A Naturalistic Study of the Associations between Changes in Alcohol Problems, Spiritual Functioning and Psychiatric Symptoms

The study evaluated how spiritual and religious functioning (SRF), alcohol-related problems, and psychiatric symptoms change over the course of treatment and follow-up. Problem drinkers (n = 55, including 39 males and 16 females) in outpatient treatment were administered questionnaires at pretreatment, posttreatment, and follow up, which assessed two aspects of SRF (religious well-being and existential well-being), two aspects of alcohol misuse (severity and consequences), and two aspects of psychiatric symptoms (depression and anxiety). Significant improvements in SRF, psychiatric symptoms and alcohol misuse were observed from pretreatment to follow-up. Although SRF scores were significantly correlated with psychiatric symptoms at all three time points, improvement in the former did not predict improvement in the latter. When measured at the same time points, SRF scores were not correlated with the measures of alcohol misuse. However, improvement in SRF (specifically in existential well-being) over the course of treatment was predictive of improvement in the alcohol misuse measures at follow-up. These results suggest that the association between SRF, emotional problems, and alcohol misuse is complex. They further suggest that patients who improve spiritual functioning over the course of treatment are more likely to experience improvement in drinking behavior and alcohol-related problems after treatment has ended. (PsycINFO Database Record (c) 2011 APA, all rights reserved

Psychology Doctoral Students’ Perspectives on Addressing Spirituality and Religion with Clients: Associations with Personal Preferences and Training

Students (n = 543) in doctoral clinical and counseling psychology programs were surveyed about training experiences with regard to addressing the spiritual and religious beliefs and practices (SRBP) of their patients. About one fourth of the respondents indicated they had received no training related to patients’ SRBP. Another half had only read material on their own or discussed such issues with a supervisor. Nonetheless, respondents almost universally endorsed the idea that patients should be asked about spirituality and religiousness. Participants also rated the appropriateness of spiritual and religious queries that might be asked of patients. As expected, queries about the relevance of SRBP were rated as the most appropriate, whereas queries that implied a disrespectful or challenging tone were rated as the least appropriate. Participants’ personal SRBP and training that was specific to patients’ SRBP were weakly but significantly associated with appropriateness ratings. The results suggest that students are formulating ideas about how to ask patients about their spiritual and religious issues despite potentially inadequate formal instruction

Eschmann Introducer Through Laryngeal Mask Airway: A Cadaveric Trial of An Alternate Means of Rescue Intubation

Study Objective: Laryngeal mask airways (LMAs) are often used as airway rescue devices where laryngoscopy is difficult. The LMA does not protect the airway and is preferably replaced with a cuffed endotracheal tube. There are reports of cases where an Eschmann tracheal tube introducer (ETTI) was successfully used to bridge between a standard LMA and an endotracheal tube. This project was designed to determine whether an Eschmann stylet can reliably be passed through an LMA into the trachea as a means of rescue intubation.Methods: Nineteen emergency medicine residents and attending physicians, who were participants in a cadaveric airway course, placed and inflated a size 4 LMA (The Laryngeal Mask Company Ltd., San Diego, CA) on each of six unembalmed human cadavers in the usual fashion. They then attempted to pass a lubricated, 15 Fr, reusable, coude-tipped ETTI (Portex, Smiths Medical, Keene, NH)) through the airspace/handle of the inflated LMA. The LMA was then deflated and removed while the ETTI was held in place. Investigators then determined the location of the ETTI by laryngoscopy.Results: Of 114 attempts at the rescue procedure, 59 resulted in placement of the bougie into the trachea, yielding an overall success rate of 52% (95% CI 48%-56%). There were no significant differences in performance based on level of training of residents or years of experience of attending physicians.Conclusions: While not a primary difficult airway option, the use of a ETTI as a bridge device between LMA and endotracheal tube was successful about 50% of the time. [West J Emerg Med. 2010;11:16-19.

