The Extracellular Vesicle Citrullinome and Signature in a Piglet Model of Neonatal Seizures

Neonatal seizures are commonly associated with acute perinatal brain injury, while understanding regarding the downstream molecular pathways related to seizures remains unclear. Furthermore, effective treatment and reliable biomarkers are still lacking. Post-translational modifications can contribute to changes in protein function, and post-translational citrullination, which is caused by modification of arginine to citrulline via the calcium-mediated activation of the pep-tidylarginine deiminase (PAD) enzyme family, is being increasingly linked to neurological injury. Extracellular vesicles (EVs) are lipid-bilayer structures released from cells; they can be isolated from most body fluids and act as potential liquid biomarkers for disease conditions and response to treatment. As EVs carry a range of genetic and protein cargo that can be characteristic of pathological processes, the current study assessed modified citrullinated protein cargo in EVs isolated from plasma and CSF in a piglet neonatal seizure model, also following phenobarbitone treatment. Our findings provide novel insights into roles for PAD-mediated changes on EV signatures in neonatal seizures and highlight the potential of plasma-and CSF-EVs to monitor responses to treatment

Optimizing hemodynamic care in neonatal encephalopathy

Hemodynamic impairment occurs in up to 80% of infants with neonatal encephalopathy (NE). Not all infants benefit from therapeutic hypothermia (HT); there are some indications that the trajectory of brain injury might be modified by neurologic monitoring and early management over the first 72-h period. It is also possible that optimizing hemodynamic management may further improve outomes. The coupling between cerebral blood flow and cerebral metabolism is disrupted in NE, increasing the vulnerability of the newborn brain to secondary injury. Hemodynamic monitoring is usually limited to blood pressure and functional echocardiographic measurements, which may not accurately reflect brain perfusion. This review explores the evidence base for hemodynamic assessment and management of infants with NE while undergoing HT. We discuss the literature behind a systematic approach to a baby with NE with the aim to define best therapies to optimize brain perfusion and reduce secondary injury

Interventions that Influence Animal-Product Consumption: A Meta-Review

Transitioning toward plant-based diets can alleviate health and sustainability challenges. However, research on interventions that influence animal-product consumption remains fragmented and inaccessible to researchers and practitioners. We conducted an overview of systematic reviews, also known as a meta-review. We searched five databases for reviews that examined interventions that influence (increase or decrease) the consumption of animal products. We quantitatively summarised results using individual studies’ directions of effect because reviews rarely reported effect sizes of primary studies. Eighteen reviews met inclusion criteria, 12 of which examined interventions intended to decrease animal-product consumption and 6 of which examined interventions intended to increase animal-product consumption. In total, only two reviews conducted quantitative meta-analyses. Across all reviews, vote counting indicated that providing information on the environmental impact of meat consumption may reduce consumption, with 10 of 11 estimates suggesting reduced consumption (91%, 95% CI [62.3%, 98.4%]; p = .012). Providing information on the health consequences, emphasising social norms, and reducing meat portion sizes also appeared promising, albeit with more limited evidence. Reviews examining interventions that decreased consumption predominately focused on meat (10/12 reviews). Future reviews should conduct quantitative syntheses where appropriate and examine interventions that influence the consumption of animal products other than meat

When Should Patient Intuition be Taken Seriously?

As a style of information processing, intuition involves implicit perceptual and cognitive processes that can be quickly and automatically executed without conscious mental will, such that people know more than they can describe. Patient intuition can influence patient and clinician decision-making and behavior. However, physicians may not always see patient intuition as credible or important, and its management in the clinical setting is poorly understood. This paper takes a step toward suggesting conditions under which patient intuition should be taken seriously. These conditions relate to the credibility or accuracy of the intuitive beliefs held by the patient, and their significance to the patient. Credibility may be increased when the intuitions of patients (1) reflect their individualized knowledge, (2) can complement the common absence of scientific evidence in managing health problems, and (3) can quickly and effectively process key information in complex cognitive tasks. Even intuitions that lack credibility can be subjectively rational and meaningful to patients, and help to shape the decisions they and clinicians make.sch_nur26pub4164pub