Τρίτη, 17 Οκτωβρίου 2017

Emergency Medical Tecnician - Concord EMS

Concnrd EMS is currently looking for Full and Part Time Emergency Medical Technicians We are offering a $2000.00 sign on bonus for Full TIme Employees Provides quality medical care to all patients in both Emergent and Non-Emergent situations within the guidelines of the Michigan Department of Community Health Paramedic or EMT License, represents the company with professionalism and courtesy, and takes ...

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Resistance in In Vitro Selected Tigecycline-Resistant Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Is Driven by Mutations in mepR and mepA Genes

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


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Antimicrobial Activity of Ceftolozane-Tazobactam Tested Against Enterobacteriaceae and Pseudomonas aeruginosa with Various Resistance Patterns Isolated in U.S. Hospitals (2013–2016) as Part of the Surveillance Program: Program to Assess Ceftolozane-Tazobactam Susceptibility

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


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High Prevalence of Multidrug-Resistant Bacteria in Libyan War Casualties Admitted to a Tertiary Care Hospital, Germany

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


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Antibiotic Resistance in Salmonella from Retail Foods of Animal Origin and Its Association with Disinfectant and Heavy Metal Resistance

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


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A Horizontally Transferred Autonomous Helitron Became a Full Polydnavirus Segment in Cotesia vestalis

Bracoviruses associate symbiotically with thousands of parasitoid wasp species in the family Braconidae, working as virulence gene vectors, and allowing the development of wasp larvae within hosts. These viruses are composed by multiple DNA circles that are packaged into infective particles and injected together with wasp's eggs during parasitization. One of the viral segments of Cotesia vestalis bracovirus contains a gene that has been previously described as a helicase of unknown origin. Here we demonstrate that this gene is a Rep/Helicase from an intact Helitron transposable element that covers the viral segment almost entirely. We also provide evidence that this element underwent at least two horizontal transfers, which appear to have occurred consecutively: first from a Drosophila host ancestor to the genome of the parasitoid wasp Cotesia vestalis and its bracovirus, and then from C. vestalis to a lepidopteran host (Bombyx mori). Our results reinforce the idea of parasitoid wasps as frequent agents of horizontal transfers in eukaryotes. Additionally, this Helitron-bracovirus segment is the first example of a transposable element that effectively became a whole viral circle.



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H+ and Pi Byproducts of Glycosylation Affect Ca2+ Homeostasis and Are Retrieved from the Golgi Complex by Homologs of TMEM165 and XPR1

Glycosylation reactions in the Golgi complex and the endoplasmic reticulum utilize nucleotide sugars as donors and produce inorganic phosphate (Pi) and acid (H+) as byproducts. Here we show that homologs of mammalian XPR1 and TMEM165 (termed Erd1 and Gdt1) recycle luminal Pi and exchange luminal H+ for cytoplasmic Ca2+, respectively, thereby promoting growth of yeast cells in low Pi and low Ca2+ environments. As expected for reversible H+/Ca2+ exchangers, Gdt1 also promoted growth in high Ca2+ environments when the Golgi-localized V-ATPase was operational but had the opposite effect when the V-ATPase was eliminated. Gdt1 activities were negatively regulated by calcineurin signaling and by Erd1, which recycled the Pi byproduct of glycosylation reactions and prevented the loss of this nutrient to the environment via exocytosis. Thus, Erd1 transports Pi in the opposite direction from XPR1 and other EXS family proteins and facilitates byproduct removal from the Golgi complex together with Gdt1.



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Removable rigid dressings for postoperative management of transtibial amputations: a review of published evidence

Forty years of clinical experience and peer reviewed research studies support the use of non-weight bearing removable rigid dressings (RRD) as an effective means of post-operative management of transtibial amputations. We reviewed the published medical evidence regarding the use of RRDs as a postoperative management strategy, culminating in an evidence-based practice recommendation. Published peer reviewed literature on the topic was searched and classified by level of evidence based on the research design utilizing the scale recommended by the PM&R Journal (level I through V).1 The search uncovered a total of 15 articles, including 5 level I randomized controlled trials (RCT), 6 level III retrospective matched controlled trials, and 4 level V case reports.

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Impact of Critical Illness Polyneuromyopathy in Rehabilitation: A Prospective Observational Study

Critical illness polyneuromyopathy (CIPNM) is increasingly recognized as a source of disability in patients requiring intensive care unit (ICU) admission. The prevalence and impact of CIPNM on patients in the rehabilitation setting has not been established.

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Evaluation of mean transit time of aerosols from the area of origin to the Arctic with 210Pb/210Po daily monitoring data

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Publication date: Available online 17 October 2017
Source:Journal of Environmental Radioactivity
Author(s): Weihua Zhang, Baki Sadi, Christopher Rinaldo, Jing Chen, Norman Spencer, Kurt Ungar
In this study, the activity concentrations of 210Pb and 210Po on the 22 daily air filter samples, collected at CTBT Yellowknife station from September 2015 to April 2016, were analysed. To estimate the time scale of atmospheric long-range transport aerosol bearing 210Pb in the Arctic during winter, the mean transit time of aerosol bearing 210Pb from its origin was determined based on the activity ratios of 210Po/210Pb and the parent-progeny decay/ingrowth equation. The activity ratios of 210Po/210Pb varied between 0.06 and 0.21 with a median value of 0.11. The aerosol mean transit time based the activity ratio of 210Po/210Pb suggests longer mean transit time of 210Pb aerosols in winter (12 d) than in autumn (3.7 d) and spring (2.9 d).Four years 210Pb and 212Pb monitoring results and meteorological conditions at the Yellowknife station indicate that the 212Pb activity is mostly of local origin, and that 210Pb aerosol in wintertime are mainly from outside of the Arctic regions in common with other pollutants and sources contributing to the Arctic. The activity concentration ratios of 210Pb and 212Pb have a relatively constant value in summer with a significant peak observed in winter, centered in the month of February. Comparison of the 210Pb/212Pb activity ratios and the estimated mean 210Pb transit time, the mean aerosol transit times were real reflection of the atmosphere transport characteristics, which can be used as a radio-chronometer for the transport of air masses to the Arctic region.



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Unsuspected schwannomas of the gallbladder

Schwannomas are neurogenic tumors that originate from the nerve sheaths of the peripheral nerves. Schwannomas arising from the gallbladder are extremely rare. In the present case, we report a 70-year-old man, who was admitted the hospital because of epigastric pain and jaundice. Based on the evidence of blood tests, ultrasonography and magnetic resonance imaging, a diagnosis of cholecystitis and cholangitis caused by stone was considered preoperatively. He underwent laparoscopic cholecystectomy and laparoscopic common bile duct exploration.

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Unsuspected schwannomas of the gallbladder

Schwannomas are neurogenic tumors that originate from the nerve sheaths of the peripheral nerves. Schwannomas arising from the gallbladder are extremely rare. In the present case, we report a 70-year-old man, who was admitted the hospital because of epigastric pain and jaundice. Based on the evidence of blood tests, ultrasonography and magnetic resonance imaging, a diagnosis of cholecystitis and cholangitis caused by stone was considered preoperatively. He underwent laparoscopic cholecystectomy and laparoscopic common bile duct exploration.

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Circadian Clocks: Role in Health and Disease

No abstract available

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Age Modulates Physiological Responses during Fan Use under Extreme Heat and Humidity

imagePurpose: We examined the effect of electric fan use on cardiovascular and thermoregulatory responses of nine young (26 ± 3 yr) and nine aged (68 ± 4 yr) adults exposed to extreme heat and humidity. Methods: While resting at a temperature of 42°C, relative humidity increased from 30% to 70% in 2% increments every 5 min. On randomized days, the protocol was repeated without or with fan use. HR, core (Tcore) and mean skin (Tsk) temperatures were measured continuously. Whole-body sweat loss was measured from changes in nude body weight. Other measures of cardiovascular (cardiac output), thermoregulatory (local cutaneous and forearm vascular conductance, local sweat rate), and perceptual (thermal and thirst sensations) responses were also examined. Results: When averaged over the entire protocol, fan use resulted in a small reduction of HR (−2 bpm, 95% confidence interval [CI], −8 to 3), and slightly greater Tcore (+0.05°C; 95% CI, −0.13 to 0.23) and Tsk (+0.03°C; 95% CI, −0.36 to 0.42) in young adults. In contrast, fan use resulted in greater HR (+5 bpm; 95% CI, 0–10), Tcore (+0.20°C; 95% CI, 0.00–0.41), and Tsk (+0.47°C; 95% CI, 0.18–0.76) in aged adults. A greater whole-body sweat loss during fan use was observed in young (+0.2 kg; 95% CI, −0.2 to 0.6) but not aged (0.0 kg; 95% CI, −0.2 to 0.2) adults. Greater local sweat rate and cutaneous vascular conductance were observed with fan use in aged adults. Other measures of cardiovascular, thermoregulatory, and perceptual responses were unaffected by fan use in both groups. Conclusions: During extreme heat and humidity, fan use elevates physiological strain in aged, but not young, adults.