A Creek in Need: A Water Chemistry Analysis of a Stream Slated for Restoration (Line Creek, Schoharie County, NY)

Surface water quality may directly impact human health and the survival of aquatic life. Schoharie County is a unique laboratory for studying surface water chemistry because many creeks and streams were ravaged by large scale flooding events associated with Hurricane Irene and Tropical Storm Lee in 2011. Currently, one of the largest stream restoration projects in the US is being conducted in the Schoharie Creek watershed. One damaged stream is Line Creek, which is a small first order stream in that watershed. Line Creek was tested for sodium, chloride, alkalinity (HCO3-), hardness (CaCO3), iron, nitrite (NO2-N), nitrate (NO3-N), total and dissolved phosphorous (PO4-P), ammonia (NH3-N) and coliform bacteria. The aforementioned parameters were measured at two sites between February and May 2014 and were compared to earlier data. Data for 2014 (upstream/downstream; all values are mg/L unless otherwise noted) are: sodium 3.18/4.46; chloride 13.5/22.5; alkalinity 29.2/55.0; hardness 40.8/58.8; iron 0.296/0.354; nitrite 0.011/0.014; nitrate 0.122/0.149; total phosphorous 0.002/0.043; dissolved phosphorous 0/0.015; ammonia 0.597/0.639; coliform bacteria(CFU) 16/42. While many parameters fell within EPA guidelines for human consumption or within an accepted range for survival of aquatic life, some like iron, were too high by EPA standards, while alkalinity was too low for aquatic life to properly develop essential hard/bony body structures. This work will be discussed with respect to the larger Schoharie Creek watershed. The broad implications of the data with respect to human and aquatic life will be discussed

Effects of low-intensity blood flow restriction training vs. no blood flow restriction training on measures of aerobic capacity in physically active individuals

Background: Blood flow restriction (BFR) training has become an extremely popular training method over the years. Improvements in measures of aerobic capacity (such as VO2max) are crucial for individuals whom seek to be physically active for longer periods of time. Recent studies have focused on the combination of BFR and aerobic exercise at lower training intensities as an adapted training method for either maintaining or improving measures of aerobic capacity in physically active individuals.Clinical Question: In physically active individuals, is low-intensity blood flow restriction training more effective than no blood flow restriction training at improving measures of aerobic capacity?Methods: A computer-assisted literature search of PubMed, MEDLINE, SPORTDiscus, and EBSCOHost databases (from inception to November 2019) was utilized to identify studies of level 3 evidence or higher that assessed the effect of low-intensity BFR training versus no BFR training on measures of aerobic capacity in physically active individuals. The main outcomes of interest were either pre-post testing assessments of aerobic fitness (such as VO2max or VO2peak) and/or pre-post testing assessments of aerobic performance (such as time to exhaustion).Summary of Key Findings: The search strategy revealed 4 studies that met the inclusion criteria. One study reported that there were no significant improvements in measures of aerobic capacity when using low-intensity BFR training versus not using BFR training (1.96%, p < 0.05), while two studies reported that there in fact were significant improvements in measures of aerobic capacity (VO2max: 6.5%, p < 0.05 and TTE: 15.4%, p < 0.01; VO2max: +9.1± 6.2%, P < 0.001). One study reported that there were significant improvements in aerobic capacity when using low-intensity BFR training versus low-intensity training without BFR (BFR group: 5.6 ± 4.2%, P = 0.006, ES = 0.33; LOW group: 0.4 ± 4.7%, P = 0.75); however, high-intensity training without BFR showed greater improvements in aerobic capacity when compared to low-intensity training with BFR (HIT group: 9.2 ± 6.5%, P = 0.002, ES = 0.9).Clinical Bottom Line: There is moderate evidence to support the use of low-intensity BFR training to improve aerobic capacity in physically active individuals.Strength of Recommendation: Grade B evidence exists that low-intensity BFR training is more effective than no BFR training at improving measures of aerobic capacity in physically active individuals

Utilizing Low-Intensity Blood Flow Restriction Training to Improve Aerobic Capacity in Physically Active and Injured Individuals: A Critically Appraised Topic

Purpose: To determine if, in physically active individuals, low-intensity Blood Flow Restriction (BFR) training is more effective than training without BFR at improving measures of aerobic capacity. Methods: A database search was conducted for articles that matched inclusion criteria (minimum level 2 evidence, physically active participants, comparison of low-intensity BFR to no BFR training, comparison of pre-post testing with aerobic fitness or performance, training protocols \u3e2 weeks, studies published after 2010) by two authors and assessed by one using the PEDro scale (a minimum of 5/10 was required) to ensure level 2 quality studies that were then analyzed. Results: Four studies met all inclusion criteria. Three of the studies found significant improvements in aerobic capacity (VO2max) using BFR compared to no BFR. While the fourth study reported significant improvements in time to exertion (TTE) training with BFR, this same study did not find significant improvements in measures of aerobic capacity with BFR training. All compared BFR to non-BFR training. It was noted that high-intensity training without BFR was superior to both low-intensity training with and without BFR with respect to improvements in aerobic capacity. Conclusions: Moderate evidence exists to support the use of low-intensity BFR training to improve measures of aerobic capacity in physically active individuals over not using BRF. Clinicians seeking to maintain aerobic capacity in their patients who are unable, for various reasons, to perform high levels of aerobic activity may find low-intensity BFR training useful as a substitution while still receiving improvements in measures of aerobic capacity

Homozygous in-frame deletion in CATSPERE in a man producing spermatozoa with loss of CatSper function and compromised fertilizing capacity

STUDY QUESTIONDoes a man (patient 1) with a previously described deficiency in principle cation channel of sperm (CatSper) function have a mutation in the CatSper-epsilon (CATSPERE) and/or CatSper-zeta (CATSPERZ) gene?SUMMARY ANSWERPatient 1 has a homozygous in-frame 6-bp deletion in exon 18 (c.2393_2398delCTATGG, rs761237686) of CATSPERE.WHAT IS KNOWN ALREADYCatSper is the principal calcium channel of mammalian spermatozoa. Spermatozoa from patient 1 had a specific loss of CatSper function and were unable to fertilize at IVF. Loss of CatSper function could not be attributed to genetic abnormalities in coding regions of seven CatSper subunits. Two additional subunits (CatSper-epsilon (CATPSERE) and CatSper-zeta (CATSPERZ)) were recently identified, and are now proposed to contribute to the formation of the mature channel complex.STUDY DESIGN, SIZE, DURATIONThis was a basic medical research study analysing genomic data from a single patient (patient 1) for defects in CATSPERE and CATSPERZ.PARTICIPANTS/MATERIALS, SETTING, METHODSThe original exome sequencing data for patient 1 were analysed for mutations in CATSPERE and CATSPERZ. Sanger sequencing was conducted to confirm the presence of a rare variant.MAIN RESULTS AND THE ROLE OF CHANCEPatient 1 is homozygous for an in-frame 6-bp deletion in exon 18 (c.2393_2398delCTATGG, rs761237686) of CATSPERE that is predicted to be highly deleterious.LIMITATIONS, REASONS FOR CAUTIONThe nature of the molecular deficit caused by the rs761237686 variant and whether it is exclusively responsible for the loss of CatSper function remain to be elucidated.WIDER IMPLICATIONS OF THE FINDINGSPopulation genetics are available for a significant number of predicted deleterious variants of CatSper subunits. The consequence of homozygous and compound heterozygous forms on sperm fertilization potential could be significant. Selective targeting of CatSper subunit expression maybe a feasible strategy for the development of novel contraceptives.STUDY FUNDING/COMPETING INTEREST(S)This study was funded by project grants from the MRC (MR/K013343/1 and MR/012492/1), Chief Scientist Office/NHS research Scotland. This work was also supported by NIH R01GM111802, Pew Biomedical Scholars Award 00028642 and Packer Wentz Endowment Will to P.V.L. C.L.R.B is the editor-in-chief of Molecular Human Reproduction, has received lecturing fees from Merck and Ferring, and is on the Scientific Advisory Panel for Ohana BioSciences. C.L.R.B was chair of the World Health Organization Expert Synthesis Group on Diagnosis of Male infertility (2012–2016)

Analysis of Cardiac Ion Channels to Understand Arrhythmias Which Lead to Sudden Cardiac Death

There are 300,000-400,000 fatalities attributed to sudden cardiac death every year in the U.S. due to a lack of sufficient research on mechanisms causing arrhythmias1. Malfunctions with the ion channels in the heart may lead to lethal arrhythmias. The purpose of this work is to study ion channels and evaluate malfunctions relative to normally functioning hearts. Plasmid insertion in E. coli assayed whether functional ion channels reach the membrane, and confocal fluorescent microscopy was used to illuminate cellular functionality. In addition, genetic analysis was used to determine the extent of hereditary factors in sudden cardiac death. Genes that encode for the voltage-gated sodium, potassium, and calcium ion channels were analyzed at the genetic level using isolated DNA samples and traditional Sanger sequencing methods to identify mutations that may be responsible for sudden cardiac death syndromes. For example, Long QT syndrome, Short QT syndrome, and Brugada syndrome are caused by mutations in these ion channels. Once these mutations are identified, genetic engineering techniques can be used in the generation of new heart cells from the stem cells found in somatic tissue. Generation of such heart cells is important because it could lead to the development of personalized treatment for degenerative diseases such as heart failure in the future. Rubart, M. et al., Mechanisms of Sudden Cardiac Death, 2005. J. clin. invest. 115(9):2305-2315