Effects of Maternal Protein Restriction on the Pulmonary Surfactant System during the Early Life and Adulthood

Fetal growth restriction (FGR) is defined by low birth weight and contributes to a variety of adult-onset diseases with different severities between males and females. However, the effects of FGR on the pulmonary surfactant are not fully elucidated. In this thesis, first, we investigated the FGR effects on the lung function and the surfactant system at the early postnatal life. It was hypothesized that FGR contributes to alterations of lung mechanics and the surfactant system during the neonatal period. Second, we assessed the FGR effects on the surfactant system in response to sepsis in adulthood. It was hypothesized that FGR contributes to the alteration of the surfactant system in response to sepsis in adulthood. Overall, the data suggest that FGR induced by maternal protein restriction affects lung compliance at the early life and predisposes the septic adults to the development of surfactant alterations in a sex-specific manner

The Effects of Intrauterine Growth Restriction (IUGR) on the Pulmonary Surfactant and Lung Injury

The Effects of Intrauterine Growth Restriction (IUGR) on the Pulmonary Surfactant and Lung Injury Khazaee R1, McCaig LA2, Hardy D1, Yamashita CM2, Veldhuizen, RAW2 Department of Physiology and Pharmacology1, Western University, London, ON, Canada. Lawson Health Research Institute2, London, ON, Canada Background: Acute respiratory distress syndrome (ARDS) is defined as severe lung dysfunction that occurs after an insult to the lung such as an infection. The lung dysfunction in ARDS is due to alterations to surfactant, a lipid-protein mixture coats the inside of the lung and maintains the lungs’ ability to expand easily during respiration. Due to surfactant dysfunction, and a lack of effective pharmacological therapies, ARDS is the most common cause of death in the ICU. Our research focuses on risk factors that indicate a susceptibility to the disease, which could provide new and earlier therapeutic options. One such potential risk factor is intrauterine growth restriction (IUGR), which is defined by a low birthweight and contributes to a variety of adult onset diseases. We hypothesize that IUGR is a risk factor for ARDS through alterations to the surfactant system. Methods: We will use an IUGR rat model induced by maternal low protein diet. Surfactant function and ARDS susceptibility in IUGR offspring will be assessed from birth to adulthood. Results: Preliminary data indicates that IUGR leads to some changes in lung function. We anticipate that IUGR rats will be more susceptible to surfactant alterations and ARDS development. Discussion & Conclusion: Investigating the IUGR effects on surfactant and understanding the surfactant-related processes in ARDS could give insights how to interfere with these processes to improve outcomes. Interdisciplinary Reflection: This novel approach involves input from different disciplines such as biophysics, biochemistry, medicine and histology, which together will ultimately help to develop new therapies. Keywords: Acute Respiratory Distress Syndrome, IUGR, Lung, Surfactant, Biophysical Functions, Infectio

Maternal Protein Restriction (MPR): A Risk Factor for Acute Respiratory Distress Syndrome (ARDS)

Background: Acute respiratory distress syndrome (ARDS) is defined as severe lung dysfunction. The lung impairments in ARDS result from alterations to pulmonary surfactant; a lipid-protein mixture coating the inside of the lung and maintains the lungs’ ability to expand easily. Due to a lack of effective pharmacological therapies mortality associated with ARDS is over 30%. Our research focuses on risk factors that indicate a susceptibility to the disease, which could provide new and early therapeutic options. One such potential risk factor is Maternal Protein Restriction (MPR). MPR is defined by low birth weight and contributes to a variety of adult-onset diseases. We hypothesized that under a systemic inflammation MPR is a risk factor for developing ARDS through alterations to the surfactant system. Methods: MPR was induced in pregnant rat model via a low protein diet. Surfactant function and ARDS susceptibility in MPR offspring were assessed from birth to adulthood. Results: MPR altered the lung function at early post-natal life. Preliminary results show that total surfactant content decreased significantly in adult males. We anticipate that surfactant reduction and altered lung function can develop severe lung injury. Discussion & Conclusion: Investigating the MPR effects on surfactant and understanding the surfactant-related processes in ARDS could give insights how to interfere with these processes to improve clinical outcomes. Interdisciplinary Reflection: This novel approach involves input from different disciplines such as biophysics, biochemistry, medicine, and histology, which together will ultimately help to develop new therapies. Keywords: ARDS, Maternal Protein Restriction, Lung, Surfactant, Inflammatio

