Kelp holdfast microclimates buffer invertebrate inhabitants from extreme temperatures

Climate change is altering environmental conditions, with microclimates providing small-scale refuges within otherwise challenging environments. Durvillaea (southern bull kelp; rimurapa) is a genus of large intertidal fucoid algae, and some species harbour diverse invertebrate communities in their holdfasts. We hypothesised that animal-excavated Durvillaea holdfasts provide a thermal refuge for epibiont species, and tested this hypothesis using the exemplar species D. poha. Using a southern Aotearoa New Zealand population as a case-study, we found extreme temperatures outside the holdfast were 4.4 °C higher in summer and 6.9 °C lower in winter than inside the holdfast. A microclimate model of the holdfasts was built and used to forecast microclimates under 2100 conditions. Temperatures are predicted to increase by 2-3 °C, which may exceed the tolerances of D. poha. However, if D. poha or a similar congeneric persists, temperatures inside holdfasts will remain less extreme than the external environment. The thermal tolerances of two Durvillaea-associated invertebrates, the trochid gastropod Cantharidus antipodum and the amphipod Parawaldeckia kidderi, were also assessed; C. antipodum, but not P. kidderi, displayed metabolic depression at temperatures above and below those inside holdfasts, suggesting that they would be vulnerable outside the holdfast and with future warming. Microclimates, such as those within D. poha holdfasts or holdfasts of similar species, will therefore be important refuges for the survival of species both at the northern (retreating edge) and southern (expanding edge) limits of their distributions.

Science fiction or clinical reality: a review of the applications of artificial intelligence along the continuum of trauma care

Artificial intelligence (AI) and machine learning describe a broad range of algorithm types that can be trained based on datasets to make predictions. The increasing sophistication of AI has created new opportunities to apply these algorithms within within trauma care. Our paper overviews the current uses of AI along the continuum of trauma care, including injury prediction, triage, emergency department volume, assessment, and outcomes. Starting at the point of injury, algorithms are being used to predict severity of motor vehicle crashes, which can help inform emergency responses. Once on the scene, AI can be used to help emergency services triage patients remotely in order to inform transfer location and urgency. For the receiving hospital, these tools can be used to predict trauma volumes in the emergency department to help allocate appropriate staffing. After patient arrival to hospital, these algorithms not only can help to predict injury severity, which can inform decision-making, but also predict patient outcomes to help trauma teams anticipate patient trajectory. Overall, these tools have the capability to transform trauma care. AI is still nascent within the trauma surgery sphere, but this body of the literature shows that this technology has vast potential. AI-based predictive tools in trauma need to be explored further through prospective trials and clinical validation of algorithms.

The Development of a Team-Based, Hybrid Inter-university Graduate Certificate Program Focused on Maternal Child Health Professionals

Introduction

Pregnancy, childbirth, and child well-being are identified by Healthy People 2030 as priority topics for improving the health of all Americans. New Mexico is the fifth largest state geographically with most of the state’s 33 counties considered rural or frontier. Accessing health care services is challenging in this resource-poor environment. The need to provide maternal and child health (MCH) education in the state was the impetus for developing a graduate certificate in maternal and child public health.

Methods

The hybrid MCH graduate certificate engaged professionals in formal training that included a public health approach to addressing MCH issues in the state’s diverse communities. Grant funds paid for the tuition, books and travel for students providing an opportunity to individuals who otherwise could not have pursued graduate education and professional development.

Results

Over a 4-year period, two cohorts were recruited, educated, and evaluated. The evaluations reflected an increase in competency knowledge scores for all students.

Discussion

This model of MCH education was successful at delivering public health graduate education to MCH practitioners and increasing their knowledge and skills. Listening to students and communities as to what their MCH public health needs are and responding with a flexible educational model provided individuals with information and tools that could be used to improve maternal and child health and reduce health disparities in rural, tribal, and underserved communities.

