Our co-hosts are joined by EMS educator Joshua Ishmael, who coordinated this year's St. Elizabeth EMS Conference in Cincinnati, Ohio
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Πέμπτη 27 Σεπτεμβρίου 2018
What goes in to organizing an EMS conference?
What goes in to organizing an EMS conference?
Our co-hosts are joined by EMS educator Joshua Ishmael, who coordinated this year's St. Elizabeth EMS Conference in Cincinnati, Ohio
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Comparing Genome-Wide Association Study Results from Different Measurements of an Underlying Phenotype
Increasing popularity of high-throughput phenotyping technologies, such as image-based phenotyping, offer novel ways for quantifying plant growth and morphology. These new methods can be more or less accurate and precise than traditional, manual measurements. Many large-scale phenotyping efforts are conducted to enable genome-wide association studies (GWAS), but it is unclear exactly how alternative methods of phenotyping will affect GWAS results. In this study we simulate phenotypes that are controlled by the same set of causal loci but have differing heritability, similar to two different measurements of the same morphological character. We then perform GWAS with the simulated traits and create receiver operating characteristic (ROC) curves from the results. The areas under the ROC curves (AUCs) provide a metric that allows direct comparisons of GWAS results from different simulated traits. We use this framework to evaluate the effects of heritability and the number of causative loci on the AUCs of simulated traits; we also test the differences between AUCs of traits with differing heritability. We find that both increasing the number of causative loci and decreasing the heritability reduce a trait's AUC. We also find that when two traits are controlled by a greater number of causative loci, they are more likely to have significantly different AUCs as the difference between their heritabilities increases. When simulation results are applied to measures of tassel morphology, we find no significant difference between AUCs from GWAS using manual and image-based measurements of typical maize tassel characters. This finding indicates that both measurement methods have similar ability to identify genetic associations. These results provide a framework for deciding between competing phenotyping strategies when the ultimate goal is to generate and use phenotype-genotype associations from GWAS.
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A GAL80 Collection To Inhibit GAL4 Transgenes in Drosophila Olfactory Sensory Neurons
Fruit flies recognize hundreds of ecologically relevant odors and respond appropriately to them. The complexity, redundancy and interconnectedness of the olfactory machinery complicate efforts to pinpoint the functional contributions of any component neuron or receptor to behavior. Some contributions can only be elucidated in flies that carry multiple mutations and transgenes, but the production of such flies is currently labor-intensive and time-consuming. Here, we describe a set of transgenic flies that express the Saccharomyces cerevisiae GAL80 in specific olfactory sensory neurons (OrX-GAL80s). The GAL80s effectively and specifically subtract the activities of GAL4-driven transgenes that impart anatomical and physiological phenotypes. OrX-GAL80s can allow researchers to efficiently activate only one or a few types of functional neurons in an otherwise nonfunctional olfactory background. Such experiments will improve our understanding of the mechanistic connections between odorant inputs and behavioral outputs at the resolution of only a few functional neurons.
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Innovations Influencing Physical Medicine and Rehabilitation
We are very pleased and honored to have been asked to serve as the guest editors of this special issue, "Innovations Influencing Physical Medicine and Rehabilitation," and to be able to leverage its content with the theme of this year's American Academy of Physical Medicine and Rehabilitation (AAPMR) annual assembly. This special issue is also significant as it is the last to be published under Dr Weinstein's tutelage, who as editor-in-chief, has led PM&R with editorial excellence for the past decade.
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Robotic and Sensor Technology for Upper Limb Rehabilitation
Robotic and sensor-based neurologic rehabilitation for the upper limb is an established concept for motor learning and is recommended in many national guidelines. The complexity of the human hands and arms and the different activities of daily living are leading to an approach in which robotic and sensor-based devices are used in combination to fulfill the multiple requirements of this intervention. A multidisciplinary team of the Fondazione Don Carlo Gnocchi (FDG), an Italian nonprofit foundation, which spans across the entire Italian territory with 28 rehabilitation centers, developed a strategy for the implementation of robotic rehabilitation within the FDG centers.