Exploring Iranian EAP Teachers' Pedagogical Content Knowledge and Their Professional Identity

This study was conducted in English for Academic Purposes (EAP) context to explore Iranian teachers' perceptions of their pedagogical content knowledge (PCK) and their sense of professional identity (PI) as well as to scrutinize how their cognitions were practiced in EAP classes. To this end, two ELT teachers and two content instructors (i.e. subject experts who teach EAP courses in addition to their specialized field of study) from a university in Tehran participated in the study and their classes were observed for a full academic semester. To thoroughly probe the teachers' cognitions, semi-structured interviews were also conducted. The results of content analysis indicated some commonalities but major discrepancies in the cognitions and practices of the two pairs of teachers with regard to their PCK. Teachers of both camps claimed to have interactive EAP classes where group work is highly appreciated and students' questions are welcomed. Attending to their discrepancies, the content instructors seemed to adhere to 'transformative' education by reflecting on their teaching, hearing learners' voice, being responsive to their learning needs, and encouraging teacher-learner collaboration. On the other hand, the ELT teachers reflected a more 'traditional' approach, leaving behind issues of flexibility and innovation in their teaching methods. As far as the EAP teachers' PI is concerned, the study came up with eight factors as the underlying constituents of their PI. It was also found that pedagogical content knowledge and professional identity are interrelated attributes of EAP teachers. The findings provide implications for syllabus designers as well as EAP teacher education

Maternal protein restriction during perinatal life affects lung mechanics and the surfactant system during early postnatal life in female rats.

Limited information is available on how fetal growth retardation (FGR) affects the lung in the neonatal period in males and females. This led us to test the hypothesis that FGR alters lung mechanics and the surfactant system during the neonatal period. To test this hypothesis a model of FGR was utilized in which pregnant rat dams were fed a low protein diet during both the gestation and lactation period. We subsequently analyzed lung mechanics using a FlexiVent ventilator in male and female pups at postnatal day 7 and 21. Lung lavage material was obtained at postnatal day 1, 7 and 21, and was used for analysis of the surfactant system which included measurement of the pool size of surfactant and its subfraction as well as the surface tension reducing ability of the surfactant. The main result of the study was a significantly lower lung compliance and higher tissue elastance which was observed in FGR female offspring at day 21 compared to control offspring. In addition, female LP offspring exhibited lower surfactant pool sizes at postnatal day 1compared to controls. These changes were not observed in the male offspring. It is concluded that FGR has a different impact on pulmonary function and on surfactant in female, as compared to male, offspring

Discrete wavelet transform and artificial neural network for gearbox fault detection based on acoustic signals

Gearboxes are widely applied in power transmission lines, so their health monitoring has a great impact in industrial applications. In the present study, acoustic signals of Pride gearbox in different conditions, namely, healthy, worn first gear and broken second gear are collected by a microphone. Discrete wavelet transform (DWT) is applied to process the signals. Decomposition is made using Daubichies-5 wavelet with five levels. In order to identify the various conditions of the gearbox, artificial neural network (ANN) is used in decision-making stage. The results indicate that this method allow identification at a 90 % level of efficiency. Therefore, the proposed approach can be reliably applied to gearbox fault detection

Evaluating The Association Between Serum Hsp27 Antibody and Hypertension in Patients without Underlying Cardiovascular Disease