A protected complex of biofactors and antioxidants improved growth performance and modulated the immunometabolic phenotype of broiler chickens undergoing early life stress

We evaluated the supplementation of a protected complex of biofactors and antioxidants [P(BF+AOx)] on growth performance, antioxidant activity, expression of immune-related genes, and immunometabolic phenotype of broilers submitted to early life stressors. The treatments were a nutritionally complete basal diet supplemented or not with P(BF+AOx) (Jefo Nutrition Inc., Saint-Hyacinthe, QC, Canada) from 1 to 14 d of age. 720 one-day old male Ross 308 chickens were placed into pens of 30 birds (12 replicates/treatment). Birds were double-vaccinated against infectious bronchitis (IB; MILDVAC-Ma5^T) at the hatchery and submitted, on d 3, to an acute reduction on environmental temperature (from 32° C to 20°C) for 48 h. Feed intake (FI), body weight gain (BWG), and feed conversion ratio (FCR) were calculated weekly. On d 7 and 15, samples were collected for expression of immune-related genes and kinome array analysis, and serum to evaluate the antioxidant status. Data were analyzed by ANOVA using SAS (SAS 9.4). From d 1 to 21 and d 1 to 28, the dietary supplementation of P(BF+AOx) significantly increased BWG (P < 0.05) by 3.6 and 3.8%, respectively, and improved FCR (P < 0.05) by 1.2 and 1.8%, respectively. From d 1 to 35, dietary supplementation enhanced BWG (P = 0.03) by 4%. Serum glutathione reductase activity on d 15 was higher in birds fed diets supplemented with P(BF+AOx) compared to the control diet-fed birds (P = 0.04). Dietary supplementation reduced the expression of IL-1β (P = 0.03) in the lungs on d 7. On d 15, dietary supplementation increased the expression of IL-6 (P = 0.02) and IL-10 (P = 0.03) in the liver. It was observed that, via decreased phosphorylation, catalase was activated in the jejunum and liver, and the phosphorylation of immunoregulatory or proinflammatory proteins was decreased. Other important cellular signaling pathways were also changed in the liver and jejunum due to the supplementation. The supplementation of P(BF+AOx) improves growth performance by promoting a general anti-inflammatory and antioxidant response in chickens undergoing early life stress.

Paediatric supraventricular tachycardia patients potentially more at risk of developing psychological difficulties compared to healthy peers

AIM

Assess executive and socio-emotional/behavioural functioning in paediatric supraventricular tachycardia (SVT) patients.

METHODS

SVT patients aged 7-17 who had not undergone catheter ablation were included. Parents completed the Child Behaviour Checklist (CBCL/6-18) and the Behavior Rating Inventory of Executive Functioning (BRIEF). Participants age 11-17 years completed the Youth Self-Report (YSR/11-18) and the BRIEF Self-Report (BRIEF-SR). One-sample z test was used to compare questionnaire results to the average t-score range (M = 50, SD = 10).

RESULTS

Thirty (18 female) children/adolescents participated (M = 12.6 years old, SD = 3.2 years) with a mean SVT onset age of 7 years (SD = 4.3 years). BRIEF and BRIEF-SR results suggested no difference in executive functioning from average. Mean t-scores of CBCL/6-18 and YSR/11-18 subscales Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Thought Problems, Diagnostic and Statistical Manual of Mental Disorders (DSM) Affective Problems, DSM Anxiety Problems and DSM Somatic Problems were significantly elevated compared to average. YSR/11-18 subscales Social Problems, Attention Problems, Internalizing Problems, DSM ADHD Problems and DSM Oppositional Defiant Problems had elevated mean t-scores compared to average. Effect sizes were small to medium (0.2 ≤ d ≤ 0.8).

CONCLUSION

Paediatric patients with SVT potentially have a greater risk of developing behaviour, especially internalizing, problems compared to similarly aged children/adolescents without SVT.