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Greater Oxidative Capacity in Primary Myotubes from Endurance-trained Women

imagePurpose: Exercise training promotes skeletal muscle mitochondrial biogenesis and an increase in maximal oxygen consumption. Primary myotubes retain some metabolic properties observed in vivo but it is unknown whether this includes exercise-induced mitochondrial adaptations. The goal of this study was to test if primary myotubes from exercise-trained women have higher mitochondrial content and maximal oxygen consumption compared with untrained women. Methods: Six trained and nine untrained white women participated in this study. Muscle biopsies from the vastus lateralis muscle of the right leg were obtained and primary muscle cells were isolated. Maximal respiration rates, mitochondrial mRNA and protein content, and succinate dehydrogenase activity were measured in skeletal muscle and primary myotubes from trained and untrained women. Results: Trained women, compared with untrained women, had higher maximal whole-body oxygen consumption (+18%, P = 0.03), in vivo maximal skeletal muscle oxidative capacity measured with near infrared spectroscopy (+48%, P

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Increased Protein Requirements in Female Athletes after Variable-Intensity Exercise

imagePurpose: Protein requirements are primarily studied in the context of resistance or endurance exercise with little research devoted to variable-intensity intermittent exercise characteristic of many team sports. Further, female populations are underrepresented in dietary sports science studies. We aimed to determine a dietary protein requirement in active females performing variable-intensity intermittent exercise using the indicator amino acid oxidation (IAAO) method. We hypothesized that these requirements would be greater than current IAAO-derived estimates in nonactive adult males. Methods: Six females (21.2 ± 0.8 yr, 68.8 ± 4.1 kg, 47.1 ± 1.2 mL O2·kg−1·min−1; mean ± SE) completed five to seven metabolic trials during the luteal phase of the menstrual cycle. Participants performed a modified Loughborough Intermittent Shuttle Test before consuming eight hourly mixed meals providing the test protein intake (0.2–2.66 g·kg−1·d−1), 6 g·kg−1·d−1 CHO and sufficient energy for resting and exercise-induced energy expenditure. Protein was provided as crystalline amino acid modeling egg protein with [13C]phenylalanine as the indicator amino acid. Phenylalanine turnover (Q) was determined from urinary [13C]phenylalanine enrichment. Breath 13CO2 excretion (F13CO2) was analyzed using mixed effects biphase linear regression with the breakpoint and upper 95% confidence interval approximating the estimated average requirement and recommended dietary allowance, respectively. Results: Protein intake had no effect on Q (68.7 ± 7.3 μmol·kg−1·h−1; mean ± SE). F13CO2 displayed a robust biphase response (R2 = 0.66) with an estimated average requirement of 1.41 g·kg−1·d−1 and recommended dietary allowance of 1.71 g·kg−1·d−1. Conclusions: The protein requirement estimate of 1.41 and 1.71 g·kg−1·d−1 for females performing variable-intensity intermittent exercise is greater than the IAAO-derived estimates of adult males (0.93 and 1.2 g·kg−1·d−1) and at the upper range of the American College of Sports Medicine athlete recommendations (1.2–2.0 g·kg−1·d−1).

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Longitudinal Associations between Physical Activity and Educational Outcomes

imagePurpose: This longitudinal study examined the role of leisure-time physical activity in academic achievement at the end of compulsory basic education and educational attainment in adulthood. Methods: The data were drawn from the ongoing longitudinal Cardiovascular Risk in Young Finns Study, which was combined with register-based data from Statistics Finland. The study consisted of children who were 12 yr (n = 1723, 49% boys) and 15 yr (n = 2445, 48% boys) of age at the time when physical activity was measured. The children were followed up until 2010, when their mean age was 40 yr. Physical activity was self-reported and included several measurements: overall leisure-time physical activity outside school hours, participation in sports club training sessions, and participation in sports competitions. Individuals' educational outcomes were measured with the self-reported grade point average at age 15 yr and register-based information on the years of completed postcompulsory education in adulthood. Ordinary least squares models and the instrumental variable approach were used to analyze the relationship between physical activity and educational outcomes. Results: Physical activity in adolescence was positively associated with educational outcomes. Both the physical activity level at age 15 yr and an increase in the physical activity level between the ages of 12 and 15 yr were positively related to the grade point average at age 15 yr and the years of postcompulsory education in adulthood. The results were robust to the inclusion of several individual and family background factors, including health endowments, family income, and parents' education. Conclusion: The results provide evidence that physical activity in adolescence may not only predict academic success during compulsory basic education but also boost educational outcomes later in life.

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Response

No abstract available

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Effects of a Long-Term Physical Activity Program on Activity Patterns in Older Adults

imagePurpose: To examine the effect of a long-term structured physical activity (PA) intervention on accelerometer-derived metrics of activity pattern changes in mobility-impaired older adults. Methods: Participants were randomized to either a PA or health education (HE) program. The PA intervention included a walking regimen with strength, flexibility, and balance training. The HE program featured health-related discussions and a brief upper body stretching routine. Participants (n = 1341) wore a hip-worn accelerometer for ≥10 h·d−1 for ≥3 d at baseline and again at 6, 12, and 24 months postrandomization. Total PA (TPA)—defined as movements registering 100+ counts per minute—was segmented into the following intensities: low-light PA (LLPA; 100–759 counts per minute), high light PA (HLPA; 760–1040 counts per minute), low moderate PA (LMPA; 1041–2019 counts per minute), and high moderate and greater PA (HMPA; 2020+ counts per minute). Patterns of activity were characterized as bouts (defined as the consecutive minutes within an intensity). Results: Across groups, TPA decreased an average of 74 min·wk−1 annually. The PA intervention attenuated this effect (PA = −68 vs HE: −112 min·wk−1, P = 0.002). This attenuation shifted TPA composition by increasing time in LLPA (10+ bouts increased 6 min·wk−1), HLPA (1+, 2+, 5+, and 10+ bouts increased 6, 3, 2, and 1 min·wk−1, respectively), LMPA (1+, 2+, 5+, and 10+ bouts increased: 19, 17,16, and 8 min·wk−1, respectively), and HMPA (1+, 2+, 5+, and 10+ bouts increased 23, 21, 17, and 14 min·wk−1, respectively). Conclusions: The PA intervention increased PA by shifting the composition of activity toward higher-intensity activity in longer-duration bouts. However, a long-term structured PA intervention did not completely eliminate overall declines in total daily activity experienced by mobility-impaired older adults.

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Cognitive Resilience and Psychological Responses across a Collegiate Rowing Season

imageIntroduction: Student-athletes face numerous challenges across their competitive season. Although mood states have been previously studied, little is known about adaptations in other psychological responses, specifically cognition. The purpose of this study was to characterize cognitive function, mood, sleep, and stress responses at select time points of a season in collegiate rowers. It was hypothesized that during baseline, typical training, and recovery, athletes would show positive mental health profiles, in contrast to decreases in cognition with increases in negative mood and measurements of stress during peak training. Methods: Male and female Division I rowers (N = 43) and healthy controls (N = 23) were enrolled and assessed at baseline, typical training, peak training, and recovery. At each time point, measures of cognitive performance (Stroop color-naming task), academic and exercise load, perceived cognitive deficits, mood states, sleep, and stress (via self-report and salivary cortisol) were recorded. Results: Repeated-measures ANOVA revealed significant group–time interactions for perceived exercise load, cognitive deficits, mood states, and perceived stress (P

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Physical Activity Dimensions Associated with Impaired Glucose Metabolism

imagePurpose: Physical activity (PA) is important in the prevention of Type 2 diabetes, yet little is known about the role of specific dimensions of PA, including sedentary time in subgroups at risk for impaired glucose metabolism (IGM). We applied a data-driven decision tool to identify dimensions of PA associated with IGM across age, sex, and body mass index (BMI) groups. Methods: This cross-sectional study included 1501 individuals (mean (SD) age, 65.6 (6.8) yr) at high risk for Type 2 diabetes from the ADDITION-PRO study. PA was measured by an individually calibrated combined accelerometer and heart rate monitor worn for 7 d. PA energy expenditure, time spent in different activity intensities, bout duration, and sedentary time were considered determinants of IGM together with age, sex, and BMI. Decision tree analysis was applied to identify subgroup-specific dimensions of PA associated with IGM. IGM was based on oral glucose tolerance test results and defined as a fasting plasma glucose level of ≥6.1 mmol·L−1 and/or a 2-h plasma glucose level of ≥7.8 mmol·L−1. Results: Among overweight (BMI ≥25 kg·m−2) men, accumulating less than 30 min·d−1 of moderate-to-vigorous PA was associated with IGM, whereas among overweight women, sedentary time was associated with IGM. Among individuals older than 53 yr with normal weight (BMI

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The Effects of Acute Interval Exercise and Strawberry Intake on Postprandial Lipemia

imagePurpose: Raised postprandial triglycerides (TAG) and related oxidative stresses are strongly associated with increased cardiovascular disease risk. Acute exercise and strawberry ingestion independently ameliorate postprandial lipid excursions and oxidative stress. However, the combined effects of these lifestyle interventions are unknown. We investigated whether acute exercise and strawberry consumption improved postprandial responses to an oral fat tolerance test (OFTT) in overweight/obese males. Methods: Overweight/obese adult males underwent four separate OFTT (73 g fat, 33 g carbohydrate) with blood sampled at baseline and hourly for 4 h after OFTT. Two OFTT contained 25 g freeze-dried strawberries and two contained strawberry flavoring (placebo). Participants performed 40 min of submaximal high-intensity interval cycling exercise 16 h before one strawberry and one placebo OFTT and rested before the remaining two OFTT. Serum TAG was analyzed, and TAG area under the curve (AUC) and incremental AUC (iAUC) were calculated. Oxidative stress markers were measured at baseline and 4 h. Differences between conditions (strawberry/placebo and exercise/rest) were assessed using repeated-measures ANOVA. Results: Ten males (age = 31.5, interquartile range = 17.8 yr, body mass index = 29.9 ± 1.8 kg·m−2) completed the study. TAG AUC was 1.5 mmol per 4 h−1·L−1 lower for the exercise conditions compared with the rest conditions (95% confidence interval [CI] = −2.3 to −0.8 mmol per 4 h−1·L−1, P = 0.001). TAG AUC was not different between strawberry and placebo conditions (95% CI = −1.3 to 0.6 mmol per 4 h−1·L−1, P = 0.475). TAG iAUC was 0.5 mmol per 4 h−1·L−1 greater for the strawberry compared with the placebo conditions (95% CI = 0.1 to 1.0 mmol per 4 h−1·L−1, P = 0.021). There were no changes in markers of lipid related oxidative stress (P > 0.05). Conclusion: Acute submaximal high-intensity interval cycling exercise appears effective in reducing postprandial lipemia in overweight/obese adult males. However, strawberry ingestion did not improve postprandial TAG.