Introduction: An association between heat shock protein 27 (Hsp27) antigen with cardiovascular risk factors has been shown previously. Furthermore, higher levels of serum anti-HSP27 antibodies are also related to higher cardiovascular morbidity and mortality. In the current study, we looked at the relationship between serum Hsp27 antibodies and hypertension, as an important cardiovascular risk factor, in individuals without evidence of cardiovascular disease (CVD).Methods: A sub-population of hypertensive patients (HTN+) without underlying CVD were recruited from the Mashhad stroke and atherosclerosis heart disease (MASHAD) study to assess the association between serum Hsp27 antibodies and hypertension; independent of other cardiovascular risk factors. A total of 1599 people were studied of whom 288 individuals had hypertension and 1311 were used as controls (HTN-).Results: Mean serum Hsp27 antibody titers were 0.20 (0.27) OD in the whole population sample and was not significantly different in the normotensive (HTN-) compared to HTN+ individuals with different degrees of hypertension.Conclusion: There were no significant associations between serum anti-Hsp27 concentrations and either the presence or severity of hypertension. Future studies are warranted to explore the association of anti-Hsp27 antibody and antigen levels and other cardiovascular risk factors

Epidemiology of injuries from fire, heat and hot substances : global, regional and national morbidity and mortality estimates from the Global Burden of Disease 2017 study

Background Past research has shown how fires, heat and hot substances are important causes of health loss globally. Detailed estimates of the morbidity and mortality from these injuries could help drive preventative measures and improved access to care. Methods We used the Global Burden of Disease 2017 framework to produce three main results. First, we produced results on incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years from 1990 to 2017 for 195 countries and territories. Second, we analysed these results to measure mortality-to-incidence ratios by location. Third, we reported the measures above in terms of the cause of fire, heat and hot substances and the types of bodily injuries that result. Results Globally, there were 8 991 468 (7 481 218 to 10 740 897) new fire, heat and hot substance injuries in 2017 with 120 632 (101 630 to 129 383) deaths. At the global level, the age-standardised mortality caused by fire, heat and hot substances significantly declined from 1990 to 2017, but regionally there was variability in age-standardised incidence with some regions experiencing an increase (eg, Southern Latin America) and others experiencing a significant decrease (eg, High-income North America). Conclusions The incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas. More resources should be invested in measuring these injuries as well as in improving infrastructure, advancing safety measures and ensuring access to care.Peer reviewe

The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017 : a systematic analysis for the Global Burden of Disease study 2017

Background: Stomach cancer is a major health problem in many countries. Understanding the current burden of stomach cancer and the differential trends across various locations is essential for formulating effective preventive strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to stomach cancer in 195 countries and territories from 21 regions between 1990 and 2017. Methods: Estimates from GBD 2017 were used to analyse the incidence, mortality, and DALYs due to stomach cancer at the global, regional, and national levels. The rates were standardised to the GBD world population and reported per 100 000 population as age-standardised incidence rates, age-standardised death rates, and age-standardised DALY rates. All estimates were generated with 95% uncertainty intervals (UIs). Findings: In 2017, more than 1·22 million (95% UI 1·19–1·25) incident cases of stomach cancer occurred worldwide, and nearly 865 000 people (848 000–885 000) died of stomach cancer, contributing to 19·1 million (18·7–19·6) DALYs. The highest age-standardised incidence rates in 2017 were seen in the high-income Asia Pacific (29·5, 28·2–31·0 per 100 000 population) and east Asia (28·6, 27·3–30·0 per 100 000 population) regions, with nearly half of the global incident cases occurring in China. Compared with 1990, in 2017 more than 356 000 more incident cases of stomach cancer were estimated, leading to nearly 96 000 more deaths. Despite the increase in absolute numbers, the worldwide age-standardised rates of stomach cancer (incidence, deaths, and DALYs) have declined since 1990. The drop in the disease burden was associated with improved Socio-demographic Index. Globally, 38·2% (21·1–57·8) of the age-standardised DALYs were attributable to high-sodium diet in both sexes combined, and 24·5% (20·0–28·9) of the age-standardised DALYs were attributable to smoking in males. Interpretation: Our findings provide insight into the changing burden of stomach cancer, which is useful in planning local strategies and monitoring their progress. To this end, specific local strategies should be tailored to each country's risk factor profile. Beyond the current decline in age-standardised incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the incident cases and deaths occur, is further reduced. Funding: Bill & Melinda Gates Foundation

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe