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0128 Maternal Sleep Quality Across Pregnancy Predicts Newborn Neurodevelopment. Sleep 2022. [DOI: 10.1093/sleep/zsac079.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The prenatal period is characterized by immense fetal neuronal growth. Such rapid growth can increase fetal susceptibility to prenatal environmental insults (Barker, 1998). A promising prenatal process that may alter fetal development is maternal prenatal sleep quality. Poor prenatal sleep quality is a public health concern affecting approximately 78% of pregnant individuals (Lucena et al., 2018). In rodents, maternal sleep deprivation across gestation predicts offspring hippocampal neurogenesis, with pups exposed to sleep deprivation early and late in pregnancy exhibiting more anxiety and depression-like behaviors (Peng et al., 2015). In humans, poor sleep quality in other developmental stages predicts hippocampi and amygdalae changes (Marshall & Born, 2007; Saghir et al., 2018). However, the relation between prenatal sleep quality and offspring brain development in humans remains poorly understood. The present study examined associations between maternal sleep quality in early, mid, and late pregnancy, and newborn hippocampal and amygdala volume, regions implicated in memory and emotion.
Methods
Pregnant individuals (N=94; Mage=30.5; SDage=5.3) reported on sleep quality three times during pregnancy. Newborn (Mageinweeks=5.1; SDageinweeks=2.7) hippocampi and amygdalae volumes were assessed during an unsedated sleep cycle using magnetic resonance imaging (MRI). Tissue segmentation was collected using a multiatlas iterative algorithm that individually segmented the regions of interest and subsequently combined T1- and T2-weighted high-resolution images (See neonate multiatlas at https://www.nitrc.org/projects/unc_brain_atlas/). Bivariate correlations examined the association between prenatal sleep quality and hippocampus and amygdala volume. Partial correlations examined these associations in the presence of significant cofounding variables including intracranial volume, body weight percentile, sex, and postconceptional age.
Results
Partial correlations revealed that poor maternal sleep quality early in pregnancy predicted larger newborn bilateral hippocampal volume (all rs<.25; ps<.038). Associations with sleep later in gestation persisted for the right hippocampus (all rs<.25; ps<.038). Prenatal maternal sleep quality did not significantly predict newborn amygdala volume (all rs<-.06; ps>.58).
Conclusion
This study provides novel evidence linking prenatal sleep quality and newborn hippocampal volume in humans, suggesting the presence of an intergenerational link between prenatal sleep health and offspring well-being.
Support (If Any)
Support (if any): NIMH R01MH109662, NHLBI R01HL155744, and diversity training supplement for 1st author; F32MH125572 for 2nd author.
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Worsening of ovarian cancer prognosis with age: an exploration of pharmacokinetics, body composition, and biology. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00338-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mn-Rich MnSb 2 Te 4 : A Topological Insulator with Magnetic Gap Closing at High Curie Temperatures of 45-50 K. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2102935. [PMID: 34469013 DOI: 10.1002/adma.202102935] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/29/2021] [Indexed: 06/13/2023]
Abstract
Ferromagnetic topological insulators exhibit the quantum anomalous Hall effect, which is potentially useful for high-precision metrology, edge channel spintronics, and topological qubits. The stable 2+ state of Mn enables intrinsic magnetic topological insulators. MnBi2 Te4 is, however, antiferromagnetic with 25 K Néel temperature and is strongly n-doped. In this work, p-type MnSb2 Te4 , previously considered topologically trivial, is shown to be a ferromagnetic topological insulator for a few percent Mn excess. i) Ferromagnetic hysteresis with record Curie temperature of 45-50 K, ii) out-of-plane magnetic anisotropy, iii) a 2D Dirac cone with the Dirac point close to the Fermi level, iv) out-of-plane spin polarization as revealed by photoelectron spectroscopy, and v) a magnetically induced bandgap closing at the Curie temperature, demonstrated by scanning tunneling spectroscopy (STS), are shown. Moreover, a critical exponent of the magnetization β ≈ 1 is found, indicating the vicinity of a quantum critical point. Ab initio calculations reveal that Mn-Sb site exchange provides the ferromagnetic interlayer coupling and the slight excess of Mn nearly doubles the Curie temperature. Remaining deviations from the ferromagnetic order open the inverted bulk bandgap and render MnSb2 Te4 a robust topological insulator and new benchmark for magnetic topological insulators.
