Δευτέρα, 16 Οκτωβρίου 2017

Editorial Board



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Editorial Board



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Is There a Link between Defects of Thyroid Hormonogenesis and Morphogenesis?

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 389-391.


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Most Low-Risk Papillary Thyroid Cancers Remain Stable During Active Surveillance

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 368-370.


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Ultrasound Has a Role in Predicting Tumor Invasiveness in Follicular Variant of Papillary Thyroid Carcinoma

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 371-374.


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Hypothyroidism in the Differential Diagnosis of Hyponatremia — A Clinical Pearl in Peril

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 395-397.


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A 10-Gene Classifier Can Accurately Diagnose Malignant Versus Benign Cytologically Indeterminate Thyroid Nodules

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 375-377.


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Mortality May Be Higher in Older Patients Whose Levels of TSH and Free T4 Are More Variable

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 385-388.


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Tumor-Volume–Doubling Time of Pulmonary Metastases in Follicular-Cell–Derived Thyroid Carcinoma May Allow More Appropriate Selection of Patients for Multikinase Inhibitor Therapy

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 378-381.


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Exposure to Flame Retardants Is Inconsistently Associated with Papillary Thyroid Cancer

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 392-394.


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Subclinical Hyperthyroidism with Serum TSH

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 382-384.


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Thyroid Cancer Tumor Board: To Surveil or Not to Surveil? That Is the Question

Clinical Thyroidology Oct 2017, Vol. 29, No. 10: 398-400.


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Magnitude of Muscle Strength and Mass Adaptations Between High-Load Resistance Training Versus Low-Load Resistance Training Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis

Abstract

Background

Low-load resistance training (< 50% of one-repetition maximum [1RM]) associated with blood-flow restriction (BFR-RT) has been thought to promote increases in muscle strength and mass. However, it remains unclear if the magnitude of these adaptations is similar to conventional high-load resistance training (> 65% 1RM; HL-RT).

Objective

To compare the effects of HL- versus BFR-RT on muscle adaptations using a systematic review and meta-analysis procedure.

Methods

Studies were identified via electronic databases based on the following inclusion criteria: (a) pre- and post-training assessment of muscular strength; (b) pre- and post-training assessment of muscle hypertrophy; (c) comparison of HL-RT vs. BFR-RT; (d) score ≥ 4 on PEDro scale; (e) means and standard deviations (or standard errors) are reported from absolute values or allow estimation from graphs. If this last criterion was not met, data were directly requested from the authors.

Results

The main results showed higher increases in muscle strength for HL- as compared with BFR-RT, even when considering test specificity, absolute occlusion pressure, cuff width, and occlusion pressure prescription. Regarding the hypertrophic response, results revealed similar effects between HL- and BFR-RT, regardless of the absolute occlusion pressure, cuff width, and occlusion pressure prescription.

Conclusions

Based on the present data, maximum muscle strength may be optimized by specific training methods (i.e., HL-RT) while both HL- and BFR-RT seem equally effective in increasing muscle mass. Importantly, BFR-RT is a valid and effective approach for increasing muscle strength in a wide spectrum of ages and physical capacity, although it may seem particularly of interest for those individuals with physical limitations to engage in HL-RT.



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Electrophysiological brain activity during the control of a motor imagery-based brain–computer interface

Abstract

This article considers the features of five electroencephalogram patterns that are most frequently extracted by the independent component analysis when subjects imagine the movement of their hands during the control of a brain–computer interface (BCI). The solution of the EEG inverse problem using the individual geometrical head model shows that the sources of the revealed patterns are located at the bottom of the left and right central sulci, as well as in the left premotor cortex, supplementary motor area, and precuneus. The functional value of the patterns is discussed by comparing the location results with the results of the metaanalysis of the published data that were obtained using a functional magnetic resonance imaging. The source locations are the same for seven healthy subjects and four poststroke patients with subcortical damage location. However, despite the same locations, the two groups of subjects significantly differed in the frequency characteristics of the revealed patterns; in particular, the patients had no clearly pronounced activity in the upper α-band and were characterized by a much lower level of inhibition of rates in the primary somatosensory areas during motor imagery.



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Effects of transcutaneous electrical spinal cord stimulation on stepping patterns during walking

Abstract

Effects of transcutaneous electrical spinal cord stimulation (tESCS) on the parameters of stepping movements in healthy subjects were investigated during two kinds of activity: walking on a moving treadmill belt (active treadmill) as well as pushing the treadmill belt by effort of the legs (passive treadmill). It was found that the total interference electromyogram (EMG) activity during stepping performance on a passive treadmill was 1.5–2 times higher than during stepping on an active treadmill. In addition, the amplitude of angular displacement of the hip joint and ankle was 2.5 times and 1.7 times higher, respectively, during passive vs. active treadmill, while the duration of stepping cycle decreased by 19%. Although the muscles were exposed to different load and the parameters of motion on the active and passive treadmill were different, tESCS caused an increase in the total EMG activity in 96% of cases both on the active and on the passive treadmill. In both cases, the stepping cycle period decreased by 4–43% in all subjects. These results suggest that tESCS can affect voluntary stepping patterns under conditions of different afferent control.



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New approaches in the rehabilitation of patients with central nervous system lesions based on the gravitational mechanisms

Abstract

This review discusses the functioning of the motor system under normal and reduced gravity. Analysis of the experimental data led to the conclusion that all changes in the functioning of tonic muscular system are related to each other. When transiting to the state of microgravity, changes are caused by one common factor, namely a sharp decrease in the activity of support afferent input, specifically oriented to the perception and analysis of gravitational loads and firmly embedded in the mechanisms of postural synergism organization. We analyzed data obtained in studies on the activation of cortical areas of the brain during the stimulation of support afferents in order to test the hypothesis that such stimulation in both healthy subjects and patients with neurologic deficiency leads to activation of both the sensory and motor cortex involved in supraspinal control of the movement of the lower limbs, in particular when walking.



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Response of external inspiration to the movements induced by transcutaneous spinal cord stimulation

Abstract

The dynamic of the parameters of lung ventilation and gas exchange have been studied in 10 young male subjects during involuntary stepping movements induced by transcutaneous spinal cord electrical stimulation applied in the projection of T 11T 12 vertebrae and during voluntary stepping movements. It has been found that the transcutaneous spinal cord stimulation inducing stepping movements leads to an increase in breathing frequency and a reduction in tidal volume. These effects may be mediated by some neurogenic factors associated with muscular activity during stepping movements, the activation of abdominal expiratory muscles, and the interaction between the stepping pattern and breathing generators.