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The Transformation of the Rehabilitation Paradigm Across the Continuum of Care
As healthcare continues to evolve, there are changes in the delivery of care for patients with severe neurologic injuries. Although the acute hospital stay is shortening, physiatrists can play a key role in preparing patients for rehabilitation, minimizing longer-term complications and helping to determine the most appropriate paths for further treatment. Inpatient rehabilitation facilities (IRFs) continue to be an important part of the care continuum for patients with severe injuries, but the role of IRFs has also evolved as patients have been admitted with increasing medical and neurologic complexity and length of stay continues to be reduced.
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New Treatment Approaches on the Horizon for Spastic Hemiparesis
This article presents 2 recent articles that propose novel interventions for treating spastic hemiparesis by changing biological infrastructure. In 18 patients with unilateral spastic arm paralysis due to chronic cerebral injury greater than 5 years' duration, Zheng et al transferred the C7 nerve from the nonparalyzed side to the side of the arm that was paralyzed. Over a follow-up period of 12 months, they found greater improvement in function and a reduction of spasticity compared to rehabilitation alone.
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Motorized Biomechatronic Upper and Lower Limb Prostheses—Clinically Relevant Outcomes
People with major limb amputations are severely impaired when it comes to activity, body structure and function, as well as participation. Demographic statistics predict a dramatic increase of this population and additional challenges with their increasing age and higher levels of amputation. Prosthetic use has been shown to have a positive impact on mobility and depression, thereby affecting the quality of life. Biomechatronic prostheses are at the forefront of prosthetic development. Actively powered designs are now regularly used for upper limb prosthetic fittings, whereas for lower limbs the clinical use of actively powered prostheses has been limited to a very low number of applications.
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Exoskeleton and End-Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review
Recovery of upper and lower limbs function is essential to reach independence in daily activities in patients with upper motor neuron syndrome (UMNS). Rehabilitation can provide a guide for motor recovery influencing the neurobiology of neuronal plasticity providing controlled, repetitive, and variable patterns. Increasing therapy dosage, intensity, number of repetition, execution of task-oriented exercises, and combining top-down and bottom-up approaches can promote plasticity and functional recovery.
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Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances
Recent technologic advancements have enabled the creation of portable, low-cost, and unobtrusive sensors with tremendous potential to alter the clinical practice of rehabilitation. The application of wearable sensors to track movement has emerged as a promising paradigm to enhance the care provided to patients with neurologic or musculoskeletal conditions. These sensors enable quantification of motor behavior across disparate patient populations and emerging research shows their potential for identifying motor biomarkers, differentiating between restitution and compensation motor recovery mechanisms, remote monitoring, telerehabilitation, and robotics.
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Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles
Advanced technology, including gait-training devices, is increasingly being integrated into neurorehabilitation. However, to use gait-training devices to their optimal potential, it is important that they are applied in accordance with motor learning and locomotor training principles. In this article, we outline the most important principles and explain how advanced gait-training devices are best used to improve therapy outcome.
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A Review of Stem Cell Therapy for Acquired Brain Injuries and Neurodegenerative Central Nervous System Diseases
Cell-based therapies have been the subject of much discussion regarding their potential role in enhancing central nervous system function for a number of pathologic conditions. Much of the current research has been in preclinical trials, with clinical trials in the phase I or I/II stage. Nevertheless, there is considerable interest in the public about the potential regenerative role that stem cells may have in improving function for these neurologic conditions. This review will describe the different types of stem cells that are available, review their possible effects, and discuss some of the variables that investigators need to consider when designing their studies.
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Transcranial Direct Current Stimulation for Poststroke Motor Recovery: Challenges and Opportunities
There has been a renewed research interest in transcranial direct current stimulation (tDCS) as an adjunctive tool for poststroke motor recovery as it has a neuro-modulatory effect on the human cortex. However, there are barriers towards its successful application in motor recovery as several scientific issues remain unresolved, including device-related issues (ie, dose-response relationship, safety and tolerability concerns, interhemispheric imbalance model, and choice of montage) and clinical trial-related issues (ie, patient selection, timing of study, and choice of outcomes).
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Is Technology for Orthostatic Hypotension Ready for Primetime?
Spinal cord injury (SCI) often results in the devastating loss of motor, sensory, and autonomic function. After SCI, the interruption of descending sympathoexcitatory pathways disrupts supraspinal control of blood pressure (BP). A common clinical consequence of cardiovascular dysfunction after SCI is orthostatic hypotension (OH), a debilitating condition characterized by rapid profound decreases in BP when assuming an upright posture. OH can result in a diverse array of insidious and pernicious health consequences.
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Ethical Issues Surrounding a New Generation of Neuroprostheses for Patients With Spinal Cord Injuries
Traumatic spinal cord injury (SCI) is a significant life event, one that often defines a fixed time point: life before SCI and life after it. However, the rise of new neuroprostheses may introduce a new point to this timeline, one that could be as precise as the injury itself: the restoration of volitional movement and perhaps even sensation. Neuroprostheses offer possibilities that may forever change physical and psychological experiences after SCI. Yet it is important to balance excitement about these possibilities with consideration of the ethical dimensions of the study and use of these technologies.
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Brain Computer Interfaces in Rehabilitation Medicine
One innovation currently influencing physical medicine and rehabilitation is brain–computer interface (BCI) technology. BCI systems used for motor control record neural activity associated with thoughts, perceptions, and motor intent; decode brain signals into commands for output devices; and perform the user's intended action through an output device. BCI systems used for sensory augmentation transduce environmental stimuli into neural signals interpretable by the central nervous system. Both types of systems have potential for reducing disability by facilitating a user's interaction with the environment.
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Adaptation, Artificial Intelligence, and Physical Medicine and Rehabilitation
Adaptation, cooperation, and trust are at the center of rehabilitation. Artificial intelligence and robots enhance adaptation with guidance for movement, cues for sensation, control of environment, and improved situational awareness. That said, how do we decide to trust complex technologies that might seek personal information or control dangerous equipment?
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Roundtable: Experts reflect on findings, trends from the 2018 EMS Trend Report
Our EMS expert panel identifies actions EMS leaders can take to improve clinical and operational performance, and to advance the profession
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Roundtable: Experts reflect on findings, trends from the 2018 EMS Trend Report
Our EMS expert panel identifies actions EMS leaders can take to improve clinical and operational performance, and to advance the profession
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Providers vs. Leaders: Trend report reveals divide on issues of safety, fatigue, mental health
An organization's leadership culture may explain the stark difference in opinion between providers and leaders on issues of patient and provider safety
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Solutions for EMS recruitment and retention are hiding in plain sight
Even though the race to recruit, hire, engage and retain EMS employees is as intense as ever, there are working solutions within reach for every agency
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How do providers and leaders perceive EMS?
The 2018 EMS Trend Report asks EMS field providers, as well as leaders and chiefs, about their perceptions of the state of EMS in the U.S.
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Liver transplant for hepatocellular carcinoma: a heavyweight therapeutic option in need of a new policy on liver graft allocation
Liver transplant for hepatocellular carcinoma: a heavyweight therapeutic option in need of a new policy on liver graft allocation
Rehabilitation of Severe Post-Malaria Neurological Syndrome
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Morel-Lavallee lesion of the right thigh mimicking sarcoma.
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Criteria wanted. Is the brain dead or alive?
Just as the physiologic activities that comprise life form a continuum, the changes during the process of dying also form a continuum. However, medicine, government, and popular culture force the binary determination as to whether a human is alive or dead. This necessitates applying a set of threshold criteria to the available clinical information. One criterion is the Uniform Determination of Brain Death Act (Anonymous 1981) used in the United States which states: "An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.
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How do providers and leaders perceive EMS?
The 2018 EMS Trend Report asks EMS field providers, as well as leaders and chiefs, about their perceptions of the state of EMS in the U.S.
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How do providers and leaders perceive EMS?
The 2018 EMS Trend Report asks EMS field providers, as well as leaders and chiefs, about their perceptions of the state of EMS in the U.S.
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Cape and Skyfire Consulting team up to support end-to-end drone integration for public safety
REDWOOD CITY, Calif. — Cape, the leading cloud platform for drone telepresence and data management, today announced a partnership with Skyfire Consulting to provide comprehensive technology solutions and support for the safe integration of commercial drones across public safety agencies, including law enforcement, fire rescue, and emergency management services. As part of the partnership,...
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Study on the bio-function of lipA gene in Aspergillus flavus
Abstract
Lipoic acid synthase (LipA) plays a role in lipoic acid synthesis and potentially affects the levels of acetyl-CoA, the critical precursor of tricarboxylic acid (TCA) cycle. Considering the potential effect of LipA on TCA cycle, whether the enzyme is involved in the growth and aflatoxin B1 (AFB1) biosynthesis, the significant events in Aspergillus flavus is yet known. The study was designed to explore the role of lipA gene in A. flavus, including growth rate, conidiation, sclerotia formation, and biosynthesis of AFB1. LipA coding lipoic acid synthetase was knocked out using homologous recombination. The role of lipA gene in A. flavus morphogenesis (including colony size, conidiation, and sclerotia formation) was explored on various media, and the bio-function of lipA gene in the biosynthesis of AFB1 was analyzed by thin layer chromatography analysis. The growth was suppressed in △lipA. The formation of conidia and sclerotia was also reduced when lipA gene was deleted. Moreover, AFB1 was down-regulated in ΔlipA compared with WT controls. LipA plays a role in the development of A. flavus and AFB1 biosynthesis, contributing to the full understanding of the lipA bio-function in A. flavus.
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Suppressed descending pain modulatory and enhanced sensorimotor networks in patients with chronic low back pain
Abstract
Purpose
Although cerebral structural and functional changes were uncovered by neuroimaging in patients with chronic low back pain (CLBP), their associations remain to be clarified. We co-analyzed anatomical and functional magnetic resonance imaging data in those patients and tested whether cortical gray matter volume changes are associated with altered pain modulatory networks underlying chronification of pain.
Methods
In 16 patients with CLBP and 16 heathy controls, we performed functional magnetic resonance imaging during mechanical pain stimulation on the lower back followed by anatomical imaging. We performed voxel-based morphometry and functional connectivity analysis from the seeds with altered gray matter volume, and examined correlations between imaging and psychophysical parameters.
Results
Patients showed decreases in gray matter volume at the right dorsolateral prefrontal cortex, middle occipital gyrus, and cerebellum, and showed increases at the bilateral primary sensorimotor cortices, left fusiform gyrus, and right cerebellum compared with controls (P < 0.001). Dorsolateral prefrontal and fusiform volumes showed negative associations with affective comorbidity, whereas motor cortex volume with impaired daily activity (P < 0.05). Connectivity was decreased between the cerebellar and limbic, and increased between the bilateral sensorimotor regions (PFDR < 0.05). Higher pain intensity and unpleasantness correlated with enhanced bilateral sensorimotor and dorsolateral–medial prefrontal networks, respectively (P < 0.05).
Conclusion
Patients showed a decreased volume of cortical center for descending pain modulation and an increased volume of sensorimotor network, in association with suppressed descending pain modulatory and cerebellum–limbic networks and enhanced sensorimotor network during pain. Such structural and functional alterations might be part of cerebral pathophysiology of CLBP.
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The role of genetic polymorphisms in the thymidylate synthase (TYMS) gene in methotrexate-induced oral mucositis in children with acute lymphoblastic leukemia
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Functional expression of human arylamine N-acetyltransferase NAT1*10 and NAT1*11 alleles: a mini review
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Evaluation of interleukin 23 (IL-23) as a non-invasive test of disease severity in patients with ulcerative colitis
Publication date: Available online 27 September 2018
Source: Arab Journal of Gastroenterology
Author(s): Tarek Youssef, Shereen A. Saleh, Angie Rund, Iman Montasser, Manal Mohsen, Ola Hazem
Abstract
Background and study aims
Studies have found increased expression of IL-23 in inflamed and non-inflamed mucosa of patients with ulcerative colitis (UC). We hypothesized that serum interleukin-23 as a non-invasive test has a role in pathogenesis of ulcerative colitis disease and correlates with the disease severity.
Patients and methods
Forty patients with biopsy proven ulcerative colitis, recruited from Ain Shams University hospitals were included. Forty healthy subjects matched in age and gender were also included in the study as a control group. Serum IL-23 level was quantified using quantitative ELISA technique (Enzyme linked Immunosorbent Assay).
