Spectral Properties of H-Reflex Recordings After an Acute Bout of Whole-Body Vibration

Although research supports the use of whole-body vibration (WBV) to improve neuromuscular performance, the mechanisms for these improvements remain unclear. The purpose of this study was to identify the effect ofWBV on the spectral properties of electrically evoked H-reflex recordings in the soleus (SOL) muscle. The H-reflex recordings were measured in the SOL muscle of 20 participants before and after a bout of WBV. The H-reflexes were evoked every 15 seconds for 150 seconds after WBV. A wavelet procedure was used to extract spectral data, which were then quantified with a principle components analysis. Resultant principle component scores were used for statistical analysis. The analysis extracted 1 principle component associated with the intensity of the myoelectric spectra and 1 principle component associated with the frequency. The scores of the principle component that were related to the myoelectric intensity were smaller at 30 and 60 milliseconds after WBV than before WBV. The WBV transiently decreased the intensity of myoelectric spectra during electrically evoked contractions, but it did not influence the frequency of the spectra. The decrease in intensity likely indicates a smaller electrically evoked muscle twitch response, whereas the lack of change in frequency would indicate a similar recruitment pattern of motor units before and after WBV

Genetic Testing, Genetic Medicine, and Managed Care

As modern human genetics moves from the research setting to the clinical setting, it will encounter the managed care system. Issues of cost, access, and quality of care will affect the availability and nature of genetic testing, genetic counseling, and genetic therapies. This articles explores such issues as professional education, coverage of genetic services, privacy and confidentiality, and liability. It concludes with a series of recommendations for the practice of genetic medicine in the age of managed care

A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

Background The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. Methods In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. Results The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Conclusions Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences

A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

Background The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. Methods In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. Results The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Conclusions Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences

The American Pathology of Inequitable Access to Medical Care

What most defines access to health care in the United States may be its stark inequity. Daily headlines in top newspapers paint the highs and lows. Articles entitled: “We Mapped the Uninsured. You’ll notice a Pattern: They tend to live in the South, and they tend to be poor” and op-eds with titles like “Do Poor People Have a Right to Health Care?” and “What it’s Like to Be Black and Pregnant when you Know How Dangerous That Can Be” run side-by-side with headlines touting “The Operating Room of the Future,” and advances in gene therapy that promise cures to everything form vision loss to cancer, accompanied by high six-figure price tags. Americans’ claims that they have access to the best medical care in the world are correct. Equally true are the claims that the system is broken.This chapter maps out the complex picture of access to medical care in the United States and reflects on how variable access illustrates, among other things, an American ambivalence about health solidarity. This Chapter first considers health care financing as one critical element that defines access to medical care and describes the multifaceted U.S. health care financing structure, predominated by public insurance programs for select populations and regulated private insurance for others. Second, this Chapter describes how access is equally shaped by legal requirements that create treatment obligations for doctors or hospitals, regardless of how someone pays for care. There is no constitutional right to health in the U.S., but various layers of statutory and common law have created some guarantees. That said, despite efforts to increase access over the past decades, the United States is still extraordinary, as compared to peer nations, on the unevenness of access to medical care among its population

Spinal Motor Control Differences between the Sexes

Activity-related knee joint dysfunction is more prevalent in females than males. One explanation for the discrepancy is differences in movement patterns between the sexes. However, the underlying mechanisms responsible for these differences remain unidentified. This study tested spinal motor control mechanisms influencing motor neuron pool output and subsequent muscle activation in 17 males and 17 females. The following variables were assessed at the soleus: the gain of the unconditioned H-reflex, gain of both intrinsic pre-synaptic inhibition (IPI) and extrinsic presynaptic inhibition (EPI), the level of recurrent inhibition (RI), the level of supraspinal drive determined by the ratio of the Vmax:Mmax (V-wave), electromechanical delay (EMD) and the rate of force development (RFD). The Wilks Lambda multivariate test of overall differences among groups was significant (p = 0.031). Univariate betweensubjects tests revealed males had greater RI (p = 0.042). However, the sexes did not differ on any of the other variables tested. In conclusion, the sexes differ on modulation of spinal motor control. Specifically, RI, a post-synaptic regulator of force output, was greater in males

No evidence of extraterrestrial noble metal and helium anomalies at Marinoan glacial termination