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40 Weeks In: A Look at How One NIH Institute Handled the Unimaginable. J Dent Res 2021; 100:673-676. [PMID: 33906484 PMCID: PMC8412845 DOI: 10.1177/00220345211013305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fevers after Impella Implantation are Common but Rarely Clinically Significant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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0998 Health Care Utilization of Pediatric Sleep Disorders in Cerner Health Facts Database. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
This study was aimed to identify health care utilization of sleep disorders in pediatrics and adults by using Cerner health facts database.
Methods
Health facts database has unidentified health records from all the participating facilities that have Cerner as their electronic medical records software. There are 68.7 million patients in the data warehouse with about 506.9 million encounters in about 100 healthcare systems. Sleep disorders are mostly seen in outpatient settings and therefore this study included outpatient records between the years 2010 to 2017.
Results
There were 20.5 million patients with total of 127.4 million outpatient encounters. In pediatric patients (ages 0-18 years), healthcare utilization of major sleep diagnoses per 100,000 encounters showed sleep related breathing disorders are the most commonly seen followed by parasomnia, insomnia, sleep movement disorders, hypersomnolence then circadian rhythm disorders (820.1, 258.1, 181.6, 68.3, 48.1 and 16.2 per 100,000 encounters). However, for adult patients the ranking was: sleep related breathing disorders, insomnia, sleep related movement disorders, hypersomnolence, parasomnia then circadian rhythm disorders (1352.6, 511.6, 166.3, 79.1, 25.7 and 4.2 per 100,000 encounters). Further analysis for the age groups showed bimodal pattern for sleep related breathing disorders and sleep movement disorders with the highest utilization were between the ages of 2-11 year and 40-60 years. Adolescents (age 12-18 years) showed increase utilization in the areas of circadian rhythm disorders.
Conclusion
Patients with sleep disorders have relatively low health care utilization despite high prevalence of these sleep disorders in the general population. This may highlight underrecognized sleep problem or decreased access to health care. In addition, this study highlights the effect of age on different sleep disorders which may have an impact on allocating resources.
Support
None
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Pathologic Analysis of Submandibular Triangle and Jugular Chain Lymph Nodes in Oral Cavity Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Health resource utilization of labor induction versus expectant management. Am J Obstet Gynecol 2020; 222:369.e1-369.e11. [PMID: 31930993 DOI: 10.1016/j.ajog.2020.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization. OBJECTIVE The objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY DESIGN This is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management. We assessed resource utilization after randomization in 3 time periods: antepartum, delivery admission, and discharge through 8 weeks postpartum. RESULTS Of 6096 women with data available, those in the induction of labor group (n = 3059) were significantly less likely in the antepartum period after randomization to have at least 1 ambulatory visit for routine prenatal care (32.4% vs 68.4%), unanticipated care (0.5% vs 2.6%), or urgent care (16.2% vs 44.3%), or at least 1 antepartum hospitalization (0.8% vs 2.2%, P < .001 for all). They also had fewer tests (eg, sonograms, blood tests) and treatments (eg, antibiotics, intravenous hydration) prior to delivery. During the delivery admission, women in the induction of labor group spent a longer time in labor and delivery (median, 0.83 vs 0.57 days), but both women (P = .002) and their neonates (P < .001) had shorter postpartum stays. Women and neonates in both groups had similar frequencies of postpartum urgent care and hospital readmissions (P > .05 for all). CONCLUSION Women randomized to induction of labor had longer durations in labor and delivery but significantly fewer antepartum visits, tests, and treatments and shorter maternal and neonatal hospital durations after delivery. These results demonstrate that the health outcome advantages associated with induction of labor are gained without incurring uniformly greater health care resource use.
