Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 663-663
DOI: 10.1055/s-0043-118833
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 656-658
DOI: 10.1055/s-0043-118984
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 691-702
DOI: 10.1055/s-0042-120237
Ausgewählte Regionalanästhesieverfahren sind für den ambulant tätigen Anästhesisten eine attraktive Alternative zu Analgosedierung und Narkose – und dies bei hoher Patientenzufriedenheit und seltenen Komplikationen. Dieser Beitrag widmet sich den organisatorischen und hygienischen Anforderungen, die es dabei zu beachten gilt. Des Weiteren gehen die Autoren auf einzelne Verfahren und ihre Anwendung in unterschiedlichen Körperregionen näher ein.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 658-658
DOI: 10.1055/s-0043-117035
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 666-678
DOI: 10.1055/s-0042-120247
Ambulante Operationen werden künftig zunehmend nachgefragt werden – Ursachen sind u. a. die alternde Bevölkerung und die finanzielle Lage der Krankenkassen. Der Beitrag geht ausführlich auf Begleiterkrankungen ein, bei denen die Entscheidung ambulant oder stationär sorgfältig abgewogen werden muss. Darüber hinaus nimmt er die betriebs- und volkswirtschaftlichen Grenzen und Möglichkeiten des ambulanten Operierens unter die Lupe.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 659-660
DOI: 10.1055/s-0043-117055
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 716-725
DOI: 10.1055/s-0042-120989
Der zerebrale Notfall ist eine häufige Notfallsituation – und das Gehirn unterscheidet sich durch seine Unersetzbarkeit und minimale Ischämietoleranz von allen anderen Organen. Dieser Beitrag verwendet bewusst den Begriff des zerebralen Notfalls und will sich so von einzelnen Erkrankungsbildern lösen. Der Fokus liegt auf der anästhesiologischen Praxis, aber auch auf dem „Notfall in uns", den jeder Notfall für das Behandlungsteam bedeuten kann.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 660-660
DOI: 10.1055/s-0043-112726
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 664-665
DOI: 10.1055/s-0043-118408
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 662-663
DOI: 10.1055/s-0043-118974
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 679-690
DOI: 10.1055/s-0042-120238
Ambulante Anästhesie erfolgt immer im Rahmen einer ambulanten Operation – somit hängt der Erfolg davon ab, wie gut die „Einheit ambulantes Operieren" organisiert und aufeinander abgestimmt ist. Dieser Beitrag beleuchtet die vielen rechtlichen Vorgaben, die es beim ambulanten Operieren und Anästhesieren zu erfüllen gilt. Darüber hinaus werden die Organisationsstrukturen im niedergelassenen Bereich und im Krankenhaus erläutert und verglichen.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 662-662
DOI: 10.1055/s-0043-118976
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 704-715
DOI: 10.1055/s-0043-100231
Im Rahmen eines operativen Eingriffs erhalten Patienten zahlreiche Arzneimittel. Entwickeln sie eine anaphylaktische Reaktion, so ist akut schwer zu beurteilen, welche Substanz für diese verantwortlich ist. Die meisten der intraoperativen Einschätzungen zur Ursache einer Anaphylaxie sind falsch. Umso wichtiger ist es, die verursachende Substanz später zu identifizieren, um eine Reexposition, z. B. bei einer erneuten OP, zu verhindern.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 727-736
DOI: 10.1055/s-0043-104921
In der „Whatʼs New in Obstetric Anesthesia" Lecture, die jedem an der anästhesiologischen Kreißsaalversorgung Interessierten in abgedruckter Form sehr ans Herz gelegt werden kann, werden seit 1975 durch die Society for Obstetric Anesthesia and Perinatology die im Rahmen des Annual Meeting als relevant für die klinische Versorgung erachteten Vorträge zusammengefasst. Nach dem Tode von Gerard W. Ostheimer, Professor of Anesthesiology im Brigham and Womenʼs Hospital in Boston, Massachusetts, wurde sie zur Gerard W. Ostheimer „Whatʼs New in Obstetric Anesthesia" Lecture umbenannt, um dessen Beiträge zur Regionalanästhesie und geburtshilflichen Anästhesie zu würdigen. Jedes Jahr gewährt die von ausgewählten Fachvertretern gehaltene Veranstaltung und ihr Abdruck in namhaften Anästhesie-Journalen Einblick in eine kritische Würdigung rezenter Literatur und die möglichen Konsequenzen für – aber nicht nur – die anästhesiologische Kreißsaalpraxis.Eine ähnliche Veranstaltung hat in Deutschland seit über 16 Jahren Tradition: Das Geburtshilfliche Anästhesiesymposium des Wissenschaftlichen Arbeitskreises Regionalanästhesie und Geburtshilfliche Anästhesie. Anders als in den von Einzelpersonen gehaltenen Vortragsveranstaltungen werden „Evergreens" oder „Hot Topics" der anästhesiologischen Kreißsaalversorgung in regelmäßigem Zyklus oder aus aktuellem Anlass aufgegriffen, präsentiert und vor allem diskutiert. In den Vortragsveranstaltungen offenbart sich oft wesentlich früher als in traditionellen Lehrbuchkapiteln der subtile Wandel in Hinblick auf die diskutierten Themen.Der 2-teilige Beitrag fasst das Symposium 2016 zusammen, stellt jedoch keine offizielle Meinungsbekundung seitens des Arbeitskreises dar. Teil 1 geht auf mütterliche Todesursachen während Schwangerschaft, Geburt und Stillzeit sowie strukturelle Voraussetzungen im Kreißsaal, Adipositas in der Schwangerschaft und Sepsis bei der Schwangeren und im Wochenbett ein. Teil 2 behandelt etablierte Standards und neue Perspektiven im Rahmen der geburtshilflichen Analgesie und Anästhesie bezüglich Epiduralanalgesie, postpunktionellem Kopfschmerz, Anästhesie und Analgesie während und nach Sectio, hämodynamischem Monitoring und postpartaler Blutung.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 656-656
DOI: 10.1055/s-0043-118982
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 630-639
DOI: 10.1055/s-0043-114676
Remifentanil wird seit 20 Jahren mit Erfolg in vielen Bereichen der Anästhesiologie eingesetzt. Im 1. Teil wurde die Substanz mit ihren pharmakologischen Charakteristika sowie ihren erwünschten und unerwünschten Wirkungen beschrieben. Der hier vorliegende 2. Teil befasst sich mit der Anwendung des Opioids bei speziellen Patientengruppen und in den verschiedenen anästhesiologisch betreuten Fachdisziplinen.