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Glorious jubilee of a renowned scientist



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Ground reaction force values in cosmonauts during locomotor exercises on board the International Space Station

Abstract

Optimal methods for the prevention of negative impact of weightlessness have been developed based on the concept of Kozlovskaya, which states that support afferentation plays a trigger role in the development of the hypogravity motor syndrome. In this study, the maximal vertical ground reaction force (GRF) values were analyzed when locomotor training was performed on a BD-2 treadmill in long-term spaceflights. The study involved 12 cosmonauts. Recorded segments of the locomotor training (4554) performed in active (motor-driven) and passive (non-motor-driven) modes of BD-2 belt motion were analyzed. The data were analyzed by the methods of correlation and regression analysis and the nonparametric Mann–Whitney test. It was found that when running, regardless of the treadmill modes, an increase in the axial load by 1 kg was associated with a more than 1-kg increase in GRF; during walking an increase in GRF was less than 1 kg. As the speed increased, the GRF values increased most quickly when running in a passive mode and most slowly when walking in a passive mode. The GRF values in different BD-2 modes depended on both individual parameters of cosmonauts and locomotion types (walking or running). Our data can be the basis for the individualization of locomotor training onboard the ISS.



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Gravity mechanisms in tonic motor system. Neurophysiological and muscle aspects

Abstract

Nowadays it is widely believed that the animal motor system historically evolved under the powerful pressure of gravity forces. By the late 1970s, many manifestations of the microgravity effects on the motor system had already been known. At the same time, the basic sensorimotor relationships during exposure to zero-gravity remained unexplored. The article considers the main results of the studies of the scientific school of I.B. Kozlovskaya regarding the roles of the gravitational forces in the functioning of the tonic motor system in humans and other mammals. In these studies, it was demonstrated that the muscle tonic system is relatively independent and possesses its own structures and mechanisms at every level—from receptors to effectors. The support afferent input plays the main role in the regulation of the postural tonic system. The withdrawal of the support afferentation leads to the decline of the tonic motor units activity in extensor muscles and the alteration of the motor units recruitment patterns in the spinal cord. The decline of the tonic activity of the extensor motoneurons triggers on the development of the sensorimotor effects of microgravity including atony and muscle atrophy.



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Metabolic features of cosmonauts after ballistic descent from the Earth orbit

Abstract

The features of metabolic reactions in five cosmonauts after long-term flights on the International Space Station (ISS) and landing along a ballistic trajectory and in the cosmonauts returning to Earth in the mode of automatic controlled descent were studied. Venous blood samples were collected, and 50 biochemical parameter values that reflect the functional state of organs and tissues and characterize the main metabolic pathways were determined. On the first day of the recovery period after ballistic descent, the activity of the myocardial, liver, and gastrointestinal enzymes in the blood serum of cosmonauts was increased 1.3- to 2.1-fold; a number of the parameter values exceeded the upper normal limit. The level of C-reactive protein increased fivefold as compared with the preflight values. Marked signs of glycolysis, glycogenolysis and lipolysis activation as well as disorders of acid–base balance were observed. Changes in the biochemical parameter values in cosmonauts after landing along a ballistic trajectory differed significantly from those revealed in the same cosmonauts after long-term missions followed by automatic controlled descent to Earth. Negative metabolic changes tendency after landing along a ballistic trajectory remained for at least 14 days of the recovery period. It was concluded that changes in the metabolic reactions of cosmonauts after long-term missions to the ISS depend on the flights final stage conditions. After landing on Soyuz spaceships in the ballistic descent mode, the cosmonauts had adverse prognosis changes in the biochemical values characterizing the state of the cardiovascular system and marked shifts in the activity of the liver and gastrointestinal constellation enzymes. The dynamics of carbohydrate, lipid, and protein metabolism as well as acid–base balance indicates a significant tension of all body systems and exhaustion of its functional reserves.



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Vestibular function and space motion sickness

Abstract

The vestibular system plays an important role in intersensory interactions and gravitation is a natural stimulus for its receptors. Weightlessness alters the input signals of the otoliths and their effect on the pattern and dynamics of changes in the vestibular function (VF), which is accompanied by development of space adaptation syndrome (SAS) and space motion sickness (SMS). These changes occur both during the spaceflight (SF) and after returning to Earth, but the mechanisms of their development are still poorly understood and require special studies. In total, 47 Russian cosmonauts (crewmembers of long-term International Space Station (ISS) missions) have participated in the studies into VF before and after SF and nine of them, in onboard studies during SF (129–215 days) as a part of the Virtual space experiment (stage 1). Electro- and video-oculography are used to record spontaneous eye movements (SpEM), static vestibular–ocular responses during head tilts to the right or left shoulder (static otolith–cervical–ocular reflex, OCOR), and dynamic vestibular-ocular response during the head rotation around the longitudinal axis of the body. The examination is accompanied by personal and questionnaire survey on subjective responses and complaints of cosmonauts about SAS and SMS. Significant changes in SpEM (drifts of eyes, spontaneous and gaze-evoked nystagmus, and arbitrary saccades) and a decrease in OCOR (statistically significant decrease in the amplitude of ocular counter-rolling in response to head tilts up to its absence or inversion, an atypical OCOR) are observed during SF. An atypical OCOR is observed at the beginning of adaptation to weightlessness in seven of the nine cosmonauts (the first one to two weeks of SF) and repeatedly throughout the flight in all cosmonauts regardless of whether it is their first flight or not. Atypical vestibular responses after SF, similar to the responses during SF, are observed in several cosmonauts by day 9 after flight. It has been shown that atypical OCOR variants are more frequently observed in the subjects lacking any previous space experience, as well as a more pronounced decrease in this response with a concurrent increase in the response of the semicircular canals. It is also demonstrated that repeated SFs lead to a considerable shortening in the after-flight readaptation to terrestrial conditions and a considerable decrease in the degree of vestibular disorders. In the initial period of SF, the changes in VF are correlated with the complaints and manifestations of SAS and SMS; however, the complaints and the corresponding symptoms are unobservable during the further flight despite significant changes in the VF state. The patterns of the VF disorders associated with the impact of weightlessness and observed during and after SF are very similar, allowing these disorders to be regarded as SAS and SMS of different severities (intensities).



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Spinal and sensory neuromodulation of spinal neuronal networks in humans

Abstract

The present experiments were designed to gain additionally insight into how the spinal networks process direct spinal stimulation and peripheral sensory inputs to control posture and locomotor movements. We have developed a plantar pressure stimulation system that can deliver naturalistic postural and gait-related patterns of pressure to the soles of the feet to simulate standing and walking, thereby activating and/or modulating the automated spinal circuitry responsible for standing and locomotion. In the present study we compare the patterns of activation among selected motor pools and the kinematic consequences of these activation patterns in response to patterned heel-to-toe mechanical stimulation of the soles of the feet, and/or transcutaneous electrical spinal stimulation, for postural and locomotion regulation. The studies were performed in healthy individuals (n = 12) as well as in subjects (n = 2) with motor complete spinal cord injury. We found that plantar pressure stimulation and/or spinal stimulation can effectively facilitate locomotor output in the subjects placed with their legs in gravity neutral position. We have shown synergistic effects of combining sensory and spinal cord stimulation, suggesting that the two networks are different, but complementary. Also we provide evidence that plantar stimulation could serve as a novel neuro-rehabilitation tool alone or as part of a multi-modal approach to restoring motor function after complete paralysis due to SCI.