Author Posting. © The Author(s), 2015. This is the author's version of the work. It is posted here for personal use, not for redistribution. The definitive version was published in Earth and Planetary Science Letters 437 (2016): 76-88, doi:10.1016/j.epsl.2015.12.040.High concentrations of extraterrestrial iridium have been reported in terminal Sturtian and Marinoan glacial marine sediments and are used to argue for long (likely 3-12 Myr) durations of these Cryogenian glaciations. Reanalysis of the Marinoan sedimentary rocks used in the original study, supplemented by sedimentary rocks from additional terminal Marinoan sections, however, does not confirm the initial report. New platinum group element concentrations, and 187Os/188Os and 3He/4He signatures are consistent with crustal origin and minimal extraterrestrial contributions. The discrepancy is likely caused by different sample masses used in the two studies, with this study being based on much larger samples that better capture the stochastic distribution of extraterrestrial particles in marine sediments. Strong enrichment of redox-sensitive elements, particularly rhenium, up-section in the basal postglacial cap carbonates, may indicate a return to more fully oxygenated seawater in the aftermath of the Marinoan snowball earth. Sections dominated by hydrogenous osmium indicate increasing submarine hydrothermal sources and/or continental inputs that are increasingly dominated by young mantle-derived rocks after deglaciation. Sedimentation rate estimates for the basal cap carbonates yield surprisingly slow rates of a few centimeters per thousand years. This study highlights the importance of using sedimentary rock samples that represent sufficiently large area-time products to properly sample extraterrestrial particles representatively, and demonstrates the value of using multiple tracers of extraterrestrial matter.We are grateful for support from a 2008 WHOI Summer Student Fellowship for CAW. BPE acknowledges financial support from WHOI’s Ocean and Climate Change Institute (CH11320) and U.S. NSF SGER grant EAR-0821878. Fieldwork in NW Canada was licensed by the Aurora Research Institute and supported by a grant to PFH from the Astrobiology Institute of the US National Aeronautics and Space Administration (NASA). Fieldwork in NW Canada and Namibia was supported by grants EAR-9905495 and EAR-0417422 (to PFH) from the US NSF. We thank Jon Husson (Harvard University) and Ricardo Trindade (University of São Paulo, Brazil) for excellent support during fieldwork in Namibia in August of 2005

Polypharmacy or medication washout: an old tool revisited

There has been a rapid increase in the use of polypharmacy in psychiatry possibly due to the introduction of newer drugs, greater availability of these newer drugs, excessive confidence in clinical trial results, widespread prescribing of psychotropic medications by primary care, and pressure to augment with additional medications for unresolved side effects or greater efficacy. Even the new generation of medications may not hold significant advantages over older drugs. In fact, there may be additional safety risks with polypharmacy being so widespread. Washout, as a clinical tool, is rarely done in medication management today. Studies have shown that augmenting therapy with additional medications resulted in 9.1%–34.1% dropouts due to intolerance of the augmentation, whereas studies of medication washout demonstrated only 5.9%–7.8% intolerance to the washout procedure. These perils justify reconsideration of medication washout before deciding on augmentation. There are unwarranted fears and resistance in the medical community toward medication washout, especially at the moment a physician is trying to decide whether to washout or add more medications to the treatment regimen. However, medication washout provides unique benefits to the physician: it establishes a new baseline of the disorder, helps identify medication efficacy from their adverse effects, and provides clarity of diagnosis and potential reduction of drug treatments, drug interactions, and costs. It may also reduce overall adverse events, not to mention a potential to reduce liability. After washout, physicians may be able to select the appropriate polypharmacy more effectively and safely, if necessary. Washout, while not for every patient, may be an effective tool for physicians who need to decide on whether to add potentially risky polypharmacy for a given patient. The risks of washout may, in some cases, be lower and the benefits may be clearly helpful for diagnosis, understanding medication effects, the doctor/patient relationship, and safer use of polypharmacy if indicated

The Effects of God Language on Perceived Attributes of God

Sixty-three participants listened to an audio· tape asking them to imagine themselves in God\u27s presence. Half the participants listened to a script in which God was presented as female and half listened to a script in which God was presented as male. Half of those in each group listened to a male narrator and the other half listened to a female narrator. Before and after listening to the script, participants rated the attributes of God on a forced-choice questionnaire. Those to whom God was presented as female were more likely to emphasize God\u27s mercy at posttest whereas those to whom God was presented as male were more likely to endorse God\u27s power. Those hearing a male voice describe a female God and those hearing a female voice describe a male God reported enjoying the experiment and the audiotape more than those hearing a narrator describing a God of the same gender. Implications are discussed

A novel method for RNA extraction from FFPE samples reveals significant differences in biomarker expression between orthotopic and subcutaneous pancreatic cancer patient-derived xenografts.

Next-generation sequencing (NGS) can identify and validate new biomarkers of cancer onset, progression and therapy resistance. Substantial archives of formalin-fixed, paraffin-embedded (FFPE) cancer samples from patients represent a rich resource for linking molecular signatures to clinical data. However, performing NGS on FFPE samples is limited by poor RNA purification methods. To address this hurdle, we developed an improved methodology for extracting high-quality RNA from FFPE samples. By briefly integrating a newly-designed micro-homogenizing (mH) tool with commercially available FFPE RNA extraction protocols, RNA recovery is increased by approximately 3-fold while maintaining standard A260/A280 ratios and RNA quality index (RQI) values. Furthermore, we demonstrate that the mH-purified FFPE RNAs are longer and of higher integrity. Previous studies have suggested that pancreatic ductal adenocarcinoma (PDAC) gene expression signatures vary significantly under in vitro versus in vivo and in vivo subcutaneous versus orthotopic conditions. By using our improved mH-based method, we were able to preserve established expression patterns of KRas-dependency genes within these three unique microenvironments. Finally, expression analysis of novel biomarkers in KRas mutant PDAC samples revealed that PEAK1 decreases and MST1R increases by over 100-fold in orthotopic versus subcutaneous microenvironments. Interestingly, however, only PEAK1 levels remain elevated in orthotopically grown KRas wild-type PDAC cells. These results demonstrate the critical nature of the orthotopic tumor microenvironment when evaluating the clinical relevance of new biomarkers in cells or patient-derived samples. Furthermore, this new mH-based FFPE RNA extraction method has the potential to enhance and expand future FFPE-RNA-NGS cancer biomarker studies