The Relationship Between Task-Induced Stress and Time Perception

A distortion of time is often reported under the presence of stress or threatening stimuli, for instance motor vehicle accidents or near-death experiences. There is a lack of research on the complexity of time distortion under stress; thus, the present study aimed to explore the relationship between stress and time perception. Given the challenges associated with producing a stress response in a laboratory setting, difficult tasks have been previously used to produce a stress response, such as anagram tasks. However, it remains unknown whether experiencing time pressure while completing a stressful task can also influence time distortion. To investigate this, participants completed either an easy or difficult anagram task and received either an unspecified time limit or no time limit to complete the task. It was hypothesized that participants would experience the greatest distortion of time when the task was difficult, and they were provided an unspecified time limit. Contrary to the hypothesis, we failed to find differences in task performance or time perception across the various conditions, which may be explained by the inability to produce a stress state. While stress manipulation was unsuccessful, the findings suggest utilizing multiple tasks may be more effective at replicating a physiological or psychological stress state. Thus, the results of this study warrant further investigation to examine the relationship between stress, time pressure, and time distortion

The Advantages of a Rural Resident Rotation in Otolaryngology Training: Comparing Surgical Case Volumes of a Rural Rotation with a University Rotation

Objective: Rural residency rotations have played a significant role in encouraging surgical residents to pursue a career in a rural community. This study reviews the resident caseload of an otolaryngology residency rural rotation in comparison with a traditional primary university-based urban location. Methods: The Accreditation Council for Graduate Medical Education (ACGME) case log system was used to review cases logged by residents during their rural rotations from July 2017 to December 2018. Case log data were compared with a matched resident of similar training experience on the university service during the same time period. Results: Rural residents reported more cases than their urban-based counterparts (1143 vs 690 cases). Junior residents had over double the number of cases in rural practice (400) compared to junior residents on the university service (168). The university service was much stronger on H&N Neck (54 vs. 28 cases), Larynx (39 vs 8) and Endoscopy (92 vs 42). In contrast, the rural rotation provided substantially more Endocrine cases (103 vs 47) and comparable Salivary cases (23 vs 21) compared to the university service. Discussion: This study defines a surgically robust rotation in rural medicine and highlights the possibility of obtaining exposure to a surgical practice unique to a rural setting. By participating in high volume surgical rural residency rotations, trainees may better understand the otolaryngologic needs of a rura

Effects of Circulating and Local Uteroplacental Angiotensin II in Rat Pregnancy.

The renin-angiotensin (Ang) system is important during placental development. Dysregulation of the renin-Ang system is important in preeclampsia (PE). Female rats transgenic for the human angiotensinogen gene crossed with males transgenic for the human renin gene develop the PE syndrome, whereas those of the opposite cross do not. We used this model to study the role of Ang II in trophoblast invasion, which is shallow in human PE but deeper in this model. We investigated the following groups: PE rats, opposite-cross rats, Ang II–infused rats (1000 ng/kg per day), and control rats. Ang II infusion increased only circulating Ang II levels (267.82 pg/mL), opposite cross influenced only uteroplacental Ang II (13.52 fmol/mg of protein), and PE increased both circulating (251.09 pg/mL) and uteroplacental (19.24 fmol/mg of protein) Ang II. Blood pressure and albuminuria occurred in the models with high circulating Ang II but not in the other models. Trophoblast invasion increased in PE and opposite-cross rats but not in Ang II–infused rats. Correspondingly, uterine artery resistance index increased in Ang II–infused rats but decreased in PE rats. We then studied human trophoblasts and villous explants from first-trimester pregnancies with time-lapse microscopy. Local Ang II dose-dependently increased migration by 75%, invasion by 58%, and motility by 282%. The data suggest that local tissue Ang II stimulates trophoblast invasion in vivo in the rat and in vitro in human cells, a hitherto fore unrecognized function. Conceivably, upregulation of tissue Ang II in the maternal part of the placenta represents an important growth factor for trophoblast invasion and migration

The Value of a Longitudinal Human Immunodeficiency Virus Track for Medical Students: 10-Year Program Evaluation

We surveyed graduates of a longitudinal medical school human immunodeficiency virus curriculum to evaluate its impact. Respondents felt comfortable caring for people with human immunodeficiency virus (PWH) and found value from the curriculum regardless of ultimate career path. Programs like this contribute to the development of culturally sensitive clinicians comfortable caring for PWH