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Individualized Estimation of Physical Activity in Older Adults with Type 2 Diabetes

imagePurpose: Compare physical activity intensity in older adults with type 2 diabetes mellitus (T2DM) using individualized, relative cutpoints with standard, absolute cutpoints. Methods: One hundred older adults with T2DM (68.9 ± 5.1 yr, 65% male, 32.7 ± 6.3 kg·m−2, 7.2% ± 1.1% glycosylated hemoglobin) completed a two-speed walking protocol (varying, walking between 1 and 2.5 mph), followed by a modified Bruce peak exercise test. Participants wore an accelerometer-based physical activity monitor at their waist, and oxygen consumption was measured. Afterward, participants wore the activity monitor for seven consecutive days. Linear equations for each individual were derived from the activity counts and energy expenditure measured during the walking protocol. Relative intensity cutpoints were calculated by using standard classifications of 44% oxygen consumption (V˙O2)peak to determine moderate and 59% V˙O2peak to determine vigorous intensity. Average time spent in intensity categories per day were calculated using relative and absolute (moderate, 2020 counts per minute; vigorous, 5999 counts per minute) cutpoints. t-Tests were run to compare estimated time spent in intensity category by cutpoint. Results: Mean V˙O2peak was 17.9 ± 4.5 mL·kg−1·min−1 and relative cutpoints were, on average, 1033.5 counts per minute (SD, 741.2 counts per minute) for moderate and 2211.7 counts per minute (SD, 1512.4) for vigorous activity. Using the relative cutpoints, participants accumulated an average of 157.2 min (SD, 73.7 min) of light, 33.3 min (SD, 35.6 min) of moderate, and 15.6 min (SD, 26.7 min) of vigorous activity per day. Use of the absolute cutpoint resulted in significantly different estimations based on intensity category: light, 200.7 min (SD, 74.7 min; P

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Generating ActiGraph Counts from Raw Acceleration Recorded by an Alternative Monitor

imagePurpose: This study aimed to implement an aggregation method in Matlab for generating ActiGraph counts from raw acceleration recorded with an alternative accelerometer device and to investigate the validity of the method. Methods: The aggregation method, including the frequency band-pass filter, was implemented and optimized based on standardized sinusoidal acceleration signals generated in Matlab and processed in the ActiLife software. Evaluating the validity of the aggregation method was approached using a mechanical setup and with a 24-h free-living recording using a convenient sample of nine subjects. Counts generated with the aggregation method applied to Axivity AX3 raw acceleration data were compared with counts generated with ActiLife from ActiGraph GT3X+ data. Results: An optimal band-pass filter was fitted resulting in a root-mean-square error of 25.7 counts per 10 s and mean absolute error of 15.0 counts per second across the full frequency range. The mechanical evaluation of the proposed aggregation method resulted in an absolute mean ± SD difference of −0.11 ± 0.97 counts per 10 s across all rotational frequencies compared with the original ActiGraph method. Applying the aggregation method to the 24-h free-living recordings resulted in an epoch level bias ranging from −16.2 to 0.9 counts per 10 s, a relative difference in the averaged physical activity (counts per minute) ranging from −0.5% to 4.7% with a group mean ± SD of 2.2% ± 1.7%, and a Cohen's kappa of 0.945, indicating almost a perfect agreement in the intensity classification. Conclusion: The proposed band-pass filter and aggregation method is highly valid for generating ActiGraph counts from raw acceleration data recorded with alternative devices. It would facilitate comparability between studies using different devices collecting raw acceleration data.

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Meta-analysis of Cigarette Smoking and Musculoskeletal Injuries in Military Training

imagePurpose: Tobacco use is common among military personnel, as is musculoskeletal injury during training. In a review of the literature on musculoskeletal injuries, there was mixed evidence on the role of smoking as a risk factor. The purpose of this study is to review and analyze the literature on the impact of cigarette smoking on lower-extremity overuse injuries in military training. Methods: We performed a literature search on articles published through October 2016. Search terms focused on lower-extremity overuse musculoskeletal injuries and cigarette smoking in military populations. We conducted a meta-analysis overall and by sex, including smoking intensity. Results: We identified 129 potential studies and selected 18 based on quality. The overall rate ratio for smoking was 1.31, 1.31 for men, and 1.23 for women. Overall and for each sex, rate ratios were significantly greater than 1.0 for each intensity level of smoking. Conclusions: Smoking is a moderate risk factor for musculoskeletal injury and may account for a meaningful proportion of injuries among men and women due to the high prevalence of smoking and injury in this population. Although enlistees are not allowed to smoke during basic training, their risk of injury remains high, indicating that smokers may remain at increased risk for medium- to long-term duration.

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Response

No abstract available

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Power Training–induced Increases in Muscle Activation during Gait in Old Adults

imageIntroduction/Purpose: Aging modifies neuromuscular activation of agonist and antagonist muscles during walking. Power training can evoke adaptations in neuromuscular activation that underlie gains in muscle strength and power but it is unknown if these adaptations transfer to dynamic tasks such as walking. We examined the effects of lower-extremity power training on neuromuscular activation during level gait in old adults. Methods: Twelve community-dwelling old adults (age ≥ 65 yr) completed a 10-wk lower-extremity power training program and 13 old adults completed a 10-wk control period. Before and after the interventions, we measured maximal isometric muscle strength and electromyographic (EMG) activation of the right knee flexor, knee extensor, and plantarflexor muscles on a dynamometer and we measured EMG amplitudes, activation onsets and offsets, and activation duration of the knee flexors, knee extensors, and plantarflexors during gait at habitual, fast, and standardized (1.25 ± 0.6 m·s−1) speeds. Results: Power training-induced increases in EMG amplitude (~41%; 0.47 ≤ d ≤ 1.47; P ≤ 0.05) explained 33% (P = 0.049) of increases in isometric muscle strength (~43%; 0.34 ≤ d ≤ 0.80; P ≤ 0.05). Power training-induced gains in plantarflexor activation during push-off (+11%; d = 0.38; P = 0.045) explained 57% (P = 0.004) of the gains in fast gait velocity (+4%; d = 0.31; P = 0.059). Furthermore, power training increased knee extensor activation (~18%; 0.26 ≤ d ≤ 0.29; P ≤ 0.05) and knee extensor coactivation during the main knee flexor burst (~24%, 0.26 ≤ d ≤ 0.44; P ≤ 0.05) at habitual and fast speed but these adaptations did not correlate with changes in gait velocity. Conclusions: Power training increased neuromuscular activation during isometric contractions and level gait in old adults. The power training–induced neuromuscular adaptations were associated with increases in isometric muscle strength and partly with increases in fast gait velocity.

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Impact of HSCT Conditioning and Glucocorticoid Dose on Exercise Adherence and Response

imagePurpose: Evidence from randomized controlled trials (RCT) that exercise interventions have beneficial effects in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) is growing. However, intensive chemotherapy conditioning and glucocorticoid (GC) treatment is always part of an allo-HSCT and possibly affect exercise adherence and training response. Therefore, we aimed to examine whether various conditioning protocols or different doses of GC treatment affect exercise adherence and/or training response during the inpatient period. Methods: We analyzed inpatient data from intervention groups of two large RCT in allo-HSCT patients (n = 113). The intervention incorporated partly supervised endurance and resistance exercise three to five times per week. According to the potentially interfering factors, the patients were divided into groups depending on intensity of conditioning (myeloablative conditioning (MAC), reduced-intensity conditioning (RIC), and nonmyeloablative conditioning (NMC)) and cumulative dose of GC treatment (GC low ≤9 mg·kg−1 prednisone or GC high >9 mg·kg−1 prednisone) and were compared. Results: Median exercise adherence (target value, five sessions weekly) during the inpatient period was 64% in MAC, 54% in RIC, and 63% in NMC. The proportion of prematurely terminated training sessions ranged from 11% to 15%. Tiredness was the most frequent cause of exercise termination in all groups. Exercise adherence, duration (min·wk1) and type of training was significantly associated with GC dose. With regard to training response, results suggest that GC-low patients tend to respond better in knee extensor muscle strength. Conclusions: Exercise adherence during inpatient period is significantly affected by dose of GC treatment but not by condition regimen. However, given the reasonable adherence rates also in the GC-high group, data support the feasibility and importance of exercising for all allo-HSCT patients during the inpatient period.

