Current state of knowledge and concerns regarding cardiopulmonary resuscitation performed in the setting of out-of-hospital sudden cardiac arrest among adult, non-medical rural residents

INTRODUCTION Every year in Poland 56,000 outside the hospital there is a sudden cardiac arrest. OBJECTIVES The aim of the study was to determine the level of knowledge of basic life support undertaken in prehospital management in rural areas. The second objective of the study was to assess needs for cardiopulmonary resuscitation(CPR) training among adults in rural areas. MATERIAL AND METHODS The study was carried out with the use of an original questionnaire based on the review of literature and guidelines of the European Resuscitation Council. The questionnaire was shared by social media. The questionnaire consisted of the following parts: metric, experience of previous CPR, knowledge about CPR, assessment of demand and interest in expanding knowledge and skills in CPR. A total of 501 responses were collected, of which 316 from adult, non-medical rural residents were analyzed. RESULTS Over 85% of respondents knew how to assess consciousness of the victim, 95% of respondents knew when to start CPR. About 33% of the respondents did not know the correct location of  chest compressions. Moreover 65% of them could not identify the correct frequency of compressions. Although rib fracture was one of the most commonly cited concerns, it was a potential reason to discontinue CPR only for 4.5% of respondents.  CONCLUSIONS It was observed that there is a need for additional CPR training among rural adult residents. The information collected in this study may allow for the planning of appropriate educational activities to increase the level of knowledge about CPR in heart accidents.&nbsp

Was zu tun ist, damit Maschinen den Menschen dienen

Prozesse algorithmischer Entscheidungsfindung berühren in vielen Bereichen gesellschaftliche Teilhabe. Daraus ergeben sich Herausforderungen auf vier Feldern: 1. Gesellschaftliche Angemessenheit (Haben algorithmische Systeme sinnvolle Optimierungsziele?) 2. Überprüfen und erklären der Umsetzung (Verwirklichen algorithmische Systeme die sinnvollen Ziele?) 3. Schaffen von Diversität (Ist die Vielfalt der Systeme und Betreibermodelle groß genug, um gesellschaftlich angemessen zu sein?) 4. Übergreifende Rahmenbedingungen für teilhabeförderliche algorithmische Systeme (Genügen staatliche und individuelle Gestaltungskompetenzen dem gesellschaftlichen Anspruch?) Der Beitrag stellt eine Auswahl von Lösungsideen in allen vier skizzierten Handlungsfeldern vor. Die Auswahl ist nicht umfassend und abschließend. Sie veranschaulicht aber auch in dieser Form, dass Akteure aus allen drei Sektoren Möglichkeiten haben, algorithmische Entscheidungsfindung für mehr gesellschaftliche Teilhabe zu gestalten. Es gibt viele Ideen für Maßnahmen und Methoden bzgl. der gesellschaftlichen Gestaltung, Intervention und Kontrolle algorithmischer Entscheidungsfindung. Keineswegs scheint der Mensch der Maschine ausgeliefert

The Portal Theory Supported by Venous Drainage–Selective Fat Transplantation

OBJECTIVE The "portal hypothesis" proposes that the liver is directly exposed to free fatty acids and cytokines increasingly released from visceral fat tissue into the portal vein of obese subjects, thus rendering visceral fat accumulation particularly hazardous for the development of hepatic insulin resistance and type 2 diabetes. In the present study, we used a fat transplantation paradigm to (artificially) increase intra-abdominal fat mass to test the hypothesis that venous drainage of fat tissue determines its impact on glucose homeostasis. RESEARCH DESIGN AND METHODS Epididymal fat pads of C57Bl6/J donor mice were transplanted into littermates, either to the parietal peritoneum (caval/systemic venous drainage) or, by using a novel approach, to the mesenterium, which confers portal venous drainage. RESULTS Only mice receiving the portal drained fat transplant developed impaired glucose tolerance and hepatic insulin resistance. mRNA expression of proinflammatory cytokines was increased in both portally and systemically transplanted fat pads. However, portal vein (but not systemic) plasma levels of interleukin (IL)-6 were elevated only in mice receiving a portal fat transplant. Intriguingly, mice receiving portal drained transplants from IL-6 knockout mice showed normal glucose tolerance. CONCLUSIONS These results demonstrate that the metabolic fate of intra-abdominal fat tissue transplantation is determined by the delivery of inflammatory cytokines to the liver specifically via the portal system, providing direct evidence in support of the portal hypothesis