Results
Patients with UC had higher level of interleukin 23 (234.5 ± 161 pg/mL) compared to control subjects (54.2 ± 15 pg/mL) and the level of IL-23 correlated with the disease severity. Cut off value of IL-23 at 68 pg/mL was the best to differentiate between cases and control subjects. Receiver operating characteristic curve (ROC) revealed that the best cut off for IL-23 to detect mild cases of ulcerative colitis was at105 pg/mL, to detect moderate cases at 200 pg/mL and to detect severe cases was at 270 pg/mL with sensitivity 80% to mild cases, 60% to moderate cases and 81% to severe cases.
Conclusion
Our findings confirm the suggestion that IL-23 level measurement may be of value as a non-invasive test in the diagnosis and disease severity assessment in patients with UC.
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Site fragmentation, hominin mobility and LCT variability reflected in the early Acheulean record of the Okote Member, at Koobi Fora, Kenya
Publication date: Available online 27 September 2018
Source: Journal of Human Evolution
Author(s): Darya Presnyakova, David R. Braun, Nicholas J. Conard, Craig Feibel, John W.K. Harris, Cornel M. Pop, Stefan Schlager, Will Archer
Abstract
From its initial appearance at ∼1.7 Ma, the Acheulean was prevalent through a vast chronological span of hominin behavioural evolution that lasted nearly 1.5 million years. The origins and production patterns of large bifacial cutting tools ('LCTs') – the marker of the Acheulean techno-complex – and the systematic changes in this behaviour through time are gaining increasing interest in paleoanthropology. Here we provide a synthesis of early Acheulean LCT variation in a landscape context by analysing assemblages from four different quasi-contemporaneous (∼1.4 Ma) sites from the Koobi Fora Formation. We characterize this variation using both 3D geometric morphometric and descriptive approaches. The expansive lateral exposures of fluvial and lacustrine sediments, as well as the associated tephrostratigraphy of the Koobi Fora Formation provide the landscape context that enables these comparative analyses. Our study demonstrates that when multiple contemporaneous early Acheulean localities are analysed together, a broader picture of LCT variability is elucidated. Four sites at Koobi Fora appear to represent a single system of lithic economy, characterized by a discrete trajectory of changes in LCT size and shape. These sites have ranges of LCT forms which appear to represent different but overlapping stages on a single reduction trajectory. Certain sites exhibit the full reduction trajectory while others exhibit only fragments of this trajectory. Other inter-site lithic proxies further complement these patterns in LCT variability. We explore patterns of site function, mobility and hominin landscape use, all of which may be suggestive of a depth of planning in early Acheulean hominins wherein technological activities were undertaken in substantial anticipation of future needs.
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Hip2 ubiquitin-conjugating enzyme has a role in UV-induced G1/S arrest and re-entry
Abstract
Regulation of cell cycle arrest and re-entry triggered by DNA damage is vital for cell division and growth and is also involved in cell survival. UV radiation can generate lesions in the DNA, which results in cell cycle arrest and the induction of the DNA repair process. However, the mechanism of promoting cell cycle progression following DNA repair is elusive. The primary aim of this study is to investigate whether Hip2 ubiquitin-conjugating enzyme has a role in UV-induced G1/S arrest and re-entry. The phase of HEK293 cells was synchronized at the G1/S border using thymidine. The synchronously proliferating cells were exposed to UV radiation to cause DNA damage. We investigated the expression of p53, Hip2, p21, cyclin D and E proteins that are involved in the cell cycle progression. Finally, we examined changes in the phosphorylation of Hip2 after UV radiation treatment using the pIMAGO™ assay. When cells were exposed to UV radiation, expression of p53 was elevated, and the cell cycle was arrested at the G1/S boundary. In response to the increased p53 level, Hip2 became phosphorylated and activated through the inhibition of its degradation. The phosphorylated Hip2 inhibited p53, thereby suppressing the expression of p21, a downstream signal, and sequentially stimulating cyclin D and cyclin E to induce re-entry to the cell cycle. Our studies demonstrate that Hip2 works as a regulator in UV-induced cell cycle arrest and re-entry.
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The fixation-related lambda response: Effects of saccade magnitude, spatial frequency, and ocular artifact removal
Publication date: Available online 26 September 2018
Source: International Journal of Psychophysiology
Author(s): Anthony J. Ries, David Slayback, Jon Touryan
Abstract
Fixation-related potentials (FRPs) enable examination of electrophysiological signatures of visual perception under naturalistic conditions, providing a neural snapshot of the fixated scene. The most prominent FRP component, commonly referred to as the lambda response, is a large deflection over occipital electrodes (O1, Oz, O2) peaking 80–100 ms post fixation, reflecting afferent input to visual cortex. The lambda response is affected by bottom-up stimulus features and the size of the preceding saccade; however, prior research has not adequately controlled for these influences in free viewing paradigms. The current experiment (N = 16, 1 female) addresses these concerns by systematically manipulating spatial frequency in a free-viewing task requiring a range of saccade sizes. Given the close temporal proximity between saccade related activity and the onset of the lambda response, we evaluate how removing independent components (IC) associated with ocular motion artifacts affects lambda response amplitude. Our results indicate that removing ocular artifact ICs based on the covariance with gaze position did not significantly affect the amplitude of this occipital potential. Moreover, the results showed that spatial frequency and saccade magnitude each produce significant effects on lambda amplitude, where amplitude decreased with increasing spatial frequency and increased as a function of saccade size for small and medium-sized saccades. The amplitude differences between spatial frequencies were maintained across all saccade magnitudes suggesting these effects are produced from distinctly different and uncorrelated mechanisms. The current results will inform future analyses of the lambda potential in natural scenes where saccade magnitudes and spatial frequencies ultimately vary.
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The risk of Parkinson’s disease in inflammatory bowel disease: A systematic review and meta-analysis
Digestive and Liver Diseases
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Statin use and gastrointestinal hemorrhage: A large retrospective cohort study
American Journal of Cardiovascular Drugs
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Proton pump inhibitors use is associated with a lower risk of acute exacerbation and mortality in patients with coexistent COPD and GERD
International Journal of COPD
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Which heart rate variability index is an independent predictor of mortality in cirrhosis
Digestive and Liver Diseases
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Correlation between port‐to‐target distance and procedural difficulty in single‐incision laparoscopic cholecystectomy: An observational study
Asian Journal of Endoscopic Surgery, EarlyView.
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Laparoscopic decompression of a stricture of the celiac artery caused by the median arcuate ligament in a gastric cancer patient: A case of report
Asian Journal of Endoscopic Surgery, EarlyView.
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Sex differences in forkhead box O3a signaling response to hindlimb unloading in rat soleus muscle
Abstract
We tested the hypothesis that there are sex differences in hindlimb unloading-induced activation of the forkhead box subfamily O3a (FoxO3a) signaling pathway in rat soleus muscle. Age-matched male and female Wistar rats were subjected to hindlimb unloading, and the soleus muscle was removed before or 1 or 7 days after unloading. Female rats showed greater percent changes in relative soleus muscle weight than males. FoxO3a phosphorylation was lower in females than in males and was associated with higher levels of protein ubiquitination 7 days after unloading. Heat shock protein 72 (Hsp72) levels were lower in female rats and increased in males during unloading. Female rats showed slightly higher myostatin levels, which showed a non-significant decline in male rats following unloading. Thus, males and females show different responses to the FoxO3a/ubiquitin–proteasome pathway following hindlimb unloading in rat soleus muscle, which may be associated with differences in Hsp72 expression and myostatin signaling.
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Perioperative management of laparoscopic surgery in a patient with protein S deficiency complications: A case report
Asian Journal of Endoscopic Surgery, EarlyView.
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Cardiorespiratory fitness is impaired and predicts mid‐term postoperative survival in patients with abdominal aortic aneurysm disease
Experimental Physiology, Volume 0, Issue ja, -Not available-.
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TBX18 overexpression enhances pacemaker function in a rat subsidiary atrial pacemaker model of sick sinus syndrome
The Journal of Physiology, Volume 0, Issue ja, -Not available-.
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The effect of steroid treatment on weight in nonambulatory males with Duchenne muscular dystrophy
American Journal of Medical Genetics Part A, EarlyView.
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The Correlation of Visfatin and Its Gene Polymorphism with Non-Small Cell Lung Cancer
Cancer Biotherapy and Radiopharmaceuticals, Ahead of Print.
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