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Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 645-648
DOI: 10.1055/s-0043-114467
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 588-593
DOI: 10.1055/s-0043-116913
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 586-586
DOI: 10.1055/s-0042-120977
Georg Thieme Verlag KG Stuttgart · New York
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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 579-580
DOI: 10.1055/s-0043-116930
Georg Thieme Verlag KG Stuttgart · New York
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Autosomal drivers violate Mendel's law of segregation in that they are overrepresented in gametes of heterozygous parents. For drivers to be polymorphic within populations rather than fixing, their transmission advantage must be offset by deleterious effects on other fitness components. In this paper we develop an analytical model for the evolution of autosomal drivers that is motivated by the neocentromere drive system found in maize. In particular we model both the transmission advantage and deleterious fitness effects on seed viability, pollen viability, seed to adult survival mediated by maternal genotype, and seed to adult survival mediated by offspring genotype. We derive general, biologically intuitive, conditions for the four most likely evolutionary outcomes and discuss the expected evolution of autosomal drivers given these conditions. Finally, we determine the expected equilibrium allele frequencies predicted by the model given recent estimates of fitness components for all relevant genotypes and show that the predicted equilibrium is within the range observed in maize land races for levels of drive at the low end of what has been observed.
Nonsense-mediated mRNA decay (NMD) is a conserved pathway that strongly influences eukaryotic gene expression. Inactivating or inhibiting NMD affects the abundance of a substantial fraction of the transcriptome in numerous species. Transcripts whose abundance is altered in NMD-deficient cells may represent either direct substrates of NMD or indirect effects of inhibiting NMD. We present a genome-wide investigation of the direct substrates of NMD in Caenorhabditis elegans. Our goals were (i) to identify mRNA substrates of NMD and (ii) to distinguish those mRNAs from others whose abundance is indirectly influenced by the absence of NMD. We previously demonstrated that Upf1p/SMG-2, the central effector of NMD in all studied eukaryotes, preferentially associates with mRNAs that contain premature translation termination codons. We used this preferential association to distinguish direct from indirect effects by coupling immunopurification of Upf1/SMG-2 with high-throughput mRNA sequencing of NMD-deficient mutants and NMD-proficient controls. We identify 680 substrates of NMD, 171 of which contain novel spliced forms that (i) include sequences of annotated introns and (ii) have not been previously documented in the C. elegans transcriptome. NMD degrades unproductively spliced mRNAs with sufficient efficiency in NMD-proficient strains that such mRNAs were not previously known. Two classes of genes are enriched among the identified NMD substrates: (i) mRNAs of expressed pseudogenes and (ii) mRNAs of gene families whose gene number has recently expanded in the C. elegans genome. Our results identify novel NMD substrates and provide a context for understanding NMD's role in normal gene expression and genome evolution.
Environmental opportunistic pathogens can exploit vulnerable hosts through expression of traits selected for in their natural environments. Pathogenicity is a complicated trait underpinned by multiple complex traits, such as thermotolerance, morphology, and stress response. The baker's yeast, Saccharomyces cerevisiae, is a species with broad environmental tolerance which has been increasingly reported as an opportunistic pathogen of humans. Here we leveraged the genetic resources available in yeast and a model insect species, the greater waxmoth Galleria mellonella, to provide a genome-wide analysis of pathogenicity factors. Using serial passaging experiments of genetically marked wild-type strains, a hybrid strain was identified as the most fit genotype across all replicates. To dissect the genetic basis for pathogenicity in the hybrid isolate, bulk segregant analysis was performed which revealed 8 quantitative trait loci significantly differing between the two bulks with alleles from both parents contributing to pathogenicity. A second passaging experiment with a library of deletion mutants for most yeast genes identified a large number of mutations whose relative fitness differed in vivo versus in vitro, including mutations in genes controlling cell wall integrity, mitochondrial function, and tyrosine metabolism. Yeast is presumably subjected to a massive assault by the innate insect immune system that leads to melanization of the host and to a large bottleneck in yeast population size. Our data support that resistance to the innate immune response of the insect is key to survival in the host and identifies shared genetic mechanisms between S. cerevisiae and other opportunistic fungal pathogens.
While cancer-induced skeletal muscle wasting has been widely investigated, the drivers of cancer-induced muscle functional decrements are only beginning to be understood. Decreased muscle function impacts cancer patient quality of life and health status, and several potential therapeutics have failed in clinical trials due to a lack of functional improvement. Furthermore, systemic inflammation and intrinsic inflammatory signaling's role in the cachectic disruption of muscle function requires further investigation. We examined skeletal muscle functional properties during cancer cachexia and determined their relationship to systemic and intrinsic cachexia indices. Male ApcMin/+ (MIN) mice were stratified by percent body weight loss into weight stable (WS; <5% loss) or cachectic (CX; >5% loss). Age-matched C57BL/6 littermates served as controls. Tibialis anterior (TA) twitch properties, tetanic force, and fatigability were examined in situ. TA protein and mRNA expression were examined in the non-stimulated leg. CX decreased muscle mass, tetanic force (Po), and specific tetanic force (sPo). Whole body and muscle fatigability were increased in WS and CX. CX had slower contraction rates, +dP/dt and -dP/dT, which were inversely associated with muscle STAT3 and P65 activation. STAT3 and P65 activation were also inversely associated with Po. However, STAT3 was not related to sPo or fatigue. Muscle SOCS3 mRNA expression was negatively associated with TA weight, Po, and sPo, but not fatigue. Our study demonstrates that multiple functional deficits that occur with cancer cachexia are associated with increased muscle inflammatory signaling. Notably, muscle fatigability is increased in the MIN mouse before cachexia development.
Muscle disuse results in the loss of muscular strength and size, due to an imbalance between protein synthesis (MPS) and breakdown (MPB). Protein ingestion stimulates MPS, although it is not established if protein is able to attenuate muscle loss with immobilization (IM) or influence the recovery consisting of ambulatory movement followed by resistance training (RT). Thirty men (49.9±0.6 years) underwent 14 days of unilateral leg IM, 14 days of ambulatory recovery (AR) and a further 6 RT sessions over 14 days. Participants were randomized to consume an additional 20g of dairy protein or placebo with a meal during the intervention. Isometric knee extension strength was reduced following IM (-24.7 ± 2.7 %), partially recovered with AR (-8.6 ± 2.6%) and fully recovered after RT (-0.6 ± 3.4 %), with no effect of supplementation. Thigh muscle cross sectional area decreased with IM (-4.1 ± 0.5 %), partially recovered with AR (-2.1 ± 0.5 %), and increased above baseline with RT (+2.2 ± 0.5 %), with no treatment effect. Myofibrillar MPS, measured using deuterated water, was unaltered by IM, with no effect of protein. During AR MPS was increased only with protein supplementation. Protein supplementation did not attenuate the loss of muscle size and function with disuse or potentiate recovery, but enhanced myofibrillar MPS during AR.