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Modeling strategies and evaluating success during repatriations of elusive and endangered species. Anim Conserv 2019. [DOI: 10.1111/acv.12537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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CROWN initiative and preterm birth prevention: researchers and editors commit to implement core outcome sets. BJOG 2019; 125:8-11. [PMID: 29055092 DOI: 10.1111/1471-0528.14987] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
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PSXII-15 Effects of poor maternal nutrition during gestation on oxidative stress in offspring muscle. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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PSXII-38 The Effects of Maternal Milk Production on Dairy Calf Growth and Health. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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442 Effects of poor maternal nutrition during gestation on the offspring muscle metabolome. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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PSXII-25 The Effects of Poor Maternal Nutrition on Fetal Brain Development. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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PSV-6 A survey of New England sheep producers. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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The Utility of Preoperative Albumin in Laparoscopic Hysterectomies. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Using social network analysis to characterize the collaboration network of backyard poultry trainers in ackCalifornia. Prev Vet Med 2018; 158:129-136. [PMID: 30220386 DOI: 10.1016/j.prevetmed.2018.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 11/19/2022]
Abstract
In order to better understand collaboration among trainers in the backyard poultry community (i.e. feed store managers, youth development programs (i.e. 4-H), veterinarians, government agencies, extension resources and backyard poultry club leaders), Social Network Analysis (SNA) was used as a tool to better characterize and quantify the current collaboration network structure of backyard poultry trainers in California. Invited trainer attendees of two "Train-the-Trainers" poultry workshops (n = 67) held in Northern and Southern California were given a survey that asked them to list contacts that they collaborated with on backyard poultry (BYP) related work. The collaboration network in this study included a total of 109 trainers, 18 practitioners, and 32 individuals who are both trainers and practitioners for a total of 170 nodes (11 individuals did not have affiliation information available). In order to help identify central actors or collaboration leaders, the surveys were analyzed using Social Network Analysis (SNA), which allows for a quantitative analysis of relationships among various stakeholders. While the SNA showed that the existing collaboration network is disconnected with a clustering coefficient of 0.043 and median total degree centrality of 1 (range 9) and therefore not conducive for collaboration, key insights that could help restructure and improve the network were identified. As an example, among different poultry groups, 4-H was identified as the organization with the second highest median coverage score and fifth highest median centrality score. In addition, 4-H group leaders act as both trainers and practitioners. Consequently, outreach to 4-H group leaders throughout the state would potentially have the greatest impact with respect to overall coverage both inside and outside the 4-H network due to their high centrality and boundary spanning roles. Using SNA to strengthen the collaboration network infrastructure of backyard poultry trainers ultimately offers a more targeted approach toward extension for backyard poultry owners, which could ultimately facilitate communication and knowledge-sharing with BYP owners during a disease outbreak.
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Human platelets express endothelial protein C receptor, which can be utilized to enhance localization of factor VIIa activity. J Thromb Haemost 2018; 16:1817-1829. [PMID: 29879294 PMCID: PMC6166658 DOI: 10.1111/jth.14165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Indexed: 12/01/2022]
Abstract
Essentials Factor VIIa binds activated platelets to promote hemostasis in hemophilia patients with inhibitors. The interactions and sites responsible for platelet-FVIIa binding are not fully understood. Endothelial cell protein C receptor (EPCR) is expressed on activated human platelets. EPCR binding enhances the efficacy of a FVIIa variant and could impact design of new therapeutics. SUMMARY Background High-dose factor VIIa (FVIIa) is routinely used as an effective bypassing agent to treat hemophilia patients with inhibitory antibodies that compromise factor replacement. However, the mechanism by which FVIIa binds activated platelets to promote hemostasis is not fully understood. FVIIa-DVQ is an analog of FVIIa with enhanced tissue factor (TF)-independent activity and hemostatic efficacy relative to FVIIa. Our previous studies have shown that FVIIa-DVQ exhibits greater platelet binding, thereby suggesting that features in addition to lipid composition contribute to platelet-FVIIa interactions. Objectives Endothelial cell protein C receptor (EPCR) also functions as a receptor for FVIIa on endothelial cells. We therefore hypothesized that an interaction with EPCR might play a role in platelet-FVIIa binding. Methods/results In the present study, we used flow cytometric analyses to show that platelet binding of both FVIIa and FVIIa-DVQ is partially inhibited in the presence of excess protein C or an anti-EPCR antibody. This decreased binding results in a corresponding decrease in the activity of both molecules in FXa and thrombin generation assays. Enhanced binding to EPCR was sufficient to account for the increased platelet binding of FVIIa-DVQ compared with wild-type FVIIa. As EPCR protein expression has not previously been shown in platelets, we confirmed the presence of EPCR in platelets using immunofluorescence, flow cytometry, immunoprecipitation, and mass spectrometry. Conclusions This work represents the first demonstration that human platelets express EPCR and suggests that modulation of EPCR binding could be utilized to enhance the hemostatic efficacy of rationally designed FVIIa analogs.