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Cardiorespiratory Reference Data in Older Adults: The Generation 100 Study

imagePurpose: Cardiorespiratory fitness (CRF) is regarded a clinical vital sign, and accurate reference values for all age groups are essential. Little data exist on CRF and cardiorespiratory function in older adults. The aim of this study was to provide normative values for CRF and cardiorespiratory function in older adults, including people with history of cardiovascular diseases (CVD). Methods: In total, 1537 (769 women) participants age 70 to 77 yr underwent clinical examinations and cardiopulmonary exercise tests. Peak oxygen uptake (V˙O2peak), ventilation (V˙Epeak), expiration of carbon dioxide (VV˙CO2peak), breathing frequency (BFpeak), tidal volume (VTpeak), oxygen pulse (O2 pulsepeak), ventilatory efficiency (EqV˙O2peak and EqV˙CO2peak), and 1-min HR recovery were assessed. Results: Men compared with women had higher V˙O2peak (31.3 ± 6.7 vs 26.2 ± 5.0 mL·min−1·kg−1), BFpeak (41.8 ± 8.0 vs 39.7 ± 7.1 breaths per minute), VTpeak (2.3 ± 0.5 vs 1.6 ± 0.3), O2 pulsepeak (16.4 ± 3.2 vs 11.3 ± 2.0), V˙CO2peak (2.9 ± 0.2 and 1.9 ± 0.1 L·min−1), V˙Epeak (96.2 ± 21.7 vs 61.1 ± 21.6 L·min−1), EqV˙O2peak (38.0 ± 6.9 vs 35.1 ± 5.6), and EqV˙CO2peak (33.5 ± 5.7 vs 31.9 ± 4.5). Women and men with CVD had lower V˙O2peak (14% and 19%), peak HR (5% and 6%), V˙Epeak (8% and 10%), VTpeak (7% and 4%), and lower EqV˙CO2peak (4% and 6%) compared with their healthy counterparts, respectively. Compared with healthy women and men, 1-min HR recovery was 12% and 16% lower for women and men with CVD. Conclusions: This study represents the largest reference material on directly measured CRF and cardiorespiratory function in older men and women, with and without CVD. This novel information will help researchers and clinicians to interpret data form cardiopulmonary testing in older adults.

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Effects of Four Weeks of Strength Training on the Corticomotoneuronal Pathway

imagePurpose: Neural adaptations to strength training have long been recognized, but knowledge of mechanisms remains incomplete. Using novel techniques and a design which limited experimental bias, this study examined if 4 wk of strength training alters voluntary activation and corticospinal transmission. Methods: Twenty-one subjects were randomized into strength training (n = 10; 7 females, 3 males; 23.5 ± 7.5 yr; mean ± SD) and control groups (n = 11; 2 females, 9 males; 23.0 ± 4.2 yr). Strength training involved 12 sessions of high-force isometric contractions of the elbow flexors. Before and after training, voluntary activation of the elbow flexors was assessed via transcranial magnetic stimulation. Also, for the first time, magnetic stimulation of corticospinal axons was used to examine spinal-level adaptations to training. The evoked responses, termed cervicomedullary motor-evoked potentials (CMEPs), were acquired in resting biceps brachii in three arm postures. Muscle adaptations were assessed via electrical stimulation of biceps. Results: Compared with the control group, the strength training group exhibited greater increases in maximal strength (12.8% ± 6.8% vs 0.0% ± 2.7%; P

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Fitness Moderates Glycemic Responses to Sitting and Light Activity Breaks

imagePurpose: This study aimed to experimentally determine whether cardiorespiratory fitness (CRF) modifies postprandial glycemia during prolonged sitting and investigated the potentially blunting influence this may have on the benefits of interrupting postprandial sitting time with light activity breaks. Methods: Thirty-four adults (18 women; 16 men; mean ± SD age, 40 ± 9 yr, body mass index, 24.5 ± 3 kg·m−2) undertook two 7.5-h experimental conditions in a randomized order: 1) Prolonged sitting; 2) Sitting interspersed with 5 min light walking bouts every 30 min. Blood samples were obtained while fasting and postprandially after ingestion of two identical meals. Incremental area under the curve (iAUC) was calculated for glucose and insulin throughout experimental conditions. Maximal exercise testing quantified peak oxygen consumption (V˙O2 peak) as a measure of CRF. A repeated-measures ANOVA investigated whether V˙O2 peak modified glucose and insulin iAUC between conditions. Results: Breaking sedentary time with light walking breaks reduced blood glucose iAUC from 3.89 ± 0.7 to 2.51 ± 0.7 mmol·L−1·h−1 (P = 0.015) and insulin iAUC from 241 ± 46 to 156 ± 24 mU·L−1·h−1 (P = 0.013) after adjustment for V˙O2 peak and sex. A significant interaction between treatment response and V˙O2 peak was observed for glucose (P = 0.035), but not insulin (P = 0.062), whereby the treatment effect reduced with higher CRF. Average blood glucose iAUC responses for a man at the 25th centile of CRF within our cohort (42.5 mL·kg−1·min−1) went from 5.80 to 2.98 mmol·L−1·h−1 during the prolonged sitting and light walking break conditions respectively, whereas average responses for a man at the 75th centile of CRF (60.5 mL·kg−1·min−1) went from 1.99 to 1.78 mmol·L−1·h−1. Similar trends were observed for women. Conclusions: Individuals with low CRF gained the most metabolic benefit from breaking prolonged sitting with regular bouts of light walking.

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Intermittent Standing but not a Moderate Exercise Bout Reduces Postprandial Glycemia

imagePurpose: This study aimed to determine whether minimum recommended moderate-to-vigorous physical activity (MVPA; 30-min bout of continuous moderate-intensity walking) is sufficient to counteract the detrimental effects of prolonged sitting on postprandial metabolism and if there are any effects of breaking up sitting with intermittent standing when achieving minimum recommended MVPA. Methods: Fourteen (n = 14) physically inactive healthy adult males underwent four intrahospital 27-h interventions: 9-h continuous sitting (SIT), 15-min standing bouts every 30 min during the 9-h sitting (STAND), 30-min moderate-intensity walking bout followed by 8.5 h of sitting (MVPA), and 30-min moderate-intensity walking bout followed by 15-min standing bouts every 30 min during 8.5 h of sitting (MVPA + STAND). Three standardized meals on intervention day (day 1) and breakfast the following day (day 2) were served. Results: Cumulative postprandial glucose response (incremental area under the curve) was lower in STAND versus SIT (↓27%, P = 0.04, effect size [ES] = −0.7) because of decreases in postprandial glucose after breakfast on day 1 (STAND vs SIT: ↓40%, P = 0.01, ES = −0.7) and day 2 (STAND vs SIT: ↓33%, P = 0.06, ES = −0.6). STAND did not affect postprandial insulin responses. Cumulative postprandial insulin response was lower in MVPA versus SIT (↓18%, P = 0.03, ES = −0.3) and MVPA + STAND versus SIT (↓26%, P = 0.02, ES = −0.4) because of expected exercise-induced decreases in postprandial insulin after breakfast on day 1 only (MVPA vs SIT: ↓36%, P = 0.003, ES = −0.7; MVPA + STAND vs SIT: ↓43%, P = 0.0001, ES = −0.8). Conclusion: Breaking up prolonged sitting with nonambulatory standing across 9 h acutely reduced postprandial glycemic response during and the day after the intervention independent of insulin levels, whereas a 30-min MVPA bout did not.

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ZOLL - Summit 2018

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Join us at SUMMIT 2018 in Denver, May 8-10. Want to register? Visit http://ift.tt/2yx9pbl.

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ZOLL - Summit 2018

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Join us at SUMMIT 2018 in Denver, May 8-10. Want to register? Visit http://ift.tt/2yx9pbl.

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Response to "Median Nerve Area Measurements Using Ultrasound: Importance of Proper Technique and Interpretation".

No abstract available

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ZOLL - Summit 2018

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ZOLL - Summit 2018

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Join us at SUMMIT 2018 in Denver, May 8-10. Want to register? Visit http://ift.tt/2yx9pbl.

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EMS1 Acquires EVALS to Expand Training Management Capabilities in Emergency Medical Services and Beyond

Combination extends the EMS1 Academy LMS platform and content library with the leading tool for in-person skills development and tracking SAN FRANCISCO — EMS1, one of the leading websites serving the emergency medical services community, and Praetorian Digital, EMS1's parent company, today announced it has acquired EVALS, the leader in tracking skills development and field training in EMS ...

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Period2 3'-UTR and microRNA-24 regulate circadian rhythms by repressing PERIOD2 protein accumulation [Genetics]

We previously created two PER2::LUCIFERASE (PER2::LUC) circadian reporter knockin mice that differ only in the Per2 3′-UTR region: Per2::Luc, which retains the endogenous Per2 3′-UTR and Per2::LucSV, where the endogenous Per2 3′-UTR was replaced by an SV40 late poly(A) signal. To delineate the in vivo functions of Per2 3′-UTR, we...

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CRISPR-Cas9-based treatment of myocilin-associated glaucoma [Genetics]

Primary open-angle glaucoma (POAG) is a leading cause of irreversible vision loss worldwide, with elevated intraocular pressure (IOP) a major risk factor. Myocilin (MYOC) dominant gain-of-function mutations have been reported in ∼4% of POAG cases. MYOC mutations result in protein misfolding, leading to endoplasmic reticulum (ER) stress in the trabecular...

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Modulation of corticospinal input to the legs by arm and leg cycling in people with incomplete spinal cord injury

The spinal cervico-lumbar interaction during rhythmic movements in humans has recently been studied; however, the role of arm movements in modulating the corticospinal drive to the legs is not well understood. The goals of this study were to investigate the effect of active rhythmic arm movements on the corticospinal drive to the legs (study 1) and assess the effect of simultaneous arm and leg training on the corticospinal pathway after incomplete spinal cord injury (iSCI) (study 2). In study 1, neurologically intact (NI) participants or participants with iSCI performed combinations of stationary and rhythmic cycling of the arms and legs while motor evoked potentials (MEPs) were recorded from the vastus lateralis (VL) muscle. In the NI group, arm cycling alone could facilitate the VL MEP amplitude, suggesting that dynamic arm movements strongly modulate the corticospinal pathway to the legs. No significant difference in VL MEP between conditions was found in participants with iSCI. In study 2, participants with iSCI underwent 12 wk of electrical stimulation-assisted cycling training: one group performed simultaneous arm and leg (A&L) cycling and the other legs-only cycling. MEPs in the tibialis anterior (TA) muscle were compared before and after training. After training, only the A&L group had a significantly larger TA MEP, suggesting increased excitability in the corticospinal pathway. The findings demonstrate the importance of arm movements in modulating the corticospinal drive to the legs and suggest that active engagement of the arms in lower limb rehabilitation may produce better neural regulation and restoration of function.

NEW & NOTEWORTHY This study aimed to demonstrate the importance of arm movements in modulating the corticospinal drive to the legs. It provides direct evidence in humans that active movement of the arms could facilitate corticospinal transmission to the legs and, for the first time, shows that facilitation is absent after spinal cord injury. Active engagement of the arms in lower limb rehabilitation increased the excitability of the corticospinal pathway and may produce more effective improvement in leg function.



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Perception of the dynamic visual vertical during sinusoidal linear motion

The vestibular system provides information for spatial orientation. However, this information is ambiguous: because the otoliths sense the gravitoinertial force, they cannot distinguish gravitational and inertial components. As a consequence, prolonged linear acceleration of the head can be interpreted as tilt, referred to as the somatogravic effect. Previous modeling work suggests that the brain disambiguates the otolith signal according to the rules of Bayesian inference, combining noisy canal cues with the a priori assumption that prolonged linear accelerations are unlikely. Within this modeling framework the noise of the vestibular signals affects the dynamic characteristics of the tilt percept during linear whole-body motion. To test this prediction, we devised a novel paradigm to psychometrically characterize the dynamic visual vertical—as a proxy for the tilt percept—during passive sinusoidal linear motion along the interaural axis (0.33 Hz motion frequency, 1.75 m/s2 peak acceleration, 80 cm displacement). While subjects (n=10) kept fixation on a central body-fixed light, a line was briefly flashed (5 ms) at different phases of the motion, the orientation of which had to be judged relative to gravity. Consistent with the model's prediction, subjects showed a phase-dependent modulation of the dynamic visual vertical, with a subject-specific phase shift with respect to the imposed acceleration signal. The magnitude of this modulation was smaller than predicted, suggesting a contribution of nonvestibular signals to the dynamic visual vertical. Despite their dampening effect, our findings may point to a link between the noise components in the vestibular system and the characteristics of dynamic visual vertical.

NEW & NOTEWORTHY A fundamental question in neuroscience is how the brain processes vestibular signals to infer the orientation of the body and objects in space. We show that, under sinusoidal linear motion, systematic error patterns appear in the disambiguation of linear acceleration and spatial orientation. We discuss the dynamics of these illusory percepts in terms of a dynamic Bayesian model that combines uncertainty in the vestibular signals with priors based on the natural statistics of head motion.



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The temporal stability of visuomotor adaptation generalization

Movement adaptation in response to systematic motor perturbations exhibits distinct spatial and temporal properties. These characteristics are typically studied in isolation, leaving the interaction largely unknown. Here we examined how the temporal decay of visuomotor adaptation influences the spatial generalization of the motor recalibration. First, we quantified the extent to which adaptation decayed over time. Subjects reached to a peripheral target, and a rotation was applied to the visual feedback of the unseen motion. The retention of this adaptation over different delays (0–120 s) 1) decreased by 29.0 ± 6.8% at the longest delay and 2) was represented by a simple exponential, with a time constant of 22.5 ± 5.6 s. On the basis of this relationship we simulated how the spatial generalization of adaptation would change with delay. To test this directly, we trained additional subjects with the same perturbation and assessed transfer to 19 different locations (spaced 15° apart, symmetric around the trained location) and examined three delays (~4, 12, and 25 s). Consistent with the simulation, we found that generalization around the trained direction (±15°) significantly decreased with delay and distance, while locations >60° displayed near-constant spatiotemporal transfer. Intermediate distances (30° and 45°) showed a difference in transfer across space, but this amount was approximately constant across time. Interestingly, the decay at the trained direction was faster than that based purely on time, suggesting that the spatial transfer of adaptation is modified by concurrent passive (time dependent) and active (movement dependent) processes.

NEW & NOTEWORTHY Short-term motor adaptation exhibits distinct spatial and temporal characteristics. Here we investigated the interaction of these features, utilizing a simple motor adaptation paradigm (recalibration of reaching arm movements in response to rotated visual feedback). We examined the changes in the spatial generalization of motor adaptation for different temporal manipulations and report that the spatiotemporal generalization of motor adaptation is generally local and is influenced by both passive (time dependent) and active (movement dependent) learning processes.



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Intercepting virtual balls approaching under different gravity conditions: evidence for spatial prediction

To accurately time motor responses when intercepting falling balls we rely on an internal model of gravity. However, whether and how such a model is also used to estimate the spatial location of interception is still an open question. Here we addressed this issue by asking 25 participants to intercept balls projected from a fixed location 6 m in front of them and approaching along trajectories with different arrival locations, flight durations, and gravity accelerations (0g and 1g). The trajectories were displayed in an immersive virtual reality system with a wide field of view. Participants intercepted approaching balls with a racket, and they were free to choose the time and place of interception. We found that participants often achieved a better performance with 1g than 0g balls. Moreover, the interception points were distributed along the direction of a 1g path for both 1g and 0g balls. In the latter case, interceptions tended to cluster on the upper half of the racket, indicating that participants aimed at a lower position than the actual 0g path. These results suggest that an internal model of gravity was probably used in predicting the interception locations. However, we found that the difference in performance between 1g and 0g balls was modulated by flight duration, the difference being larger for faster balls. In addition, the number of peaks in the hand speed profiles increased with flight duration, suggesting that visual information was used to adjust the motor response, correcting the prediction to some extent.

NEW & NOTEWORTHY Here we show that an internal model of gravity plays a key role in predicting where to intercept a fast-moving target. Participants also assumed an accelerated motion when intercepting balls approaching in a virtual environment at constant velocity. We also show that the role of visual information in guiding interceptive movement increases when more time is available.



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Influence of envelope waveform on ITD sensitivity of neurons in the auditory midbrain

Interaural time differences (ITDs) conveyed by the modulated envelopes of high-frequency sounds can serve as a cue for localizing a sound source. Klein-Hennig et al. (J Acoust Soc Am 129: 3856, 2011) demonstrated the envelope attack (the rate at which stimulus energy in the envelope increases) and the duration of the pause (the interval between successive envelope pulses) as important factors affecting sensitivity to envelope ITDs in human listeners. Modulated sounds with rapid attacks and long pauses produce the lowest ITD discrimination thresholds. The duration of the envelope's sustained component (sustain) and the rate at which stimulus energy falls at the offset of the envelope (decay) are only minor factors. We assessed the responses of 71 single neurons, recorded from the midbrains of 15 urethane-anesthetized tri-colored guinea pigs, to envelope shapes in which the four envelope components, i.e., attack, sustain, decay, and pause, were systematically varied. We confirmed the importance of the attack and pause components in generating ITD-sensitive responses. Analysis of neural firing rates demonstrated more neurons (49/71) show ITD sensitivity in response to "damped" stimuli (fast attack and slow decay) compared with "ramped" stimuli (slow attack and fast decay) (14/71). Furthermore, the lowest threshold for the damped stimulus (91 μs) was lower by a factor of 4 than that for the temporally reversed ramped envelope shape (407 μs). The data confirm the importance of fast attacks and optimal pause durations in generating sensitivity to ITDs conveyed in the modulated envelopes of high-frequency sounds and are incompatible with models of ITD processing based on the integration of sound energy over time.

NEW & NOTEWORTHY Using single-neuron electrophysiology, we show that the precise shape of a sound's "energy envelope" is a critical factor in determining how well midbrain neurons are able to convey information about auditory spatial cues. Consistent with human behavioral performance, sounds with rapidly rising energy and relatively long intervals between energy bursts are best at conveying spatial information. The data suggest specific sound energy patterns that might best be applied to hearing devices to aid spatial listening.



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Field repetition and local mapping in the hippocampus and the medial entorhinal cortex

Hippocampal place cells support spatial cognition and are thought to form the neural substrate of a global "cognitive map." A widely held view is that parts of the hippocampus also underlie the ability to separate patterns or to provide different neural codes for distinct environments. However, a number of studies have shown that in environments composed of multiple, repeating compartments, place cells and other spatially modulated neurons show the same activity in each local area. This repetition of firing fields may reflect pattern completion and may make it difficult for animals to distinguish similar local environments. In this review we 1) highlight some of the navigation difficulties encountered by humans in repetitive environments, 2) summarize literature demonstrating that place and grid cells represent local and not global space, and 3) attempt to explain the origin of these phenomena. We argue that the repetition of firing fields can be a useful tool for understanding the relationship between grid cells in the entorhinal cortex and place cells in the hippocampus, the spatial inputs shared by these cells, and the propagation of spatially related signals through these structures.



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High-frequency epidural stimulation across the respiratory cycle evokes phrenic short-term potentiation after incomplete cervical spinal cord injury

C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of "crossed spinal" synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high-frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60 s, and currents ranged from 100 to 1,000 µA. Bilateral phrenic nerve activity and ipsilateral hypoglossal (XII) nerve activity were recorded before and after HF-ES. Higher T2 stimulus currents potentiated ipsilateral phasic inspiratory activity at both 2 and 12 wk post-C2Hx, whereas higher stimulus currents delivered at C4 potentiated ipsilateral phasic phrenic activity only at 12 wk (P = 0.028). Meanwhile, tonic output in the ipsilateral phrenic nerve reached 500% of baseline values at the high currents with no difference between 2 and 12 wk. HF-ES did not trigger inspiratory burst-frequency changes. Similar responses occurred following T2 HF-ES. Increases in contralateral phrenic and XII nerve output were induced by C4 and T2 HF-ES at higher currents, but the relative magnitude of these changes was small compared with the ipsilateral phrenic response. We conclude that following incomplete cervical spinal cord injury, HF-ES of the ventrolateral midcervical or thoracic spinal cord can potentiate efferent phrenic motor output with little impact on inspiratory burst frequency. However, the substantial increases in tonic output indicate that the uninterrupted 60-s stimulation paradigm used is unlikely to be useful for respiratory muscle activation after spinal injury.

NEW & NOTEWORTHY Previous studies reported that high-frequency epidural stimulation (HF-ES) activates the diaphragm following acute spinal transection. This study examined HF-ES and phrenic motor output following subacute and chronic incomplete cervical spinal cord injury. Short-term potentiation of phrenic bursting following HF-ES illustrates the potential for spinal stimulation to induce respiratory neuroplasticity. Increased tonic phrenic output indicates that alternatives to the continuous stimulation paradigm used in this study will be required for respiratory muscle activation after spinal cord injury.



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Speed invariance of tactile texture perception

The nervous system achieves stable perceptual representations of objects despite large variations in the activity patterns of sensory receptors. Here, we explore perceptual constancy in the sense of touch. Specifically, we investigate the invariance of tactile texture perception across changes in scanning speed. Texture signals in the nerve have been shown to be highly dependent on speed: temporal spiking patterns in nerve fibers that encode fine textural features contract or dilate systematically with increases or decreases in scanning speed, respectively, resulting in concomitant changes in response rate. Nevertheless, texture perception has been shown, albeit with restricted stimulus sets and limited perceptual assays, to be independent of scanning speed. Indeed, previous studies investigated the effect of scanning speed on perceived roughness, only one aspect of texture, often with impoverished stimuli, namely gratings and embossed dot patterns. To fill this gap, we probe the perceptual constancy of a wide range of textures using two different paradigms: one that probes texture perception along well-established sensory dimensions independently and one that probes texture perception as a whole. We find that texture perception is highly stable across scanning speeds, irrespective of the texture or the perceptual assay. Any speed-related effects are dwarfed by differences in percepts evoked by different textures. This remarkable speed invariance of texture perception stands in stark contrast to the strong dependence of the texture responses of nerve fibers on scanning speed. Our results imply neural mechanisms that compensate for scanning speed to achieve stable representations of surface texture.

NEW & NOTEWORTHY Our brain forms stable representations of objects regardless of viewpoint, a phenomenon known as invariance that has been described in several sensory modalities. Here, we explore invariance in the sense of touch and show that the tactile perception of texture does not depend on scanning speed. This perceptual constancy implies neural mechanisms that extract information about texture from the response of nerve fibers such that the resulting neural representation is stable across speeds.



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Isoflurane, ketamine-xylazine, and urethane markedly alter breathing even at subtherapeutic doses

Anesthetics are widely used for animal research on respiratory control in vivo, but their effect on breathing and CO2 chemoreception has not been well characterized in mice, a species now often used for these studies. We previously demonstrated that 1% isoflurane markedly reduces the hypercapnic ventilatory response (HCVR) in adult mice in vivo and masks serotonin [5-hydroxytryptamine (5-HT)] neuron chemosensitivity in vitro. Here we investigated effects of 0.5% isoflurane on breathing in adult mice and also found a large reduction in the HCVR even at this subanesthetic concentration. We then tested the effects on breathing of ketamine-xylazine and urethane, anesthetics widely used in research on breathing. We found that these agents altered baseline breathing and blunted the HCVR at doses within the range typically used experimentally. At lower doses ventilation was decreased, but mice appropriately matched their ventilation to metabolic demands due to a parallel decrease in O2 consumption. Neither ketamine nor urethane decreased chemosensitivity of 5-HT neurons. These results indicate that baseline breathing and/or CO2 chemoreception in mice are decreased by anesthetics widely viewed as not affecting respiratory control, and even at subtherapeutic doses. These effects of anesthetics on breathing may alter the interpretation of studies of respiratory physiology in vivo.

NEW & NOTEWORTHY Anesthetics are frequently used in animal research, but their effects on physiological functions in mice have not been well defined. Here we investigated the effects of commonly used anesthetics on breathing in mice. We found that all tested anesthetics significantly reduced the hypercapnic ventilatory response (HCVR), even at subtherapeutic doses. In addition, ketamine-xylazine and urethane anesthesia altered baseline breathing. These data indicate that breathing and the HCVR in mice are highly sensitive to anesthetic modulation.



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Altered modulation of sensorimotor rhythms with chronic paralysis

After paralysis, the disconnection between the cortex and its peripheral targets leads to neuroplasticity throughout the nervous system. However, it is unclear how chronic paralysis specifically impacts cortical oscillations associated with attempted movement of impaired limbs. We hypothesized that μ- (8–13 Hz) and β- (15–30 Hz) event-related desynchronization (ERD) would be less modulated for individuals with hand paralysis due to cervical spinal cord injury (SCI). To test this, we compared the modulation of ERD from magnetoencephalography (MEG) during attempted and imagined grasping performed by participants with cervical SCI (n = 12) and able-bodied controls (n = 13). Seven participants with tetraplegia were able to generate some electromyography (EMG) activity during attempted grasping, whereas the other five were not. The peak and area of ERD were significantly decreased for individuals without volitional muscle activity when they attempted to grasp compared with able-bodied subjects and participants with SCI,with some residual EMG activity. However, no significant differences were found between subject groups during mentally simulated tasks (i.e., motor imagery) where no muscle activity or somatosensory consequences were expected. These findings suggest that individuals who are unable to produce muscle activity are capable of generating ERD when attempting to move, but the characteristics of this ERD are altered. However, for people who maintain volitional muscle activity after SCI, there are no significant differences in ERD characteristics compared with able-bodied controls. These results provide evidence that ERD is dependent on the level of intact muscle activity after SCI.

NEW & NOTEWORTHY Source space MEG was used to investigate sensorimotor cortical oscillations in individuals with SCI. This study provides evidence that individuals with cervical SCI exhibit decreased ERD when they attempt to grasp if they are incapable of generating muscle activity. However, there were no significant differences in ERD between paralyzed and able-bodied participants during motor imagery. These results have important implications for the design and evaluation of new therapies, such as motor imagery and neurofeedback interventions.



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Lethal digenic mutations in the K+ channels Kir4.1 (KCNJ10) and SLACK (KCNT1) associated with severe-disabling seizures and neurodevelopmental delay

A 2-yr-old boy presented profound developmental delay, failure to thrive, ataxia, hypotonia, and tonic-clonic seizures that caused the death of the patient. Targeted and whole exome sequencing revealed two heterozygous missense variants: a novel mutation in the KCNJ10 gene that encodes for the inward-rectifying K+ channel Kir4.1 and another previously characterized mutation in KCNT1 that encodes for the Na+-activated K+ channel known as Slo2.2 or SLACK. The objectives of this study were to perform the clinical and genetic characterization of the proband and his family and to examine the functional consequence of the Kir4.1 mutation. The mutant and wild-type KCNJ10 constructs were generated and heterologously expressed in Xenopus laevis oocytes, and whole cell K+ currents were measured using the two-electrode voltage-clamp technique. The KCNJ10 mutation c.652C>T resulted in a p.L218F substitution at a highly conserved residue site. Wild-type KCNJ10 expression yielded robust Kir current, whereas currents from oocytes expressing the mutation were reduced, remarkably. Western Blot analysis revealed reduced protein expression by the mutation. Kir5.1 subunits display selective heteromultimerization with Kir4.1 constituting channels with unique kinetics. The effect of the mutation on Kir4.1/5.1 channel activity was twofold: a reduction in current amplitudes and an increase in the pH-dependent inhibition. We thus report a novel loss-of-function mutation in Kir4.1 found in a patient with a coexisting mutation in SLACK channels that results in a fatal disease.

NEW & NOTEWORTHY We present and characterize a novel mutation in KCNJ10. Unlike previously reported EAST/SeSAME patients, our patient was heterozygous, and contrary to previous studies, mimicking the heterozygous state by coexpression resulted in loss of channel function. We report in the same patient co-occurrence of a KCNT1 mutation resulting in a more severe phenotype. This study provides new insights into the phenotypic spectrum and to the genotype-phenotype correlations associated with EAST/SeSAME and MMFSI.



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The absence or temporal offset of visual feedback does not influence adaptation to novel movement dynamics

Delays in transmitting and processing sensory information require correctly associating delayed feedback to issued motor commands for accurate error compensation. The flexibility of this alignment between motor signals and feedback has been demonstrated for movement recalibration to visual manipulations, but the alignment dependence for adapting movement dynamics is largely unknown. Here we examined the effect of visual feedback manipulations on force-field adaptation. Three subject groups used a manipulandum while experiencing a lag in the corresponding cursor motion (0, 75, or 150 ms). When the offset was applied at the start of the session (continuous condition), adaptation was not significantly different between groups. However, these similarities may be due to acclimation to the offset before motor adaptation. We tested additional subjects who experienced the same delays concurrent with the introduction of the perturbation (abrupt condition). In this case adaptation was statistically indistinguishable from the continuous condition, indicating that acclimation to feedback delay was not a factor. In addition, end-point errors were not significantly different across the delay or onset conditions, but end-point correction (e.g., deceleration duration) was influenced by the temporal offset. As an additional control, we tested a group of subjects who performed without visual feedback and found comparable movement adaptation results. These results suggest that visual feedback manipulation (absence or temporal misalignment) does not affect adaptation to novel dynamics, independent of both acclimation and perceptual awareness. These findings could have implications for modeling how the motor system adjusts to errors despite concurrent delays in sensory feedback information.

