Climate change and rising energy costs will change everything: A new mindset and action plan for 21st Century public health

Western governments currently prioritize economic growth and the pursuit of profit above alternative goals of sustainability, health and equality. Climate change and rising energy costs are challenging this consensus. The realization of the transformation required to meet these challenges has provoked denial and conflict, but could lead to a more positive response which leads to a health dividend; enhanced well-being, less overconsumption and greater equality. This paper argues that public health can make its best contribution by adopting a new mindset, discourse, methodology and set of tasks

Imaging-guided chest biopsies: techniques and clinical results

Background This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. Methods Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive. Results Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy. Conclusion Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications

Musculotopic organization of the motor neurons supplying the mouse hindlimb muscles: a quantitative study using Fluoro-Gold retrograde tracing

We have mapped the motor neurons (MNs) supplying the major hindlimb muscles of transgenic (C57/BL6J-ChAT-EGFP) and wild-type (C57/BL6J) mice. The fluorescent retrograde tracer Fluoro-Gold was injected into 19 hindlimb muscles. Consecutive transverse spinal cord sections were harvested, the MNs counted, and the MN columns reconstructed in 3D. Three longitudinal MN columns were identified. The dorsolateral column extends from L4 to L6 and consists of MNs innervating the crural muscles and the foot. The ventrolateral column extends from L1 to L6 and accommodates MNs supplying the iliopsoas, gluteal, and quadriceps femoris muscles. The middle part of the ventral horn hosts the central MN column, which extends between L2–L6 and consists of MNs for the thigh adductor, hamstring, and quadratus femoris muscles. Within these longitudinal columns, the arrangement of the different MN groups reflects their somatotopic organization. MNs innervating muscles developing from the dorsal (e.g., quadriceps) and ventral muscle mass (e.g., hamstring) are situated in the lateral and medial part of the ventral gray, respectively.MN pools belonging to proximal muscles (e.g., quadratus femoris and iliopsoas) are situatedventral to those supplying more distal ones (e.g., plantar muscles). Finally, MNs innervatingflexors (e.g., posterior crural muscles) are more medial than those belonging to extensors ofthe same joint (e.g., anterior crural muscles). These data extend and modify the MN maps in the recently published atlas of the mouse spinal cord and may help when assessing neuronal loss associated with MN diseases

Embryonic Origins of a Motor System:Motor Dendrites Form a Myotopic Mapin Drosophila

The organisational principles of locomotor networks are less well understood than those of many sensory systems, where in-growing axon terminals form a central map of peripheral characteristics. Using the neuromuscular system of the Drosophila embryo as a model and retrograde tracing and genetic methods, we have uncovered principles underlying the organisation of the motor system. We find that dendritic arbors of motor neurons, rather than their cell bodies, are partitioned into domains to form a myotopic map, which represents centrally the distribution of body wall muscles peripherally. While muscles are segmental, the myotopic map is parasegmental in organisation. It forms by an active process of dendritic growth independent of the presence of target muscles, proper differentiation of glial cells, or (in its initial partitioning) competitive interactions between adjacent dendritic domains. The arrangement of motor neuron dendrites into a myotopic map represents a first layer of organisation in the motor system. This is likely to be mirrored, at least in part, by endings of higher-order neurons from central pattern-generating circuits, which converge onto the motor neuron dendrites. These findings will greatly simplify the task of understanding how a locomotor system is assembled. Our results suggest that the cues that organise the myotopic map may be laid down early in development as the embryo subdivides into parasegmental units

Development of the rhopalial nervous system in Aurelia sp.1 (Cnidaria, Scyphozoa)

We examined the development of the nervous system in the rhopalium, a medusa-specific sensory structure, in Aurelia sp.1 (Cnidaria, Scyphozoa) using confocal microscopy. The rhopalial nervous system appears primarily ectodermal and contains neurons immunoreactive to antibodies against tyrosinated tubulin, taurine, GLWamide, and FMRFamide. The rhopalial nervous system develops in an ordered manner: the presumptive gravity-sensing organ, consisting of the lithocyst and the touch plate, differentiates first; the “marginal center,” which controls swimming activity, second; and finally, the ocelli, the presumptive photoreceptors. At least seven bilaterally arranged neuronal clusters consisting of sensory and ganglion cells and their neuronal processes became evident in the rhopalium during metamorphosis to the medusa stage. Our analysis provides an anatomical framework for future gene expression and experimental studies of development and functions of scyphozoan rhopalia

