Extracellular vesicle characteristics and micro RNA content in cerebral palsy and typically developed individuals at rest and in response to aerobic exercise.

In this study, the properties of circulating extracellular vesicles (EVs) were examined in cerebral palsy (CP) and typically developed (TD) individuals at rest and after aerobic exercise, focusing on the size, concentration, and microRNA cargo of EVs. Nine adult individuals with CP performed a single exercise bout consisting of 45 min of Frame Running, and TD participants completed either 45 min of cycling (n = 10; TD EX) or were enrolled as controls with no exercise (n = 10; TD CON). Blood was drawn before and 30 min after exercise and analyzed for EV concentration, size, and microRNA content. The size of EVs was similar in CP vs. TD, and exercise had no effect. Individuals with CP had an overall lower concentration (~25%, p \u3c 0.05) of EVs. At baseline, let-7a, let-7b and let-7e were downregulated in individuals with CP compared to TD (p \u3c 0.05), while miR-100 expression was higher, and miR-877 and miR-4433 lower in CP compared to TD after exercise (p \u3c 0.05). Interestingly, miR-486 was upregulated ~2-fold in the EVs of CP vs. TD both at baseline and after exercise. We then performed an in silico analysis of miR-486 targets and identified the satellite cell stemness factor Pax7 as a target of miR-486. C2C12 myoblasts were cultured with a miR-486 mimetic and RNA-sequencing was performed. Gene enrichment analysis revealed that several genes involved in sarcomerogenesis and extracellular matrix (ECM) were downregulated. Our data suggest that circulating miR-486 transported by EVs is elevated in individuals with CP and that miR-486 alters the transcriptome of myoblasts affecting both ECM- and sarcomerogenesis-related genes, providing a link to the skeletal muscle alterations observed in individuals with C

A global view of protein expression in human cells, tissues, and organs

Defining the protein profiles of tissues and organs is critical to understanding the unique characteristics of the various cell types in the human body. In this study, we report on an anatomically comprehensive analysis of 4842 protein profiles in 48 human tissues and 45 human cell lines. A detailed analysis of over 2 million manually annotated, high-resolution, immunohistochemistry-based images showed a high fraction (>65%) of expressed proteins in most cells and tissues, with very few proteins (<2%) detected in any single cell type. Similarly, confocal microscopy in three human cell lines detected expression of more than 70% of the analyzed proteins. Despite this ubiquitous expression, hierarchical clustering analysis, based on global protein expression patterns, shows that the analyzed cells can be still subdivided into groups according to the current concepts of histology and cellular differentiation. This study suggests that tissue specificity is achieved by precise regulation of protein levels in space and time, and that different tissues in the body acquire their unique characteristics by controlling not which proteins are expressed but how much of each is produced

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Neonatal Exposure to Anaesthesia and Adjuvants : Acute Effects on Cerebral Apoptosis and Neuroproteins, and Late Behavioural Aberrations in Mice

During a finite developmental phase – the brain growth spurt – the brain grows and matures at an accelerated rate. During this period the brain is more sensitive to harmful substances such as ethanol and environmental toxins than before or after. This period extends from the last trimester to the second year in humans and occurs postnatally in the mice used for these studies. The aims of this thesis were; to investigate common anaesthetics ability to promote acute apoptosis and late persistant behavioural aberrations measured with spontaneous behaviour in a novel home environment, learning in a radial arm maze and anxiety-like behaviour in an elevated plus maze, to measure alterations in BDNF, CaMKII, GAP-43, synaptophysin and tau after anaesthesia exposure, to evaluate clonidine as a potentially protecting agent and examine if theophylline, a chemically unrelated compound, causes similar effects as anaesthetics. Some of the results are: combinations of anaesthetics acting on the GABAA receptor (propofol or pentothal) and NMDA receptor (ketamine) exhibit more apoptosis and behavioural alterations than single anaesthetics. Ketamine, but not propofol, alters the content of CaMKII and GAP-43 proteins important in brain development. Propofol exposure alters the content of BDNF (brain derived neurotrophic factor) in hippocampus, frontal and parietal cortex. Neonatal propofol exposure leads to less sensitiveness to diazepam in adult age as measured with induced spontaneous behaviour and an elevated plus maze. Clonidine, an alpha2 adrenergic agonist does not cause any aberrations and appears to prevent apoptosis and behavioural alterations after ketamine. Theophylline, used as apnoea treatment in neonates, also increases apoptosis and alters normal behaviour. Thus, alterations both in neuronal survival, function and protein expression is apparent after neonatal exposure to anaesthetics. This is also shown in studies of Rhesus monkeys. However, it is still difficult to assess how these findings should extrapolate to humans. Epidemiological studies give conflicting results. Insufficient anaesthesia is not a solution as pain and stress cause even more pronounced problems. Minimizing anaesthetic exposure, delaying procedures until after the sensitive phase and finding protective agents, such as clonidine, are possible strategies. Evaluation of other substances that infants are exposed to is needed