NEW & NOTEWORTHY A temporal offset between movement and distorted visual feedback (e.g., visuomotor rotation) influences the subsequent motor recalibration, but the effects of this offset for altered movement dynamics are largely unknown. Here we examined the influence of 1) delayed and 2) removed visual feedback on the adaptation to novel movement dynamics. These results contribute to understanding of the control strategies that compensate for movement errors when there is a temporal separation between motion state and sensory information.



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Model of rhythmic ball bouncing using a visually controlled neural oscillator

The present paper investigates the sensory-driven modulations of central pattern generator dynamics that can be expected to reproduce human behavior during rhythmic hybrid tasks. We propose a theoretical model of human sensorimotor behavior able to account for the observed data from the ball-bouncing task. The novel control architecture is composed of a Matsuoka neural oscillator coupled with the environment through visual sensory feedback. The architecture's ability to reproduce human-like performance during the ball-bouncing task in the presence of perturbations is quantified by comparison of simulated and recorded trials. The results suggest that human visual control of the task is achieved online. The adaptive behavior is made possible by a parametric and state control of the limit cycle emerging from the interaction of the rhythmic pattern generator, the musculoskeletal system, and the environment.

NEW & NOTEWORTHY The study demonstrates that a behavioral model based on a neural oscillator controlled by visual information is able to accurately reproduce human modulations in a motor action with respect to sensory information during the rhythmic ball-bouncing task. The model attractor dynamics emerging from the interaction between the neuromusculoskeletal system and the environment met task requirements, environmental constraints, and human behavioral choices without relying on movement planning and explicit internal models of the environment.



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Object comparison in the lateral intraparietal area

We can search for and locate specific objects in our environment by looking for objects with similar features. Object recognition involves stimulus similarity responses in ventral visual areas and task-related responses in prefrontal cortex. We tested whether neurons in the lateral intraparietal area (LIP) of posterior parietal cortex could form an intermediary representation, collating information from object-specific similarity map representations to allow general decisions about whether a stimulus matches the object being looked for. We hypothesized that responses to stimuli would correlate with how similar they are to a sample stimulus. When animals compared two peripheral stimuli to a sample at their fovea, the response to the matching stimulus was similar, independent of the sample identity, but the response to the nonmatch depended on how similar it was to the sample: the more similar, the greater the response to the nonmatch stimulus. These results could not be explained by task difficulty or confidence. We propose that LIP uses its known mechanistic properties to integrate incoming visual information, including that from the ventral stream about object identity, to create a dynamic representation that is concise, low dimensional, and task relevant and that signifies the choice priorities in mental matching behavior.

NEW & NOTEWORTHY Studies in object recognition have focused on the ventral stream, in which neurons respond as a function of how similar a stimulus is to their preferred stimulus, and on prefrontal cortex, where neurons indicate which stimulus is being looked for. We found that parietal area LIP uses its known mechanistic properties to form an intermediary representation in this process. This creates a perceptual similarity map that can be used to guide decisions in prefrontal areas.



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Mechanisms for shaping receptive field in monkey area TE

Visual object information is conveyed from V1 to area TE along the ventral visual pathway with increasing receptive field (RF) sizes. The RFs of TE neurons are known to be large, but it is largely unknown how large RFs are shaped along the ventral visual pathway. In this study, we addressed this question in two aspects, static and dynamic mechanisms, by recording neural responses from macaque area TE and V4 to object stimuli presented at various locations in the visual field. As a component related to static mechanisms, we found that in area TE, but not in V4, response latency to objects presented at fovea were different from objects in periphery. As a component of the dynamic mechanisms, we examined effects of spatial attention on the RFs of TE neurons. Spatial attention did not affect response latency but modulated response magnitudes depending on attended location, shifting of the longitudinal axis of RFs toward the attended locations. In standard models of large RF formation, downstream neurons pool information from nearby RFs, and this process is repeated across the visual field and at each step along the ventral visual pathway. The present study revealed that this mechanism is not that simple: 1) different circuit mechanisms for foveal and peripheral visual fields may be situated between V4 and area TE, and 2) spatial attention dynamically changes the shape of RFs.

NEW & NOTEWORTHY Receptive fields (RFs) of neurons are progressively increased along the ventral visual pathway so that an RF at the final stage, area TE, covers a large area of the visual field. We explored the mechanism and suggested involvement of parallel circuit mechanisms between V4 and TE for foveal and peripheral parts of visual field. We also found a dynamic component of RF shape formation through attentional modulation of responses in a location-dependent manner.



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Short-term Prospective Questionnaire Study of Early Postoperative Quality of Life After Colorectal Endoscopic Submucosal Dissection

Abstract

Background

Endoscopic submucosal dissection (ESD) has become popular as an alternative to laparoscopy-assisted colectomy (LAC) for early colorectal cancer.

Aim

To validate postoperative quality of life (QOL) based on subjective symptoms of patients from questionnaire survey.

Methods

We prospectively enrolled patients planned to undergo ESD for adenoma or Tis/T1a cancer at our institution between December 2011 and January 2013. Controls were prospectively enrolled LAC patients diagnosed with T1b cancer. Patients answered questionnaire survey on QOL on postoperative day (POD) 1 and POD14. Questions were scored using visual analog scale (0 points = worst condition, 100 points = best condition) and were classified into six categories: health status, mental status (MeS), motor status (MoS), bodily painless, passage and anorectal function (PAF), and stress for the treatment. Total score was also calculated. We compared the median scores among categories using the Wilcoxon rank-sum test.

Results

A total of 82 ESDs and 41 LACs were included. Median score for the factors in questionnaire (POD1/POD14) in ESDs versus LACs for colonic lesion (rectal lesion) was as follows: MeS, 74/83 versus 54/73 (72/85 vs. 42/62); MoS, 98/96 versus 51/75 (95/90 vs. 66/67); PAF, 90/96 versus 80/80 (90/95 vs. 70/53); total score, 83/91 versus 58/75 (81/87 vs. 51/66). These items showed statistical significant differences between ESDs and LACs.

Conclusions

Postoperative QOL and symptoms are significantly better on POD1 and POD14 following ESD compared with LAC.



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Stress Hormone Cortisol Enhances Bcl2 Like-12 Expression to Inhibit p53 in Hepatocellular Carcinoma Cells

Abstract

Background and Aims

The pathogenesis of hepatocellular carcinoma (HC) is unclear. It is suggested that psychological stress associates with the pathogenesis of liver cancer. Bcl2-like protein 12 (Bcl2L12) suppresses p53 protein. This study tests a hypothesis that the major stress hormone, cortisol, inhibits the expression of p53 in HC cells (HCC) via up regulating the expression of Bcl2L12.

Methods

Peripheral blood samples were collected from patients with HC to be analyzed for the levels of cortisol. HCC were cultured to assess the role of cortisol in the regulation of the expression of Bcl2L12 and p53 in HCC.

Results

We observed that the serum cortisol levels were higher in HC patients. Expression of Bcl2L12 in HCC was correlated with serum cortisol. Cortisol enhanced the Bcl2L12 expression in HCC. Bcl2L12 binding to the TP53 promoter was correlated with p53 expression in HCC. Cortisol increased the Bcl2L12 expression in HCC to inhibit p53 expression.

Conclusions

Stress hormone cortisol suppresses p53 in HCC via enhancing Bcl2L12 expression in HCC. The results suggest that cortisol may be a therapeutic target for the treatment of HC.



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Specialty Care Access Network-Extension of Community Healthcare Outcomes Model Program for Liver Disease Improves Specialty Care Access

Abstract

Background and Aims

To improve subspecialty access, VA Ann Arbor Healthcare System (VAAAHS) implemented the first Specialty Care Access Network (SCAN)-Extension of Community Healthcare Outcomes (ECHO) in chronic liver disease. SCAN-ECHO Liver links primary care providers (PCPs) to hepatologists via secure video-teleconferencing. We aim to describe characteristics of participants (PCPs) and patients (clinical question and diagnosis) in SCAN-ECHO Liver.

Methods

This is a prospective study of the VAAAHS SCAN-ECHO Liver (June 10, 2011–March 31, 2015). This evaluation was carried out as a non-research activity under the guidance furnished by VHA Handbook 1058.05. It was approved through the Medicine Service at VAAAHS as noted in the attestation document which serves as documentation of approved non-research, quality improvement activities in VHA.

Results

In total, 106 PCPs from 23 sites participated. A total of 155 SCAN-ECHO sessions discussed 519 new and 49 return patients. 29.4% of Liver Clinic requests were completed in SCAN-ECHO Liver. SCAN-ECHO Liver consults were completed an average of 10 days sooner than in conventional clinic. Potential travel saving was 250 miles round-trip (median 255 (IQR 142–316) per patient.

Conclusion

SCAN-ECHO Liver provided specialty care with increased efficiency and convenience for chronic liver disease patients. One of three of Liver Clinic consults was diverted to SCAN-ECHO Liver, reducing consult completion time by 20%.



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Fecal Calprotectin in Monitoring the Disease Activity in Colonic Inflammatory Bowel Disease



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Factors Associated with Surveillance Adenoma and Sessile Serrated Polyp Detection Rates

Abstract

Background

Adenoma detection rate (ADR) and sessile serrated polyp detection rate (SSPDR) data in surveillance colonoscopy are limited.

Aims

Our aim was to determine surveillance ADR and SSPDR and identify associated predictors.

Methods

A retrospective review of subjects who underwent surveillance colonoscopy for adenoma and/or SSP at an academic center was performed. The following exclusion criteria were applied: prior colonoscopy ≤ 3 years, incomplete examination, or another indication for colonoscopy. Patient, endoscopist, and procedure characteristics were collected. Predictors were identified using multivariable logistic regression.