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1042 Whole-exome sequencing of the patient with pyoderma gangrenosum. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
The origin of the complex reflection splitting in potassium sodium niobate doped with lithium and manganese was investigated using temperature-dependent high-resolution X-ray and neutron diffraction as well as electron probe microanalysis and scanning electron microscopy. Two structural models were developed from the diffraction data. A single-phase monoclinic Pm model is known from the literature and is able to reproduce the diffraction patterns perfectly. However, a model with phase coexistence of two classical orthorhombic Amm2 phases can also reproduce the diffraction data with equal accuracy. Scanning electron microscopy in combination with electron probe microanalysis revealed segregation of the A-site substituents potassium and sodium. This favours the model with phase coexistence and confirms the need for comprehensive analyses with complementary methods to cover a broad range of length scales as well as to assess both average and local structure.
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Report from the Annual Conference of the British Society of Echocardiography, November 2016, Queen Elizabeth II Conference Centre, London. Echo Res Pract 2017; 4:M1. [PMID: 30390608 PMCID: PMC8693153 DOI: 10.1530/erp-17-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 11/16/2022] Open
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Acute mental status changes following an ultramarathon. Br Paramed J 2017. [DOI: 10.29045/14784726.2017.2.1.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Decreasing Postoperative Pain Following Endometrial Ablation. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Increase in Prophylactic Salpingectomy Across All Approaches Following an Educational Initiative. J Minim Invasive Gynecol 2016; 22:S19. [PMID: 27678997 DOI: 10.1016/j.jmig.2015.08.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Constipation: an emerging risk factor for Parkinson's disease? Eur J Neurol 2016; 23:1606-1613. [PMID: 27444575 DOI: 10.1111/ene.13082] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 06/09/2016] [Indexed: 12/11/2022]
Abstract
Constipation is the most prominent and disabling manifestation of lower gastrointestinal (GI) dysfunction in Parkinson's disease (PD). The prevalence of constipation in PD patients ranges from 24.6% to 63%; this variability is due to the different criteria used to define constipation and to the type of population enrolled in the studies. In addition, constipation may play an active role in the pathophysiological changes that underlie motor fluctuations in advanced PD through its negative effects on absorption of levodopa. Several clinical studies now consistently suggest that constipation may precede the first occurrence of classical motor features in PD. Studies in vivo, using biopsies of the GI tract and more recently functional imaging investigations, showed the presence of α-synuclein (α-SYN) aggregates and neurotransmitter alterations in enteric tissues. All these findings support the Braak proposed model for the pathophysiology of α-SYN aggregates in PD, with early pathological involvement of the enteric nervous system and dorsal motor nucleus of the vagus. Therefore, constipation could have the potential sensitivity to be used as a clinical biomarker of the prodromal phase of the disease. The use of colonic biopsies to look at α-SYN pathology, once confirmed by larger prospective studies, might eventually represent a feasible, albeit partially invasive, new diagnostic biomarker for PD.
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An activated factor VII variant with enhanced tissue factor-independent activity speeds wound healing in a mouse hemophilia B model. J Thromb Haemost 2016; 14:1249-54. [PMID: 26952654 DOI: 10.1111/jth.13311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 02/23/2016] [Indexed: 12/30/2022]
Abstract
UNLABELLED Essentials Disorders of hemostasis can lead to delayed and defective wound healing. In hemophilia B (HB) mice, 7 days of Factor (F)IX or VIIa are needed to normalize wound healing. One dose of a highly active FVIIa variant (DVQ) restored normal wound closure time in HB mice. Coagulation factors with enhanced activity may acquire biological effects not due to hemostasis. SUMMARY Introduction We have previously reported that hemophilia B (HB) mice have delayed healing of cutaneous wounds and alterations in wound histology. Administration of a single dose of either factor IX or recombinant activated FVII (rFVIIa) (NovoSeven) prior to wounding did not improve wound closure time or histology. The FVIIa analog DVQ (V158D, E296V and M298Q mutations) was designed to have higher tissue factor-independent activity than rVIIa. We hypothesized that a single dose of DVQ would be more effective in restoring wound healing in HB mice. Methods Cutaneous punch wounds were made on the backs of HB and wild-type mice, and the time to wound closure was monitored. HB mice were treated with a dose of rFVIIa (10 mg kg(-1) ) or DVQ (1 mg kg(-1) ) that corrected the tail bleeding time. Skin samples were taken at various time points after wounding, fixed, and stained, and the histology was examined. Results As previously reported, wound closure times in HB mice given one dose of rFVIIa were not improved over those in untreated HB mice. Surprisingly, healing times in HB mice treated with an equally hemostatic dose of DVQ were normalized to that in wild-type mice. However, DVQ did not correct all histologic abnormalities in HB mice. Conclusions As the doses of DVQ and rFVIIa were chosen to support comparable levels of hemostasis, our data suggest that the improved healing seen with DVQ is not solely attributable to its hemostatic activity. It is possible that the improved wound healing arises through the effect of DVQ on cell signaling mechanisms.
