Τετάρτη 13 Σεπτεμβρίου 2017

Case Report: Aquatic Therapy and End-Stage Dementia

A 54-year old female, retired due to progressive cognitive decline, was diagnosed with early-onset Alzheimer's dementia. Conventional medication therapy for dementia had proven futile. Initial evaluation revealed a non-verbal female seated in a wheelchair, dependent on 2-person assist for all transfers and activities of daily living (ADLs.) She had been either non-responsive or actively resistive for both ADLs and transfers in the 6 months prior to assessment. Following a total of 17 one hour therapy sessions over 19 weeks in a warm water therapy pool, she achieved ability to tread water for 15 minutes, transfers improved to moderate to-maximum assist from seated, ambulation improved to 1000' with minimum-to-moderate assist of 2 persons.

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Mild Traumatic Brain Injury in a High School Football Player with Familial Hemiplegic Migraine: A Case Report

Mild traumatic brain injury is a major concern in young athletes, with an estimated 1.6 to 3.8 million reported concussions in the US annually. Familial hemiplegic migraine is a rare autosomal-dominant condition characterized by sporadic episodes of transient unilateral motor weakness which may begin at any age. We present a case of a 17-year-old male with a history of familial hemiplegic migraine who suffered prolonged symptoms following a mild traumatic brain injury during sports participation.

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Atherosclerotic Disease and its Relationship to Lumbar Degenerative Disc Disease, Facet Arthritis and Stenosis with Computed Tomography Angiography

The intervertebral disc is the largest avascular structure in the body. It relies on passive diffusion from arteries at the periphery of the disc for nutrition. Prior studies have suggested a correlation between vascular disease and lumbar degenerative disc disease (DDD) but the association with facet arthritis and stenosis has not been evaluated.

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Secondary Loss of Response to Infliximab in Pediatric Crohn's Disease: Does it Matter How and When We Start?.

Objectives: A significant proportion of children with Crohn's disease develop a secondary loss of response (LOR) to infliximab. Our aim was to study the impact of initial treatment strategies on secondary LOR. Methods: We reviewed the medical records of children with Crohn's disease who received scheduled maintenance infliximab therapy for at least 12 months. We compared children who developed LOR with those who did not; with regards to their clinical and laboratory parameters, disease phenotype and treatment strategy before developing LOR. Results: 73 children (Median age at diagnosis- 11 (2-16) years, 41 boys) who had received a median duration of 33 (13-110) months of infliximab therapy were included in the final analysis. LOR was seen in 25(34.2%). Demographic variables, disease phenotype (age, disease location and behavior), inflammatory parameters and PCDAI at induction with infliximab, was similar between both groups. Children with LOR had a significantly greater number of flares of the disease when compared to those who did not have LOR [4 (1 - 8) vs. 2(1-5) p = 0.03]. The choice of the concomitant immunomodulator - Methotrexate [11/29(37.9%)] vs. Azathioprine [11/36(30.5%)] (p = 0.6) did not affect LOR rates. The median time-lag between diagnosis and induction with infliximab was significantly longer in children with LOR as compared to those who did not have a LOR[28 (4-90) months vs. 12.5(1-121) months, p = 0.004]. Conclusion: Early use of infliximab in pediatric Crohn's disease is associated with a decrease in secondary LOR. The type of concomitant immunomodulator used does not make a difference to LOR rates. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Polyethylene Glycol 3350 With Electrolytes vs Polyethylene Glycol 4000 for Constipation: A Randomized, Controlled Trial.

Objectives: The long-term efficacy and safety of polyethylene glycol (PEG) in constipated children are unknown, and a head-to-head comparison of the different PEG formulations is lacking. We aimed to investigate non-inferiority of PEG3350 with electrolytes (PEG3350+E) compared to PEG4000 without electrolytes (PEG4000). Methods: In this double-blind trial, children aged 0.5 - 16 years with constipation, defined as a defecation frequency of =3 per week with

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Nutritional State and Feeding Behaviors of Children With Eosinophilic Esophagitis and Gastroesophageal Reflux Disease.

Objective: Because both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) are associated with malnutrition and feeding dysfunction, this study compares growth, nutrition and feeding behaviors in children with GERD and EoE. Methods: Subjects aged 1-7 with GERD or EoE were enrolled in a prospective study. Assessments included length/height, weight, 3-day food diary, serum biomarkers of nutrition, and the Behavioral Pediatric Feeding Assessment Scale (BPFAS). Results: Mean weight-for-length z-scores in GERD and EoE children were -0.93 and -1.14 (p = NS) and mean body mass index z-scores were 0.29 and -0.13 (p = NS). Vitamin D intake was below the daily recommended intake (DRI) in GERD subjects. EoE subjects' intake was below DRI of Vitamin D and calcium. GERD and EoE groups both had normal intake of calories, carbohydrates, proteins, fats, and iron and normal serum ferritin (25 vs. 34 ng/mL), prealbumin (21 vs. 20 mg/dL), PTH (42 vs. 37 pg/mL), and Vitamin D (both 30 ng/mL). BPFAS problem and frequency scores were similar in GERD and EoE subjects but were higher than those of a historical cohort of healthy controls (Hedges'g of 0.95 and 1.1 respectively). EoE subjects on food allergen restriction diets had significantly less feeding dysfunction than those on regular diets. Conclusion: Since a selected group of children with uncomplicated GERD or EoE were without nutritional deficiencies but had maladaptive feeding, providing anticipatory guidance to minimize mealtime challenges, monitoring for improvement, or referring to a feeding therapist may be beneficial. A trial of food allergen restriction may provide additional benefit for those with EoE. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Enteroaggregative E. coli Subclinical Infection and co-Infections and Impaired Child Growth in the MAL-ED Cohort Study.

Objective: We evaluated the impact of subclinical enteroaggregative Escherichia coli (EAEC) infection alone and in combination with other pathogens in the first six months of life on child growth. Methods: Non-diarrheal samples from 1,684 children across eight Multisite Birth Cohort Study, Malnutrition and Enteric Diseases (MAL-ED) sites in Asia, Africa, and Latin America were tested monthly; over 90% of children were followed-up twice weekly for the first six months of life. Results: Children with subclinical EAEC infection did not show altered growth between enrollment and six months. Conversely, EAEC co-infection with any other pathogen was negatively associated with delta weight-for-length (WLZ) (p 0.05) z-scores between 0 and 6 months. The presence of two or more pathogens without EAEC was not significantly associated with delta WLZ and WAZ. The most frequent EAEC co-infections included Campylobacter spp. heat-labile toxin-producing enterotoxigenic E. coli, Cryptosporidium spp., and atypical enteropathogenic E. coli. Myeloperoxidase levels were increased with EAEC co-infection (p

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Changes in Proteases, Antiproteases and Bioactive Proteins From Mother's Breast Milk to the Premature Infant Stomach.

