The use of spirometry in a primary care setting

Elizabeth A Blain, Timothy J CraigPenn State Hershey Medical Center, Hershey, PA, USAObjective: To determine the use of spirometry in family practice, internal medicine, and pediatric outpatient settings.Methods: Data were collected from 45 outpatient offices in the central Pennsylvania area via phone survey that asked a set of four questions: 1) Do you have spirometry in your office? 2) Do you use spirometry for asthma patients? 3) In what situation do you use spirometry for? 4) Do you use spirometry more for chronic obstructive pulmonary disease (COPD) or asthma? Results: It was found that pediatricians used spirometry 66% of the time, family practitioners 47% of the time, and internal medicine practitioners 60% of the time. Of those who did not use spirometry, 94% stated that they refer to a hospital if they required spirometry and 6% referred to subspecialists if the patient required spirometry. 10% of pediatricians performed the test on each asthma visit, otherwise the others used it only for exacerbations or as a baseline. No internists used spirometry regularly for asthma patients, and 22% used it more for COPD. In family practice only 14% used spirometry routinely at each visit for asthma patients.Conclusions: Pediatricians used spirometry more often in the outpatient setting than other specialists, followed closely by internal medicine physicians. Family practice physicians were the least likely to use spirometry. Multiple barriers seemed to prevent routine use of spirometry, but no one barrier accounted for the majority.Keywords: spirometry, asthma, primary car

Potential of zebrafish as a model to characterise MicroRNA profiles in mechanically mediated joint degeneration

Mechanically mediated joint degeneration and cartilage dyshomeostasis is implicated in highly prevalent diseases such as osteoarthritis. Increasingly, MicroRNAs are being associated with maintaining the normal state of cartilage, making them an exciting and potentially key contributor to joint health and disease onset. Here, we present a summary of current in vitro and in vivo models which can be used to study the role of mechanical load and MicroRNAs in joint degeneration, including: non-invasive murine models of PTOA, surgical models which involve ligament transection, and unloading models based around immobilisation of joints or removal of load from the joint through suspension. We also discuss how zebrafish could be used to advance this field, namely through the availability of transgenic lines relevant to cartilage homeostasis and the ability to accurately map strain through the cartilage, enabling the response of downstream MicroRNA targets to be followed dynamically at a cellular level in areas of high and low strain

Heterogeneous abnormalities of in-vivo left ventricular calcium influx and function in mouse models of muscular dystrophy cardiomyopathy

BACKGROUND: Manganese-enhanced cardiovascular magnetic resonance (MECMR) can non-invasively assess myocardial calcium influx, and calcium levels are known to be elevated in muscular dystrophy cardiomyopathy based on cellular studies. METHODS: Left ventricular functional studies and MECMR were performed in mdx mice (model of Duchenne Muscular Dystrophy, 24 and 40 weeks) and Sgcd−/− mice (Limb Girdle Muscular Dystrophy 2 F, 16 and 32 weeks), compared to wild type controls (C57Bl/10, WT). RESULTS: Both models had left ventricular hypertrophy at the later age compared to WT, though the mdx mice had reduced stroke volumes and the Sgcd−/− mice increased heart rate and cardiac index. Especially at the younger ages, MECMR was significantly elevated in both models (both P<0.05 versus WT). The L-type calcium channel inhibitor diltiazem (5 mg/kg i.p.) significantly reduced MECMR in the mdx mice (P<0.01), though only with a higher dose (10 mg/kg i.p.) in the Sgcd−/− mice (P<0.05). As the Sgcd−/− mice had increased heart rates, to determine the role of heart rate in MECMR we studied the hyperpolarization-activated cyclic nucleotide-gated channel inhibitor ZD 7288 which selectively reduces heart rate. This reduced heart rate and MECMR in all mouse groups. However, when looking at the time course of reduction of MECMR in the Sgcd−/− mice at up to 5 minutes of the manganese infusion when heart rates were matched to the WT mice, MECMR was still significantly elevated in the Sgcd−/− mice (P<0.01) indicating that heart rate alone could not account for all the increased MECMR. CONCLUSIONS: Despite both mouse models exhibiting increased in-vivo calcium influx at an early stage in the development of the cardiomyopathy before left ventricular hypertrophy, there are distinct phenotypical differences between the 2 models in terms of heart rates, hemodynamics and responses to calcium channel inhibitors

Modeling Relations Between Event-Related Potential Factors and Broader Versus Narrower Dimensions of Externalizing Psychopathology

The organization of the Hierarchical Taxonomy of Psychopathology (HiTOP) model provides unique opportunities to evaluate whether neural risk measures operate as indicators of broader latent liabilities (e.g., externalizing proneness) or narrower expressions (e.g., antisociality and alcohol abuse). Following this approach, the current study recruited a sample of 182 participants (54% female) who completed measures of externalizing psychopathology (also internalizing) and associated traits. Participants also completed three tasks (Flanker-No Threat, Flanker-Threat, and Go/No-Go tasks) with event-related potential (ERP) measurement. Three variants of two research domain criteria (RDoC)-based neurophysiological indicators—P3 and error-related negativity (ERN)—were extracted from these tasks and used to model two latent ERP factors. Scores on these two ERP factors independently predicted externalizing factor scores when accounting for their covariance with sex—suggesting distinct neural processes contributing to the broad externalizing factor. No predictive relation with the broad internalizing factor was found for either ERP factor. Analyses at the finer-grained level revealed no unique predictive relations of either ERP factor with any specific externalizing symptom variable when accounting for the broad externalizing factor, indicating that ERN and P3 index general liability for problems in this spectrum. Overall, this study provides new insights about neural processes in externalizing psychopathology at broader and narrower levels of the HiTOP hierarchy