Functional characterization of a novel hERG variant in a family with recurrent sudden infant death syndrome: Retracting a genetic diagnosis

Long QT syndrome (LQTS) is the most common cardiac ion channelopathy and has been found to be responsible for approximately 10% of sudden infant death syndrome (SIDS) cases. Despite increasing use of broad panels and now whole exome sequencing (WES) in the investigation of SIDS, the probability of identifying a pathogenic mutation in a SIDS victim is low. We report a family-based study who are afflicted by recurrent SIDS in which several members harbor a variant, p.Pro963Thr, in the C-terminal region of the human-ether-a-go-go (hERG) gene, published to be responsible for cases of LQTS type 2. Functional characterization was undertaken due to the variable phenotype in carriers, the discrepancy with published cases, and the importance of identifying a cause for recurrent deaths in a single family. Studies of the mutated ion channel in in vitro heterologous expression systems revealed that the mutation has no detectable impact on membrane surface expression, biophysical gating properties such as activation, deactivation and inactivation, or the amplitude of the protective current conducted by hERG channels during early repolarization. These observations suggest that the p.Pro963Thr mutation is not a monogenic disease-causing LQTS mutation despite evidence of co-segregation in two siblings affected by SIDS. Our findings demonstrate some of the potential pitfalls in post-mortem molecular testing and the importance of functional testing of gene variants in determining disease-causation, especially where the impacts of cascade screening can affect multiple generations.

Lateral trunk lean gait modification increases the energy cost of treadmill walking in those with knee osteoarthritis

OBJECTIVE

To compare the energy expenditure of increased lateral trunk lean walking - a suggested method of reducing medial compartment knee joint load - compared to normal walking in a population of older adults with medial knee osteoarthritis (OA).

METHOD

Participants completed two randomly-presented treadmill walking conditions: 15 min of normal walking or walking with ten degrees of peak lateral trunk lean. Lateral trunk lean angle was displayed in front of the participant in real-time during treadmill conditions. Energy expenditure (VO2 and METs), heart rate (HR), peak lateral trunk lean angle, knee pain and perceived exertion were measured and differences between conditions were compared using paired t-tests.

RESULTS

Twelve participants (five males, mean (standard deviation (SD)) age 64.1 (9.4) years, body mass index (BMI) 28.3 (4.9) kg/m²) participated. All measures were significantly elevated in the lateral trunk lean condition (P < 0.008), except for knee pain (P = 0.22). Oxygen consumption (VO2) was, on average 9.5% (95% CI 4.2-14.7%) higher, and HR was on average 5.3 beats per minute (95% CI 1.7-9.0 bpm) higher during increased lateral trunk lean walking.

CONCLUSION

Increased lateral trunk lean walking on a treadmill resulted in significantly higher levels of steady-state energy expenditure, HR, and perceived exertion, but no difference in knee pain. While increased lateral trunk lean has been shown to reduce biomechanical measures of joint loading relevant to OA progression, it should be prescribed with caution given the potential increase in energy expenditure experienced when it is employed.

FlumeJava

MapReduce and similar systems significantly ease the task of writing data-parallel code. However, many real-world computations require a pipeline of MapReduces, and programming and managing such pipelines can be difficult. We present FlumeJava, a Java library that makes it easy to develop, test, and run efficient data-parallel pipelines. At the core of the FlumeJava library are a couple of classes that represent immutable parallel collections, each supporting a modest number of operations for processing them in parallel. Parallel collections and their operations present a simple, high-level, uniform abstraction over different data representations and execution strategies. To enable parallel operations to run efficiently, FlumeJava defers their evaluation, instead internally constructing an execution plan dataflow graph. When the final results of the parallel operations are eventually needed, FlumeJava first optimizes the execution plan, and then executes the optimized operations on appropriate underlying primitives (e.g., MapReduces). The combination of high-level abstractions for parallel data and computation, deferred evaluation and optimization, and efficient parallel primitives yields an easy-to-use system that approaches the efficiency of hand-optimized pipelines. FlumeJava is in active use by hundreds of pipeline developers within Google.