Neonatal Exposure to Anaesthesia and Adjuvants : Acute Effects on Cerebral Apoptosis and Neuroproteins, and Late Behavioural Aberrations in Mice

During a finite developmental phase – the brain growth spurt – the brain grows and matures at an accelerated rate. During this period the brain is more sensitive to harmful substances such as ethanol and environmental toxins than before or after. This period extends from the last trimester to the second year in humans and occurs postnatally in the mice used for these studies. The aims of this thesis were; to investigate common anaesthetics ability to promote acute apoptosis and late persistant behavioural aberrations measured with spontaneous behaviour in a novel home environment, learning in a radial arm maze and anxiety-like behaviour in an elevated plus maze, to measure alterations in BDNF, CaMKII, GAP-43, synaptophysin and tau after anaesthesia exposure, to evaluate clonidine as a potentially protecting agent and examine if theophylline, a chemically unrelated compound, causes similar effects as anaesthetics. Some of the results are: combinations of anaesthetics acting on the GABAA receptor (propofol or pentothal) and NMDA receptor (ketamine) exhibit more apoptosis and behavioural alterations than single anaesthetics. Ketamine, but not propofol, alters the content of CaMKII and GAP-43 proteins important in brain development. Propofol exposure alters the content of BDNF (brain derived neurotrophic factor) in hippocampus, frontal and parietal cortex. Neonatal propofol exposure leads to less sensitiveness to diazepam in adult age as measured with induced spontaneous behaviour and an elevated plus maze. Clonidine, an alpha2 adrenergic agonist does not cause any aberrations and appears to prevent apoptosis and behavioural alterations after ketamine. Theophylline, used as apnoea treatment in neonates, also increases apoptosis and alters normal behaviour. Thus, alterations both in neuronal survival, function and protein expression is apparent after neonatal exposure to anaesthetics. This is also shown in studies of Rhesus monkeys. However, it is still difficult to assess how these findings should extrapolate to humans. Epidemiological studies give conflicting results. Insufficient anaesthesia is not a solution as pain and stress cause even more pronounced problems. Minimizing anaesthetic exposure, delaying procedures until after the sensitive phase and finding protective agents, such as clonidine, are possible strategies. Evaluation of other substances that infants are exposed to is needed

Neonatal Exposure to Anaesthesia and Adjuvants : Acute Effects on Cerebral Apoptosis and Neuroproteins, and Late Behavioural Aberrations in Mice

During a finite developmental phase – the brain growth spurt – the brain grows and matures at an accelerated rate. During this period the brain is more sensitive to harmful substances such as ethanol and environmental toxins than before or after. This period extends from the last trimester to the second year in humans and occurs postnatally in the mice used for these studies. The aims of this thesis were; to investigate common anaesthetics ability to promote acute apoptosis and late persistant behavioural aberrations measured with spontaneous behaviour in a novel home environment, learning in a radial arm maze and anxiety-like behaviour in an elevated plus maze, to measure alterations in BDNF, CaMKII, GAP-43, synaptophysin and tau after anaesthesia exposure, to evaluate clonidine as a potentially protecting agent and examine if theophylline, a chemically unrelated compound, causes similar effects as anaesthetics. Some of the results are: combinations of anaesthetics acting on the GABAA receptor (propofol or pentothal) and NMDA receptor (ketamine) exhibit more apoptosis and behavioural alterations than single anaesthetics. Ketamine, but not propofol, alters the content of CaMKII and GAP-43 proteins important in brain development. Propofol exposure alters the content of BDNF (brain derived neurotrophic factor) in hippocampus, frontal and parietal cortex. Neonatal propofol exposure leads to less sensitiveness to diazepam in adult age as measured with induced spontaneous behaviour and an elevated plus maze. Clonidine, an alpha2 adrenergic agonist does not cause any aberrations and appears to prevent apoptosis and behavioural alterations after ketamine. Theophylline, used as apnoea treatment in neonates, also increases apoptosis and alters normal behaviour. Thus, alterations both in neuronal survival, function and protein expression is apparent after neonatal exposure to anaesthetics. This is also shown in studies of Rhesus monkeys. However, it is still difficult to assess how these findings should extrapolate to humans. Epidemiological studies give conflicting results. Insufficient anaesthesia is not a solution as pain and stress cause even more pronounced problems. Minimizing anaesthetic exposure, delaying procedures until after the sensitive phase and finding protective agents, such as clonidine, are possible strategies. Evaluation of other substances that infants are exposed to is needed

The school- and child healthcare- nurse experience of consulting with families with child maltreatment