Dysbindin-1 in dorsolateral prefrontal cortex of schizophrenia cases is reduced in an isoform-specific manner unrelated to altered dysbindin-1 gene expression

DTNBP1 (dystrobrevin binding protein 1) remains one of the top candidate genes in schizophrenia. Reduced expression of this gene and the protein it encodes, dysbindin-1, has been reported in the dorsolateral prefrontal cortex (DLPFC) of schizophrenia cases. It has not been established, however, if all dysbindin-1 isoforms are reduced in the DLPFC or if the reduction is associated with reduced DTNBP1 gene expression. Using Western blotting of whole-tissue lysates of the DLPFC with antibodies differentially sensitive to the three major isoforms of this protein (dysbindin-1A, -1B, and -1C), we found no significant differences between our schizophrenia cases and matched controls in dysbindin-1A or -1B, but did find a mean 46% reduction in dysbindin-1C in 71% of 28 case-control pairs (p = 0.022). This occurred in the absence of the one DTNBP1 risk haplotype for schizophrenia reported in the US and without alteration in levels of dysbindin-1C transcripts. Conversely, the absence of changes in the dysbindin-1A and -1B isoforms was accompanied by increased levels of their transcripts. We thus found no correspondence between alterations in dysbindin-1 gene and protein expression, the latter of which might be due to posttranslational modifications such as ubiquitination. Reduced DLPFC dysbindin-1C in schizophrenia probably occurs in PSDs, where we find dysbindin-1C to be heavily concentrated in the human brain. Given known postsynaptic effects of dysbindin-1 reductions in the rodent homolog of the prefrontal cortex, these findings suggest that reduced dysbindin-1C in the DLPFC may contribute to cognitive deficits of schizophrenia by promoting NMDA receptor hypofunction

Buffalo embryos produced by in vitro fertilization from oocytes matured during long-term transport

El búfalo (Bubalus bubalis) es una especie con excelente adaptación a sectores inundables. El mejoramiento genético a través de superovulación y transferencia embrionaria ha tenido escasos resultados debido a difcultades en la detección de celo, pobre respuesta ovárica y limitada recuperación de embriones post-lavaje. La técnica de fertilización in vitro de embriones (FIV) es una biotecnología de gran impacto en el progreso genético. El objetivo del presente trabajo fue estudiar los eventos tempranos de la FIV, analizando la tasa de maduración y desarrollo embrionario post-fertilización de ovocitos madurados in vitro (IVM) durante el transporte. Ovocitos bovinos y bubalinos fueron obtenidos por punción folicular de ovarios post-mortem e IVM durante el transporte por un período de 18 h. Se realizó la FIV con toros de fertilidad comprobada, con una concentración en microgotas de inseminación de 3-4 x 106 espermatozoides motiles/ml por un período de 6 horas. Los embriones fueron cultivados en medio oviductal sintético SOFaa en incubadora gaseada y ambiente humidificado a 38,5ºC durante 9 días. Se evaluaron las tasas de IVM, clivaje (día 2 post-fertilización) y blastocisto (días 7 a 9). Los resultados fueron analizados estadísticamente utilizando Fischer's Exact Test (p<0,05). No se observaron diferencias significativas en la tasa de maduración de ovocitos bubalinos de buena calidad respecto al control sin transporte (72 vs 88%), pero se registró una reducción significativa en la maduración de los ovocitos bubalinos de mala calidad (35%). Asimismo, se lograron producir los primeros embriones bubalinos luego de FIV, aunque las tasas de clivaje (34 vs 70 y 78%) y blastocisto (3 vs 27 y 31%) fueron significativamente menores en búfalos que en bovinos con y sin transporte, respectivamente. Los datos del presente trabajo constituirían el primer informe de FIV en búfalos y producción in vitro de embriones luego de IVM de ovocitos durante el transporte.The water buffalo (Bubalus bubalis) is a species with excellent adaptation to food-prone environments. Genetic improvement using the multiple ovulation and embryo transfer approach has been met with poor results in the buffalo, mainly due to difficulties in heat detection, erratic ovarian response to treatments and low embryo recovery post-flush. In vitro fertilization (IVF) is a powerful reproductive biotechnology that may provide a tool for genetic improvement in this species. The objective of this experiment was to study early embryonic events after IVF in the buffalo, analyzing in vitro maturation and IVF of oocytes matured during ground transportation. Bovine and bubaline oocytes were collected by follicular aspiration of post-mortem ovaries and in vitro matured for 18 h during ground transportation. In vitro fertilization was conducted, semen form bulls of proven fertility was processed and adjusted to a fnal concentration of 3-4 x 106 motile spermatozoa/ml in the insemination drops, oocytes were co-incubated for a period of 6 h. Embryos were then cultured in synthetic oviductal fluid (SOFaa) medium in an incubator and humidified atmosphere at 38.5ºC for 9 days. Oocyte maturation, cleavage and blastocyst rates were evaluated on days 0, 2 and 7 to 9, respectively and results were statistically analyzed using Fischer´s Exact Test (p<0.05). No significant difference was observed in the maturation rate of bubaline oocytes of good quality vs the non-transported control (72 vs 88%); however, the maturation rate of bubaline oocytes of bad quality was significantly lower (35%) than the rest of the groups. Data of present experiment are the first report of buffalo embryos produced by IVF from oocytes matured during transportation, although the cleavage (34 vs 70 and 78%) and blastocyst (3 vs 27 and 31%) rates were significantly lower for the buffalo than for the transported and non-transported domestic cattle, respectively.Fil: Konrad, José Luis. Universidad Nacional del Nordeste. Facultad de Cs.veterinarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Scian, R.. Pont. Universidad Catolica Arg."sta.maria de Los Bs.as.". Facultad de Cs.agrarias; ArgentinaFil: Garrido, María José. Universidad Nacional del Nordeste. Facultad de Cs.veterinarias; ArgentinaFil: Taminelli, G.. Pont. Universidad Catolica Arg."sta.maria de Los Bs.as.". Facultad de Cs.agrarias; ArgentinaFil: Sansinena, Marina Julia. Pont. Universidad Catolica Arg."sta.maria de Los Bs.as.". Facultad de Cs.agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Applying time series analyses on continuous accelerometry data—A clinical example in older adults with and without cognitive impairment

Introduction: Many clinical studies reporting accelerometry data use sum score measures such as percentage of time spent in moderate to vigorous activity which do not provide insight into differences in activity patterns over 24 hours, and thus do not adequately depict circadian activity patterns. Here, we present an improved functional data analysis approach to model activity patterns and circadian rhythms from accelerometer data. As a use case, we demonstrated its application in patients with mild cognitive impairment (MCI) and age-matched healthy older volunteers (HOV). Methods: Data of two studies were pooled for this analysis. Following baseline cognitive assessment participants were provided with accelerometers for seven consecutive days. A function on scalar regression (FoSR) approach was used to analyze 24 hours accelerometer data. Results: Information on 48 HOV (mean age 65 SD 6 years) and 18 patients with MCI (mean age 70, SD 8 years) were available for this analysis. MCI patients displayed slightly lower activity in the morning hours (minimum relative activity at 6:05 am: -41.3%, 95% CI -64.7 to -2.5%, p = 0.031) and in the evening (minimum relative activity at 21:40 am: -48.4%, 95% CI -68.5 to 15.4%, p = 0.001) as compared to HOV after adjusting for age and sex. Discussion: Using a novel approach of FoSR, we found timeframes with lower activity levels in MCI patients compared to HOV which were not evident if sum scores of amount of activity were used, possibly indicating that changes in circadian rhythmicity in neurodegenerative disease are detectable using easy-to-administer accelerometry. Clinical trials: Effects of Brain Stimulation During Nocturnal Sleep on Memory Consolidation in Patients With Mild Cognitive Impairments, ClinicalTrial.gov identifier: NCT01782391. Effects of Brain Stimulation During a Daytime Nap on Memory Consolidation in Patients With Mild Cognitive Impairment, ClinicalTrial.gov identifier: NCT01782365

Postglacial fluctuations of Cordillera Darwin glaciers (southernmost Patagonia) reconstructed from Almirantazgo fjord sediments