Role of psychological factors in postoperative pain control and recovery with patient-controlled analgesia

OBJECTIVE

We examined the extent to which preoperative state and trait anxiety, general need to control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of postoperative pain, discomfort, anxiety, duration of recovery, and patient-controlled analgesia (PCA) behaviors.

DESIGN

Preoperative and outcome variables were analyzed using Pearson product-moment correlations and forward stepwise multiple linear regression.

SETTING

This study was conducted at a university hospital in preoperative and postoperative settings.

PATIENTS

Ninety-nine consecutively consenting ASA physical status I-II women (age 46 +/- 11 years, 70% caucasian, 28% Afro-American, 2% Hispanic) undergoing simple hysterectomy procedures with no known cancer were included in the study.

INTERVENTIONS

Standardized general anesthesia, surgery, and PCA therapy was conducted.

OUTCOME MEASURES

The McGill Pain Questionnaire (MPQ), patient requests and delivered analgesic medication, visual analog scales (VAS) for pain and anxiety, time to oral medications and hospital discharge, and Likert scale measurements of overall pain and discomfort were utilized.

RESULTS

Older patients generally reported less pain, but used the same amount of analgesic medication as younger patients. Preoperative trait anxiety correlated with increased PCA requests, but not with postoperative pain. In contrast, preoperative state anxiety correlated positively with postoperative pain and with shorter time to hospital discharge. The patients' need for control was positively correlated with the Present Plan Index scale of the MPQ, with morphine requirement, and with PCA requests.

CONCLUSIONS

Psychological factors do influence postoperative recovery and pain control in women receiving PCA therapy after abdominal hysterectomy, and attention to individual patient differences may lead to improved postoperative outcomes.

Ethics and impaired healthcare executives

Healthcare executives are not expected to poorly manage their own health. When they do, they do more than diminish their own public image: They can also damage the public image of their organizations of employment.

Shared governance: a Canadian experience

Control over practice, nursing shortages and better utilization of personnel are serious problems facing nurses in hospitals today. Shared governance models are one way to enhance professionalism, thus making the practice of nursing appealing. Effects of moving toward a shared governance model are described with examples derived from a rural hospital in British Columbia. Practical recommendations are given which support nursing leaders who dare to risk deep structural change.

Autonomic components of the human pupillary light reflex

To investigate the autonomic components of the pupillary light reflex in humans, we used infrared pupillometry combined with a partial local cholinergic (tropicamide) or alpha-adrenergic (thymoxamine) blockade. The pupillary response curve was analyzed using parameters identical or similar to those employed previously to study the autonomic components of the pupillary light reflex. Tropicamide increased baseline pupil area and affected five of the eight measured parameters. Thymoxamine lowered baseline pupil area but did not affect any of the parameters. We found the expected cholinergic contribution to the constrictive phase of the pupillary light reflex but no evidence for peripheral alpha-adrenergic activity during redilation. We propose that redilation primarily involves parasympathetic relaxation, modulated by cholinergic inhibition of the dilator muscle and central sympathetic inhibition of the Edinger-Westphal nucleus.

Paradoxical analgesia produced by low doses of the opiate-antagonist naloxone is mediated by interaction at a site with characteristics of the delta opioid receptor

This study addressed the opiate receptor subclass which underlies the paradoxical analgesic action of intrathecal administration of low doses of the stereospecific opiate receptor antagonist, naloxone. The analgesic effect of low dose naloxone was abolished in rats that had been pretreated 24 hr earlier with a large intrathecal dose of naloxone or 20 min previously with the delta receptor specific antagonist, ICI-174,864. A large intrathecal dose of naloxone administered 24 hr previously also abolished the analgesic effects of the delta-specific ligands [D-Pen2,5]-enkephalin and [D-Ser2]-Leu enkephalin-Thr but not those produced by mu-ligands Tyr-D-Ala-Gly-NMe-Phe-Gly-ol and beta-Casomorphin(1-4) amide or by the kappa-specific ligand, U50,488H. Furthermore, the analgesic action of low dose naloxone (on thermal and mechanical nociceptive threshold tests) persisted in rats made tolerant to mu-opioid receptor specific ligands. We conclude that the analgesic action of a low dose of naloxone is mediated via interaction with a stereospecific binding site with the characteristics of the delta-opioid receptor.