Bakgrund: Att upptäcka och stödja barn som far illa är ett stort och unikt ansvar. Sjuksköterskan är den enda utanför familjen som regelbundet träffar barn och följer deras hälsa, tillväxt och utveckling. Sjuksköterskan kan hamna i en svår situation då de misstänker att barn far illa och samtidigt vill behålla en god kontakt med föräldrarna. Alla föräldrar vill sina barns bästa men förutsättningarna varierar. Syfte: Syftet var att undersöka Skol- och BVC-sjuksköterskans erfarenheter av att möta familjer där barn far illa i hemmet. Metod: Datamaterialet utgörs av intervjuer med sju Skol- och BVC-sjuksköterskor med specialistexamen. Studien har analyserats med en kvalitativ innehållsanalys med induktiv ansats. Resultat: Ur analysen framträdde två huvudkategorier, Att samverka för barnet och Att vara en stödjande person. Resultatet visade att det var av betydelse att våga se och hjälpa familjer genom uppbyggnad av förtroende och stöd från sjuksköterskan. Konklusion: Av resultatet framkommer att sjuksköterskan såg en stor vikt av att bygga upp ett förtroende till barnet och familjen då det hade betydelse för hur sjuksköterskan sedan skulle kunna ge det stöd barnet och familjen behövde. Dock fanns en ständig rädsla för att familjen skulle tappa förtroendet. Det krävdes mod att våga se de barn som far eller riskerar att fara illa och vidta åtgärder

Vad ska du bli när du blir stor? : Vilka faktorer påverkar gymnasievalet?

Huvudsyftet med denna studie är att kartlägga vilka faktorer som påverkar i gymnasievalet. Frågeställningar som belyses är vilka faktorer som påverkar eleverna och vilka personer som är betydelsefulla. I studien diskuteras också skillnader mellan olika grupper som exempelvis kön. Metoden som valdes var enkätundersökning med elever i årskurs 9 som stod inför sitt gymnasieval. Resultatet visar att intresse och att programmet ska förbereda för högre studier är de faktorer som påverkar mest. Betydelsefulla personer är framförallt eleven själv, men också vårdnadshavare. Som teoretisk utgångspunkt har Pierre Bourdieus begreppsram använts. Resultatet visar att vårdnadshavarnas utbildningsnivå har en direkt påverkan på elevens meritvärde vilket i sin tur påverkar valet mot ett bredare program med inriktning mot teoretiska ämnen. Det finns ett samband mellan vilket intresse som utvecklas och elevens habitus. Vårdnadshavarnas informationskapital och skolkapital påverkar också elevens val av program.The main objective of this study is to identify factors that affect the high school choice. The research questions highlights factors that affect students and which persons were significant. The study also discusses the differences between various groups such as sex. The chosen method was a questionnaire survey of students in grade 9 who were facing their election. The results showed that interest and the program to prepare for higher studies was the factors that impacted the most. Important people were mainly pupils themselves, but also parents. As a theoretical point, Pierre Bourdieu's conceptual framework has been used. The results shown that parents education has a direct impact on the student's merit rating, which affects the choice of a broader program focusing on academic subjects. There is a relationship between the interest which is being developed and the student's habitus. Parents' information capital and school capital also affects the student's choice of programs

The importance of the nurse´s knowledge in the meeting with the depressed patient : a literature review

Depression är en av de vanligaste folksjukdomarna i världen. Symtombilden är dock ofta olika hos äldre och yngre samt hos kvinnor och män vilket komplicerar upptäckten av depressioner och gör att de ofta förblir oupptäckta och obehandlade och orsakar onödigt lidande hos de drabbade och deras anhöriga. Syftet med denna studie vara att beskriva betydelsen av allmänsjuksköterskans kunskap om symtom och riskfaktorer för depression i möte med patienter. Frågeställningarna var: Varför behöver sjuksköterskan ökad kunskap om depressioner och vad behöver hon kunskap om. Metoden som användes var litteraturöversikt och resultatet består av tjugotre artiklar. Resultatet visade att sjuksköterskan bör bygga upp en relation med patienten då hon med hjälp av denna relation har störst möjlighet att uppmärksamma en depression vilket gör att hon kan minska onödigt lidande. Men Sjuksköterskor har ofta inte tillräckligt med kunskap om vad en depression innebär och vad de bör uppmärksamma hos olika människor då symtomen varierar sig mellan kön och åldersgrupper, vilket orsakar att många depressioner förblir oupptäckta och obehandlade.Depression is one of the most common diseases in the world. The symptom of depression are often different among older people and younger and among women and men which often complicate nurses ability to detect depression and may lead to several undetected and untreated depressions that may cause unnecessary suffering to the patient and their relative’s. The aim of this study is to discribe the importance of the nurse’s knowledge of symtoms and riskfactors of depression in the meeting with the patients. The question at issue was: Why does the nurse need to gain more knowledge about depression and what do she / he need to gain more knowledge about. The method which is used is literary review and the results consist of twenty three articles. The result of this study shows that the nurse’s should build a relationship with the patient, which give them the opportunity to detect depressions and reduce unnecessary suffering. But nurse’s often does not have enough knowledge about what depression is and what they should notice because the symptoms vary between the genders and age which may cause several depressions remain undetected and untreated