This study tested the hypothesis that intermittent compression of the lower limb would increase blood flow during exercise and post-exercise recovery. Data were collected from 12 healthy individuals (8 men) who performed three minutes of standing plantar flexion exercise. Three conditions were tested: no applied compression (NoComp), compression during the exercise period only (ExComp), and compression during two minutes of standing post-exercise recovery (RecComp). Doppler ultrasound was used to determine superficial femoral artery (SFA) blood flow responses. Mean arterial pressure (MAP) and cardiac stroke volume (SV) were assessed using finger photoplethysmography, with vascular conductance (VC) calculated as VC = SFA flow / MAP. Compared to the NoComp condition, compression resulted in increased MAP during exercise (+3.5 ± 4.1 mmHg, mean ± SD), but not during post-exercise recovery (+1.6 ± 5.9 mmHg). SV increased with compression during both exercise (+4.8 ± 5.1 mL) and recovery (+8.0 ± 6.6 mL) compared to NoComp. There was a greater increase in SFA flow with compression during exercise (+52.1 ± 57.2 mL/min) and during recovery (+58.6 ± 56.7 mL/min). VC immediately following exercise was also significantly greater in the ExComp condition compared to the NoComp condition (+0.57 ± 0.42 mL/min/mmHg) suggesting the observed increase in blood flow during exercise was in part due to changes in VC. Results from this study support the hypothesis that intermittent compression applied during exercise and recovery from exercise results in increased limb blood flow, potentially contributing to changes in exercise performance and recovery.
Recent research indicates that fascia is capable of changing its biomechanical properties. As it, moreover, links the skeletal muscles, forming a body-wide network of multidirectional myofascial continuity, the classical conception of muscles as independent actuators has been challenged. The present synthesis review hence aims to characterize the mechanical relevance of the connective tissue for the locomotor system. Results of cadaveric and animal studies suggest a clinically relevant myofascial force transmission to neighboring structures within one limb (e.g., between synergists) and in the course of muscle-fascia chains (e.g. between leg and trunk). Initial in vivo trials appear to underpin these findings, demonstrating the existence of non-local exercise effects. However, the factors influencing the amount of transmitted force (e.g., age and physical activity) remain controversial as well as the role of the central nervous system within the context of the observed remote exercise effects.
Lateral pelvic lymph node dissection (LPND) is a challenging procedure due to its technical difficulty and higher incidence of surgical morbidity. We compared short-term outcomes between laparoscopic and robotic LPND in patients with rectal cancer.
Between May 2006 and December 2014, prospectively collected data from consecutive patients undergoing robotic or laparoscopic total mesorectal excision (TME) with LPND were retrospectively compared. Patients' demographics, perioperative outcomes, functional results, and initial oncologic outcomes were analyzed.
Fifty and 35 patients underwent robotic or laparoscopic TME with LPND, respectively. Bilateral LPND was performed in 10 patients (20%) in the robotic group and 6 (17.1%) in the laparoscopic group. For unilateral pelvic dissection, the mean operative time was not significantly different between groups (robotic vs. laparoscopic group, 41.0 ± 15.8 min vs. 35.3 ± 13.4 min; P = 0.146), but the EBL was significantly lower in the robotic group (34.6 ± 21.9 mL vs. 50.6 ± 23.8 mL; P = 0.002). Two patients (4.0%) in the robotic group and 7 (20.0%) in the laparoscopic group underwent Foley catheter reinsertion for urinary retention postoperatively (P = 0.029). The mean number of harvested lateral pelvic lymph nodes (LPNs) was 6.6 (range 0–25) in the robotic group and 6.4 (range 1–14) in the laparoscopic group. Pathologic LPN metastatic rate was not different between groups (robotic vs. laparoscopic group, 28.0 vs. 41.2%; P = 0.243). During the median follow-up of 26.3 months, overall recurrence rate was not different between groups (robotic vs. laparoscopic group, 30.0 vs. 31.2%; P = 0.850). Three patients (6.0%) in the robotic group and 4 (11.4%) in the laparoscopic group developed local recurrence (P = 0.653).
Robotic TME with LPND is safe and feasible with favorable short-term surgical outcomes.
Despite recent developments in surgical education, obstacles including inadequate budget, limited human resources, and a scarcity of time have limited its widespread adoption. To provide systematic training for laparoscopic inguinal hernia repair, we had previously developed and validated a checklist to evaluate the recorded performance of transabdominal preperitoneal (TAPP) repair. We had also developed an educational system that included didactic materials based on the TAPP checklist and incorporated remote evaluation and feedback system. The aim of this study was to evaluate the educational impact of the TAPP education system on novice surgeons.
Residents and surgeons from participating hospitals, who had performed 0 or 1 TAPP procedure, were randomly assigned to the intervention group (IG), who trained using this new educational tool, and the control group (CG), who trained using the conventional system. Their surgical videos were rated by blinded raters. All participants performed their first case prior to randomization. The primary outcome was improvement of TAPP checklist score from the first to the third case.
Eighteen participants from 9 institutes were recruited for this study. Seven participants in the IG and 5 participants in the CG were included in the final analysis. The participants in the IG demonstrated significant improvement in their TAPP performance (p = 0.044) from their first case to their third case, whereas their counterparts in the CG failed to make any significant progress during the same period (p = 0.581).
The new TAPP educational system was effective in improving the TAPP performance of novice surgeons.
Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery, together with reduced food intake, loss of gastric reservoir, small bowel bacterial overgrowth and rapid small bowel transit. Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI. The efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear. This review article summarizes relevant studies addressing PERT after gastric resection.
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Current evidence suggests that corticosteroid injection alone expedites the recovery of pain-free ROM in patients with adhesive capsulitis compared to physiotherapy or placebo. However, it remains unclear whether the addition of hydrodilatation with corticosteroid provides improvement in pain-free ROM as well as pain relief.
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Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion.