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Rates of Autism Spectrum Disorder Diagnosis Under the DSM-5 Criteria Compared to DSM-IV-TR Criteria in a Hospital-Based Clinic. Pediatr Neurol 2016; 57:34-8. [PMID: 26869267 DOI: 10.1016/j.pediatrneurol.2016.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND We aimed to determine whether there was a decrease in the number of children diagnosed on the autism spectrum after the implementation of the new diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition published in May 2013. METHOD We reviewed 1552 charts of children evaluated at the Women and Children's Hospital of Buffalo, Autism Spectrum Disorders Clinic. A comparison was made of children diagnosed with autism spectrum disorder (autism, Asperger disorder, pervasive developmental disorder-not otherwise specified) from 2010 to May 2013 using the Diagnostic and Statistical Manual of Mental Health Disorders Fourth Edition, Text Revision criteria with children diagnosed from June 2013 through June 2015 under the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition. RESULTS Using χ(2) analysis, the 2013-2015 rate of autism spectrum disorder diagnosis (39%) was significantly lower (P < 0.01) than the 2010 to May 2013 sample years rate (50%). CONCLUSION The rate of autism spectrum disorder diagnosis was significantly lower under the recently implemented Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition criteria.
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Coated platelet assay: a feasible approach to a complicated science. Haemophilia 2015; 22:e67-70. [PMID: 26612351 DOI: 10.1111/hae.12845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2015] [Indexed: 11/26/2022]
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Coated platelets and severe haemophilia A bleeding phenotype: Is there a connection? Haemophilia 2015; 22:148-51. [PMID: 26561343 DOI: 10.1111/hae.12844] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/23/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Coated platelets are a subpopulation of platelets that possess highly prothrombotic properties. Previous observational data suggest that bleeding phenotype in severe haemophilia A is associated with coated platelet levels. Haemophilia A patients with higher coated platelet levels may have a mild bleeding phenotype; those with lower levels may have a more severe bleeding phenotype. AIM The aim of the study was to test the hypothesis that coated platelet levels are correlated with clinical bleeding phenotype. METHODS This cross-sectional, observational study enrolled 20 severe haemophilia A patients, including 15 with severe and five with a mild bleeding phenotype, and a control group of 12 healthy volunteers. The haemophilia bleeding phenotype was determined by the patient's medical history and haemophilia treatment centre records. Blood was obtained from each patient by venipuncture and platelets were analysed by flow cytometry. RESULTS Patients categorized as having a severe bleeding phenotype experienced a median eight bleeds per year compared to one bleed annually in the mild bleeding phenotype group. Both groups had similar total platelet counts and fibrinogen levels. There was no difference in coated platelet percentage between severe and mild bleeding phenotype (17 and 16% respectively), however, both groups had significantly lower % coated platelets compared to controls (44%, P < 0.0001). CONCLUSION Coated platelet levels were not associated with bleeding phenotype in this study; however, these data may suggest coated platelet levels are lower in haemophilia patients relative to healthy volunteers.
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Incidence of Endometrial Hyperplasia or Carcinoma at the Time of Endometrial Ablation. J Minim Invasive Gynecol 2015; 22:S109. [DOI: 10.1016/j.jmig.2015.08.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The value of occlusive balloons in the management of abnormal placentation: A retrospective study. J OBSTET GYNAECOL 2015; 36:333-6. [DOI: 10.3109/01443615.2015.1052962] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Evolution of lung breathing from a lungless primitive vertebrate. Respir Physiol Neurobiol 2015; 224:11-6. [PMID: 26476056 DOI: 10.1016/j.resp.2015.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/28/2015] [Accepted: 09/29/2015] [Indexed: 11/25/2022]
Abstract
Air breathing was critical to the terrestrial radiation and evolution of tetrapods and arose in fish. The vertebrate lung originated from a progenitor structure present in primitive boney fish. The origin of the neural substrates, which are sensitive to metabolically produced CO2 and which rhythmically activate respiratory muscles to match lung ventilation to metabolic demand, is enigmatic. We have found that a distinct periodic centrally generated rhythm, described as "cough" and occurring in lamprey in vivo and in vitro, is modulated by central sensitivity to CO2. This suggests that elements critical for the evolution of breathing in tetrapods, were present in the most basal vertebrate ancestors prior to the evolution of the lung. We propose that the evolution of breathing in all vertebrates occurred through exaptations derived from these critical basal elements.
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Abstract 11: Morcellation and the incidence of occult malignancy: a dual-institution review. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gastrointestinal Distress and Race Diet in 161-km Ultramarathoners. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477059.76244.d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Morcellation and the incidence of occult malignancy: A dual-institution review. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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P094: La sarcopénie chez le sujet cirrhotique ascitique : prévalence et analyse des paramètres cliniques associés. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70736-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A comparison of five glucometers in South Africa. JOURNAL OF ENDOCRINOLOGY METABOLISM AND DIABETES OF SOUTH AFRICA 2014. [DOI: 10.1080/22201009.2009.10872202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
A combined anterior and posterior surgical approach is generally recommended in the treatment of severe congenital kyphosis, despite the fact that the anterior vascular supply of the spine and viscera are at risk during exposure. The aim of this study was to determine whether the surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach is feasible, safe and effective. We reviewed the records of ten patients with a mean age of 11.1 years (5.4 to 14.1) who underwent surgery either by pedicle subtraction osteotomy or by vertebral column resection with instrumented fusion through a single posterior approach. The mean kyphotic deformity improved from 59.9° (45° to 110°) pre-operatively to 17.5° (3° to 40°) at a mean follow-up of 47.0 months (29 to 85). Spinal cord monitoring was used in all patients and there were no complications during surgery. These promising results indicate the possible advantages of the described technique over the established procedures. We believe that surgery should be performed in case of documented progression and before structural secondary curves develop. Our current strategy after documented progression is to recommend surgery at the age of five years and when 90% of the diameter of the spinal canal has already developed. Cite this article: Bone Joint J 2013;95-B:1527–32.
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Risk of Reoperation after Second-Generation Global Endometrial Ablation Procedures. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Does ATLS trauma training fit into Western countries: evaluation of the first 8 years of ATLS in Germany. Eur J Trauma Emerg Surg 2013; 39:517-22. [PMID: 26815450 DOI: 10.1007/s00068-013-0316-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 07/19/2013] [Indexed: 11/25/2022]
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Progressive improvement in wound healing with increased therapy in haemophilia B mice. Haemophilia 2013; 19:926-32. [PMID: 23879625 DOI: 10.1111/hae.12220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2013] [Indexed: 11/29/2022]
Abstract
Previous work has shown that normalized haemostasis only at the time of an injury is not sufficient to promote optimal wound healing in haemophilia B (HB) mice. However, the duration of treatment required for optimal healing has not been established. The goal of these studies was to determine the effect of different durations of replacement or bypassing therapy [factor IX(FIX) or factor VIIa (FVIIa)] on wound healing parameters in a mouse model of HB. A dermal wound was placed on the back of HB mice. Animals were either untreated or pretreated and then subsequently treated for 3 days, 5 days, or 7 days with FIX or FVIIa. Wound area, time to wound healing, haematoma formation and iron deposition were measured. All treated animals showed shortened time to healing relative to untreated animals. Haematoma formation was prevented by treatment and bleeding into the wounds, measured by iron scores, was reduced by treatment. In addition, there was a progressive improvement in healing with 7 days of treatment more effective than 5 days which was more effective than 3 days. Replacement therapy with FIX had slightly shorter healing times than bypassing therapy with FVIIa. HB mice treated with FIX had slightly smaller wound area than untreated animals; by contrast, FVIIa-treated animals had much smaller wound areas that were close to the wound areas seen in wild-type animals. The data suggest that sustained therapy is required for normal wound healing.