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Rehabilitation potential of post-stroke patients training for kinesthetic movement imagination: Motor and cognitive aspects

Abstract

The rehabilitation potential of post-stroke patients was evaluated after a rehabilitation procedure using a hand exoskeleton controlled via a brain–computer interface (BCI). Examples are given for parameters describing the motor and cognitive functions and the capacity for kinesthetic movement imagination. It is emphasized that instrumental quantitative methods are important to use for adequate assessment of both the rehabilitation potential and the effectiveness of the BCI + exoskeleton procedure.



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Effect of transcutaneous electrical spinal cord stimulation on the blood flow in the skin of lower limbs

Abstract

Changes in the blood flow in the skin of the plantar surface of the hallux were investigated by laser Doppler flowmetry in eight healthy subjects during transcutaneous electrical spinal cord stimulation (tESCS) with the pulse parameters used to activate locomotion. Continuous tESCS in the area of C5–C6 vertebrae did not cause significant changes in the blood flow, while electrical stimulation at T 12T 1 and L 1L 2 levels resulted in an increase in skin perfusion by 22–27%. Wavelet analysis of microcirculatory fluctuations showed that tESCS induced flaxomotions in the range of sensory peptidergic fibers and enhanced the amplitude of fluctuations of microcirculation in the endothelium-dependent range. These results suggest that tESCS stimulates microcirculation in the skin mainly due to antidromic stimulation of sensory peptidergic nerve fibers, which promotes activity of microvascular endothelium, vasodilator secretion, a decrease in vascular resistance, and an increase in microcirculation.



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Influence of long-term intracortical microstimulation on the motor cortex

Abstract

Long-term (0.5–1 s) stimulation of the hand region of the motor cortex in both macaque and human through a microelectrode by a series of biphasic current pulses of small amplitude evokes different complex, coordinated movements of the hand. There are two different opinions on how these movements are produced. The first hypothesis associates the movements with the presence of specific subregions in the motor cortex, which reflect different ethologically relevant categories of movement. According to the second hypothesis, these evoked complex movements are the artifacts of electrical stimulation. This article discusses the results of a number of studies in favor of each of the hypotheses. The conclusion about the validity of the first hypothesis is based on the analysis of the results of microstimulation and their comparison with the data obtained by the latest methods without the use of electric current. Moreover, this finding suggests the possibility of testing the condition changes of the monkey motor cortex through analysis the characteristics of the movements caused by long-term microstimulation.



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Effects of bed rest and the use of intermittent centrifugation to protect human balance and neuromotor reflexes

Abstract

Introduction

Intermittent artificial gravity (AG) treatments may reduce bone, muscle, and cardiovascular deconditioning during prolonged space flight; however, the effects of repeated centrifugation on central processing of vestibular information remain unknown. This study investigated the effects of one intermittent AG prescription on balance control and neuromotor reflex function in a ground-based study of subjects exposed to bed rest.

Methods

Fifteen male volunteers were exposed to 21 days of 6° head-down-tilt (HDT) bed rest (BR) to simulate some of the effects of space flight. Eight were treated with daily 1 h AG exposures aboard a short radius centrifuge that provided 1-g footward loading at heart level. The other seven served as control subjects. Balance control was assessed using a computerized dynamic posturography (CDP) protocol modified by adding low frequency pitch-plane head movements. Neuromotor reflex function was assessed using tendon (MSR) and functional stretch reflex (FSR) data collected from the triceps surae muscle group.

Results

CDP performance was degraded by BR in both groups, but was unaffected by AG. BR also degraded MSR and FSR functions in both groups, but AG blunted the decrement in MSR.

Conclusion

This AG prescription had little functionally relevant effect on balance control, but may have had some salutary effect on neuromotor reflexes.



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Acknowledgment to reviewers



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Topical thermal therapy with hot packs suppresses physical inactivity-induced mechanical hyperalgesia and up-regulation of NGF

Abstract

We focused on the analgesic effect of hot packs for mechanical hyperalgesia in physically inactive rats. Male Wistar rats were randomly divided into four groups: control, physical inactivity (PI), PI + sham treatment (PI + sham), and PI + hot pack treatment (PI + hot pack) groups. Physical inactivity rats wore casts on both hind limbs in full plantar flexed position for 4 weeks. Hot pack treatment was performed for 20 min a day, 5 days a week. Although mechanical hyperalgesia and the up-regulation of NGF in the plantar skin and gastrocnemius muscle were observed in the PI and the PI + sham groups, these changes were significantly suppressed in the PI + hot pack group. The present results clearly demonstrated that hot pack treatment was effective in reducing physical inactivity-induced mechanical hyperalgesia and up-regulation of NGF in plantar skin and gastrocnemius muscle.



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Erratum to: An approach to the research on ion and water properties in the interphase between the plasma membrane and bulk extracellular solution

The article An approach to the research on ion and water properties in the interphase between the plasma membrane and bulk extracellular solution, written by Hiroshi Hibino, Madoka Takai, Hidenori Noguchi, Seishiro Sawamura, Yasufumi Takahashi, Hideki Sakai and Hitoshi Shiku, was originally published Online First without open access.



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Effects of voluntary exercise on antiretroviral therapy-induced neuropathic pain in mice

Abstract

Antiretroviral therapy (ART) often results in painful peripheral neuropathy. Given that voluntary exercise has been shown to be beneficial in terms of modulating pain-like behaviors in various animal models of peripheral neuropathy, we have investigated the effects of voluntary wheel running on neuropathic pain induced by chronic ART. We first established an animal model of peripheral neuropathy induced by chronic 2′,3′-dideoxycytidine (ddC) treatment. We showed that mice receiving ddC (3 mg/kg/day) had increased mechanical and thermal sensitivity at 9 weeks after the onset of the treatment. We also found that voluntary wheel running attenuated or delayed the onset of ddC-induced peripheral neuropathy. This phenomenon was associated with the attenuation of dorsal root ganglion nociceptive neuron membrane excitability and reduction in the expression of the transient receptor potential cation channel subfamily V member 1 (TRPV1). Taken together, these results suggest that voluntary exercise is an effective strategy by which ART-induced peripheral neuropathy can be alleviated.



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Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism

Abstract

A number of studies have reported that zinc plays a substantial role in the development of metabolic syndrome, taking part in the regulation of cytokine expression, suppressing inflammation, and is also required to activate antioxidant enzymes that scavenge reactive oxygen species, reducing oxidative stress. Zinc also plays a role in the correct functioning of lipid and glucose metabolism, regulating and forming the expression of insulin. In numerous studies, zinc supplementation has been found to improve blood pressure, glucose, and LDL cholesterol serum level. Deeper knowledge of zinc's properties may help in treating metabolic syndrome, thus protecting against stroke and angina pectoris, and ultimately against death.



