circulation.
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Value of physical tests in diagnosing cervical radiculopathy: a systematic review
Background contextIn clinical practice, the diagnosis of cervical radiculopathy is based on information from the patient history, physical examination and diagnostic imaging. Various physical tests may be performed, but their diagnostic accuracy is unknown.PurposeTo summarize and update the evidence on diagnostic performance of tests carried out during a physical examination for the diagnosis of cervical radiculopathy.Study designReview of the accuracy of diagnostic tests.Study SampleDiagnostic studies comparing results of tests performed during a physical examination in diagnosing cervical radiculopathy with a reference standard of imaging or surgical findings.
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Central angiotensin 1–7 increases osmotic thirst
Abstract
Introduction
Angiotensin 1–7 (ANG 1–7) is generated by type 2 angiotensin converting enzyme (ACE 2) and binds to MAS receptor. Although it is well known that angiotensin 1–7 functionally antagonizes the effects of the classical renin-angiotensin system (RAS) in several situations, the role of ANG 1–7 in hydromineral homeostasis is not clear. This study aimed to assess the role of ANG 1–7 on neuroendocrine responses to hyperosmolality in rats.
Methods
Male Wistar rats were divided into the following three groups: control, 24 hours of water deprivation (WD) and 24 hours of salt loading (SL, 1.8% NaCl). Intracerebroventricular (icv) injections of ANG 1–7 or vehicle were given to assess water intake and vasopressin (AVP) plasma levels. Additionally, the brains from control and WD groups were collected to evaluate gene expression in the subfornical (SFO), paraventricular (PVN), and supraoptic (SON) nuclei.
Results
Icv ANG 1–7 did not change water and salt intake in control rats; however, ANG 1–7 increased water intake following WD and SL, with no change in salt intake. Plasma AVP was not changed by icv ANG 1–7 in control or WD rats. Moreover, WD increased MAS gene expression in the SON and PVN, with no changes in ACE 2 mRNA levels.
Conclusion
ANG 1–7 increases thirst after osmotic stimuli, indicating that a previous sensitization to its action is necessary. This finding is consistent with the increased MAS gene expression in PVN and SON after water deprivation.
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S199 Generation of healthy and pathological synchronous events in the hippocampus: Modulation of cellular and network parameters results in altered dynamics
Cortical activity is characterized by behavior associated alternation of network states, such as physiological sharp-wave ripples (SWRs) and theta phase modulated gamma in the hippocampus. Epileptiform bursts are characteristic in the pathological case. In in vitro mouse hippocampal slice preparation the activity can be switched among SWR, gamma and epileptic states.We asked:SWRs and epileptiform bursts share similar initiation mechanisms, and express high-frequency oscillations (HFOs) with different features.
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O214 Interdependence of heart and brain bioelectrical activity
To study relationship between bioelectrical activity of brain and heart. The aim was to extract components related to heart activity in multichannel EEG recordings of healthy subjects.
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P223 Analysis of abductor pollicis brevis and orbicularis oris muscles representation of full face transplantation patients using TMS
Facial transplantation is defined as transfer of facial tissue from a donor to a patient who has suffered facial loss as a result of total denervation. Loss of facial tissue in the patient's transplant history is important for synaptic change. Our study aims to develop neurophysiological approaches by defining the change of motor representations in the brain.In this study, Transcranial Magnetic Stimulation (TMS) is used to create Orbicularis Oris (O.Oris) and Abductor Pollicis Brevis (APB) muscles representation maps in facial transplant cases.
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O206 The efficacy of repetitive transcranial magnetic stimulation in treating patients with chronic daily headache
Headache is the most prevalent pain disorder, affecting around 66% of the global population. This study aimed to investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the left DLPFC in treating patients with primary chronic daily headaches (chronic tension type headache and chronic migraine).
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P227 Carpal tunnel syndrome grading using high-resolution ultrasonography
Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the wrist. The diagnosis of CTS has been a concern for physicians for a long time. The aim of this study is to evaluate the use of the median nerve (MN) cross-sectional area (CSA) in the wrist compared with the CSA in the forearm to grade the severity of carpal tunnel syndrome in Egyptian patients.
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P218 Motor cortical adaptation to external stimuli is altered in unverricht-lundborg type myoclonus epilepsy
Unverricht-Lundborg disease, or progressive myoclonus epilepsy type 1 (EPM1), affects cortical excitability and inhibition, and neuroanatomy of the thalamocortical system. Stimulus sensitive myoclonus with potentially disabling features associates with EPM1. Our objective was to assess neurophysiological adaptation in EPM1 to further understand the role of the impaired thalamocortical system in the characteristic features of the disease.
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O202 Combining the strengths of passive functional mapping and electrical cortical stimulation
The identification of eloquent cortex, surrounding the seizure onset zone, is important for predictable surgical outcome in epilepsy patients. The symptoms during electrical cortical stimulation (ECS) lead to a functional map that includes motor, sensory, and other functions. In this study we test whether a prevenient high-gamma mapping (HGM) with electrocorticography can guide ECS mapping and therefore optimizes it in terms of time and stimulation related risks.