Doc’Apella: A Vocal Performance Group Designed to Reduce Stress And Prevent Burnout Among Medical and Health Sciences Students

Introduction: Burnout is common among health professions trainees characterized by emotional exhaustion induced by repeated stressors. Although traditional stress management activities to promote wellness are effective in reducing stress short-term, alternative approaches are needed with the potential for long-term impact. To address burnout among students at the University of Nebraska Medical Center (UNMC), a vocal group was formed to provide a creative outlet. The purpose of this study was to determine the students’ motivation for joining Doc’Apella and assess the impact on burnout. Methods: Students enrolled in a health sciences program were invited to participate during the 2018-19 academic year (August-May). Two volunteer students arranged the music, recorded individual practice tracks, and directed the group during rehearsals two nights/week from 5:30-6:30. Group members selected arrangements and performed in a variety of settings. At the end of the year, participants were invited to complete an anonymous online survey. Results: Of the 98 students on the roster, 18 (18.4%) responded to the survey. Participants included medical students (n = 9, 50.0%), three graduate students (16.7%), two public health students (11.1%), one pharmacy student (5.5%), and three classified as “other” (16.7%). Nine (50.0%) indicated the aspect of the group that was MOST important was “escaping my stress or frustration with a creative activity.” Thirteen (72.2%) felt Doc’Apella was very or extremely beneficial to their “own sense of wellbeing” and 94.4% (n = 17) reported Doc’Apella “helped reduce stress and burnout” somewhat or very much. Conclusion: Creating music with others may provide an effective way for medical trainees to not only to express creative energy but also to connect with others across health professions. Although the results support structured creative activities to reduce stress and burnout, a large-scale study is needed will strengthen empirical evidence and highlight the impact for health professions trainees

Local intra-uterine Ang-(1-7) infusion attenuates PGE2 and 6-keto PGF1α in decidualized uterus of pseudopregnant rats

Background: Cyclooxygenase (COX)-derived prostanoids (PGE2, PGI2) are important contributors to the process of decidualization. Previous studies showed the presence of Ang-(1-7) in the primary and secondary decidualized zones of the implantation site at early pregnancy. Decreased concentrations of Ang-(1-7) were found in the decidualized uterus compared to the non-decidualized uterus of pseudopregnant rats, suggesting that low levels of Ang-(1-7) are required for successful decidualization at early pregnancy. Methods: To understand the role of Ang-(1-7) in prostaglandin production in a decidualized uterus, induced by a bolus injection of sesame oil, Ang-(1-7) (24 μg/kg/h) or vehicle was then infused directly into the decidualized uterine horn using an osmotic minipump. The right horns were not injected or infused and served as nondecidualized uterine horns in both groups of animals. Results: Decidualization increased PGE2 concentration in the uterus (0.53±0.05 vs. 12.0±3.2 pmol/mg protein, p\u3c0.001, non-decidualized vs. decidualized horns); Ang-(1-7) infusion attenuated the increase of PGE2 (12.0± 3.2 vs. 5.1±1.3 pmol/mg protein, p\u3c0.01 control vs. Ang-(1-7) treated decidualized horns). The stable metabolite of PGI2 (6-keto PGF1α) was increased with decidualization (0.79±0.17 vs. 3.5±0.82 pmol/mg protein, p\u3c0.001, non-decidualized vs. decidualized horns). Ang-(1-7) infusion attenuated the increase in 6keto PGF1α in the decidualized horn (3.5±0.82 vs 1.8±0.37 pmol/mg protein, p\u3c0.05 control vs. Ang-(1-7) treated decidualized horns). The circulating levels of 6-keto-PGF1a and TXB2 were decreased by Ang-(1-7) infusion, while no difference was observed in circulating PGE2. Although the global assessment of cleaved caspase 3 immunostaining, a marker of apoptosis, was unchanged within the Ang-(1-7) decidualized horn, there were localized decreases in cleaved caspase 3 staining in the luminal region in the decidualized uterus of Ang-(1-7)-treated rats. Conclusions: These studies show that increased local uterine Ang-(1-7) alters the uterine prostaglandin environment, possibly leading to disruptions of early events of decidualization