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Electrophysiological characteristics of the rat azygos vein under electrical pacing and adrenergic stimulation

Abstract

Rodent thoracic veins are characterized by an extended myocardial coating. In the present study, the electrical activity in the cardiac tissue of the rat azygos vein (AZV) was investigated for the first time. The atrial-like action potentials (AP) and atrial-like conduction of the excitation were observed in the rat AZV under continuous electrical pacing. Termination of electrical pacing resulted in spontaneous positive shift of resting membrane potential (RMP) in AZV. Boradrenaline induced biphasic effects on RMP in all quiescent AZV preparations but only in 25% preparations—bursts of spontaneous AP, which were suppressed by both α- and β-adrenoreceptor antagonists. Phenylephrine induced additional depolarization of RMP in quiescent AZV preparations, while isoproterenol caused hyperpolarization. In conclusion, bioelectrical properties of the rat AZV resemble those of atrial myocardium under continuous electrical pacing; however, depolarized RMP and NA-induced spontaneous AP characterize AZV as a tissue prone to rare automaticity.



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The complete mitochondrial genome of Damora sagana and phylogenetic analyses of the family Nymphalidae

Abstract

The monotypic genus Damora (Nymphalidae, Heliconiinae) contains a single species, Damora sagana, which is widely distributed across southern China. Herein, its complete mitogenome was sequenced to further understand lepidopteran mitogenome characteristics, reconstruct the nymphalid family phylogeny, and infer the subdivision of Heliconiinae species. The circular mitogenome was 15,151 bp long, abundant in A and T, and comprised of 13 protein-coding genes (PCGs), 22 transfer RNA (tRNA) genes, 2 ribosomal RNA (rRNA) genes, and one control region with a gene arrangement typical of lepidopteran mitogenomes. ATN codons initiated all PCGs, except cytochrome c oxidase subunit 1 (COX1), which was initiated by a CGA sequence as has been observed in other lepidopterans. Three PCGs (COX1, COX2 and ND4) employed a single T termination signal, whereas others had the typical complete termination codon (TAA). All tRNA genes were folded into the typical cloverleaf structure except for tRNA-Ser (AGN). The A+T-rich region included the conserved motif 'ATAGA' followed by a 17 bp poly-T stretch, which was also observed in tribe Argynnini mitogenomes. A phylogenetic tree was constructed via multiple methods using the 13 PCGs data of D. sagana and other available mitogenomes of nymphalid species. All three phylogenetic trees yielded the same topology. These results were consistent with those from previous studies of most major nymphalid groups, except those regarding tribe subdivision in certain subfamilies such as Argynnini + (Acraeini + Heliconiini) for Heliconiine. Furthermore, our analyses identified that the genus Cethosia was grouped with the genus Acraea composing the tribe Acraeini with strong support.



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Endomorphins potentiate ASIC currents and enhance the lactic acid-mediated increase in arterial blood pressure—effects amplified in hindlimb ischemia

Abstract

Chronic muscle ischemia leads to accumulation of lactic acid and other inflammatory mediators with a subsequent drop in interstitial pH. Acid-sensing ion channels (ASICs), expressed in thin muscle afferents, sense the decrease in pH and evoke a pressor reflex known to increase mean arterial pressure. The naturally occurring endomorphins are also released by primary afferents under ischemic conditions. We examined whether high affinity mu opioid receptor (MOR) agonists, endomorphin-1 (E-1) and -2 (E-2), modulate ASIC currents and the lactic acid-mediated pressor reflex. In rat dorsal root ganglion (DRG) neurons, exposure to E-2 in acidic solutions significantly potentiated ASIC currents when compared to acidic solutions alone. The potentiation was significantly greater in DRG neurons isolated from rats whose femoral arteries were ligated for 72 hr. Sustained ASIC current potentiation was also observed in neurons pretreated with pertussis toxin, an uncoupler of G proteins and MOR. The endomorphin-mediated potentiation was a result of a leftward shift of the activation curve to more basic pH values and a slight shift of the inactivation curve to more acidic pH values. Intra-arterial co-administration of lactic acid and E-2 led to a significantly greater pressor reflex than lactic acid alone in the presence of naloxone. Finally, E-2 effects were inhibited by pretreatment with the ASIC3 blocker (APETx2) and enhanced by pretreatment with the ASIC1a blocker psalmotoxin-1. These findings have uncovered a novel role of endomorphins by which the opioids can enhance the lactic acid-mediated reflex increase in arterial pressure that is MOR stimulation-independent and APETx2-sensitive.

This article is protected by copyright. All rights reserved



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Dissecting Nucleosome Function with a Comprehensive Histone H2A and H2B Mutant Library

Using a comprehensive library of histone H2A and H2B mutants, we assessed the biological function of each amino acid residue involved in various stress conditions including exposure to different DNA damage-inducing reagents, different growth temperatures and other chemicals. H2B N- and H2A C-termini were critical for maintaining nucleosome function and mutations in these regions led to pleiotropic phenotypes. Additionally, two screens were performed using this library, monitoring heterochromatin gene silencing and genome stability, to identify residues which could compromise normal function when mutated. Many distinctive regions within the nucleosome were revealed. Furthermore, we used the bar-seq method to profile the mutant composition of many libraries in one high-throughput sequencing experiment, greatly reducing the labor and increasing the capacity. This study not only demonstrates the applications of the versatile histone library, but also revealed many previously unknown functions of histone H2A and H2B.



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Effects of continuous visual feedback during sitting balance training in chronic stroke survivors

Postural control deficits are common in stroke survivors and often the rehabilitation programs include balance training based on visual feedback to improve the control of body position or of the voluntary shif...

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Satisfaction with Life over Time in People with Burn Injury: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study

Publication date: Available online 16 October 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Dagmar Amtmann, Fraser D. Bocell, Kara McMullen, Alyssa M. Bamer, Kurt L. Johnson, Shelley Wiechman, Jeffrey C. Schneider
ObjectivesTo examine trajectories of satisfaction with life (SWL) of burn survivors over time and their clinical, demographic and other predictors.DesignLongitudinal survey.SettingN/A.ParticipantsIndividuals 18 and over who underwent burn-related surgery and met one of the following criteria: (1) > 10% total burn surface area (TBSA) burn and ≥ 65 years of age; (2) > 20% TBSA burn and 18 to 64 years of age; (3) electrical high voltage/lightning injury; or (4) burn injury to the hands, face, or feet. A total of 378 participants had data on all variables of interest and were included in the analyses.InterventionsN/A.Main Outcome MeasuresSatisfaction with Life ScaleResultsGrowth mixture modeling (GMM) identified two classes with different trajectories of SWL. The mean SWL of the unchanged class (n=224, 60%) was flat over two years with high initial SWL scores. The SWL of the dissatisfied class (n=154, 40%) was at the low end of average and got progressively worse over time.ConclusionsSWL after burn injury can be described by two different trajectories with substantially different outcomes. Older age, mental health and unemployment prior to injury predicted the membership in the dissatisfied class. Additional services could be provided to those at high risk for low SWL to achieve better outcomes.