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Bleeding risk in warfarinized patients with a therapeutic international normalized ratio: the effect of low factor IX levels. J Thromb Haemost 2013; 11:1043-52. [PMID: 23581252 DOI: 10.1111/jth.12244] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 04/01/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Bleeding is the main complication of warfarin therapy, even patients with an international normalized ratio (INR) in the target range can suffer bleeding, suggesting that INR does not perfectly reflect the therapeutic effect of warfarin. We hypothesized the INR might underestimate the level of anticoagulation in a subject with a lower factor (F) IX level than average. METHODS AND RESULTS We modeled warfarin anticoagulation in our in vitro thrombin generation (TG) model by adjusting the levels of vitamin K-dependent factors to those of patients with an INR of 2-3. Variation in FIX had a marked effect on TG but had no effect on the prothrombin time (PT)-INR. A prospective observational, cross-sectional clinical study including 341 consecutive patients admitted to the emergency department with an INR between 2 and 3, showed a statistically lower FIX activity in bleeders (P = 0.004) compared with others. No correlation was found between TG capacity and PT-INR results (P = 0.36). However, in patients, presenting with a warfarin-related hemorrhage, TG was significantly lower (P < 0.001) than others. A correlation on the boundary of significance was observed between TG capacity and FIX levels (P = 0.09). CONCLUSION These data demonstrates that patients who bleed when their PT-INR is in the target range 2-3 might have defective TG related to a lower level of FIX than expected.
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Utilization of family members to provide hospital care in Malawi: the role of Hospital Guardians. Malawi Med J 2012; 24:74-78. [PMID: 23638281 PMCID: PMC3623026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
AIM Like most of sub-Saharan Africa, Malawi suffers from a paucity of human resources in the health sector. With an average of one physician for every 50,000 persons, and a health care professional to in-patient population ratio of 1:277, patient care suffers. At Kamuzu Central Hospital (KCH) of Lilongwe, Malawi, family members, termed Hospital Guardians, are utilized to provide basic care for patients. The aim of our study is to characterize this population and explore their role in the health care system of KCH. METHODS Seventy three semi-qualitative surveys and nineteen in-depth interviews were conducted with hospital administrators, Guardians, nurses, and physicians from these wards. The results were analyzed using descriptive analysis and emergent coding. RESULTS It was found that Hospital Guardians were primarily female family members of patients and have a low literacy rate. They performed a wide range of daily tasks in patient care from wound care to advocacy. Despite their essential role in the health care system, the Guardians were provided with little support from the hospital. There was often conflict between the Guardians and hospital personnel due to overcrowding with more than one Guardian per patient; a lack of understanding of hospital rules and regulations; and a lack of respect for the Guardian role by hospital staff. CONCLUSIONS Until their role can be reduced by additional trained health care professionals, patient care could be improved by institutional support including a clarification of the role of the Hospital Guardians. Recommendations include a one-patient one-guardian policy; Guardian education; and enhancing Guardian resources.
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Robotic Assisted Resection of a Noncommunicating Rudimentary Uterine Horn with a Broad Connection to the Uterus. J Minim Invasive Gynecol 2012. [DOI: 10.1016/j.jmig.2012.08.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Understanding the mechanism of action of normal hemostasis and how the bypassing agents recombinant activated factor VII (rFVIIa; NovoSeven) and plasma-derived activated prothrombin complex concentrate (Factor Eight Inhibitor Bypassing Agent [FEIBA]) control abnormal bleeding is imperative for healthcare professionals who treat patients with hemophilia and other bleeding disorders. A cell-based model has improved our understanding of in vivo mechanisms of hemostasis and the basis of the bleeding tendency in hemophilia. Bypassing agents do not restore the normal pathways of hemostasis in hemophilia, but rather boost thrombin generation in spite of a lack of platelet surface FVIIIa-FIXa ('tenase') activity. Thus, the common clinical laboratory coagulation assays do not reflect the clinically relevant hemostatic activity of bypassing agents, and no validated assay is available with which to measure the in vivo efficacy of these agents or predict individual patient responses to treatment. Global hemostasis assays measuring overall coagulation capacity have potential for assessment of the effects of bypassing agents. This review will focus on the mechanisms of clotting and their relationship to understanding the mechanisms of action of the bypassing agents in vivo and the methodologies that are emerging to monitor the clinical efficacy of bypassing agent therapy.
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