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P385 Analysis of EEG correlates during n-back working memory test in epilepsy patients investigated with surface and invasive electrodes
The brain process of short term storage of multimodal information is called generally as working memory. This is thought to be located in the frontal and parietal lobes, however recent evidences show that the temporal lobe has important function in maintaining short-term and spatial information. Among multiple neuropsychological tests used for short term memory, the N-back test (NBT) has the advantage, that higher values of memory load can be set by increasing the recall distance (value n).
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P384 The role of sleep spindles in overnight verbal memory consolidation in temporal lobe epilepsy patients
Declarative memory performance and hippocampal functioning are highly associated. Learning induced memory consolidation results in an increased coupling between mesial temporal lobe, thalamus and frontal areas during sleep, resulting in the increase of sleep spindles and slow wave sleep. Our aim was to investigate the modulatory effect of learning on sleep spindles in temporal lobe epilepsy (TLE) patients and to see whether the association between declarative memory consolidation and sleep parameters are altered.
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P383 Multiscale lempel-ZIV complexity in schizophrenia at rest and while performing a naming task
Schizophrenic patients show cognitive deficits which are evident in EEG measures. Recent studies have suggested that non-linear EEG indexes might more adequately reflect the complex, irregular, nonstationary behavior of neural processes in schizophrenia than more traditional ERP measures (Fernandez et al., 2011). So far, non-linear analyses have mainly been performed to EEGs from patients at rest, whereas differences in complexity might be more evident during task performance. In addition, most studies have explored complexity at a single time scale.
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Postoperative bleeding in patients on antithrombotic therapy after gastric endoscopic submucosal dissection
World Journal of Gastroenterology
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Britain's Creo receives speedy FDA approval for its endoscopic device
Reuters Health News
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Cost analysis of robot-assisted choledochotomy and common bile duct exploration as an option for complex choledocholithiasis
Surgical Endoscopy
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Evaluation of infliximab therapy in children with Crohn's disease using trough levels predictors
Digestive Diseases
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Fusobacterium nucleatum as a prognostic marker of colorectal cancer in a Japanese population
Journal of Gastroenterology
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Efficacy of vitamin D supplementation in combination with conventional antiviral therapy in patients with chronic hepatitis C infection: A meta-analysis of randomised controlled trials
Journal of Human Nutrition and Dietetics
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Physical exercise following esophageal cancer treatment (PERFECT) study: Design of a randomized controlled trial
BMC Cancer
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Efficacy and safety results of patients with HCV genotype 2 or 3 infection treated with ombitasvir/paritaprevir/ritonavir and sofosbuvir with or without ribavirin (QUARTZ II-III)
Journal of Viral Hepatitis
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Effects of a brief educational program on optimization of fluoroscopy to minimize radiation exposure during endoscopic retrograde cholangiopancreatography
Clinical Gastroenterology and Hepatology
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Proton pump inhibitors as risk factor for metabolic syndrome and hepatic steatosis in coeliac disease patients on gluten-free diet
Journal of Gastroenterology
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Application of transcutaneous ultrasonography for the diagnosis of muscle mass loss in patients with liver cirrhosis
Journal of Gastroenterology
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iTRAQ based investigation of plasma proteins in HIV infected and HIV/HBV coinfected patients - C9 and KLK are related to HIV/HBV coinfection
International Journal of Infectious Diseases
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New Novartis drug takes aim at tough-to-treat malaria
Reuters Health News
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Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer
Gastric Cancer
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Optimization of RAS/BRAF mutational analysis confirms improvement in patient selection for clinical benefit to anti-EGFR treatment in metastatic colorectal cancer
Molecular Cancer Therapeutics
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Serum ghrelin is associated with risk of colorectal adenocarcinomas in the ATBC study
Gut
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Exercise might prevent liver cirrhosis in overweight and obese adults
Liver International
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Colorectal cancer screening: How health gains and cost-effectiveness vary by ethnic group, the impact on health inequalities, and the optimal age range to screen
Cancer Epidemiology, Biomarkers & Prevention
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Worldwide burden of and trends in mortality from gallbladder and other biliary tract cancers
Clinical Gastroenterology and Hepatology
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Pregnancy outcomes in women with Budd Chiari Syndrome before onset of symptoms and after treatment
Liver International
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Molecular composition and heterogeneity of the LRRC8-containing swelling-activated osmolyte channels in primary rat astrocytes
Abstract
Volume-regulated anion channel (VRAC) is the ubiquitously expressed vertebrate Cl−/anion channel that is comprised of proteins belonging to the LRRC8 family and activated by cell swelling. In the brain, VRAC contributes to physiological and pathological release of a variety of small organic molecules, including the amino acid neurotransmitters glutamate, aspartate, and taurine. In the present work, we explored the role of all five LRRC8 family members in the release of organic osmolytes from primary rat astrocytes. Expression of LRRC8 proteins was modified using an RNAi approach, and amino acid fluxes via VRAC were quantified by radiotracer assays in cells challenged with hypoosmotic medium (30% reduction in osmolarity). Consistent with our prior work, knockdown of LRRC8A potently and equally suppressed the release of radiolabelled d-[14C]aspartate and [3H]taurine. Among other LRRC8 subunits, downregulation of LRRC8D, strongly inhibited release of the uncharged osmolytes [3H]taurine and myo-[3H]inositol, without major impact on the simultaneously measured efflux of the charged d-[14C]aspartate. In contrast, the release of d-[14C]aspartate was preferentially sensitive to deletion of LRRC8C + LRRC8E, but unaffected by downregulation of LRRC8D. Finally, siRNA knockdown of LRRC8C + LRRC8D strongly inhibited the release of all osmolytes. Overall, our findings suggest the existence of at least two distinct heteromeric VRACs in astroglial cells. The LRRC8A/D-containing permeability pathway appears to dominate the release of uncharged osmolytes, while an alternative channel (or channels) is composed of LRRC8A/C/D/E and responsible for the loss of charged molecules.