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Effect of Upper limb Rehabilitation compared to No Upper limb Rehabilitation in Lung Transplant Recipients – A Randomized Controlled trial

Publication date: Available online 16 October 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): L.M. Fuller, D. El-Ansary, B.M. Button, M. Corbett, G. Snell, S. Marasco, A.E. Holland
Objectiveto investigate effects of a supervised UL exercise program (SULP) versus no supervised UL exercise program (NULP) after lung transplantation (LTX).DesignRandomized controlled trialSettingPhysiotherapy gymParticipantsPost LTX>18years, N=80InterventionAll participants underwent lower limb strength thrice weekly and endurance training. Participants randomised to supervised upper limb program (SULP) completed progressive UL strength training program using hand weights & adjustable pulley equipment.OutcomesOverall bodily pain rated on visual analogue scale (VAS). Shoulder flexion, abduction strength and HRQOL (SF36) were measured.MeasurementsAt baseline, 6 & 12 weeks & 6 months by blinded assessors.Results80 participants recruited,43 randomized to SULP and 37 to NULP. After 6 weeks of training, SULP(41) participants had less overall bodily pain on VAS than those NULP(36) (mean 2.1cm (SD 1.3) vs 3.8cm (SD1.7), p <0.001) and greater UL strength than NULP participants (peak force 8.4Nm (4.0) versus 6.7Nm (2.8) p = 0.037). At 12 weeks SULP participants had better HRQOL – bodily pain domain (76(17) vs 66(26), p=0.05) but at 6 months there was no difference between groups for any outcome. No serious adverse events reported.ConclusionUL rehabilitation results in short term improvements in pain and muscle strength following LTX, but no longer-term impacts were evident.



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Development of a computerized adaptive testing system of the Functional Assessment of Stroke

Publication date: Available online 16 October 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Gong-Hong Lin, Yi-Jing Huang, Shih-Chieh Lee, Sheau-Ling Huang, Ching-Lin Hsieh
ObjectiveTo develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living (BADL) with optimal efficiency and without sacrificing psychometric properties in patients with stroke.DesignSimulation study using the data from a previous study. Participants were assessed with the UE/LE subscales of the Fugl-Meyer Assessment (UE-FM/LE-FM), Postural Assessment Scale for Stroke patients (PASS), and Barthel Index (BI) at 14- and 30-day after stroke.SettingOne rehabilitation unit in a medical center.ParticipantsA total of 301 and 262 participants were assessed at 14 and 30 days after stroke, respectively.InterventionsNot applicable.Main Outcome MeasuresThe UE-FM, LE-FM, PASS, and BIResultsThe CAT-FAS adopting the optimal stopping rule (limited reliability increased < 0.010) had good Rasch reliability across the 4 domains (0.88–0.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs. the original tests, Pearson's r = 0.91–0.95) and responsiveness (standardized response mean = 0.65–0.76) of the CAT-FAS were good in patients with stroke.ConclusionWe developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and BADL using, on average, no more than 10 items; this efficiency is very useful for reducing the assessment burdens of both clinicians and patients.



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Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases.

Purpose: The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the community setting due to concerns of fragility fracture. We examined the efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases. Methods: Between 2012 and 2015, 57 prostate cancer patients (70.0+/-8.4 years; BMI 28.7+/-4.0 kg/m2) with bone metastases (pelvis 75.4%, femur 40.4%, rib/thoracic spine 66.7%, lumbar spine 43.9%, humerus 24.6%, other sites 70.2%) were randomised to multi-modal supervised aerobic, resistance and flexibility exercises undertaken thrice weekly (EX, n=28) or usual care (CON, n=29) for 3 months. Physical function subscale of the SF-36 was the primary endpoint as an indicator of patient-rated physical functioning. Secondary endpoints included objective measures of physical function, lower body muscle strength, body composition and fatigue. Safety was assessed by recording the incidence and severity of any adverse events, skeletal complications, and bone pain throughout the intervention. Results: There was a significant difference between groups for self-reported physical functioning (3.2 points, 95% CI 0.4-6.0 points; p=0.028) and lower body muscle strength (6.6 kg, 95% CI 0.6-12.7; p =0.033) at 3 months favouring EX. However, there was no difference between groups for lean mass (p=0.584), fat mass (p=0.598), or fatigue (p=0.964). There were no exercise-related adverse events or skeletal fractures and no differences in bone pain between EX and CON (p=0.507). Conclusion: Multi-modal modular exercise in prostate cancer patients with bone metastases led to self-reported improvements in physical function and objectively measured lower body muscle strength with no skeletal complications or increased bone pain. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. (C) 2017 American College of Sports Medicine

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The Italian version of the Outpatient Physical Therapy Improvement in Movement Assessment Log: cross-cultural adaptation and psychometric properties.

Instruments to measure movement abilities from a patient's perspective are generally unavailable across diverse cultures and languages. The aim of this study was to translate, culturally adapt, and validate the Italian version of the Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) confidence scale. This study was an observational multicenter study. The Italian version of the OPTIMAL confidence scale (OPTIMAL-I) was developed following forward-backward translation and pretesting with a small group of patients. Reliability was measured by internal consistency (Cronbach [alpha]), and a factor analysis was carried out to explore the internal structure. Convergent validity was measured by comparing the OPTIMAL-I with the Italian version of the Activities-specific Balance Confidence (ABC-I). The process for obtaining the OPTIMAL-I required 3 months and it was administered to 290 outpatients in two different rehabilitation clinics. OPTIMAL-I showed high acceptability, high internal consistency (Cronbach's [alpha]=0.963), and high test-retest stability (intraclass correlation coefficient=0.92, P=0.001). Convergent validity with ABC-I was also high (r=0.56-0.86; P

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Prevalence and correlations between suicide attempt, depression, substance use, and functionality among patients with limb amputations.

Most patients undergoing limb amputations suffer significant emotional changes. The aim of this study was to estimate the prevalence of suicide attempts and depression in a sample of Mexican patients with limb amputations and, second, to determine whether the patients' functionality correlates with the presence of depression. We studied 40 patients who had undergone a limb amputation. The suicide attempt was evaluated using the Suicide Intent Scale. The depression was assessed using the Hamilton Depression Rating Scale, whereas the functionality of the patients was measured using the Functional Independence Measure. In this sample, 90% were men, whereas only 10% were women. In terms of the suicide behavior, we identified suicide attempts in 27.5% of the patients. The rate of depression was 92.5%. In the Functional Independence Measure, we observed that 57.5% of the patients showed complete dependence. Finally, a significant correlation was found between depression and functionality (r=-0.75, P

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Ultrasound Detection of Arteria Comitans: A Novel Technique to Locate the Sciatic Nerve.

In the gluteal and thigh region, the arteria comitans accompanies the sciatic nerve for a short distance, then penetrates the nerve and runs to the lower part of the thigh. There is no study that recognizes this artery as a guide to the location of the sciatic nerve. In this report, we describe a series of 6 knee arthroplasty patients in whom ultrasound-guided sciatic nerve block was successfully performed using color Doppler and pulsed wave Doppler to visualize the arteria comitans as a guide to the location of the sciatic nerve. We have found that detecting the arteria comitans as a landmark is novel and may offer an additional tool with the existing methods for sciatic nerve block. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Ethnic Disparity in the Incidence and Outcome of Biliary Atresia in New Zealand.