Objectives: Our previous studies suggested that human milk proteases begin to hydrolyze proteins in the mammary gland and continue within the term infant stomach. No research has measured milk protease and pepsin activity in the gastric aspirates of preterm infants after human milk feeding. This study investigated how the concentrations of human milk proteases and protease inhibitors changed in the premature infant stomach. Methods: Human milk and infant gastric samples were collected from 18 preterm-delivering mother-infant pairs (24-32 wk gestational age). Paired human milk and gastric samples were collected across postnatal age (2-47 days). Protease concentrations were determined by spectrophotometric or fluorometric assays, and the concentrations of protease inhibitors and bioactive proteins were determined by ELISA. Paired t-tests were applied to compare enzymes, antiproteases and bioactive proteins between human milk and gastric samples. Results: Our study reveals that although human milk proteases, including carboxypeptidase B2, kallikrein, plasmin, cathepsin D, elastase, thrombin and cytosol aminopeptidase are present in the preterm infant stomach, only plasmin and cathepsin D can actively hydrolyze proteins at gastric pH. ELISA and peptidomic evidence suggest that all milk antiproteases as well as lactoferrin and immunoglobulin A are partially digested in the preterm stomach. Conclusions: Most human milk proteases are active in milk but not at preterm infant gastric pH. Only cathepsin D and plasmin have potential to continue degrading milk proteins within the preterm infant stomach. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Variceal Hemorrhage and Adverse Liver Outcomes in Patients With Cystic Fibrosis Cirrhosis.

Objectives: Cirrhosis occurs in 5-10% of CF (cystic fibrosis) patients, often accompanied by portal hypertension. We analyzed three adverse liver outcomes, variceal bleeding (VB), liver transplant (LT), and liver death (LD), and risk factors for these in CF Foundation Patient Registry (CFFPR) subjects with reported cirrhosis. Methods: We determined 10-year incidence rates for VB, LT, LD, and all-cause mortality (ACM), and examined risk factors using competing risk models and Cox-proportional hazard regression. Results: From 2003-2012, 943 participants (41% female, mean age 18.1 years) had newly reported cirrhosis; 24.7% required insulin, 85% had prior pseudomonas. Seventy-three subjects had reported VB; 38 with first VB and new cirrhosis reported simultaneously and 35 with VB after cirrhosis report. 10-year cumulative VB, LT, and LD rates were 6.6% (95% Confidence Interval (CI): 4.0, 9.1%), 9.9% (95% CI: 6.6%, 13.2%), and 6.9% (95% CI: 4.0%, 9.8%), respectively, with an ACM of 39.2% (95% CI: 30.8, 36.6%). ACM was not increased in subjects with VB compared to those without (HR 1.10, 95% CI: 0.59, 2.08). CF related diabetes (CFRD (hazard ratio (HR): 3.141, 95% CI:1.56, 6.34) and VB (HR: 4.837, 95% CI: 2.33, 10.0) were associated with higher LT risk while only worse lung function was associated with increased LD in multivariate analysis. Death rate among subjects with VB was 24% with LT and 20.4% with native liver. Conclusions: VB is an uncommon complication of CF cirrhosis and can herald the diagnosis, but does not affect ACM. Adverse liver outcomes and ACM are frequent by 10 years after cirrhosis report. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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10 New Beech King Air B250 + 1 Cessna Citation Latitude :-)

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Start video at 2 minutes. A B200 taking of from Alta. We are replacing the fix-wing ambulances, and adding a jet, for better and safer service. Glass cocpits, best avionics and medical eqipment. The jet is better for ECMO transport etc. The jet will be at Oslo airport. 8 B250 on standby, -2 extra ( -During maint. on aircraft, and faster to fly a macine directly to a base, if tec. problem, so the crew don`t hawe to go and pick up working machine, -they get it delivered. Original plan was 2 jet, but "Health North" did not find / wanted to use the money. ( Norway divided innto 4 healt-regions wwith own budgets ) There was also a local debate about response-time, some would get bit longer time. Not ShortTakeOfLanding capasety on the jet. ( Norway have 26 STOL (800 meter) airports for local traffic. ) Always sorry for my sorry English... ExEMTNor

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Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial

Abstract
Background: Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme.Methods: We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge.Results: A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P=0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9–38.6] and a number needed to treat of 5 (95% CI 3–17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises.Conclusions: An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear.Clinical trial registration: NCT01693172.

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Correction

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Publication date: Available online 13 September 2017
Source:Archives of Physical Medicine and Rehabilitation





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10 New Beech King Air B250 + 1 Cessna Citation Latitude :-)

hqdefault.jpg

Start video at 2 minutes. A B200 taking of from Alta. We are replacing the fix-wing ambulances, and adding a jet, for better and safer service. Glass cocpits, best avionics and medical eqipment. The jet is better for ECMO transport etc. The jet will be at Oslo airport. 8 B250 on standby, -2 extra ( -During maint. on aircraft, and faster to fly a macine directly to a base, if tec. problem, so the crew don`t hawe to go and pick up working machine, -they get it delivered. Original plan was 2 jet, but "Health North" did not find / wanted to use the money. ( Norway divided innto 4 healt-regions wwith own budgets ) There was also a local debate about response-time, some would get bit longer time. Not ShortTakeOfLanding capasety on the jet. ( Norway have 26 STOL (800 meter) airports for local traffic. ) Always sorry for my sorry English... ExEMTNor

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Racial and Insurer-Based Disparities of Care Exist Among Thyroid Cancer Patients in the United States

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 351-353.


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Large Retrospective Study Confirms the 2015 American Thyroid Association Guidelines for Classifying Small Thyroid Nodules on Ultrasound

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 344-347.


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Conflicting Occurrence of Thyroid-Stimulating or Blocking Antibodies Is Seen in 4 to 9% of Patients with Autoimmune Thyroid Disease

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 335-337.


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Hypothyroid Symptoms in Pregnant Women Fail to Predict Hypothyroid Status

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 332-334.


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A Deiodinase 2 Polymorphism May Lower Serum T3 and Tissue T3 in Levothyroxine-Treated Patients

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 338-340.


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Moderate-Risk versus High-Risk RET Mutation Does Not Impact Medullary Thyroid Cancer Outcomes in MEN2A Patients

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 348-350.


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Is There a Distinct Pattern of Mutations in Benign Adenomatous Nodules?

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 341-343.


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Does Empathy, a Central Element of the Art of Medicine, Proscribe Using “Good Cancer” Themes in Clinical Practice?

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 354-357.


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Spasticity may obscure motor learning ability after stroke

Previous motor learning studies based on adapting movements of the hemiparetic arm in stroke subjects have not accounted for spasticity occurring in specific joint ranges (spasticity zones), resulting in equivocal conclusions about learning capacity. We compared the ability of participants with stroke to rapidly adapt elbow extension movements to changing external load conditions outside and inside spasticity zones. Participants with stroke (n=12, aged: 57.8±9.6 years) and healthy age-matched controls (n=8, 63.5±9.1 years) made rapid 40-50° horizontal elbow extension movements from an initial (3°) to a final (6°) target. Sixteen blocks (6-10 trials/block) consisting of alternating loaded (30% MVC) and non-loaded trials were made in one (controls) or two sessions (stroke; 1 wk apart). For the stroke group, the tonic stretch reflex threshold angle at which elbow flexors began to be activated during passive elbow extension was used to identify the beginning of the spasticity zone. The task was repeated in joint ranges that did or did not include the spasticity zone. Error correction strategies were identified by the angular positions before correction and compared between groups and sessions. Changes in load condition from no-load to load and vice-versa resulted in undershoot and overshoot errors respectively. Stroke subjects corrected errors in 1-4 trials compared to 1-2 trials in controls. When movements did not include the spasticity zone, there was an immediate decrease in the number of trials needed to restore accuracy, suggesting that the capacity to learn may be preserved after stroke but masked by the presence of spasticity.



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Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy.

Introduction: Exaggerated sensory activity has been assumed to contribute to functional impairment following lesion of the central motor pathway. However, recent studies have suggested that sensory contribution to muscle activity during gait is reduced in stroke patients and children with cerebral palsy (CP). We investigated whether this also occurs in CP adults and whether daily treadmill training is accompanied by alterations in sensory contribution to muscle activity. Materials and Methods: 17 CP adults and 12 uninjured individuals participated. The participants walked on a treadmill while a robotized ankle-foot orthosis applied unload perturbations at the ankle hereby removing sensory feedback naturally activated during push-off. Reduction of electromyographic (EMG) activity in the soleus muscle caused by unloads was compared and related to kinematics and ankle joint stiffness measurements. Similar measures were obtained after 6 weeks of gait training. Results: Sensory contribution to soleus EMG activation was reduced in CP adults compared with uninjured adults. The lowest contribution of sensory feedback was found in participants with lowest maximal gait speed. This was related to increased ankle plantar flexor stiffness. 6 weeks of gait training did not alter the contribution of sensory feedback. Conclusion: Exaggerated sensory activity is unlikely to contribute to impaired gait in CP adults, since sensory contribution to muscle activity during gait was reduced compared with uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait so that a larger part of plantar flexor muscle activity must be generated by descending motor commands.



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Influence of Biases in Numerical Magnitude allocation on Human Pro-Social Decision Making

Over the past decade neuroscientific research has attempted to probe the neurobiological underpinnings of human pro-social decision-making. Such research has almost ubiquitously employed tasks such as the dictator game or similar variations (i.e. ultimatum game). Considering the explicit numerical nature of such tasks, it is surprising that the influence of numerical cognition upon decision-making during task performance remains unknown. Whilst performing these tasks, participants typically tend to anchor upon a 50:50 split that necessitates an explicit numerical judgement (i.e. number-pair bisection). Accordingly, we hypothesise that the decision-making process during the dictator game recruits overlapping cognitive processes to those known to be engaged during number-pair bisection. We observed that biases in numerical magnitude allocation correlated with the formulation of decisions during the dictator game. That is, intrinsic biases towards smaller numerical magnitudes were associated with the formulation of less favourable decisions, whereas biases towards larger magnitudes were associated with more favourable choices. We proceeded to corroborate this relationship by subliminally and systematically inducing biases in numerical magnitude towards either higher or lower numbers using a visuo-vestibular stimulation paradigm. Such subliminal alterations in numerical magnitude allocation led to proportional and corresponding changes to an individual's decision-making during the dictator game. Critically, no relationship was observed between neither intrinsic nor induced biases in numerical magnitude on decision-making when assessed using a non-numerical based pro-social questionnaire. Our findings demonstrate numerical influences upon decisions formulated during the dictator game and highlight the necessity to control for confounds associated with numerical cognition in human decision-making paradigms.



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Diversity in Spatial Scope of Contrast Adaptation among Mouse Retinal Ganglion Cells

Retinal ganglion cells adapt to changes in visual contrast by adjusting their response kinetics and sensitivity. While much work has focused on the time scales of these adaptation processes, less is known about the spatial scale of contrast adaptation. For example, do small, localized contrast changes affect a cell's signal processing across its entire receptive field? Previous investigations have provided conflicting evidence, suggesting either that contrast adaptation occurs locally within subregions of a ganglion cell's receptive field or globally over the receptive field in its entirety. Here, we investigated the spatial extent of contrast adaptation in ganglion cells of the isolated mouse retina through multielectrode-array recordings. We applied visual stimuli so that ganglion cell receptive fields contained regions where the average contrast level changed periodically as well as regions with constant average contrast level. This allowed us to analyze temporal stimulus integration and sensitivity separately for stimulus regions with and without contrast changes. We found that the spatial scope of contrast adaptation depends strongly on cell identity, with some ganglion cells displaying clear local adaptation, whereas others, in particular large transient ganglion cells, adapted globally to contrast changes. Thus, the spatial scope of contrast adaptation in mouse retinal ganglion cells appears to be cell-type specific. This could reflect differences in mechanisms of contrast adaptation and may contribute to the functional diversity of different ganglion cell types.



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Stability of Hand Force Production: I. Hand Level Control Variables and Multi-Finger Synergies

We combined the theory of neural control of movement with referent coordinates and the uncontrolled manifold hypothesis to explore synergies stabilizing the hand action in accurate four-finger pressing tasks. In particular, we tested a hypothesis on two classes of synergies - those among the four fingers and those within a pair of control variables - stabilizing hand action under visual feedback and disappearing without visual feedback. Subjects performed four-finger total force and moment production tasks under visual feedback; the feedback was later partially or completely removed. The "inverse piano" device was used to lift and lower the fingers smoothly at the beginning and at the end of each trial. These data were used to compute pairs of hypothetical control variables. Inter-trial analysis of variance within the finger force space was used to quantify multi-finger synergies stabilizing both force and moment. A data permutation method was used to quantify synergies among control variables. Under visual feedback, synergies in the spaces of finger forces and hypothetical control variables were found to stabilize total force. Without visual feedback, the subjects showed a force drift to lower magnitudes and a moment drift toward pronation. This was accompanied by disappearance of the four-finger synergies and strong attenuation of the control-variable synergies. The indices of the two types of synergies correlated with each other. The findings are interpreted within the scheme with multiple levels of abundant variables.



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Surface electrodes record and label brain neurons in insects

We used suction electrodes to reliably record the activity of identified ascending auditory interneurons from the anterior surface of the brain in crickets. Electrodes were gently attached to the sheath covering the projection area of the ascending interneurons and the ring-like auditory neuropil in the protocerebrum. The specificity and selectivity of the recordings were determined by the precise electrode location, which could easily be changed without causing damage to the tissue. Different non-auditory fibres were recorded at other spots of the brain surface; stable recordings lasted for several hours. The same electrodes were used to deliver fluorescent tracers into the nervous system by means of electrophoresis. This allowed us to retrograde label the recorded auditory neurons, and to reveal their cell body and dendritic structure in the first thoracic ganglion. By adjusting the amount of dye injected, we specifically stained the ring-like auditory neuropil in the brain, demonstrating the clusters of cell bodies contributing to it. Our data provide a proof that surface electrodes are a versatile tool to analyse neural processing in small brains of invertebrates.