Results

Of 3807 colonoscopies, 2416 met inclusion criteria. Surveillance ADR was 49% and, SSPDR was 8%. Higher ADR was associated with: age per year (OR 1.03; 95% CI 1.02–1.04), male gender (OR 1.55; 95% CI 1.29–1.88), BMI per kg/m2 (OR 1.02; 95% CI 1.01–1.04), withdrawal time per minute (OR 1.09; 95% CI 1.07–1.10), and endoscopists' screening ADR (OR 1.01; 95% CI 1.00–1.03). Years since training (OR 0.99; 95% CI 0.98–0.99) was associated with lower ADR. Family history of CRC (OR 1.58; 95% CI 1.02–2.27) and endoscopists' screening ADR (OR 1.40; 95% CI 1.15–1.74) were associated with higher SSPDR. African-American race (OR 0.36; 95% CI 0.10–0.75) and diabetes (OR 0.41; 95% CI 0.21–0.76) were associated with lower SSPDR.

Conclusions

For surveillance colonoscopy, nearly half of patients had an adenoma and one in twelve had an SSP. In addition to established factors, BMI, endoscopists' screening ADR, and years since training were associated with ADR, whereas African-American race and diabetes were inversely associated with SSPDR. Further studies are needed prior to integrating surveillance ADR and SSPDR into quality metrics.



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"Two-hand-manoeuver" during nasotracheal intubation.

Related Articles

"Two-hand-manoeuver" during nasotracheal intubation.

Saudi J Anaesth. 2017 Oct-Dec;11(4):512

Authors: Solanki SL, Kaur J

PMID: 29033749 [PubMed]



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Gum elastic bougie as a guide in nasotracheal intubation: A novel technique.

Related Articles

Gum elastic bougie as a guide in nasotracheal intubation: A novel technique.

Saudi J Anaesth. 2017 Oct-Dec;11(4):503

Authors: Bhat Pai RV, Kamat S, Kambli D

PMID: 29033742 [PubMed]



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Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer

Abstract

Introduction

A growing number of patients with obstructive colorectal cancer are being treated with self-expanding metallic stents (SEMS) followed by laparoscopic resection. The aim of this study was to assess the feasibility of stent insertion and laparoscopic surgery for obstructive colorectal cancer and to compare these outcomes to regular laparoscopic surgery for non-obstructive colorectal cancer.

Methods

We retrospectively analyzed the outcomes of patients with a malignant colonic obstruction who underwent SEMS placement followed by elective laparoscopic resection. The comparison was made between stent-laparoscopy and laparoscopy alone for non-obstructive colorectal cancer.

Results

Colonic stenting as a bridge to surgery was successful in 97.1% of all cases. Fifteen patients underwent an elective laparoscopic surgery for left-sided colon and rectal cancer after SEMS. The mean interval from SEMS insertion to laparoscopic surgery was 21.5 days. There was no conversion to open surgery and no need for a diverting stoma. One patient (6.7%) experienced paralytic ileus. Our comparison of stent-laparoscopy to regular laparoscopy for non-obstructive colorectal cancer treatment showed comparable short-term postoperative outcomes with the exception of blood loss, which was greater in the stent-laparoscopy group.

Conclusion

Elective laparoscopic surgery after colonic stenting is a safe and feasible strategy for the treatment of an acute malignant colonic obstruction.



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Proper training in laparoscopic hernia repair is necessary to minimize the rising recurrence rate in Japan

Abstract

Introduction

The Japan Society for Endoscopic Surgery reported that the recurrence rate for inguinal hernia repair in Japan was less than 1% in 2010. However, its 2012 survey found that the recurrence rate had increased to 4% for the transabdominal preperitoneal procedure and 5% for the totally extraperitoneal procedure. We held 14 hernia repair training courses from 2011 to 2016 with help from Covidien. This study aimed to determine the effect of this training on the recurrence rate.

Methods

Training was composed of a theoretical revision of inguinal anatomy, dry laboratory suturing, a video lecture, and practice on an animal model. We made inquiries about the length of each surgeon's career, post-training changes in surgical methods, and recurrence rates before and after training.

Results

We received responses from 159 of 300 trainees (53%). The mean career length was 12.7 ± 8.2 years. The annual number of transabdominal preperitoneal procedures performed increased from 20.9 ± 29.9 to 32.4 ± 56.1 after training (P < 0.001), and the number of totally extraperitoneal procedures increased from 9.5 ± 13.9 to 13.9 ± 16.9 (P = 0.0218). The annual number of procedures performed via the anterior approach decreased from 153.1 ± 28.4 to 28.4 ± 52.2 after training (P < 0.001). The pre-training transabdominal preperitoneal procedure recurrence rate was 0.9%, and this decreased to 0.4% after training. There was no pre-training recurrence rate for the totally extraperitoneal procedure, but this was 0.4% after training.

Conclusion

The high recurrence rate after inguinal hernia repair in Japan was mainly due to inadequate training in the laparoscopic method. Our laparoscopic hernia repair training course achieved low recurrence rates.



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Determination of the optimal depth of a left internal jugular venous catheter in infants: A prospective observational study

Summary

Background

Few reports exist regarding the optimal depth of a left-sided central venous catheter in pediatric patients. We aimed to provide a guideline for the optimal depth of central venous catheters at the left internal jugular vein in infants, using anatomical landmarks, age, height, and weight.

Methods

A two-stage study was conducted. In the first observational study, infants aged ≤1 year and scheduled for elective surgery requiring a central venous catheter were enrolled. The tip of the central venous catheter was confirmed using transthoracic echocardiography. Linear regression modeling was performed to determine the association between the insertion depth of the central venous catheter and the I-A-B distance (I, the insertion point; A, the sternal head of the left clavicle; B, the midpoint of the perpendicular line drawn between the sternal head of the right clavicle and an imaginary line between the nipples), based on age, height, and weight. In the second study, the results of the first study were validated in another group of consecutive infants.

Results

In the first study, the data of 67 patients were analyzed. The infant's height and I-A-B distance were highly correlated with the level of the central venous catheter tip (R2=0.763 and 0.772, respectively; all < .01), using the regression equations 0.11 ×  height (cm) + 0.19 and 1.02 ×  I-A-B (cm) + 1.55, respectively. In the second study, height was also highly correlated with the insertion depth of the central venous catheter in another 42 infants (r = .938, = <.001). In a Bland-Altman's analysis, the mean bias and precision of the actual insertion depth and predicted depth using height were 0.09 and 0.15 cm, respectively. The limits of agreement were −0.19 and 0.38 cm, respectively.

Conclusion

In infants, the optimal depth of a central venous catheter at the left internal jugular vein can be determined with a simple formula using height.



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Optimal management of apparatus dead space in the anesthetized infant

Summary

Mechanical ventilation of the anesthetized infant requires careful attention to equipment and ventilator settings to assure optimal gas exchange and minimize the potential for lung injury. Apparatus dead space, defined as dead space resulting from devices placed between the endotracheal tube and the Y-piece of the breathing circuit, is the primary source of dead space controlled by the clinician. Due to the small tidal volumes required by infants and neonates, it is easy to create excessive apparatus dead space resulting in unintended hypercarbia or increased minute ventilation in an effort to achieve a desirable PCO2. The goal of this review was to evaluate the apparatus that are commonly added to the breathing circuit during anesthesia care, and develop recommendations to guide the clinician in selecting apparatus that are best matched to the clinical goals and the patient's size. We include specific recommendations for apparatus that are best suited for different size pediatric patients, with a particular focus on patients <5 kg.



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Openness to experience and adapting to change: Cardiovascular stress habituation to change in acute stress exposure

Abstract

Underlying psychophysiological mechanisms of effect linking openness to experience to health outcomes, and particularly cardiovascular well-being, are unknown. This study examined the role of openness in the context of cardiovascular responsivity to acute psychological stress. Continuous cardiovascular response data were collected for 74 healthy young female adults across an experimental protocol, including differing counterbalanced acute stressors. Openness was measured via self-report questionnaire. Analysis of covariance revealed openness was associated with systolic blood pressure (SBP; p = .016), and diastolic blood pressure (DBP; p = .036) responsivity across the protocol. Openness was also associated with heart rate (HR) responding to the initial stress exposure (p = .044). Examination of cardiovascular adaptation revealed that higher openness was associated with significant SBP (p = .001), DBP (p = .009), and HR (p = .002) habituation in response to the second differing acute stress exposure. Taken together, the findings suggest persons higher in openness are characterized by an adaptive cardiovascular stress response profile within the context of changing acute stress exposures. This study is also the first to demonstrate individual differences in cardiovascular adaptation across a protocol consisting of differing stress exposures. More broadly, this research also suggests that future research may benefit from conceptualizing an adaptive fitness of openness within the context of change. In summary, the present study provides evidence that higher openness stimulates short-term stress responsivity, while ensuring cardiovascular habituation to change in stress across time.



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Dynamics of cognitive control: Theoretical bases, paradigms, and a view for the future

Abstract

Cognitive control (with the closely related concepts of attention control and executive function) encompasses the collection of processes that are involved in generating and maintaining appropriate task goals and suppressing task goals that are no longer relevant, as well as the way in which current goal representations are used to modify attentional biases to improve task performance. Here, we provide a comprehensive but nonexhaustive review of this complex literature, with an emphasis on the contributions made by techniques for studying human brain function. The review is divided into five sections: (a) overview and historical perspective of cognitive control, its subcomponent processes, and its neural substrate; (b) most common types of tasks used to assess and/or manipulate the level of control; (c) main research findings obtained with various imaging methodologies, with a focus on ERP data, and briefer overviews of oscillatory (event-related spectral perturbations) and fMRI data; (d) major theories of cognitive control; and (e) discussion of open questions regarding how to integrate the various dimensions of control, as well as the faster versus slower temporal dynamics informing this complex and multifaceted concept.



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