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Coordination of the upper and lower limbs for vestibular control of balance
Abstract
Vestibular stimulation can evoke responses in the arm when it is used for balance. Here we determine how these responses are affected by grip context, and how they are coordinated with the rest of the body. Galvanic vestibular stimulation (GVS) was used to evoke balance responses under three conditions of manual contact with an earth-fixed object: no contact (NC), light grip (<1 N) (LG), and firm grip (FG). As grip progressed along this continuum, we observed an increase in GVS-evoked hand force, with a simultaneous reduction in ground reaction force (GRF) through the feet. During LG, hand force was secondary to the GVS-evoked body sway response, indicating that the arm performed a mostly passive role. In contrast, during FG the arm became actively involved in driving body sway, as revealed by an early force impulse in the opposite direction to that seen in LG. We then examined how the direction of this active hand vector was coordinated with the lower limbs. Consistent with previous findings on sway anisotropy, FG skewed the direction of the GVS-evoked GRF vector towards the axis of baseline postural instability. However, this was effectively cancelled by the hand force vector, such that the whole-body sway response remained aligned with the inter-aural axis, maintaining the craniocentric principle. These results show that a minimum level of grip is necessary before the upper limb plays an active role in vestibular-evoked balance responses. Furthermore, they demonstrate that upper and lower-limb forces are coordinated to produce an appropriate whole-body sway response.
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Injury of the Hypothalamus in Patients With Hypoxic-Ischemic Brain Injury: A Diffusion Tensor Imaging Study.
Objectives: The survival rate for hypoxic-ischemic brain injury (HI-BI) is less than 20%. Several brain regions, including the caudate, hippocampus, and hypothalamus, are vulnerable to HI-BI. Hypothalamus is involved in regulation of temperature, sleep-wakefulness cycle, emotional behavior, and memory function. Using diffusion tensor imaging, we examined injury of the hypothalamus in patients with HI-BI. Methods: Twelve patients with HI-BI and 27 healthy control subjects were recruited. The region of interest was defined for the hypothalamus and the fractional anisotropy and apparent diffusion coefficient were measured. Results: The fractional anisotropy value was significantly lower in the patient group compared with the control group (P
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Exercise and estrogens: aerobic high- intensity exercise promotes leg vascular and skeletal muscle mitochondrial adaptations in early postmenopause
Abstract
Recent advances in healthcare have led to increases in life expectancy. With increases in longevity, women will spend a significant amount of time in post-menopause.
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Inducible satellite cell depletion attenuates skeletal muscle regrowth following a scald-burn injury
Abstract
Severe burns result in profound skeletal muscle atrophy; persistent muscle atrophy and weakness are major complications that hamper recovery from burn injury. Many factors contribute to the erosion of muscle mass following burn trauma, and we have previously shown concurrent activation and apoptosis of muscle satellite cells following a burn injury in pediatric patients. To determine the necessity of satellite cells during muscle recovery following a burn injury, we utilized a genetically modified mouse model (Pax7CreER-DTA) that allows for the conditional depletion of satellite cells in skeletal muscle. Additionally, mice were provided 5-ethynyl-2'-deoxyuridine to determine satellite cell proliferation, activation and fusion. Juvenile satellite cell-wild type (SC-WT) and satellite cell-depleted (SC-Dep) mice (8 weeks of age) were randomized to sham or burn injury consisting of a dorsal scald burn injury covering 30% of total body surface area. Both hind-limb and dorsal muscles were studied at 7, 14 and 21 days post-burn. SC-Dep mice had >93% depletion of satellite cells compared to SC-WT (P < 0.05). Burn injury induced robust atrophy in muscles located both proximal and distal to the injury site (∼30% decrease in fibre cross-sectional area [CSA], P < 0.05). Additionally, burn injury induced skeletal muscle regeneration, satellite cell proliferation, and fusion. Depletion of satellite cells impaired post-burn recovery of both muscle fibre CSA and volume (P < 0.05). These findings support an integral role for satellite cells in the etiology of lean tissue recovery following a severe burn injury.
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Sleep awakens active expiration
Abstract
Pulmonary ventilation is achieved by the repeated cyclical process of inhalation and exhalation, efficiently exchanging air between the environment and the alveoli, the highly specialized gas exchange units of the lungs.
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Quality and Safety in Anesthesia and Perioperative Care.
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