In order to determine incidence and outcome of biliary atresia (BA) between ethnic groups in New Zealand (NZ), a retrospective review was undertaken of children with BA born 2002-2014. Prioritised ethnicity was used to determine ethnicity and was compared to population data. Uni- and multivariate analyses were undertaken to determine demographic and biochemical factors associated with outcome. Overall incidence was 1 in 9,181 (Maori 1 in 5,285; European 1 in 16,228; p

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Exchangeable Zinc Pool Size at Birth in Pakistani SGA and AGA Infants Do Not Differ but are Lower than in US Infants.

Objectives: Small for gestational age (SGA) infants are more susceptible to infectious morbidity and growth faltering compared to their appropriate for gestational age (AGA) counterparts. Zinc supplementation of SGA infants may be beneficial but the underlying susceptibility to zinc deficiency of SGA infants has not been examined. Methods: In a community-based, observational, longitudinal study in a peri-urban settlement of Karachi, Pakistan, we compared the size of the exchangeable zinc pools (EZP) in term SGA and AGA infants at birth and at 6 months of age, hypothesizing that the EZP would be lower in the SGA group. To measure EZP size, a zinc stable isotope was intravenously administered within 48 hours of birth (n = 17 and 22) at 6 months (n = 11 and 14) in SGA and AGA infants, respectively. Isotopic enrichment in urine was used to determine EZP. Results: No significant difference was detected in the mean (+/- SD) EZP between SGA and AGA infants at birth, with values of 9.8 +/- 3.5 and 10.1 +/- 4.1 mg/kg, respectively (p = 0.86), or at 6 months. Longitudinal EZP measurements demonstrated a significant decline in EZP relative to body weight in both groups at 6 months (p

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The Reasoning Beyond The Potential Use Of Exclusive Enteral Nutrition And Other Specified Diets In Children With Ulcerative Colitis.

The incidence of inflammatory bowel disease (IBD) is steadily on the rise in Western as well as in developing countries paralleling the increase of westernized diets, characterized by high protein and fat as well as excessive sugar intake, with less vegetables and fiber. Furthermore, nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of remission of disease. Exclusive enteral nutrition (EEN) has been shown to induce remission, including in patients with isolated colonic disease, and leads to mucosal healing in Crohn disease (CD). One hypothesis for the beneficial effect of this modality is exclusion of dietary components thought to cause dysbiosis or impair innate immune mechanisms such as the mucous layer, intestinal permeability or colonization and adherence with adherent-invasive Escherichia coli (AIEC). Although there is not yet definitive data illustrating a role for EEN in the management of active UC, there are several lines of evidence that illustrate that dietary interventions may be helpful. In particular, the key mechanisms of the activity of EEN (namely, changes in the intestinal microflora in CD) are likely also relevant to UC. Furthermore, the use of EEN in pediatric UC patients may add to a better bone health. Prospective studies are now required to evaluate the role of EEN in UC in children. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Holder-Pasteurized Human Donor Milk: How Long Can It Be Preserved?.

Objective: When own mother's milk falls short, pasteurized human donor milk is recommended as alternative feeding for preterm infants. Donor milk has to meet the highest safety standards, but its processing and storage is expensive. The recommended storage time of pasteurized donor milk is three months. The objective of this study was to determine if the frozen storage time of pasteurized donor milk can be extended beyond 3 months without compromising its safety and quality. Methods: For this prospective observational study breast-milk samples of 34 unique women, collected between November 2014 and June 2015, were provided by the Dutch Human Milk Bank. Samples were Holder pasteurized within 3 months after expression and stored at -20 [degrees]C. Analysis of both bacterial growth (by inoculation of milk on a blood and a cysteine-, carbohydrate-, and electrolyte-deficient agar) and fat, crude protein, carbohydrate and energy content of milk (analyzed by infrared spectroscopy) was done monthly during the first six months and every two months thereafter, up to one year post-pasteurization. Results: 30 of 306 (9.8%) follow-up samples showed bacterial growth when cultured. None of the samples showed sequential contamination with the same strain up to eight months of frozen storage. No significant decreases in macronutrients and energy content were observed over eight months. Conclusion: Pasteurized human donor milk can be stored safely for eight months at -20 [degrees]C, without compromising its macronutrient and energy content. This longer storage time will reduce disposal of expired donor milk and subsequently reduce costs. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Long-term survival after repeated resection of metachronous lung metastases from pStage IA pancreatic adenocarcinoma

Abstract

Case report

A 70-year-old woman with pancreatic ductal adenocarcinoma was initially treated by distal pancreatectomy (DP). Thirty-five months later, another tumor appeared in the pancreatic head and was treated by pancreaticoduodenectomy. Histopathological findings identified both tumors as pancreatic ductal adenocarcinoma pStage IA. Computed tomography (CT) of the chest 16 months after the second pancreatectomy revealed a ground-glass opacity in segment 3 of the right lung. Chest CT 23 months after the second pancreatectomy revealed a nodular shadow in segment 1a of the right lung. Chest CT 39 months after the second pancreatectomy revealed a nodular shadow in segment 5 of the left lung. These lesions were treated by video-assisted thoracoscopic surgery partial resection. Histopathological and immunohistochemical features (positive for cytokeratin (CK)7 and CK20, negative for transcription factor-1) for these three lesions and the secondary pancreatic ductal adenocarcinoma were similar, indicating a diagnosis of lung metastasis from the second pancreatic ductal adenocarcinoma. The patient has remained alive and free of new metastases for 8 years after initial DP, 3 years after the last lung resection.

Conclusion

This patient has survived over the long term after undergoing three resections of lung metastases from resected pancreatic ductal adenocarcinoma.



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Finding the joy: Beyond job satisfaction in EMS

A strange thing happened during our first of four Regional Meetings for the EMS Agenda 2050 project. The setup is that everyone who participates is involved in a series of dialogues with members of the Technical Expert Panel. Each of these dialogues is focused around a question designed to provoke creativity and inspire visionary thinking. The topics include person-centered system design, inherent safety ...

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Keep safety in UTV public safety rescue

Essential precautions for deploying side-by-sides with rescue skid units

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Attenuation of high-frequency (30–200 Hz) thalamocortical EEG rhythms as correlate of anaesthetic action: evidence from dexmedetomidine

Abstract
Background
Gamma (30–80 Hz) and high-gamma (80–200 Hz) thalamocortical EEG rhythms are involved in conscious processes and are attenuated by isoflurane and propofol. To explore the hypothesis that this attenuation is a correlate of anaesthetic action, we characterized the effect dexmedetomidine, a selective adrenergic α-2 agonist with lesser hypnotic potency, on these rhythms.
Methods
We recorded local field potentials from barrel cortex and ventroposteromedial thalamic nucleus in ten previously instrumented rats to measure spectral power (30–50 Hz, 51–75 Hz, 76–125 Hz, 126–200 Hz bands) during baseline, at four dexmedetomidine plasma concentrations obtained by i.v. target-controlled infusion (1.86, 3.75, 5.63 and 7.50 ng ml−1), and during recovery. Thalamocortical coherence over 0.3–200 Hz was also measured.
Results
Loss of righting reflex (LORR) occurred with 5.63 ng ml−1. Dexmedetomidine produced a linear concentration-dependent attenuation of cortical (P<0.04) and thalamic (P ≤ 0.0051) log power in all bands. Slopes for cortex and thalamus were similar. The slope for dexmedetomidine on thalamic power in the 76–200 Hz range was less than half that of the other agents (P<0.003). LORR was associated with an increase in delta band (0.3–4.0 Hz) thalamocortical coherence (P<0.001). Increased low-frequency coherence also occurred with propofol and isoflurane.
Conclusions
Dexmedetomidine attenuates high-frequency thalamocortical rhythms, but to a lesser degree than isoflurane and propofol. The main differences between dexmedetomidine and the other anaesthetics involved thalamic rhythms, further substantiating the link between impaired thalamic function and anaesthesia. Increased delta coherence likely reflects cyclic hyperpolarization of thalamocortical networks and may be a marker for loss of consciousness.