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4462780848360Chronic dysimmune neuropathies (CDN) are a heterogenous group of acquired inflammatory demyelinating neuropathies including chronic inflammatory demyelinating polyneuropathies (CIDP), Lewis-Sumner Syndrome (LSS), multifocal motor neuropathy (MMN) and other rare entities. CIDP is the most common treatable CDN worldwide. Its prevalence is ranging between approximately 1 to 8.9 cases per 100.000, depending on the diagnostic criteria employed (e.g. AAN or EFNS/PNS criteria) (Laughlin et al., 2009; Lunn et al., 1999; Mahdi-Rogers and Hughes, 2014; Rajabally et al., 2009a, 2009b).
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Epilepsy surgery is a treatment option that can be considered in patients with refractory focal epilepsy. Presurgical identification of the epileptogenic zone, defined as the minimum area of cortex that has to be resected to achieve seizure freedom (Lüders et al., 2006), is essential for a good surgery outcome. Currently 52% to 62% of patients are reported to be seizure free five years after surgery (de Tisi et al., 2011; Hauptman et al., 2012; Jobst and Cascino 2015), suggesting limitations in the presurgical identification of the epileptogenic zone.
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LigaSure has been reported as a safe and effective approach for parenchymal transection in open hepatectomy; however, its roles in laparoscopic hepatectomy (LH) with liver cirrhosis have not been evaluated. The aim of this study was to compare the outcomes of LigaSure vs. Cavitron Ultrasonic Surgical Aspirator (CUSA) for LH in hepatocellular carcinoma (HCC) patients with cirrhosis.
We retrospectively reviewed the medical records of 135 HCC patients with background cirrhosis who underwent pure LH using CUSA (n = 55) or LigaSure (n = 80) for parenchymal transection between January 2015 and May 2017 at West China Hospital of Sichuan University. We performed 1:1 propensity score matching between the LigaSure and CUSA groups. Subsequently, 48 patients were included in each group.
The mean parenchymal transection time (74.3 ± 23.6 vs. 86.3 ± 25.8 min, P = 0.019) in the LigaSure group was obviously shorter than that in the CUSA group. The LigaSure did not increase the intraoperative blood loss or blood transfusion requirement when compared with CUSA. Moreover, the degree of postoperative reperfusion injury and complications were not significantly different between the two groups. Furthermore, there were no significant differences between the two groups regarding 2-year overall survival rate or disease-free survival rate. In addition, the total hospitalization costs (P = 0.032) and intraoperative costs (P = 0.006) per case were significantly lower in the LigaSure group than those in the CUSA group.
The two devices were safe and effective for LH in patients with cirrhosis. The LigaSure method may be a simple, feasible, and cost-effective surgical technique for LH in selected HCC patients with cirrhosis.
Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery, together with reduced food intake, loss of gastric reservoir, small bowel bacterial overgrowth and rapid small bowel transit. Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI. The efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear. This review article summarizes relevant studies addressing PERT after gastric resection.
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As a research scientist, my work tends to focus on scientific investigations. Our group occasionally makes discoveries or has a successful demonstration, and sometimes we can even repeatedly demonstrate someth...
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Muscle force estimation could advance the comprehension of the neuromuscular strategies that diabetic patients adopt to preserve walking ability, which guarantees their independence as they deal with their neu...
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Publication date: Available online 9 November 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Simon Décary, Pierre Frémont, Bruno Pelletier, Michel Fallaha, Belzile Sylvain, Johanne Martel-Pelletier, Pelletier Jean-Pierre, Debbie Feldman, Sylvestre Marie-Pierre, Pascal-André Vendittoli, François Desmeules
Objectiveto assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP).Designprospective diagnostic study.Settingsorthopaedic outpatients clinics (n=2), family medicine clinics (n=2) and community-dwelling.Participantsconsecutive patients (n=279) consulting one of the participating orthopaedic surgeons (n=3) or sport medicine physicians (n=2) for any knee complaint.Interventionsnot applicable.Main Outcome Measureshistory elements and physical examination tests were obtained by a trained physiotherapist blinded to the reference standard: a composite diagnosis including both physical tests and imaging results interpretation performed by an expert physician. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of PFP and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated.Resultstwo hundred seventy-nine participants were evaluated and 75 had a diagnosis of PFP (26.9%). Different combinations of history elements and physical examination tests including the age of participants, knee pain location, difficulty descending stairs, patellar facets palpation, and passive knee extension range of motion were associated with a diagnosis of PFP and used in clusters to accurately discriminate between PFP and non-PFP individuals. Two diagnostic clusters to confirm the presence of PFP yielded a LR+ of 8.7 (95% CI: 5.2-14.6) and three clusters to exclude PFP yielded a LR-: of 0.12 (95% CI: 0.06-0.27).ConclusionDiagnostic clusters combining common history elements and physical examination tests that can accurately diagnose or exclude PFP compared to various knee disorders were developed. External validation is required before clinical use.
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Introduction Most women in the U.S. are employed during pregnancy and work until the month of childbirth. For many, working throughout pregnancy poses little threat to their health; however, women experiencing difficult pregnancies and/or working in strenuous or inflexible jobs may benefit from taking time from work as they approach childbirth, but almost no empirical evidence examines antenatal leave (ANL). Methods Using a national survey of English-speaking women, this paper offers the first national description of ANL and examines state policy predictors of uptake. Results Thirty-seven percent of employed women worked until the week their baby was due. After controlling for characteristics of women and their jobs, living in a state with any or multiple leave laws increased the probability of ANL by 14 and 23% points, respectively. Women living in states with multiple leave laws stopped work almost 2 weeks earlier than women in states without a policy. Discussion Paid leave policies currently being considered at the federal, state, and local levels should consider the potential impact on antenatal leave, in addition to postnatal leave, and how they influence population health.
We are Hiring 2 full time and 2 part time highly motivated and hard working emt's with a $500.00 sign on bonus. here is also a link they can click on to fill out app.
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In addition to the rapid advancement in Next-Generation Sequencing (NGS) technology, clinical panel sequencing is being used increasingly in clinical studies and tests. However, tools that are used in NGS data analysis have not been comparatively evaluated in performance for panel sequencing. This study aimed to evaluate the tools used in the alignment process, the first procedure in bioinformatics analysis, by comparing tools that have been widely used with ones that have been introduced recently. With the accumulated panel sequencing data, detected variant lists were cataloged and inserted into simulated reads produced from the reference genome (h19). The amount of unmapped reads and misaligned reads, mapping quality distribution, and runtime were measured as standards for comparison. As the most widely used tools, Bowtie2 and BWA–MEM each showed explicit performance with AUC of 0.9984 and 0.9970 respectively. Kart, maintaining superior runtime and less number of misaligned read, also similarly possessed high level of AUC (0.9723). Such selection and optimization method of tools appropriate for panel sequencing can be utilized for fields requiring error minimization, such as clinical application and liquid biopsy studies.
Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SCAT) have different structures and metabolic functions and play different roles in the regulation of the mammal endocrine system. However, little is known about morphology and physiological and metabolic functions between VAT and SCAT in fish. We compared the morphological, physiological, and biochemical characteristics of VAT and SCAT in Nile tilapia and measured their functions in energy intake flux, lipolytic ability, and gene expression patterns. SCAT contained more large adipocytes and nonadipocytes than VAT in Nile tilapia. VAT had higher lipid content and was the primary site for lipid deposition. Conversely, SCAT had higher hormone-induced lipolytic activity. Furthermore, SCAT had a higher percentage of monounsaturated and lower polyunsaturated fatty acids than VAT. SCAT had higher mitochondrial DNA, gene expression for fatty acid β-oxidation, adipogenesis, and brown adipose tissue characteristics, but it also had a lower gene expression for inflammation and adipocyte differentiation than VAT. SCAT and VAT have different morphological structures, as well as physiological and metabolic functions in fish. VAT is the preferable lipid deposition tissue, whereas SCAT exhibits higher lipid catabolic activity than VAT. The physiological functions of SCAT in fish are commonly overlooked. The present study indicates that SCAT has specific metabolic characteristics that differ from VAT. The differences between VAT and SCAT should be considered in future metabolism studies using fish as models, either in biomedical or aquaculture studies.
Blood lactate increases during incremental exercise at high-intensity workloads, and limited exercise capacity is a characteristic of obese animals. This study examined whether blood lactate changes in response to incremental exercise is disrupted in obese animals. Muscular and hepatic proteins that are critical in lactate metabolism were also investigated. Rats were randomized to either standard chow (control) or high-fat diet (HFD) groups. All animals underwent an incremental treadmill test after 14 wk of diet intervention. Blood lactate levels were measured before and after the treadmill test. Activities of mitochondrial oxidative phosphorylation and glycolysis were examined in muscle tissues. Proteins in the liver and skeletal muscles that participate in the turnover of blood lactate were determined by Western blot. Running time in the incremental treadmill test decreased in the HFD group, and blood lactate accumulated faster in these animals than in the control group. Animals with HFD had a decreased level of hepatic monocarboxylate transporter 2, the protein responsible for blood lactate uptake in the liver. Skeletal muscles of animals with HFD showed greater glycolytic activity and decreased content of lactate dehydrogenase B, which converts lactate to pyruvate. We conclude that blood lactate accumulated faster during incremental exercise in obese animals and was associated with their decreased exercise performance. Changes in the metabolic pattern of muscles and changes of liver and muscle proteins associated with lactate utilization likely contribute to the abnormal response of blood lactate to incremental exercise in obese animals.
Obesity is a common comorbidity of chronic obstructive pulmonary disease (COPD) and has been associated with worse outcomes. However, it is unknown whether the interaction between obesity and COPD modulates diaphragm shape and consequently its function. The body mass index (BMI) has been used as a correlate of obesity. We tested the hypothesis that the shape of the diaphragm muscle and size of the ring of its insertion in non-COPD and COPD subjects are modulated by BMI. We recruited 48 COPD patients with postbronchiodilator forced expiratory volume in 1 s (FEV1)-to-forced vital capacity (FVC) < 0.7 and 29 age-matched smoker/exsmoker control (non-COPD) subjects, who underwent chest computed tomography (CT) at lung volumes ranging from functional residual capacity (FRC) to total lung capacity (TLC). We then computed maximum principal diaphragm curvature in the midcostal region of the left hemidiaphragm at the end of inspiration during quiet breathing (EI) and at TLC. The radius of maximum curvature of diaphragm muscle increased with BMI in both COPD and non-COPD subjects. The size of diaphragm ring of insertion on the chest wall also increased significantly with increasing BMI. Surprisingly, COPD severity did not appear to cause significant alteration in diaphragm shape except in normal-weight subjects at TLC. Our data uncovered important factors such as BMI, the size of the diaphragm ring of insertion, and disease severity that modulate the structure of the ventilatory pump in non-COPD and COPD subjects.
Inactivity, obesity, and insulin resistance are significant risk factors for the development of Alzheimer's disease (AD). Several studies have demonstrated that diet-induced obesity, inactivity, and insulin resistance exacerbate the neuropathological hallmarks of AD. The aggregation of β-amyloid peptides is one of these hallmarks. β-Site amyloid precursor protein-cleaving enzyme 1 (BACE1) is the rate-limiting enzyme in amyloid precursor protein (APP) processing, leading to β-amyloid peptide formation. Understanding how BACE1 content and activity are regulated is essential for establishing therapies aimed at reducing and/or slowing the progression of AD. Exercise training has been proven to reduce the risk of AD as well as decrease β-amyloid production and BACE1 content and/or activity. However, these long-term interventions also result in improvements in adiposity, circulating metabolites, glucose tolerance, and insulin sensitivity making it difficult to determine the direct effects of exercise on brain APP processing. This review highlights this large void in our knowledge and discusses our current understanding of the direct of effect of exercise on β-amyloid production. We have concentrated on the central role that brain-derived neurotrophic factor (BDNF) may play in mediating the direct effects of exercise on reducing brain BACE1 content and activity as well as β-amyloid production. Future studies should aim to generate a greater understanding of how obesity and exercise can directly alter APP processing and AD-related pathologies. This knowledge could provide evidence-based hypotheses for designing therapies to reduce the risk of AD and dementia.
A reduction in central blood volume can lead to cardiovascular decompensation (i.e., failure to maintain blood pressure). Cooling the forehead and cheeks using ice water raises blood pressure. Therefore, face cooling (FC) could be used to mitigate decreases in blood pressure during central hypovolemia. We tested the hypothesis that FC during central hypovolemia induced by lower-body negative pressure (LBNP) would increase blood pressure. Ten healthy participants (22 ± 2 yr, three women, seven men) completed two randomized LBNP trials on separate days. Trials began with 30 mmHg of LBNP for 6 min. Then, a 2.5-liter plastic bag of ice water (0 ± 0°C) (LBNP+FC) or thermoneutral water (34 ± 1°C) (LBNP+Sham) was placed on the forehead, eyes, and cheeks during 15 min of LBNP at 30 mmHg. Forehead temperature was lower during LBNP+FC than LBNP+Sham, with the greatest difference at 21 min of LBNP (11.1 ± 1.6 vs. 33.9 ± 1.4°C, P < 0.001). Mean arterial pressure was greater during LBNP+FC than LBNP+Sham, with the greatest difference at 8 min of LBNP (98 ± 15 vs. 80 ± 8 mmHg, P < 0.001). Cardiac output was higher during LBNP+FC than LBNP+Sham with the greatest difference at 18 min of LBNP (5.9 ± 1.4 vs. 4.9 ± 1.0 liter/min, P = 0.005). Forearm cutaneous vascular resistance was greater during LBNP+FC than LBNP+Sham, with the greatest difference at 15 min of LBNP (7.2 ± 3.4 vs. 4.9 ± 2.7 mmHg/perfusion units (PU), P < 0.001). Face cooling during LBNP increases blood pressure through increases in cardiac output and vascular resistance.