Local uterine Ang-(1-7) infusion augments the expression of cannabinoid receptors and differentially alters endocannabinoid metabolizing enzymes in the decidualized uterus of pseudopregnant rats

Background Endocannabinoids (ECs) are important contributors to implantation and decidualization and are suppressed in early pregnancy. Elevated levels of anandamide (AEA), the endogenous ligand for the CB1 and CB2 receptors (R), interfere with receptivity of the blastocyst. Ang-(1–7) is down-regulated in the implantation site (IS) in normal pregnancy at day 7 of gestation. We determined the effects of intra-uterine angiotensin-(1–7) [Ang-(1–7)] (24 microg/kg/h) or vehicle given into the left uterine horn on the ECs in the decidualized uterus. Methods Ovariectomized rats were sensitized for the decidual cell reaction by steroid treatment and decidualization was induced by a bolus of oil injected into the left horn; the right horn served as a control. Results Decidualization increased endometrial permeability (3.1+/−0.2 vs. 7.1+/−0.5 uterus/muscle of cpm of (125)I-BSA, p \u3c 0.0001). VEGF mRNA was increased by the decidualization (1.4-fold, p \u3c 0.05) and by Ang-(1–7) (2.0-fold, p \u3c 0.001). CB1R mRNA was reduced by decidualization (2.7-fold, p \u3c 0.001), but increased by Ang-(1–7) (1.9-fold, p \u3c 0.05). CB2R mRNA was increased by decidualization (4-fold, p \u3c 0.05) and by Ang-(1–7) (2.4-fold, p \u3c 0.001). The enzyme metabolizing AEA, fatty acid amide hydrolase (FAAH), was reduced by decidualization (7.8 fold, p \u3c 0.001) and unchanged by Ang-(1–7) (p \u3e 0.05), whereas the enzyme metabolizing 2-arachidonoylglycerol, monoacyl glycerol lipase (MAGL), was unchanged by decidualization (p \u3e 0.05) and increased by Ang-(1–7) (1.7 fold, p \u3c 0.001). Conclusions These findings report for the first time that Ang-(1–7) augments the expression of CB1R, CB2R and MAGL in the decidualized uterus and thus may interfere with the early events of decidualization

Angiotensin II and angiotensin-(1-7) decrease sFlt1 release in normal but not preeclamptic chorionic villi: an in vitro study

<p>Abstract</p> <p>Background</p> <p>During preeclampsia, placental angiogenesis is impaired. Factors released from the placenta including vascular endothelial growth factor (VEGF), placental growth factor (PLGF), soluble VEGF receptor 1 (sFlt1), and soluble endoglin (sEng) are regulatory molecules of placental development and function. While the renin angiotensin system has been shown to regulate angiogenic factors in other research fields, these mechanisms have not been extensively studied during pregnancy.</p> <p>Methods</p> <p>We evaluated the effects of angiotensin II (Ang II) and angiotensin-(1-7) [Ang-(1-7)] on the release of VEGF, PLGF, sFlt1, and sEng from placental chorionic villi (CV). CV were collected from nulliparous third-trimester normotensive and preeclamptic subjects. CV were incubated for 0, 2, 4, and 16 hours with or without Ang II (1 nM and 1 microM) or Ang-(1-7) (1 nM and 1 microM). The release of VEGF, PLGF, sFlt1, sEng, lactate dehydrogenase (LDH), and human placenta lactogen (HPL) was measured by ELISA.</p> <p>Results</p> <p>The release of sFlt1, PLGF, sEng from normal and preeclamptic CV increased over time. Release of sFlt1 and sEng was significantly higher from preeclamptic CV. VEGF was below the detectable level of the assay in normal and preeclamptic CV. After 2 hours, sFlt1 release from normal CV was significantly inhibited with Ang II (1 nM and 1 microM) and Ang-(1-7) (1 nM and 1 microM). There was a time-dependent increase in HPL indicating that the CV were functioning normally.</p> <p>Conclusions</p> <p>Our study demonstrates a critical inhibitory role of angiotensin peptides on sFlt1 in normal pregnancy. Loss of this regulation in preeclampsia may allow sFlt1 to increase resulting in anti-angiogenesis and end organ damage in the mother.</p