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Individualized positive end-expiratory pressure in obese patients during general anaesthesia: a randomized controlled clinical trial using electrical impedance tomography

Abstract
Background
General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects.
Methods
Patients with a BMI ≥35 kg m−2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg−1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5). Gas exchange, regional ventilation distribution, and EELV (multiple breath nitrogen washout method) were determined before, during, and after anaesthesia. The primary end point was the ratio of arterial partial pressure of oxygen to inspiratory oxygen fraction (PaO2/FiO2).
Results
For PEEPIND (n=25) and PEEP5 (n=25) arms together, PaO2/FiO2 and EELV decreased by 15 kPa [95% confidence interval (CI) 11–20 kPa, P<0.001] and 1.2 litres (95% CI 0.9–1.6 litres, P<0.001), respectively, after intubation. Mean (sd) PEEPIND was 18.5 (5.6) cm H2O. In the PEEPIND arm, PaO2/FiO2 before extubation was 23 kPa higher (95% CI 16–29 kPa; P<0.001), EELV was 1.8 litres larger (95% CI 1.5–2.2 litres; P<0.001), driving pressure was 6.7 cm H2O lower (95% CI 5.4–7.9 cm H2O; P<0.001), and regional ventilation was more equally distributed than for PEEP5. After extubation, however, these differences between the arms vanished.
Conclusions
In obese patients, an RM and higher PEEPIND restored EELV, regional ventilation distribution, and oxygenation during anaesthesia, but these differences did not persist after extubation. Therefore, lung protection strategies should include the postoperative period.
Clinical trial registration
German clinical trials register DRKS00004199, http://ift.tt/2gfFcmy.

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The role of Journal of Anesthesia as a flagship anesthesia journal in Asia



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Molecular analysis and genotype-phenotype correlation of Diamond-Blackfan anemia

Diamond-Blackfan anemia (DBA) features hypoplastic anemia and congenital malformations, largely caused by mutations in various ribosomal proteins. The aim of this study was to characterize the spectrum of genetic lesions causing DBA and identify genotypes that correlate with phenotypes of clinical significance. Seventy-four patients with DBA from across Canada were included. Nucleotide-level mutations or large deletions were identified in 10 ribosomal genes in 45 cases. The RPS19 mutation group was associated with higher requirement for chronic treatment for anemia than other DBA groups. Patients with RPS19 mutations, however, were more likely to maintain long-term corticosteroid response without requirement for further chronic transfusions. Conversely, patients with RPL11 mutations were less likely to need chronic treatment. Birth defects, including cardiac, skeletal, hand, cleft lip or palate and genitourinary malformations, also varied among the various genetic groups. Patients with RPS19 mutations had the fewest number of defects, while patients with RPL5 had the greatest number of birth defects.

Thumbnail image of graphical abstract

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Identification of the first homozygous 1-bp deletion in GDF9 gene leading to primary ovarian insufficiency by using targeted massively parallel sequencing

Targeted massively parallel sequencing (TMPS) has been used in genetic diagnosis for Mendelian disorders. In the past few years, the TMPS has identified new and already described genes associated with primary ovarian insufficiency phenotype. Here, we performed a targeted gene sequencing to find a genetic diagnosis in idiopathic cases of Brazilian POI cohort. A custom SureSelectXT DNA target enrichment panel was designed and the sequencing was performed on Illumina NextSeq sequencer. We identified one homozygous 1-bp deletion variant (c.783delC) in the GDF9 gene in one patient with POI. The variant was confirmed and segregated using Sanger sequencing. The c.783delC GDF9 variant changed an aminoacid creating a premature termination codon (p.Ser262Hisfs*2). This variant was not present in all public databases (ExAC/gnomAD, NHLBI/EVS and 1000 Genomes). Moreover, it was absent in 400 alleles from fertile Brazilian women screened by Sanger sequencing. The patient's mother and her unaffected sister carried the c.783delC variant in a heterozygous state, as expected for an autosomal recessive inheritance. Here, the targeted massively parallel sequencing identified the first homozygous 1-bp deletion variant in GDF9. This finding reveals a novel inheritance pattern of pathogenic variant in GDF9 associated with POI, thus improving the genetic diagnosis of this disorder.

Thumbnail image of graphical abstract

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Top EMS Game Changers – #1: Cellphones

Mobile phones changed day-to-day EMS operations more than any medical device or innovation

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Top EMS Game Changers – #1: Cellphones

What if the most significant EMS innovation of the last 25 years isn't a medical device at all, but an everyday item owned by over 90 percent of the U.S. population" I'm talking about the smartphone in its embryonic state: the cellphone. I wasn't an early adaptor of cellular technology. I still owned a rotary phone well into the '90s – a no-frills source of pride for me ...

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Three cases of implantation of a SureScan ® system and MRI for investigating causes of pain

Abstract

We report three cases of implantation of the SureScan® system and magnetic resonance imaging (MRI) for investigating causes of pain. Although there were metal-induced artifacts on the MR images of 2 patients, the artifacts did not affect the images of structures that needed to be assessed to make the diagnosis. The SureScan® system enabled patients implanted with spinal cord stimulation devices to undergo MRI.



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Reliability of muscle blood flow and oxygen consumption response from exercise using near-infrared spectroscopy

Abstract

Near-infrared spectroscopy (NIRS), coupled with rapid venous (VO) and arterial occlusions (AO) can be used to non-invasively estimate resting local skeletal muscle blood flow (mBF) and oxygen consumption (mV̇O2), respectively. However, the day-to-day reliability of mBF and mV̇O2 responses to stressors such as incremental dynamic exercise has not been established.

Purpose

To determine the reliability of NIRS derived mBF and mV̇O2 response from incremental dynamic exercise.

Methods

Measurements of mBF and mV̇O2 were collected in the vastus lateralis of twelve healthy, physically active adults [7 m and 5 f; 25 y (SD 6)] over 3 non-consecutive visits within 10 days. After 10 mins rest, participants performed 3 mins of rhythmic isotonic knee extension (1 extension/4 s) at 5, 10, 15, 20, 25, and 30% of maximal voluntary contraction (MVC), prior to 4 VOs and then 2 AOs.