Increased whole-body fat oxidation (FOx) has been consistently demonstrated in response to moderate intensity continuous exercise training. Completion of high intensity interval training (HIIT) and its more intense form, sprint interval training (SIT), has also been reported to increase FOx in different populations. An explanation for this increase in FOx is primarily peripheral adaptations via improvements in mitochondrial content and function. However, studies examining changes in FOx are less common in response to HIIT or SIT than those determining increases in maximal oxygen uptake which is concerning, considering that FOx has been identified as a predictor of weight gain and glycemic control. In this review, we explored physiological and methodological issues underpinning existing literature concerning changes in FOx in response to HIIT and SIT. Our results show that completion of interval training increases FOx in approximately 50% of studies, with the frequency of increased FOx higher in response to studies using HIIT compared to SIT. Significant increases in β-HAD, citrate synthase, fatty acid binding protein, or FAT/CD36 are likely responsible for the greater FOx seen in these studies. We encourage scientists to adopt strict methodological procedures to attenuate day-to-day variability in FOx, which is dramatic, and develop standardized procedures for assessing FOx, which may improve detection of changes in FOx in response to HIIT.
Self-motion perception was studied in patients with unilateral vestibular lesions (UVL) due to acute vestibular neuritis at 1 wk and 4, 8, and 12 mo after the acute episode. We assessed vestibularly mediated self-motion perception by measuring the error in reproducing the position of a remembered visual target at the end of four cycles of asymmetric whole-body rotation. The oscillatory stimulus consists of a slow (0.09 Hz) and a fast (0.38 Hz) half cycle. A large error was present in UVL patients when the slow half cycle was delivered toward the lesion side, but minimal toward the healthy side. This asymmetry diminished over time, but it remained abnormally large at 12 mo. In contrast, vestibulo-ocular reflex responses showed a large direction-dependent error only initially, then they normalized. Normalization also occurred for conventional reflex vestibular measures (caloric tests, subjective visual vertical, and head shaking nystagmus) and for perceptual function during symmetric rotation. Vestibular-related handicap, measured with the Dizziness Handicap Inventory (DHI) at 12 mo correlated with self-motion perception asymmetry but not with abnormalities in vestibulo-ocular function. We conclude that 1) a persistent self-motion perceptual bias is revealed by asymmetric rotation in UVLs despite vestibulo-ocular function becoming symmetric over time, 2) this dissociation is caused by differential perceptual-reflex adaptation to high- and low-frequency rotations when these are combined as with our asymmetric stimulus, 3) the findings imply differential central compensation for vestibuloperceptual and vestibulo-ocular reflex functions, and 4) self-motion perception disruption may mediate long-term vestibular-related handicap in UVL patients.
NEW & NOTEWORTHY A novel vestibular stimulus, combining asymmetric slow and fast sinusoidal half cycles, revealed persistent vestibuloperceptual dysfunction in unilateral vestibular lesion (UVL) patients. The compensation of motion perception after UVL was slower than that of vestibulo-ocular reflex. Perceptual but not vestibulo-ocular reflex deficits correlated with dizziness-related handicap.
Following the suggestion that a command encoding current target location feeds the oculomotor system during interceptive saccades, we tested the involvement of the deep superior colliculus (dSC). Extracellular activity of 52 saccade-related neurons was recorded in three monkeys while they generated saccades to targets that were static or moving along the preferred axis, away from (outward) or toward (inward) a fixated target with a constant speed (20°/s). Vertical and horizontal motions were tested when possible. Movement field (MF) parameters (boundaries, preferred vector, and firing rate) were estimated after spline fitting of the relation between the average firing rate during the motor burst and saccade amplitude. During radial target motions, the inner MF boundary shifted in the motion direction for some, but not all, neurons. Likewise, for some neurons, the lower boundaries were shifted upward during upward motions and the upper boundaries downward during downward motions. No consistent change was observed during horizontal motions. For some neurons, the preferred vectors were also shifted in the motion direction for outward, upward, and "toward the midline" target motions. The shifts of boundary and preferred vector were not correlated. The burst firing rate was consistently reduced during interceptive saccades. Our study demonstrates an involvement of dSC neurons in steering the interceptive saccade. When observed, the shifts of boundary in the direction of target motion correspond to commands related to past target locations. The absence of shift in the opposite direction implies that dSC activity does not issue predictive commands related to future target location.
NEW & NOTEWORTHY The deep superior colliculus is involved in steering the saccade toward the current location of a moving target. During interceptive saccades, the active population consists of a continuum of cells ranging from neurons issuing commands related to past locations of the target to neurons issuing commands related to its current location. The motor burst of collicular neurons does not contain commands related to the future location of a moving target.
-Amino butyric acid (GABA) and glycine typically mediate synaptic inhibition because their ligand-gated ion channels support the influx of Cl–. However, the electrochemical gradient for Cl– across the postsynaptic plasma membrane determines the voltage response of the postsynaptic cell. Typically, low cytosolic Cl– levels support inhibition, whereas higher levels of cytosolic Cl– can suppress inhibition or promote depolarization. We previously reported that nitric oxide (NO) releases Cl– from acidic organelles and transiently elevates cytosolic Cl–, making the response to GABA and glycine excitatory. In this study, we test the hypothesis that the cystic fibrosis transmembrane conductance regulator (CFTR) is involved in the NO-dependent efflux of organellar Cl–. We first establish the mRNA and protein expression of CFTR in our model system, cultured chick retinal amacrine cells. Using whole cell voltage-clamp recordings of currents through GABA-gated Cl– channels, we examine the effects of pharmacological inhibition of CFTR on the NO-dependent release of internal Cl–. To interfere with the expression of CFTR, we used clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 genome editing. We find that both pharmacological inhibition and CRISPR/Cas9-mediated knockdown of CFTR block the ability of NO to release Cl– from internal stores. These results demonstrate that CFTR is required for the NO-dependent efflux of Cl– from acidic organelles.
NEW & NOTEWORTHY Although CFTR function has been studied extensively in the context of epithelia, relatively little is known about its function in neurons. We show that CFTR is involved in an NO-dependent release of Cl– from acidic organelles. This internal function of CFTR is particularly relevant to neuronal physiology because postsynaptic cytosolic Cl– levels determine the outcome of GABA- and glycinergic synaptic signaling. Thus the CFTR may play a role in regulating synaptic transmission.
We used suction electrodes to reliably record the activity of identified ascending auditory interneurons from the anterior surface of the brain in crickets. Electrodes were gently attached to the sheath covering the projection area of the ascending interneurons and the ringlike auditory neuropil in the protocerebrum. The specificity and selectivity of the recordings were determined by the precise electrode location, which could easily be changed without causing damage to the tissue. Different nonauditory fibers were recorded at other spots of the brain surface; stable recordings lasted for several hours. The same electrodes were used to deliver fluorescent tracers into the nervous system by means of electrophoresis. This allowed us to retrograde label the recorded auditory neurons and to reveal their cell body and dendritic structure in the first thoracic ganglion. By adjusting the amount of dye injected, we specifically stained the ringlike auditory neuropil in the brain, demonstrating the clusters of cell bodies contributing to it. Our data provide a proof that surface electrodes are a versatile tool to analyze neural processing in small brains of invertebrates.
NEW & NOTEWORTHY We show that surface suction electrodes can be used to monitor the activity of auditory neurons in the cricket brain. They also allow delivering electrophoretically a fluorescent tracer to label the structure of the recorded neurons and the local neuropil to which the electrode was attached. This new extracellular recording and labeling technique is a versatile and useful method to explore neural processing in invertebrate sensory and motor systems.
Microsaccades are tiny saccades that occur during gaze fixation. Even though visual processing has been shown to be strongly modulated close to the time of microsaccades, both at central and peripheral eccentricities, it is not clear how these eye movements might influence longer term fluctuations in brain activity and behavior. Here we found that visual processing is significantly affected and, in a rhythmic manner, even several hundreds of milliseconds after a microsaccade. Human visual detection efficiency, as measured by reaction time, exhibited coherent rhythmic oscillations in the α- and β-frequency bands for up to ~650–700 ms after a microsaccade. Surprisingly, the oscillations were sequentially pulsed across visual hemifields relative to microsaccade direction, first occurring in the same hemifield as the movement vector for ~400 ms and then the opposite. Such pulsing also affected perceptual detection performance. Our results suggest that visual processing is subject to long-lasting oscillations that are phase locked to microsaccade generation, and that these oscillations are dependent on microsaccade direction.
NEW & NOTEWORTHY We investigated long-term microsaccadic influences on visual processing and found rhythmic oscillations in behavioral performance at α- and β-frequencies (~8–20 Hz). These oscillations were pulsed at a much lower frequency across visual hemifields, first occurring in the same hemifield as the microsaccade direction vector for ~400 ms before switching to the opposite hemifield for a similar interval. Our results suggest that saccades temporally organize visual processing and that such organization can sequentially switch hemifields.
To investigate the role of interhemispheric β-synchronization in the selection of motor effectors, we trained two monkeys to memorize and perform multiple two-movement sequences that included unimanual repetition and bimanual switching. We recorded local field potentials simultaneously in the bilateral supplementary motor area (SMA) and pre-SMA to examine how the β-power in both hemispheres and the interhemispheric relationship of β-oscillations depend on the prepared sequence of arm use. We found a significant ipsilateral enhancement of β-power for bimanual switching trials in the left hemisphere and an enhancement of β-power in the right SMA while preparing for unimanual repetition. Furthermore, interhemispheric synchrony in the SMA was significantly more enhanced while preparing unimanual repetition than while preparing bimanual switching. This enhancement of synchrony was detected in terms of β-phase but not in terms of modulation of β-power. Furthermore, the assessment of the interhemispheric phase difference revealed that the β-oscillation in the hemisphere contralateral to the instructed arm use significantly advanced its phase relative to that in the ipsilateral hemisphere. There was no arm use-dependent shift in phase difference in the pairwise recordings within each hemisphere. Both neurons with and without arm use-selective activity were phase-locked to the β-oscillation. These results imply that the degree of interhemispheric phase synchronization as well as phase differences and oscillatory power in the β-band may contribute to the selection of arm use depending on the behavioral conditions of sequential arm use.
NEW & NOTEWORTHY We addressed interhemispheric relationships of β-oscillations during bimanual coordination. While monkeys prepared to initiate movement of the instructed arm, β-oscillations in the contralateral hemisphere showed a phase advance relative to the other hemisphere. Furthermore, the sequence of arm use influenced β-power and the degree of interhemispheric phase synchronization. Thus the dynamics of interhemispheric phases and power in β-oscillations may contribute to the specification of motor effectors in a given behavioral context.
Chronic experimentally induced hyperglycemia augments subunit-specific -aminobutyric acid A (GABAA) receptor-mediated inhibition of parasympathetic preganglionic motor neurons in the dorsal motor nucleus of the vagus (DMV). However, the contribution of α1 or GABAA receptor subunits, which are ubiquitously expressed on central nervous system neurons, to this elevation in inhibitory tone have not been determined. This study investigated the effect of chronic hyperglycemia/hypoinsulinemia on α1- and -subunit-specific GABAA receptor-mediated inhibition using electrophysiological recordings in vitro and quantitative RT-PCR. DMV neurons from streptozotocin-treated mice demonstrated enhancement of both phasic and tonic inhibitory currents in response to application of the α1-subunit-selective GABAA receptor-positive allosteric modulator zolpidem. Responses to low concentrations of the GABAA receptor antagonist gabazine suggested an additional increased contribution of -subunit-containing receptors to tonic currents in DMV neurons. Consistent with the functional elevation in α1- and -subunit-dependent activity, transcription of both the α1- and 2-subunits was increased in the dorsal vagal complex of streptozotocin-treated mice. Overall, these findings suggest an increased sensitivity to both zolpidem and gabazine after several days of hyperglycemia/hypoinsulinemia, which could contribute to altered parasympathetic output from DMV neurons in diabetes.
NEW & NOTEWORTHY Glutamate and GABA signaling in the dorsal vagal complex is elevated after several days of chronic hyperglycemia in a mouse model of type 1 diabetes. We report persistently enhanced GABAA receptor-mediated responses to the somnolescent zolpidem in preganglionic vagal motor neurons. These results imply a broader impact of chronic hyperglycemia on central vagal function than previously appreciated and reinforce the hypothesis that diabetes effects in the brain can impact regulation of metabolic homeostasis.
Recent findings in monkeys suggest that intrinsic periodic spiking activity in selective cortical areas occurs at timescales that follow a sensory or lower order-to-higher order processing hierarchy (Murray JD, Bernacchia A, Freedman DJ, Romo R, Wallis JD, Cai X, Padoa-Schioppa C, Pasternak T, Seo H, Lee D, Wang XJ. Nat Neurosci 17: 1661–1663, 2014). It has not yet been fully explored if a similar timescale hierarchy is present in humans. Additionally, these measures in the monkey studies have not addressed findings that rhythmic activity within a brain area can occur at multiple frequencies. In this study we investigate in humans if regions may be biased toward particular frequencies of intrinsic activity and if a full cortical mapping still reveals an organization that follows this hierarchy. We examined the spectral power in multiple frequency bands (0.5–150 Hz) from task-independent data using magnetoencephalography (MEG). We compared standardized power across bands to find regional frequency biases. Our results demonstrate a mix of lower and higher frequency biases across sensory and higher order regions. Thus they suggest a more complex cortical organization that does not simply follow this hierarchy. Additionally, some regions do not display a bias for a single band, and a data-driven clustering analysis reveals a regional organization with high standardized power in multiple bands. Specifically, theta and beta are both high in dorsal frontal cortex, whereas delta and gamma are high in ventral frontal cortex and temporal cortex. Occipital and parietal regions are biased more narrowly toward alpha power, and ventral temporal lobe displays specific biases toward gamma. Thus intrinsic rhythmic neural activity displays a regional organization but one that is not necessarily hierarchical.
NEW & NOTEWORTHY The organization of rhythmic neural activity is not well understood. Whereas it has been postulated that rhythms are organized in a hierarchical manner across brain regions, our novel analysis allows comparison of full cortical maps across different frequency bands, which demonstrate that the rhythmic organization is more complex. Additionally, data-driven methods show that rhythms of multiple frequencies or timescales occur within a particular region and that this nonhierarchical organization is widespread.
Sensory feedback influences motor circuits and/or their projection neuron inputs to adjust ongoing motor activity, but its efficacy varies. Currently, less is known about regulation of sensory feedback onto projection neurons that control downstream motor circuits than about sensory regulation of the motor circuit neurons themselves. In this study, we tested whether sensory feedback onto projection neurons is sensitive only to activation of a motor system, or also to the modulatory state underlying that activation, using the crab Cancer borealis stomatogastric nervous system. We examined how proprioceptor neurons (gastropyloric receptors, GPRs) influence the gastric mill (chewing) circuit neurons and the projection neurons (MCN1, CPN2) that drive the gastric mill rhythm. During gastric mill rhythms triggered by the mechanosensory ventral cardiac neurons (VCNs), GPR was shown previously to influence gastric mill circuit neurons, but its excitation of MCN1/CPN2 was absent. In this study, we tested whether GPR effects on MCN1/CPN2 are also absent during gastric mill rhythms triggered by the peptidergic postoesophageal commissure (POC) neurons. The VCN and POC pathways both trigger lasting MCN1/CPN2 activation, but their distinct influence on circuit feedback to these neurons produces different gastric mill motor patterns. We show that GPR excites MCN1 and CPN2 during the POC-gastric mill rhythm, altering their firing rates and activity patterns. This action changes both phases of the POC-gastric mill rhythm, whereas GPR only alters one phase of the VCN-gastric mill rhythm. Thus sensory feedback to projection neurons can be gated as a function of the modulatory state of an active motor system, not simply switched on/off with the onset of motor activity.
NEW & NOTEWORTHY Sensory feedback influences motor systems (i.e., motor circuits and their projection neuron inputs). However, whether regulation of sensory feedback to these projection neurons is consistent across different versions of the same motor pattern driven by the same motor system was not known. We found that gating of sensory feedback to projection neurons is determined by the modulatory state of the motor system, and not simply by whether the system is active or inactive.
Introduction The purpose of the study is to evaluate delivery method and breastfeeding initiation in women enrolled in group prenatal care (CenteringPregnancy) and in traditional prenatal care. Methods Data were obtained from medical records of a hospital-based midwifery practice in south central Connecticut that offered both types of prenatal care programs. Medical information from 307 women enrolled in this practice was included in the analysis. Out of the 307, 80 were enrolled in group prenatal care. Socio-demographic, lifestyle, and previous and current obstetrical information from medical records formed the basis of comparison. Bivariate and logistic regression analyses were carried out. Results Women in Centering had fewer planned cesarean sections (1.3 vs. 12.8%) and had a higher breastfeeding initiation (88.7 vs. 80.0%). However, Centering women were found to have a higher portion of unplanned cesarean sections (27.5 vs. 11.0%). Both the unadjusted and the adjusted odds ratios of having a cesarean planned delivery were lower in the group care. Women in Centering had 2.44 (95% CI 1.05, 5.66) times the odds of breastfeeding initiation compared to the odds for women in traditional prenatal care after adjusting for maternal age, smoking status, gestation and race. Discussion CenteringPregnancy can have positive impact for the woman and baby. This program implementation saw lower rates of elective cesarean sections and increased breastfeeding compared to women in traditional care.
Adolescents with depression are at risk for negative long-term consequences and recurrence of depression. Many do not receive nor access treatment, especially Latino youth. New treatment approaches are needed. This study examined the feasibility and acceptability of a stepped collaborative care treatment model (SCIPT-A) for adolescents with depression utilizing interpersonal psychotherapy for adolescents (IPT-A) and antidepressant medication (if needed) compared to Enhanced Treatment as Usual (E-TAU) in urban pediatric primary care clinics serving primarily Latino youth. Results suggest the SCIPT-A model is feasible, acceptable and potentially beneficial for urban Latino adolescents. Clinicians delivered the SCIPT-A model with fidelity using supervision successfully implemented in a community setting.
ATLANTIC CITY, N.J. — Telrepco will be at the 2017 New Jersey Statewide Conference on EMS at Harrah's Resort in Atlantic City, NJ from November 9th – November 11th. We will be displaying new and refurbished Panasonic Toughbooks and related accessories. We will also be raffling off a $100 American Express Gift Card at our table, so make sure you stop by and see us! Telrepco specializes ...
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