Malignant Hyperthermia

Complications related to the anesthetic process are multifaceted and abundant. As a future nurse anesthesia student, the underlying pathophysiology, diagnosis, and treatment of anesthesia-related complications are of particular interest. One such anesthesia-induced life-threatening metabolic process involves the hypermetabolism of skeletal muscle. This pharmacogenetic process, known as malignant hyperthermia (MH), has a variable incidence rate ranging from 1:10,000 to 1: 250,000 anesthetic cases. However, the prevalence of the genetic abnormalities may be as great as one in 400 individuals (Rosenberg, Pollock, Schiemann, Bulger, & Stowell, 2015, p. 1). “Malignant hyperthermia (MH) is a rare, but life-threatening, autosomal-dominant inherited disorder that may lead to metabolic crisis of skeletal muscle in susceptible individuals following exposure to triggering agents, such as volatile anesthetics or depolarizing muscle relaxants” (Schneiderbanger, Johannsen, Roewer, & Schuster, 2014, p. 355)

Development of an R script for simple lipidomic and metabolomic data analysis

Background: Metabolomic and lipidomic studies generate vast quantities of data that are often analysed in a closed software environment with little to no access to the underlying algorithms. As a result, data processed via different software pipelines yield different results thus leading to a widespread problem of low reproducibility within these fields. To address this problem, we are developing LipidAnalyst; an R based lipidomics software pipeline. As a part of this project, we are creating a simple statistical analysis and graphing module in R to generate accurate, reproducible, high-resolution figures. Methods: R scripts were developed under version 3.5.3 with the capability to undertake statistical analyses (e.g. ANOVA) and post-hoc tests (e.g. Tukey). Additional code plotted resultant information as high resolution violin and box plots that depicted statistical significance. Thereafter, lipidomic and metabolomic data were analysed by this code and compared against commercial software and Metaboanalyst, a primary software used in metabolomic and lipidomic research. Results: Code generated in house demonstrated the same results as those generated using commercial software (e.g. JMP 14.0 Pro) but were different from results obtained by using the MetaboAnalyst pipeline. Conclusions: This study demonstrated the prevalent danger of using closed-source software pipelines for the analysis of lipidomic and metabolomic data without validating the analysis outcomes via open-source software. Open source software such as LipidAnalyst, that has also been independently validated using multiple data sets, can then be published with the results to enable transparency of data analysis and improve the replicability of results across different labs.https://scholarscompass.vcu.edu/gradposters/1092/thumbnail.jp

Change, Dependency, and Regime Plasticity in Offshore Financial Intermediation: The Saga of the Netherlands Antilles

The legal regimes of offshore jurisdictions have historically differed in significant ways from those applicable in onshore jurisdictions. Inevitably, legal and financial professionals have seized upon these differences to develop strategies for reducing transactions costs. A prominent example of such cross-border arbitrage was the routing of Eurodollar loans through a small group of former Dutch island colonies in the Caribbean, a practice which peaked in the mid-1980s, when virtually every major U.S. corporation made interest payments to a Netherlands Antilles finance subsidiary. The Antilles sandwich strategy exploited the difference between high U.S. withholding tax rates that applied to interest payments made to most foreign lenders, and the zero rate of tax that applied to U.S. interest payments made to residents of the Antilles under its tax treaty with the United States. Both jurisdictions reaped significant benefits from the strategy until the United States unilaterally terminated the tax treaty in 1987, virtually wiping out the Antilles offshore financial sector overnight. Unfortunately, because of rigidity in its governance structure, the Antilles failed to develop alternative financial intermediation strategies to replace the Antilles sandwich structure before its demise. The rise and fall of the Antilles\u27 offshore financial sector provides insight into the current struggle between onshore and offshore governments over the role of offshore financial centers like the Antilles within the global economy. Concerned about tax evasion by their residents, onshore jurisdictions including France, Germany, and the United States are pressing for major changes in offshore jurisdictions\u27 legal and regulatory regimes that may eliminate legitimate opportunities for international arbitrage. In such an environment, offshore financial centers may find it difficult to survive. In this article, we distill from the Antilles experience a theory of regime plasticity and examine the role that it plays in allowing offshore financial centers to adapt to changes in the legal and political environments within which they operate. How offshore financial centers react, and whether they have learned the lessons of the Antilles\u27 experience will play a major role in determining the future of the global offshore financial sector

UPPER BODY MOVEMENTS IN ELITE JAVELIN THROWS

INTRODUCTION - For an athlete to compete at an international level he will not only need the raw materials necessary for the event, but an effective training programme. That will enable him to utilise these resources to the full. It is well accepted that exercise prescription must match the mode of training to the desired effect. This is embodied in the specificity principle which states that training adaptations are specific to the cells and their structural and functional elements that are overloaded (McCafferty & Horvath, 1977).Hence, to provide training advice to the elite javelin thrower exact details of the thrower's movements during the event must be known. Otherwise, developing a training programme to fit the thrower's requirements will be impossible. It was the aim of this study to quantify the upper body movements of a group of elite javelin throwers when performing at the highest level of competition. Every throw of12 athletes competing in the men's javelin final of the 1995 World Championships were filmed and, subsequently analysed. Filming was conducted using 2 phase-locked High speed Photosonics 1PL cine cameras which were zoomed on the javelin runway such that all of the thrower's movements incorporating the last few cross-over strides, the delivery and the first few meters of the javelin6gM after release, were in full view. Calibration of this area was achieved by mounting Rflective spherical markers on a system of vertical poles that were arranged to surround a 7 m x 4 m x 3.2 m volume. Three dimensional coordinates of the markers were generated using an Elta Ill tachymeter. The films developed and the best performances of the competitors were digitised using a sys-tem developed by Bartlett (1 990) compatible with Acorn Archimedes computers. RESULTS -Analysis of the best throws by the three medallists (all over 86 m) showed that all three athletes achieved release speeds in excess of 30 m.s-I. However, the way in which each athlete achieved such a high speed was very different indeed. For example, the gold and silver medallists were found to laterally align the trunk during the delivery in a similar manner. Nevertheless, the path of the javelin grip in a lateral direction differed by 54 cm between the two athletes. Furthermore, angular velocities of the elbow joints in extension were found to range between 45.0 rad.s-I and 26.5 rad.s! Similarly the movement of the upper arm during the delivery was a combination of extension, horizontal flexion and abduction, the angular velocities of which ranged from 21.8rad.s-I to 15.6 rad.s-I. Medial rotation angular velocities were as high as 45.0 rad.s-I indicating that this also is a important contributor to the release speed of the javelin. CONCLUSIONS - These results suggest that the patterns of muscular activation or the muscles used to accelerate the javelin were very different for the three medal lists. It would therefore seem appropriate that the training programmes of each athlete should be different and designed very specifically to meet their unique movement pattern. Examining the contribution of the upper body musculature to the release speed of the javelin is an aim of future research. REFERENCES Bartlett, R.M. (1 990). A biomechanical analysisprogramme package. Unpub. Mas. Thes.McCafferty, W.B. & Horvath, S.M. (1977).Research Quarterly, 48, 358-37 1

Multimodal evidence for delayed threat extinction learning in adolescence and young adulthood

Previous research in rodents and humans points to an evolutionarily conserved profle of blunted threat extinction learning during adolescence, underpinned by brain structures such as the amygdala and medial prefrontal cortex (mPFC). In this study, we examine age-related efects on the function and structural connectivity of this system in threat extinction learning in adolescence and young adulthood. Younger age was associated with greater amygdala activity and later engagement of the mPFC to learned threat cues as compared to safety cues. Furthermore, greater structural integrity of the uncinate fasciculus, a white matter tract that connects the amygdala and mPFC, mediated the relationship between age and mPFC engagement during extinction learning. These fndings suggest that age-related changes in the structure and function of amygdala-mPFC circuitry may underlie the protracted maturation of threat regulatory precesses

Involuntary Cotenants: Eminent Domain and Energy and Communications Infrastructure Growth

The spread of renewable energy mandates, new discoveries of unconventional oil and gas, and the need to harden and upgrade telecommunications infrastructure will lead to expansions in large infrastructure easements over the next decade. Many of these easements will be taken by eminent domain. In this paper we examine the problems posed by this involuntary creation of co-ownership of land. Existing eminent domain laws are insufficient to address the problems created because they allow the courts to vary only one term: price. Given difficulty in pricing many of the other terms to the easements (e.g. indemnification agreements for landowners, controlling impacts on hunting leases, or compliance efforts to control invasive species), reforms are necessary to allow courts to substitute for the bargaining process that eminent domain short circuits

Involuntary Cotenants: Eminent Domain and Energy and Communications Infrastructure Growth

The spread of renewable energy mandates, new discoveries of unconventional oil and gas, and the need to harden and upgrade telecommunications infrastructure will lead to expansions in large infrastructure easements over the next decade. Many of these easements will be taken by eminent domain. In this paper we examine the problems posed by this involuntary creation of co-ownership of land. Existing eminent domain laws are insufficient to address the problems created because they allow the courts to vary only one term: price. Given difficulty in pricing many of the other terms to the easements (e.g. indemnification agreements for landowners, controlling impacts on hunting leases, or compliance efforts to control invasive species), reforms are necessary to allow courts to substitute for the bargaining process that eminent domain short circuits

It’s not over yet: the impact of worry on emotional recovery

Emotional reactivity and recovery are crucial for maintaining well-being. It remains unknown, however, to what extent emotion modulates the time course of recovery assessed using a simple categorization task and how this varies based on individual differences in worry. To address these questions, 35 participants viewed emotional pictures, followed by abstract greeble targets, which were to be categorized. Greebles were presented between 100 ms and 4,000 ms after picture offset. Physiological measures including skin conductance level and the corrugator supercilii were recorded and served as indicators of responsivity to emotional pictures. Measures of reaction time (RT) and accuracy scores were taken as indicators of the impact of emotion on facilitation or interference to the greeble target. Effects of interference and facilitation were observed up to 4,000 ms after emotional pictures on RT and accuracy scores. High worry was associated with greater (1) corrugator supercilii and skin conductance level to negative versus positive and neutral pictures and (2) interference from emotional pictures on accuracy scores. Overall, these findings suggest that subsequent processing is still impacted up to 4,000 ms after the offset of emotional pictures, particularly for negative events in individuals with high worry

Its time: a commentary on fear extinction in the human brain using fMRI

The recent meta-analysis by Fullana et al. (2018) is both timely and significant, providing a vital milestone towards understanding the neural networks involved in threat extinction in humans. Fullana et al. (2018) examined both threat extinction and recall separately using sophisticated meta-analytic methods based on raw contrast maps. Importantly, the meta-analysis highlighted a lack of consistent activation across studies for key neural "players" in the threat extinction circuit: the amygdala and ventromedial prefrontal cortex (vmPFC). In the current commentary, we highlight reasons for which this key circuitry may not have resulted from this meta-analysis, and call for a 'gold standard' in the examination of threat extinction using fMRI

The role of threat level and intolerance of uncertainty in extinction

Recent evidence suggests that individual differences in intolerance of uncertainty (IUS) are associated with disrupted threat extinction. However, it is unknown what maintains the learned threat association in high IUS individuals: is it the experienced uncertainty during extinction or the combination of experienced uncertainty with potential threat during extinction? Here we addressed this question by running two independent experiments with uncertain auditory stimuli that varied in threat level (Experiment 1, aversive human scream (n = 30); Experiment 2, neutral tone (n = 47) and mildly aversive tone (n = 49)). During the experiments, we recorded skin conductance responses and subjective ratings to the learned cues during acquisition and extinction. In experiment 1, high IUS was associated with heightened skin conductance responding to the learned threat vs. safe cue during extinction. In experiment 2, high IUS was associated only with larger skin conductance responding to the learned cues with more threatening properties during extinction i.e. mildly aversive tone. These findings suggest that uncertainty in combination with threat, even when mild, disrupts extinction in high IUS individuals. Such findings help us understand the link between IUS and threat extinction, and its relevance to anxiety disorder pathology