Forced Moves or Good Tricks in Design Space? Landmarks in the Evolution of Neural Mechanisms for Action Selection

This review considers some important landmarks in animal evolution, asking to what extent specialized action-selection mechanisms play a role in the functional architecture of different nervous system plans, and looking for “forced moves” or “good tricks” (see Dennett, D., 1995, Darwin’s Dangerous Idea, Penguin Books, London) that could possibly transfer to the design of robot control systems. A key conclusion is that while cnidarians (e.g. jellyfish) appear to have discovered some good tricks for the design of behavior-based control systems—largely lacking specialized selection mechanisms—the emergence of bilaterians may have forced the evolution of a central ganglion, or “archaic brain”, whose main function is to resolve conflicts between peripheral systems. Whilst vertebrates have many interesting selection substrates it is likely that here too the evolution of centralized structures such as the medial reticular formation and the basal ganglia may have been a forced move because of the need to limit connection costs as brains increased in size

Pulse oximetry in the oesophagus

Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO(2)) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Since central blood flow may be preferentially preserved, this review explores a new alternative site, the oesophagus, for monitoring blood oxygen saturation by pulse oximetry. This review article presents the basic physics, technology and applications of pulse oximetry including photoplethysmography. The limitations of this technique are also discussed leading to the proposed development of the oesophageal pulse oximeter. In the majority, the report will be focused on the description of a new oesophageal photoplethysmographic/SpO(2) probe, which was developed to investigate the suitability of the oesophagus as an alternative monitoring site for the continuous measurement of SpO(2) in cases of poor peripheral circulation. The article concludes with a review of reported clinical investigations of the oesophageal pulse oximeter

Investigation of the human oesophagus as a new monitoring site for blood oxygen saturation

Pulse oximeter probes placed peripherally may fail to give accurate values of arterial blood oxygen saturation (SpO2) when peripheral perfusion is poor. Since central blood flow may be preferentially preserved, the oesophagus was suggested as an alternative monitoring site. A reflectance oesophageal photoplethysmographic (PPG) probe and a multiplexed data acquisition system, operating simultaneously at two wavelengths and incorporating an external three-lead electrocardiogram (ECG) reference channel, has been developed. It has been used to investigate the suitability of the oesophagus as a possible monitoring site for SpO2 in cases of compromised peripheral perfusion. Oesophageal PPG signals and standard ECG traces were obtained from 16 anaesthetized patients and displayed on a laptop computer. Measurable PPG signals with high signal-to-noise ratios at both infrared and red wavelengths were obtained from all five oesophageal depths investigated. The maximum PPG amplitude occurred at 25 cm from the upper incisors in the mid-oesophagus. The measured pulse transit times (PTTs) to the oesophagus were consistent with previous measurements at peripheral sites and had a minimum value of 67 +/- 30 ms at a depth of 30 cm. There was broad agreement between the calculated values of oesophageal SpO2 and those from a commercial finger pulse oximeter

The Sparrow Question: Social and Scientific Accord in Britain, 1850-1900.

During the latter-half of the nineteenth century, the utility of the house sparrow (Passer domesticus) to humankind was a contentious topic. In Britain, numerous actors from various backgrounds including natural history, acclimatisation, agriculture and economic ornithology converged on the bird, as contemporaries sought to calculate its economic cost and benefit to growers. Periodicals and newspapers provided an accessible and anonymous means of expression, through which the debate raged for over 50 years. By the end of the century, sparrows had been cast as detrimental to agriculture. Yet consensus was not achieved through new scientific methods, instruments, or changes in practice. This study instead argues that the rise and fall of scientific disciplines and movements paved the way for consensus on "the sparrow question." The decline of natural history and acclimatisation stifled a raging debate, while the rising science of economic ornithology sought to align itself with agricultural interests: the latter overwhelmingly hostile to sparrows