Author Posting. © The Author(s), 2017. This is the author's version of the work. It is posted here under a nonexclusive, irrevocable, paid-up, worldwide license granted to WHOI. It is made available for personal use, not for redistribution. The definitive version was published in Quaternary Science Reviews 177 (2017):265-275, doi:10.1016/j.quascirev.2017.10.029.Most outlet glaciers of the Cordillera Darwin Icefield (CDI; Patagonia, 54⁰S) are currently transitioning from calving to land-based conditions. Whether this situation is unique to the modern climate or also occurred during the Holocene is entirely unknown. Here, we investigate the Holocene fluctuations of outlet glaciers from the northern flank of the CDI using a multi-proxy sedimentological and geochemical analysis of a 13.5 m long sediment core from Almirantazgo fjord. Our results demonstrate that sedimentation in Almirantazgo fjord started prior to 14,300 cal yr BP, with glacier-proximal deposits occurring until 13,500 cal yr BP. After 12,300 cal yr BP, most glaciers had retreated to land-locked locations and by 9800 cal yr BP, Almirantazgo fjord was a predominantly marine fjord environment with oceanographic conditions resembling the present-day setting. Our sediment record shows that during the first part of the Holocene, CDI glaciers were almost entirely land-based, with a possible re-advance at 7300–5700 cal yr BP. This is in clear contrast with the Neoglaciation, during which CDI glaciers rapidly re-advanced and shrank back several times, mostly in phase with the outlet glaciers of the Southern Patagonian Icefield (SPI). Two significant meltwater events, indicative of rapid glacier retreat, were identified at 3250–2700 and 2000–1200 cal yr BP, based on an increase in grain-size mode and related inorganic geochemical parameters. This interpretation is additionally supported by concomitant decreases in organic carbon of marine origin and in Cl counts (salinity), reflecting higher terrestrial input to the fjord and freshening of the fjord waters. Overall, our record suggests that CDI outlet glaciers advanced in phase with SPI glaciers during the Neoglaciation, and retreated far enough into their valleys twice to form large outwash plains. Our results also highlight the potential of fjord sediments to reconstruct glacier variability at high resolution on multi-millennial timescales.This research was supported by an EU Marie Curie FP6 postdoctoral fellowship to S.B., by National Geographic Grant 8379-07 (to S.B.), by COPAS Center FONDAP Grant 150100007 and COPAS Sur-Austral CONICYT PIA PFB31 (to C.L and S.P), and by IDEAL Center FONDAP Grant 15150003 (to C.L.)

Impact of pulmonary rehabilitation on patients’ health care needs and asthma control:a quasi-experimental study

Background!#!Pulmonary rehabilitation offers potential benefits to people with asthma. It is however unknown if rehabilitation favourably affects patients' health care needs. We therefore examined if rehabilitation reduced needs and, in addition, if it improved asthma control.!##!Methods!#!One hundred fifty patients with asthma were surveyed in three rehabilitation clinics at admission and at discharge. Additionally, we surveyed 78 participants with asthma twice 4 weeks apart. The latter sample (i.e. the control group) was recruited through other pathways than rehabilitation clinics. The Patient Needs in Asthma Treatment (NEAT) questionnaire and the Asthma Control Test (ACT) were completed at baseline and follow-up. Differences between baseline and follow-up and between rehabilitation and control group were examined by t-tests and chi-squared-tests. Univariate ANCOVAS were used to examine if NEAT and ACT follow-up scores differed significantly between groups. Within the rehabilitation group, linear regressions were used to examine if self-reported utilization of more interventions that addressed needs were associated with NEAT scores at follow-up.!##!Results!#!At baseline, there were no differences between the rehabilitation and the control group regarding needs and asthma control. At follow-up, the rehabilitation group showed reduced needs (t(149) = 10.33, p &amp;lt;  0.01) and increased asthma control (t(130) = -6.67, p &amp;lt;  0.01), whereas members of the control group exhibited no changes. Univariate ANCOVAS showed that unmet follow-up needs (F(1, 212) = 36.46, p &amp;lt;  0.001) and follow-up asthma control (F(1, 195) = 6.97, p = 0.009) differed significantly between groups. In the rehabilitation group, self-reported utilization of more interventions was associated with reduced needs (β = 0.21; p = 0.03).!##!Conclusions!#!This study provides preliminary evidence suggestion that pulmonary rehabilitation in adults with asthma may reduce asthma-related needs and confirms previous findings that rehabilitation may improve asthma control