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The superior colliculus and the steering of saccades toward a moving visual target

Following the suggestion that a command encoding the current target location feeds the oculomotor system during interceptive saccades, we tested the involvement of the deep superior colliculus (dSC). Extracellular activity of 52 saccade-related neurons was recorded in three monkeys while they generated saccades to targets that were static or moving along the preferred axis, away from (outward) or toward a fixated target (inward) with a constant speed (20°/s). Vertical and horizontal motions were tested when possible. Movement field (MF) parameters (boundaries, preferred vector and firing rate) were estimated after spline fitting the relation between the average firing rate during the motor burst and saccade amplitude. During radial target motions, the inner MF boundary shifted in the motion direction for some, but not all, neurons. Likewise, for some neurons, the lower boundaries were shifted upward during upward motions, the upper boundaries downward during downward motions. No consistent change was observed during horizontal motions. For some neurons, the preferred vectors were also shifted in the motion direction for outward, upward and "toward the midline" target motions. The shifts of boundary and preferred vector were not correlated. The burst firing rate was consistently reduced during interceptive saccades. Our study shows an involvement of dSC neurons in steering the interceptive saccade. When observed, the shifts of boundary in the direction of target motion correspond to commands related to past target locations. The absence of shift in the opposite direction implies that dSC activity does not issue predictive commands related to the future target location.



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METHODOLOGICAL CONSIDERATIONS FOR A CHRONIC NEURAL INTERFACE WITH THE CUNEATE NUCLEUS OF MACAQUES

While the response properties of neurons in the somatosensory nerves and anterior parietal cortex have been extensively studied, little is known about the encoding of tactile and proprioceptive information in the cuneate nucleus (CN) or external cuneate nucleus (ECN), the first recipients of upper limb somatosensory afferent signals. The major challenge in characterizing neural coding in CN/ECN has been to record from these tiny, difficult to access brainstem structures. Most previous investigations of CN response properties have been carried out in decerebrate or anesthetized animals, thereby eliminating the well-documented top-down signals from cortex, which likely exert a strong influence on CN responses. Seeking to fill this gap in our understanding of somatosensory processing, we describe an approach to chronically implant arrays of electrodes in the upper limb representation in the brain stem in primates. First, we describe the topography of CN/ECN in Rhesus macaques, including its somatotopic organization and the layout of its submodalities (touch and proprioception). Second, we describe the design of electrode arrays and the implantation strategy to obtain stable recordings. Third, we show sample responses of CN/ECN neurons in brainstem obtained from awake, behaving monkeys. With this method, we are in a position to characterize, for the first time, somatosensory representations in CN and ECN of primates.



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Characterization of ion channels and O2 sensitivity in gill neuroepithelial cells of the anoxia-tolerant goldfish (Carassius auratus)

The neuroepithelial cell (NEC) of the fish gill is an important model for O2 sensing in vertebrates; however, a complete picture of the chemosensory mechanisms in NECs is lacking, and O2 chemoreception in vertebrates that are tolerant to anoxia has yet not been explored. Using whole-cell patch-clamp recording, we characterized four types of ion channels in NECs isolated from the anoxia-tolerant goldfish. A Ca2+-dependent K+ current (IKCa) peaked at ~20 mV, was potentiated by increased intracellular Ca2+, and was reduced by 100 μM Cd2+. A voltage-dependent inward current in Ba2+ solution, with peak at 0 mV, confirmed the presence of Ca2+ channels. A voltage-dependent K+ current (IKV) was inhibited by 20 mM tetraethylammonium and 5 mM 4-aminopyridine, revealing a background K+ current (IKB) with open rectification. Mean resting membrane potential of –45.2 +/- 11.6 mV did not change upon administration of hypoxia (PO2 = 11 mmHg), nor were any of the K+ currents sensitive to changes in PO2 during whole-cell recording. By contrast, when the membrane and cytosol were left undisturbed during Fura-2 or FM1-43 imaging experiments, hypoxia increased intracellular Ca2+ concentration and initiated synaptic vesicle activity. 100 μM Cd2+ and 50 μM nifedipine eliminated uptake of FM1-43. We conclude that Ca2+ influx via L-type Ca2+ channels is correlated with vesicular activity during hypoxic stimulation. In addition, we suggest that expression of IKCa in gill NECs is species specific and, in goldfish, may contribute to an attenuated response to acute hypoxia.



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Comparison of three models of saccade disconjugacy in strabismus

In pattern strabismus the horizontal and vertical misalignments vary with eye position along the orthogonal axis. The disorder is typically described in terms of overaction or underaction of oblique muscles. Recent behavioral studies in humans and monkeys, however, have reported that such actions are insufficient to fully explain the patterns of directional and amplitude disconjugacy of saccades. There is mounting evidence that the oculomotor abnormalities associated with strabismus are at least partially attributable to neurophysiological abnormalities. A number of control systems models have been developed to simulate the kinematic characteristics of saccades in normal primates. In the present study we sought to determine whether these models could simulate the abnormalities of saccades in strabismus by making two assumptions: 1) in strabismus the burst generator gains differ for the two eyes and 2) abnormal cross-talk exists between the horizontal and vertical saccadic circuits in brainstem. We tested three models, distinguished by the location of the horizontal-vertical cross-talk. All three models were able to simulate amplitude and directional saccade disconjugacy, postsaccadic drift, and a pattern strabismus for static fixation, but they made different predictions about the dynamics of saccades. By assuming that crosstalk occurs at multiple nodes, the Distributed Crosstalk Model correctly predicted the dynamics of saccades. These new models make additional predictions that can be tested with future neurophysiological experiments.



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Hyperpolarization-activated cyclic-nucleotide gated channels potentially modulate axonal excitability at different thresholds

Hyperpolarization-activated cyclic-nucleotide gated (HCN) channels mediate differences in sensory and motor axonal excitability at different thresholds in animal models. Importantly, HCN channels are responsible for voltage-gated inward rectifying (Ih) currents activated during hyperpolarization. The Ih currents exert a crucial role in determining the resting membrane potential and have been implicated in a variety of neurological disorders, including neuropathic pain. In humans, differences in biophysical properties of motor and sensory axons at different thresholds remain to be elucidated and could provide crucial pathophysiological insights in peripheral neurological diseases. Consequently, the aim of this study was to characterise sensory and motor axonal function at different threshold. Median nerve motor and sensory axonal excitability studies were undertaken in 15 health subjects (45 studies in total). Tracking targets were set to 20%, 40% and 60% of maximum for sensory and motor axons. Hyperpolarizing threshold electrotonus (TEh) at 90-100 ms was significantly increased in lower threshold sensory axons (F=11.195, P<0.001). In motor axons, the hyperpolarizing I/V gradient was significantly increased in lower threshold axons (F=3.191, P < 0.05). The minimum I/V gradient was increased in lower threshold motor and sensory axons. In conclusion, variation in the kinetics of HCN isoforms could account for the findings in motor and sensory axons. Importantly, assessing the function of HCN channels in sensory and motor axons of different thresholds may provide insights into the pathophysiological processes underlying peripheral neurological diseases in humans, particularly focusing on the role of HCN channels with the potential of identifying novel treatment targets.



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10 New Beech King Air B250 + 1 Cessna Citation Latitude :-)

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Start video at 2 minutes. A B200 taking of from Alta. We are replacing the fix-wing ambulances, and adding a jet, for better and safer service. Glass cocpits, best avionics and medical eqipment. The jet is better for ECMO transport etc. The jet will be at Oslo airport. 8 B250 on standby, -2 extra ( -During maint. on aircraft, and faster to fly a macine directly to a base, if tec. problem, so the crew don`t hawe to go and pick up working machine, -they get it delivered. Original plan was 2 jet, but "Health North" did not find / wanted to use the money. ( Norway divided innto 4 healt-regions wwith own budgets ) There was also a local debate about response-time, some would get bit longer time. Not ShortTakeOfLanding capasety on the jet. ( Norway have 26 STOL (800 meter) airports for local traffic. ) Always sorry for my sorry English... ExEMTNor

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10 New Beech King Air B250 + 1 Cessna Citation Latitude :-)

hqdefault.jpg

Start video at 2 minutes. A B200 taking of from Alta. We are replacing the fix-wing ambulances, and adding a jet, for better and safer service. Glass cocpits, best avionics and medical eqipment. The jet is better for ECMO transport etc. The jet will be at Oslo airport. 8 B250 on standby, -2 extra ( -During maint. on aircraft, and faster to fly a macine directly to a base, if tec. problem, so the crew don`t hawe to go and pick up working machine, -they get it delivered. Original plan was 2 jet, but "Health North" did not find / wanted to use the money. ( Norway divided innto 4 healt-regions wwith own budgets ) There was also a local debate about response-time, some would get bit longer time. Not ShortTakeOfLanding capasety on the jet. ( Norway have 26 STOL (800 meter) airports for local traffic. ) Always sorry for my sorry English... ExEMTNor

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Mapping Loci That Control Tuber and Foliar Symptoms Caused by PVY in Autotetraploid Potato (Solanum tuberosum L.)

Potato tuber necrotic ringspot disease (PTNRD) is a tuber deformity associated with infection by the tuber necrotic strain of Potato virus Y (PVYNTN). PTNRD negatively impacts tuber quality and marketability and poses a serious threat to seed and commercial potato production worldwide. PVYNTN symptoms differ in the cultivars Waneta and Pike: Waneta expresses severe PTNRD and foliar mosaic with vein and leaf necrosis, whereas Pike does not express PTNRD and mosaic is the only foliar symptom. To map loci that influence tuber and foliar symptoms, 236 F1 progeny of a cross between Waneta and Pike were inoculated with PVYNTN isolate NY090029 and genotyped using 12,808 Potato SNPs. Foliar symptom type and severity were monitored for 10 weeks, while tubers were evaluated for PTNRD expression at harvest and again after 60 days in storage. Pairwise correlation analyses indicate a strong association between PTNRD and vein necrosis ( = 0.4195). QTL analyses revealed major-effect QTLs on chromosomes 4 and 5 for mosaic, 4 for PTNRD, and 5 for foliar-necrosis symptoms. Locating QTLs associated with PVY-related symptoms provides a foundation for breeders to develop markers that can be used to screen out potato clones with undesirable phenotypes, e.g., those likely to develop PTNRD or to be symptomless carriers of PVY.



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Serotonin Drives Predatory Feeding Behavior via Synchronous Feeding Rhythms in the Nematode Pristionchus pacificus

Feeding behaviors in a wide range of animals are regulated by the neurotransmitter serotonin, although the exact neural circuits and associated mechanism are often unknown. The nematode Pristionchus pacificus can kill other nematodes by opening prey cuticles with movable teeth. Previous studies showed that exogenous serotonin treatment induces a predatory-like tooth movement and slower pharyngeal pumping in the absence of prey, however, physiological functions of serotonin during predation and other behaviors in P. pacificus remained completely unknown. Here, we investigate the roles of serotonin by generating mutations in Ppa-tph-1 and Ppa-bas-1, two key serotonin biosynthesis enzymes and by genetic ablation of pharynx-associated serotonergic neurons. Mutations in Ppa-tph-1 reduced the pharyngeal pumping rate during bacterial feeding compared to wild type. Moreover, the loss of serotonin or a subset of serotonergic neurons decreased the success of predation, but did not abolish the predatory feeding behavior completely. Detailed analysis using high-speed camera revealed that the elimination of serotonin or the serotonergic neurons disrupted the timing and coordination of predatory tooth movement and pharyngeal pumping. This loss of synchrony significantly reduced the efficiency of successful predation events. These results suggest that serotonin has a conserved role in bacterial feeding and in addition drives the feeding rhythm of predatory behavior in Pristionchus.



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Structural neuroimaging in sport-related concussion

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Publication date: Available online 13 September 2017
Source:International Journal of Psychophysiology
Author(s): Erin D. Bigler
Structural neuroimaging of athletes who have sustained a sports-related concussion (SRC) can be viewed as either standard clinical imaging or with advanced neuroimaging methods that quantitatively assess brain structure. Negative findings from conventional computed tomography (CT) or magnetic resonance imaging (MRI) are the norm in SRC. Nonetheless, these conventional measures remain the first line of neuroimaging of the athlete as they do detect clinically significant pathologies, when present, such as hemorrhagic abnormalities in the form of hematomas, contusions and mircobleeds along with regions of focal encephalomalacia or other signal abnormalities, with CT best capable of detecting skull fractures. However, advanced neuroimaging techniques hold particular promise in detecting subtle neuropathology in the athlete which standard clinical neuroimaging cannot. To best understand what conventional as well as quantitative neuroimaging methods are detecting in SRC, this review begins by covering basic neuroanatomical principles associated with mild traumatic brain injury (mTBI) and the brain regions most vulnerable to injury from SRC, as these regions define where advanced neuroimaging methods most likely detect abnormalities. Advanced MRI techniques incorporate quantitative metrics that include volume, shape, thickness along with diffusion parameters that provide a more fine-grained analysis of brain structure. With advancements in image analysis, multiple quantitative neuroimaging metrics now can be utilized in assessing SRC. Such multimodality approaches are particularly relevant and important for assessing white matter and network integrity of the brain following injury, including SRC. This review focuses just on the structural side of neuroimaging in SRC, but these techniques also are being integrated with functional neuroimaging, where the combination of the two approaches may provide superior methods in assessing the pathological effects of SRC.



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Fit for duty: How to be a resilient responder

Fit for duty does not always mean being physically fit; it also refers to being resilient to the stress and emotional impacts of the job

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Novel spatiotemporal analysis of gait changes in body weight supported treadmill trained rats following cervical spinal cord injury

Common gait measures such as stride length, cycle time, and step height are not independent variables, but different aspects of the same multidimensional step. This complicates comparisons between experimental...

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New dental and postcranial material of Agerinia smithorum (Primates, Adapiformes) from the type locality Casa Retjo-1 (early Eocene, Iberian Peninsula)

Publication date: December 2017
Source:Journal of Human Evolution, Volume 113
Author(s): Joan Femenias-Gual, Judit Marigó, Raef Minwer-Barakat, Salvador Moyà-Solà
New material attributed to Agerinia smithorum from Casa Retjo-1 (early Eocene, NE Iberian Peninsula), consisting of 13 isolated teeth and a fragment of calcaneus, is studied in this work. These fossils allow the first description of the calcaneus and the upper premolars for the genus Agerinia, as well as the first description of the P2 and M2 for A. smithorum. The newly recovered lower teeth are virtually identical to the holotype of A. smithorum and are clearly distinguishable from the other species of Agerinia. The upper teeth also show clear differences with Agerinia marandati. The morphology of the calcaneal remains reveals that A. smithorum practiced a moderately active arboreal quadrupedal mode of locomotion, showing less leaping proclivity than notharctines but more than asiadapids. All the morphological features observed in the described material reinforce the hypothesis of a single lineage consisting of the species A. smithorum, A. marandati, and Agerinia roselli. Furthermore, the phylogenetic analysis developed in this work, which incorporates the newly described remains of A. smithorum, maintains the position of Agerinia as closely related to sivaladapids and asiadapids.



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Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials

Transcranial Direct Current Stimulation (tDCS) is an emerging approach for improving capacity in activities of daily living (ADL) and upper limb function after stroke. However, it remains unclear what type of ...

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Genome-wide analysis of codon usage bias patterns in an enterotoxigenic Escherichia coli F18 strain

Abstract

Enterogenic Escherichia coli (ETEC) F18 strains are the main pathogenic bacteria causing severe diarrhea in humans and domestic animals. However, the information about synonymous codon usage pattern of ETEC F18 genome remains unclear. We conducted a genome-wide analysis of synonymous codon usage patterns in the ETEC F18 strain SRA: SAMN02471895. After filtering of the complete genome sequence, 4327 coding sequences were analyzed using multivariate statistical methods to calculate synonymous codon usage patterns and to evaluate the influence of various factors in shaping the codon usage. The mean GC content was 51.38%, with a slight preference for G/C-ending codons. Twenty-two codons were determined as ''optimal codons". ENC plots showed some of the genes were on or close to the expected curve, while only points with low-ENC values were below the curve. PR2 analysis showed that GC and AT were not used proportionally, suggesting major roles for mutational pressure and natural selection in shaping usage. Neutrality plots showed a significant correlation between GC12 and GC3, suggesting that mutational pressure is responsible for nucleotide composition in shaping the strength of codon usage. Translational selection was the main factor shaping the codon usage pattern of ETEC F18 genome, while other factors such as protein length, GRAVY and ARO values also influenced codon usage to some extent. We analyzed the codon usage pattern systematically and identified the factors shaping codon usage bias in the ETEC F18 genome. Such information further elucidates the mechanisms of synonymous codon usage bias and provides the basis of molecular genetic engineering and evolutionary studies.



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Innovation Zone - Operative IQ

963482465001_5573937542001_5573928876001

Learn More Today at Operative IQ

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Innovation Zone - Operative IQ

963482465001_5573937542001_5573928876001

Learn More Today at Operative IQ

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Wearable sensors to predict improvement following an exercise intervention in patients with knee osteoarthritis

Muscle strengthening exercises consistently demonstrate improvements in the pain and function of adults with knee osteoarthritis, but individual response rates can vary greatly. Identifying individuals who are...

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Innovation Zone - Operative IQ

963482465001_5573937542001_5573928876001

Learn More Today at Operative IQ

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Innovation Zone - Operative IQ

963482465001_5573937542001_5573928876001

Learn More Today at Operative IQ

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Cure sometimes, treat often, comfort always

My partner and I got an "attaboy" from my employer a few weeks back. With it came an official commendation in my personnel file, and a $25 gift certificate. My employer is pretty good about handing these things out for what they deem going above and beyond the call of duty. It was a welcome and not infrequent bit of positive feedback from my employer, who understands the importance of such ...

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Expanding the clinical and molecular spectrum of PRMT7 mutations: three additional patients and review

Abstract

Protein arginine methyltransferase 7 (PRMT7) is a member of a family of enzymes that catalyze the transfer of methyl groups from S-adenosyl-l-methionine to nitrogen atoms on arginine residues. Arginine methylation is involved in multiple biological processes, such as signal transduction, mRNA splicing, transcriptional control, DNA repair, and protein translocation. Currently, seven patients have been described harboring compound heterozygous or homozygous variants in the PRMT7 gene, causing a novel intellectual disability syndrome, known as SBIDDS syndrome (Short Stature, Brachydactyly, Intellectual Developmental Disability, and Seizures).

We report on three additional patients from two consanguineous families with severe/moderate intellectual disability, short stature, brachydactyly and dysmorphisms. Exome sequencing revealed two novel homozygous mutations in PRMT7. Our findings expand the clinical and molecular spectrum of homozygous PRMT7 mutations, associated to the SBIDDS syndrome, showing a possible correlation between the type of mutation and the severity of the phenotype.

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We describe 3 patients from 2 unrelated families with SBIDDS syndrome, displaying two novel homozygous mutations in the PRMT7 gene. The patients reported in this study extend the clinical and mutational spectrum of the PRMT7-related disorder, showing a possible genotype/phenotype correlation that can have an impact on clinical management of patients. A clinical review of currently reported SBIDDS patients is provided.



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Genetic and Epigenetic Insights into Uveal Melanoma

Abstract

Uveal melanoma (UM) is the most frequent primary intraocular tumor in Caucasian adults and is potentially fatal if metastases develop. While several prognostic genetic changes have been identified in UM, epigenetic influences are now getting closer attention. Recent technological advances have allowed to examine the human genome to a greater extent and have improved our understanding of several diseases including malignant tumors. In this context, there has been tremendous progress in the field of UM pathogenesis. Herein, we review the literature with emphasis on genetic alterations, epigenetic modifications and signaling pathways as well as possible biomarkers in UM. In addition, different research models for UM are discussed. New insights and major challenges are outlined in order to outline the current status for this potentially devastating disease.

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Genetic, epigenetic and predisposing factors contribute to the pathogenesis of uveal melanoma



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Dyspnea catastrophizing and neural activations during the anticipation and perception of dyspnea

Abstract

Dyspnea is an aversive symptom in various diseases. High levels of negative affectivity are typically associated with increased dyspnea and changes in its neural processing. Recently, more dyspnea-specific forms of negative affectivity such as dyspnea catastrophizing were suggested to contribute to increased perception of dyspnea beyond effects of rather unspecific negative affectivity such as general anxiety levels. The involved neural mechanisms have not yet been explored. Therefore, the present retrospective analysis examined the associations of dyspnea catastrophizing with neural activations during the anticipation and perception of dyspnea. Sixty-six healthy volunteers underwent 20 blocks of inspiratory resistive load breathing with parallel acquisition of fMRI data. Loads inducing either severe or mild dyspnea (dyspnea conditions) were presented in alternating order, with each condition being visually cued (anticipation conditions). Dyspnea catastrophizing and general trait anxiety were measured with the Breathlessness Catastrophizing Scale (BCS) and the State-Trait Anxiety Inventory, respectively. Correlating the BCS scores with neural activations during the perception of dyspnea yielded no significant results. However, during the anticipation of dyspnea, BCS scores correlated positively with activations of the anterior cingulate cortex (ACC), even after controlling for general anxiety levels. These activations in the ACC were not related to concurrent respiratory parameters. Results suggest that dyspnea catastrophizing in healthy volunteers is associated with stronger ACC recruitment during dyspnea anticipation. Given the established role of the ACC in processing affective states, affect regulation, and antinociception, this might reflect increased affective and/or top-down modulatory processing in individuals with higher dyspnea catastrophizing when anticipating dyspnea.



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Acute hypoxemia and vascular function in healthy humans

Abstract

Endothelium-dependent flow mediated dilation (FMD) and endothelium-independent dilation (GTN) are impaired at high altitude (5050 m), and FMD is impaired following acute exposure (<60-minutes) to normobaric hypoxia equivalent to ∼5050 m (∼FIO2 = 0.11). Whether glyceryl trinitrate (GTN)-induced dilation is impaired acutely, and whether FMD is impaired during milder hypoxia is unknown. Therefore, we assessed brachial FMD at baseline and following 30-minutes of mild (74 ± 2 mmHg PETO₂) and moderate (50 ± 3 mmHg PETO₂) normobaric hypoxia (n = 12) or normoxia (time-control trial; n = 10). We also assessed GTN-dilaiton following the hypoxic FMD tests and in normoxia on a separate control day (n = 8). Compared to normoxic baseline, reduction during mild and moderate hypoxic exposure were evident in FMD (mild vs moderate: −1.2 ± 1.1% vs. −3.1 ± 1.7%; P = 0.01) and GTN-dilation (−2.1 ± 1.0 vs. −4.2 ± 2.0; P = 0.01); the decline in FMD and GTN-dilation were greater during moderate hypoxia (P < 0.01). When allometrically corrected for baseline diameter and FMD shear rate under the curve (SRAUC), relative FMD was attenuated in both conditions (mild vs moderate: 0.6 ± 0.9% vs. 0.8 ± 0.7%; P ≤ 0.01). Following 30-minutes of normoxic time-control, FMD was reduced (-0.6 ± 0.3%; P = 0.02). In summary, there was a graded impairment in FMD during mild and moderate hypoxic exposure, which appears to be influenced by shear patterns and incremental declines in smooth muscle vasodilator capacity (impaired GTN-dilation). Our findings from the normoxic controls study, suggest the decline in FMD in acute hypoxia also appears to be influenced by 30-minutes of supine rest/inactivity.

This article is protected by copyright. All rights reserved



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Radiation hazards and lifetime risk assessment of tap water using liquid scintillation counting and high-resolution gamma spectrometry

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Publication date: November 2017
Source:Journal of Environmental Radioactivity, Volumes 178–179
Author(s): K.F. Al-Shboul, A.E. Alali, I.M. Batayneh, H.Y. Al-Khodire
In this work, two complementary techniques, viz. liquid scintillation counting and high-resolution gamma spectrometry are utilized to analyze radionuclides concentrations in tap water of Irbid governorate, Jordan, and study their correlation. Gross alpha and gross beta concentrations, in the tap water samples collected from the nine districts of Irbid governorate, ranged from <82 to 484 mBq/L with a mean of 295 mBq/L and from <216 to 984 mBq/L with a mean of 611 mBq/L, respectively. Furthermore, gamma spectrometry analysis, for the tap water samples, shows that the activity concentrations of 226Ra, 232Th, and 40K ranged between <19 and 302 mBq/L, 24 to 119 mBq/L, and <101 to 342 mBq/L, respectively. There was a weak or even no correlation among the identified natural radionuclides with no trace of artificial radioactivity. In addition, the results of both techniques show that storing tap water in drilled wells leads to higher levels of radioactivity concentrations beyond the international permissible limits. Furthermore, the average lifetime risk and annual effective dose received by age-grouped inhabitants due to direct and indirect tap water consumption are evaluated, where most of the received dose is attributed to 226Ra.



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Complete mitochondrial genome of the Pleuronichthys lighti (Pleuronectiformes, Pleuronectidae) with phylogenetic consideration

Abstract

Mitochondrial genome has been used to shed light on many fields of both basic and applied research, including the study of molecular evolution. The complete mitochondrial genome sequence of 17368 bp nucleotides from the Pleuronichthys lighti was determined. It was a circular double-stranded DNA molecule with identical set of 22 transfer RNA genes, 2 ribosomal RNA genes, 13 protein-coding genes as well as a non-coding control region. Stand asymmetry in the nucleotide composition was reflected in the codon usage of genes oriented in opposite directions. In the control region, we identified the extended termination associated sequence domain, the central conserved sequence block domain and the conserved sequence block domain, and two complete repeat region. They were "TTACAATA" and "TGTTGTAA", respectively. All known 12 mitochondrial genomes of Pleuronectinae fishes were downloaded and analyzed; there were 5570 variable sites in the consensus sequences of 15241 base pairs, calculation of total sites were 35.5%. The highest sequence divergence was 50% (ATP8) and the Kimura-2-parameter genetic distance was 0.235 (ND6), whereas the COIII had the lowest sequence divergence (28.8%) and genetic distance (0.128); the protein coding genes were mainly acted by purifying selection which was detected by selection tests. Analysis of confidence and the information content for per nucleotide revealed ND5, ATP6, COI and ND4 genes were suitable molecular markers for phylogenetic study of Pleuronectinae fishes. Phylogenetic analysis using Bayesian computational algorithms based on COI genes provided support for the taxonomic status of P. lighti, which was consistent with the traditional taxonomy.



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Development and characterization of simple sequence repeat (SSR) markers based on a full-length cDNA library of Napier Grass ( Pennisetum purpureum Schum)

Abstract

Napier grass (Pennisetum purpureum Schum.) is an economically important species used as a fodder crop, reflecting its high biomass, perennial nature and pest resistance. In order to understand the genomic information and development of this species based on SSR markers, the transcriptome for Napier grass was obtained using next-generation sequencing. A total of 117,076 sequence contigs were obtained, with lengths of 201–10,652 bp. Among these contigs, 44,313 (37.85%) sequences were annotated against public protein databases (E-value <10−5). In addition, the contigs generated from the transcript sequencing were also analysed for the presence of simple sequence repeats (SSRs). A total of 12,744 SSR motifs were identified with in these contigs and corresponding primer pairs were designed. Empirical validation of a cohort of 200 SSRs was performed, with 34% being polymorphic for 20 Napier grass accessions. The polymorphic index content values for each primer ranged from 0.105 to 0.749, with an average of 0.409. The development of genetic, genomic resources and EST-SSRs for Napier grass will contribute to novel gene discovery and the marker-assisted selective breeding of this species.



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Paediatric anaesthesia for low-resource settings

1H022A033J02

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Comparing the face inversion effect in crows and humans

Abstract

Humans show impaired recognition of faces that are presented upside down, a phenomenon termed face inversion effect, which is thought to reflect the special relevance of faces for humans. Here, we investigated whether a phylogenetically distantly related avian species, the carrion crow, with similar socio-cognitive abilities to human and non-human primates, exhibits a face inversion effect. In a delayed matching-to-sample task, two crows had to differentiate profiles of crow faces as well as matched controls, presented both upright and inverted. Because crows can discriminate humans based on their faces, we also assessed the face inversion effect using human faces. Both crows performed better with crow faces than with human faces and performed worse when responding to inverted pictures in general compared to upright pictures. However, neither of the crows showed a face inversion effect. For comparative reasons, the tests were repeated with human subjects. As expected, humans showed a face-specific inversion effect. Therefore, we did not find any evidence that crows—like humans—process faces as a special visual stimulus. Instead, individual recognition in crows may be based on cues other than a conspecific's facial profile, such as their body, or on processing of local features rather than holistic processing.



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Proton pump inhibitor use is associated with a reduced risk of infection with intestinal protozoa

Wilderness & Environmental Medicine

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Eating in synch with your body clock may help curb fat gain

Reuters Health News

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Outcomes after fecal diversion for colonic and perianal Crohn disease in children

Journal of Pediatric Surgery

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Ibuprofen more likely to raise BP than naproxen or celecoxib

Reuters Health News

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Regulatory NK cells mediated between immunosuppressive monocytes and dysfunctional T cells in chronic HBV infection

Gut

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The body composition profile is associated with response to anti-TNF therapy in Crohn's disease and may offer an alternative dosing paradigm

Alimentary Pharmacology and Therapeutics

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Postprandial high resolution impedance manometry identifies mechanisms of non-response to proton pump inhibitors

Clinical Gastroenterology and Hepatology

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Impact of maternal nutrition in hepatitis E infection in pregnancy

Archives of Gynecology and Obstetrics

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Assessing Children’s Report of Stool Consistency: Agreement Between the Pediatric Rome III Questionnaire and the Bristol Stool Scale

The Journal of Pediatrics

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A clinical comparison of short-term efficacy, survival and adverse reactions between raltitrexed/cisplatin-based and docetaxel/cisplatin-based concurrent chemoradiotherapy in the treatment of advanced esophageal squamous cell carcinoma

Translational Cancer Research

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Young adulthood and adulthood adiposity in relation to incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis

Journal of Epidemiology and Community Health

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Review article: Transient receptor potential channels as possible therapeutic targets in irritable bowel syndrome

Alimentary Pharmacology and Therapeutics

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Doctors who take pharmaceutical money use Twitter to hype drugs

Reuters Health News

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Psychosocial distress and quality of life impairment are associated with symptom severity in PPI non-responders with normal impedance-pH profiles

The American Journal of Gastroenterology

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Pancreatic enzyme replacement therapy in children with severe acute malnutrition: a randomized controlled trial

The Journal of Pediatrics

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Biologic agents are associated with excessive weight gain in children with inflammatory bowel disease

Digestive Diseases and Sciences

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Antiretroviral therapy for pregnant women living with HIV or hepatitis B: A systematic review and meta-analysis

BMJ Open

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The safety and efficacy of transarterial chemoembolization combined with sorafenib and sorafenib mono-therapy in patients with BCLC stage B/C hepatocellular carcinoma

BMC Cancer

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Suboptimal interobserver agreement among cytopathologists for endoscopic ultrasound fine needle aspirates of solid pancreatic lesions

Clinical Gastroenterology and Hepatology

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Effect of colonoscopy vs FIT outreach on CRC screening completion

JAMA

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Issue Information



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Pectoral nerve block1 versus modified pectoral nerve block2 for postoperative pain relief in patients undergoing modified radical mastectomy: a randomized clinical trial †

Abstract
Background. Pectoral nerve block1 (PEC1) given between pectoralis major and minor, and modified pectoral nerve block2 (mPEC2) performed between pectoralis minor and serratus anterior, can provide continuous analgesia after modified radical mastectomy (MRM) when catheters are placed before skin closure. This study was designed to compare PEC1 and mPEC2 block for providing postoperative pain relief after MRM.Methods. Sixty-two physically fit patients undergoing MRM were assigned into two groups (Group PEC1, n=31 and Group mPEC2, n=31). Before wound closure, epidural catheter was placed in the group designated muscle plane and 30ml of 0.25% bupivacaine was injected through the catheter after wound closure. Bupivacaine 15ml of 0.25% top up was given on patient's demand or whenever visual analogue scale (VAS) score was>4. Time for first analgesia (TFA), number of top ups and VAS was recorded at 0.5, 6, 12, 18, 24 h after surgery. Sensory blockade was assessed 30 min after extubation.Results. Analgesia was significantly prolonged in group mPEC2 [mean(SD)] 313.45(43.05) vs 258.87(34.71) min in group PEC1, P<0.001. Total pain experienced over 24 h was significantly less in group mPEC2 [mean(SD)] 9.77(6.93) than in group PEC1 24.19(10.81), P<0.0001. Consequently, top up requirements were significantly reduced in group mPEC2 than in group PEC1 [median(range)] 3(2-4) vs 4(3-5) respectively, P<0.001. Lateral pectoral (77.42% and 35.48%) and thoracodorsal nerves (93.55% and 48.39%) had higher incidence of sensory block in group mPEC2 than group PEC1, P<0.001.Conclusions. mPEC2 provides better postoperative analgesia than PEC1 when catheters are placed under direct vision after MRM.Clinical trial registration. CTRI/2017/02/007811 (REF/2015/11/010185).

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Beta-blockers in sepsis: time to reconsider current constraints?

New insights into the mechanisms of action of beta-blockers, and the potential consequences for clinical practice, are continually evolving. Originally, this class of drugs was targeted towards treatment or prevention of hypertension, arrhythmias and myocardial ischaemia. Their therapeutic potential then expanded towards the reduction of mortality after myocardial infarction and heart failure.1 Although these indications are now widely accepted, they were not immediately apparent. So why may the use of beta-blockers be beneficial in patients already suffering from impaired myocardial contractility? Clinical observations suggested that the beneficial effect of beta-blockers was greater in patients with the worst cardiac performance.2 Concurrent findings that chronic use of an oral beta-agonist was associated with increased mortality led to re-evaluation of the paradigm,34 fuelled new research that unravelled the concept of maladaptive sympathetic overstimulation in heart failure,5 and changed clinical practice towards the use of beta-blockade.

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