Comparison of local tumor recurrence following excision with the CO2 laser, Nd:YAG laser, and Argon Beam Coagulator

This study compares the incidence of local tumor recurrence following primary excision with the CO2 laser, Nd:YAG laser (contact), Argon Beam Coagulator, or electrocautery. One hundred eight Fisher 344 rats with R3230AC mammary tumors (1.6 +/- 0.04 [SD] cm diameter) were used. All animals were randomized into groups of similar tumor size. In groups C and CS, excision was performed with a Sharplan 1060 CO2 laser (TEMoo, 25 W, continuous wave [CW], 0.2-mm spot size). Wounds in group CS were "sterilized" (0.5-mm spot size, 25 W, CW) by gently heating the wound without causing blanching or charring. In group N, a 0.4-mm contact Laser Blade and a Cooper 8000 Nd:YAG laser at 20 W CW was used. In groups SA1 and SA2, tumors were excised with the scalpel, and hemostasis and wound "sterilization" were accomplished with the Bard System 6000 Argon Beam Coagulator (ABC) at 40 W and 4 liters/min argon gas flow in SA1 and 12 liters/min in SA2. In group E, excision was accomplished at 40 W blend mode, 10 W spray mode. In group EA, excision was accomplished at 60 W cutting current, and hemostasis was achieved with the ABC. The animals were examined for evidence of recurrence for 34 days postoperatively. Mortalities were excluded from analysis. The incidence of recurrence was 11/14 (79%) in C, 6/16 (38%) in CS, 10/14 (71%) in SA1, 6/13 (46%) in SA2, 6/15 (40%) in N, 7/10 (70%) in EA, and 3/15 (20%) in E. Group E is statistically different (P less than .01) from groups EA, C, and SA1. Group C was different (P less than .01) from groups E, CS, and N. These results demonstrate an inverse relationship between tumor recurrence and local thermal effects at the surgical site. The ABC did not increase tumor recurrence. Contact YAG surgery was similar to CO2 laser excision and "sterilization." An attempt to study the influence of gas flow and pressure on local tumor recurrence and metastases should be made.

Discrimination of sleep onset stages: behavioral responses and verbal reports

In a descriptive experiment on discrimination five human subjects were studied during the transitional period of sleep onset. Subjects were aroused by an abrupt auditory stimulus, attempted to discriminate the pre-arousal stage by a behavioral response, and answered a series of standardized questions. These questions focused on specific characteristics of private experience associated with sleep onset. Of 180 awakenings, subjects correctly identified 109 sleep-onset stages. Subjects' answers were analyzed to determine what criteria were used to make the discrimination among sleep-onset stages and to examine their self-awareness of changes in private experience. It was established that there are stage-related changes in mental processes and content and that these may aid subjects in making such discriminations. Implications of the methodological approach used in this study are discussed.

Discrimination of early sleep stages: behavioral indicators

Six subjects participated in a one-night sleep-onset experiment. They were aroused from stage 1 and stage 2 as defined by standard electroencephalographic criteria. Subjects pressed a button upon arousal to indicate which of two subjective states they were in just before awakening. Performance accuracy from stage 1 awakenings appeared to remain relatively constant at approximately 83%; performance from stage 2 awakenings showed increasing accuracy. Response latencies increased between stage 1 and stage 2 awakenings.

Patient advocacy program links board and patient

The patient advocacy program at Hurley Medical Center, Flint, MI, was developed as part of an administrative effort to make the institution more responsive to the human needs of patients. The program acts as a direct link between the patient and the trustee by bringing to the board's attention specific information on patient problems along with corrective actions that have been implemented.

Medical center supports patient advocacy

At Hurley Medical Center, patient advocates enjoy an amiable relationship with administrators and are considered a valuable management information resource.