A human embryonic limb cell atlas resolved in space and time

Human limbs emerge during the fourth post-conception week as mesenchymal buds, which develop into fully formed limbs over the subsequent months1. This process is orchestrated by numerous temporally and spatially restricted gene expression programmes, making congenital alterations in phenotype common2. Decades of work with model organisms have defined the fundamental mechanisms underlying vertebrate limb development, but an in-depth characterization of this process in humans has yet to be performed. Here we detail human embryonic limb development across space and time using single-cell and spatial transcriptomics. We demonstrate extensive diversification of cells from a few multipotent progenitors to myriad differentiated cell states, including several novel cell populations. We uncover two waves of human muscle development, each characterized by different cell states regulated by separate gene expression programmes, and identify musculin (MSC) as a key transcriptional repressor maintaining muscle stem cell identity. Through assembly of multiple anatomically continuous spatial transcriptomic samples using VisiumStitcher, we map cells across a sagittal section of a whole fetal hindlimb. We reveal a clear anatomical segregation between genes linked to brachydactyly and polysyndactyly, and uncover transcriptionally and spatially distinct populations of the mesenchyme in the autopod. Finally, we perform single-cell RNA sequencing on mouse embryonic limbs to facilitate cross-species developmental comparison, finding substantial homology between the two species

Análisis de sistemas binarios con período variable

Estarnos llevando a cabo un monitoreo fotomètrico de una muestra de sistemas binarios eclipsantes con período variable, considerados preliminarmente como semiseparados o en contacto, a fin de determinar sus parámetros astrofísicos fundamentales y caracterizar la interacción entre sus componentes. En este trabajo presentamos las curvas de luz de cuatro sistemas y el modelado de dos de ellas. Verificamos que la fotometría obtenida es adecuada para los objetivos del proyecto. Conjuntamente presentamos la primera clasificación espectral de siete de estos sistemas.We are conducting a photometric monitoring of a sample of eclipsing binary systems with variable periods, preliminarly considered as semidetached or in contact. We aim at determining the fundamental astrophysical parameters of these objects and at characterizing the interactions between their components. In this work we present the light curves of four systems and the modeling of two of them. The photometry has revealed to be adequate for the project purposes. We also report the first spectral classification of seven systems from the sample.Facultad de Ciencias ExactasInstituto de Astrofísica de La Plat

Análisis de sistemas binarios con período variable

Estarnos llevando a cabo un monitoreo fotomètrico de una muestra de sistemas binarios eclipsantes con período variable, considerados preliminarmente como semiseparados o en contacto, a fin de determinar sus parámetros astrofísicos fundamentales y caracterizar la interacción entre sus componentes. En este trabajo presentamos las curvas de luz de cuatro sistemas y el modelado de dos de ellas. Verificamos que la fotometría obtenida es adecuada para los objetivos del proyecto. Conjuntamente presentamos la primera clasificación espectral de siete de estos sistemas.We are conducting a photometric monitoring of a sample of eclipsing binary systems with variable periods, preliminarly considered as semidetached or in contact. We aim at determining the fundamental astrophysical parameters of these objects and at characterizing the interactions between their components. In this work we present the light curves of four systems and the modeling of two of them. The photometry has revealed to be adequate for the project purposes. We also report the first spectral classification of seven systems from the sample.Facultad de Ciencias ExactasInstituto de Astrofísica de La Plat

A Mixed Blessing: Market-Mediated Religious Authority in Neopaganism

This research explores how marketplace dynamics affect religious authority in the context of Neopagan religion. Drawing on an interpretivist study of Wiccan practitioners in Italy, we reveal that engagement with the market may cause considerable, ongoing tensions, based on the inherent contradictions that are perceived to exist between spirituality and commercial gain. As a result, market success is a mixed blessing that can increase religious authority and influence, but is just as likely to decrease authority and credibility. Using an extended case study method, we propose a theoretical framework that depicts the links between our informants’ situated experiences and the macro-level factors affecting religious authority as it interacts with market-mediated dynamics at the global level. Overall, our study extends previous work in macromarketing that has looked at religious authority in the marketplace) and how the processes of globalization are affecting religion

Long-Term Blocking of Calcium Channels in mdx Mice Results in Differential Effects on Heart and Skeletal Muscle

The disease mechanisms underlying dystrophin-deficient muscular dystrophy are complex, involving not only muscle membrane fragility, but also dysregulated calcium homeostasis. Specifically, it has been proposed that calcium channels directly initiate a cascade of pathological events by allowing calcium ions to enter the cell. The objective of this study was to investigate the effect of chronically blocking calcium channels with the aminoglycoside antibiotic streptomycin from onset of disease in the mdx mouse model of Duchenne muscular dystrophy (DMD)

Análisis de sistemas binarios con período variable

Estarnos llevando a cabo un monitoreo fotomètrico de una muestra de sistemas binarios eclipsantes con período variable, considerados preliminarmente como semiseparados o en contacto, a fin de determinar sus parámetros astrofísicos fundamentales y caracterizar la interacción entre sus componentes. En este trabajo presentamos las curvas de luz de cuatro sistemas y el modelado de dos de ellas. Verificamos que la fotometría obtenida es adecuada para los objetivos del proyecto. Conjuntamente presentamos la primera clasificación espectral de siete de estos sistemas.We are conducting a photometric monitoring of a sample of eclipsing binary systems with variable periods, preliminarly considered as semidetached or in contact. We aim at determining the fundamental astrophysical parameters of these objects and at characterizing the interactions between their components. In this work we present the light curves of four systems and the modeling of two of them. The photometry has revealed to be adequate for the project purposes. We also report the first spectral classification of seven systems from the sample.Facultad de Ciencias ExactasInstituto de Astrofísica de La Plat