Results

mBF and mV̇O2 proportionally increased with intensity (0.55 to 7.68 ml∙min−1∙100 ml−1 and 0.05 to 1.86 mlO2∙min−1∙100 g−1, respectively) up to 25% MVC where it began to plateau at 30% MVC. Moreover, a mBF/mV̇O2 mV̇Oratio of ∼5 was consistent for all exercise stages. The intra-class coefficient (ICC) for mBF indicated high to very high reliability for 10–30% MVC (0.82–0.9). There was very high reliability for mV̇O2 across all exercise stages (ICC 0.91–0.96).

Conclusion

NIRS can reliably assess muscle blood flow and oxygen consumption responses to low-moderate exercise, meriting potential applications in clinical diagnosis and therapeutic assessment.

This article is protected by copyright. All rights reserved



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Transcriptional profiling of antioxidant defense system and heat shock protein ( Hsp ) families in the cadmium- and copper-exposed marine ciliate Euplotes crassu

Abstract

To understand the transcriptional response of antioxidant defense system and heat shock protein (Hsp) families of the marine ciliate Euplotes crassus, we analyzed the transcriptome profile using RNA-seq technology after exposure to cadmium (Cd) and copper (Cu). De novo sequence assembly produced 61,240 unigenes with 21,330 BLAST hits and showed high sequence orthology with transcriptomes of other ciliates. Gene annotation and gene ontology (GO) comparison revealed that E. crassus expressed highly diversified but conserved stress-responsive gene families of the antioxidant defense system and Hsps. After waterborne exposure to 250 μg/L of Cd and 25 μg/L of Cu, transcriptional responses of the gene families were significantly modulated, suggesting that even the unicellular E. crassus has a conserved molecular defense mechanism, such as modulating mRNA expression, for homeostasis. These transcriptional responses make E. crassus a potential model for understanding the molecular response of single cell ciliates to heavy metal contamination.



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The Effect of a Behavioral Weight-Loss Intervention on Depressive Symptoms Among Latino Immigrants in a Randomized Controlled Trial

Abstract

Evidence of whether behavioral weight-loss interventions reduce depressive symptoms among Latino immigrants is limited. The effect of a behavioral weight-loss intervention on depressive symptoms was assessed using data from a clinical trial among Latino immigrants. Participants were randomized to a usual care (UC) control (n = 41), case management (CM) alone (n = 84), or CM with community health worker support (CM+CHW) (n = 82). Generalized estimating equation models were used to compare the impact of each intervention with UC. Effect modification by poverty level was further investigated. Overall, treatment groups were not significantly associated with 24-month changes in CES-D scores. Among participants below the 100% federal poverty level (FPL), those randomized to CM+CHW had 24-month CES-D scores significantly lower (Β coefficient = 0.72; 95% CI 0.55–0.93) than those in UC (p = 0.01). A behavioral weight-loss intervention providing case management and support from a CHW reduced depressive symptoms among Latino immigrants below the 100% FPL.



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A gastric glomus tumor resected using non-exposed endoscopic wall-inversion surgery

Abstract

Gastric glomus tumors are extremely rare, constituting approximately 1% of gastric mesenchymal tumors. We report the case of a 45-year-old female patient in whom upper gastrointestinal endoscopy revealed a 3-cm submucosal tumor with a bridging fold in the posterior wall of the antrum of the stomach. Contrast-enhanced computed tomography revealed the tumor to be hypervascular in the arterial phase and exhibit continuous enhancement in the post-venous phase. Dynamic contrast-enhanced magnetic resonance imaging showed that the tumor was hypervascular in the early phase and persistently enhanced in the late phase. Endoscopic ultrasonography revealed a mosaic echo pattern. Endoscopic ultrasound-guided fine-needle aspiration biopsy was performed. Immunohistochemical examination revealed that the tumor was positive for α-smooth muscle actin and synaptophysin, but negative for CD56, chromogranin A and C-kit. Furthermore, 1–2% of the tumor cell nuclei were Ki-67-positive. Thus, the preoperative diagnosis was a benign glomus tumor. The patient then underwent non-exposed endoscopic wall-inversion surgery (NEWS), and the tumor was completely resected. In conclusion, NEWS is an effective method for the treatment of gastric glomus tumors.



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Caffeine and Autosomal Dominant Polycystic Kidney Disease

Journal of Caffeine Research , Vol. 0, No. 0.


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Caffeine and Autosomal Dominant Polycystic Kidney Disease

Journal of Caffeine Research , Vol. 0, No. 0.


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Could Frequent Carbapenem Use Be a Risk Factor for Colistin Resistance?

Microbial Drug Resistance , Vol. 0, No. 0.


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Migratory White Stork (Ciconia ciconia): A Potential Vector of the OXA-48-Producing Escherichia coli ST38 Clone in Algeria

Microbial Drug Resistance , Vol. 0, No. 0.


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Antimicrobial Resistance and Genotypes of Campylobacter jejuni from Pig and Cattle Carcasses Isolated in Poland During 2009–2016

Microbial Drug Resistance , Vol. 0, No. 0.


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Extended-Spectrum Beta-Lactamase-/AmpC Beta-Lactamase-Producing Enterobacteriaceae in Broiler Farms: Transmission Dynamics at Farm Level

Microbial Drug Resistance , Vol. 0, No. 0.


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Prevalence of Aminoglycoside-Modifying Enzymes in Escherichia coli and Klebsiella pneumoniae Producing Extended Spectrum β-Lactamases Collected in Two Multicenter Studies in Spain

Microbial Drug Resistance , Vol. 0, No. 0.


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Identification of Carbapenem-Resistant Klebsiella pneumoniae with Emphasis on New Delhi Metallo-Beta-Lactamase-1 (blaNDM-1) in Bandar Abbas, South of Iran

Microbial Drug Resistance , Vol. 0, No. 0.


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Diversity of Class 1 Integrons, and Disruption of carO and dacD by Insertion Sequences Among Acinetobacter baumannii Isolates in Tehran, Iran

Microbial Drug Resistance , Vol. 0, No. 0.


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Molecular Characterization of Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates from Milk Samples of Dairy Cows with Mastitis in Bavaria, Germany

Microbial Drug Resistance , Vol. 0, No. 0.


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Evolution of Regions Containing Antibiotic Resistance Genes in FII-2-FIB-1 ColV-Colla Virulence Plasmids

Microbial Drug Resistance , Vol. 0, No. 0.


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Risk Factors for Nasal Colonization by Methicillin-Resistant Staphylococci in Healthy Humans in Professional Daily Contact with Companion Animals in Portugal

Microbial Drug Resistance , Vol. 0, No. 0.


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Frequency and Antibiotic Resistance of Bacteria Implicated in Community Urinary Tract Infections in North Aveiro Between 2011 and 2014

Microbial Drug Resistance , Vol. 0, No. 0.


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The Effect of Lysozyme on Reducing Biofilms by Staphylococcus aureus, Pseudomonas aeruginosa, and Gardnerella vaginalis: An In Vitro Examination

Microbial Drug Resistance , Vol. 0, No. 0.


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