How European cardiologists perceive the role of calcium antagonists in follow-up after myocardial infarction

About one hundred European cardiologists discussed the role of calcium antagonists in the follow-up management of myocardial infarction, β-blockers are the treatment of choice. Where these are contra-indicated or otherwise unsuitable, many clinicians would use a non-dihydropyridine calcium antagonist alone or in combination with an ACE inhibitor. There is broad agreement that calcium antagonists should not be used in patients with concomitant left ventricular failure. Cholesterol estimation in post-infarction patients is essentia

Speech rhythm and language acquisition: an amplitude modulation phase hierarchy perspective.

Language lies at the heart of our experience as humans and disorders of language acquisition carry severe developmental costs. Rhythmic processing lies at the heart of language acquisition. Here, I review our understanding of the perceptual and neural mechanisms that support language acquisition, from a novel amplitude modulation perspective. Amplitude modulation patterns in infant- and child-directed speech support the perceptual experience of rhythm, and the brain encodes these rhythm patterns in part via neuroelectric oscillations. When brain rhythms align themselves with (entrain to) acoustic rhythms, speech intelligibility improves. Recent advances in the auditory neuroscience of speech processing enable studies of neuronal oscillatory entrainment in children and infants. The "amplitude modulation phase hierarchy" theoretical perspective on language acquisition is applicable across languages, and cross-language investigations adopting this novel perspective would be valuable for the field

Application of an equine composite pain scale and its association with plasma adrenocorticotropic hormone concentrations and serum cortisol concentrations in horses with colic

This study assessed the application of a modified equine composite pain scale (CPS) and identified the inter‐observer reliability. Associations between CPS scores and the measured concentrations of serum cortisol ([cortisol]) and plasma adrenocorticotrophic hormone ([ACTH]) in horses presenting with colic were determined. The study design was prospective, uni‐centred and observational. The inter‐observer reliability of the adapted CPS was determined for 59 horses hospitalised for a variety of conditions. The associations between CPS, ACTH and cortisol were assessed in a further 49 horses admitted for medical or surgical colic. During hospitalisation, blood samples were obtained each morning and analysed for serum [cortisol] and plasma [ACTH]. Horses were pain scored using the adapted CPS score. Data from the most painful time point (n = 48 horses; n = 48 [cortisol]; n = 44 [ACTH]) and all data time points (n = 49 horses and n = 133 time points) were used for analysis of association between [cortisol], [ACTH] and CPS score. The CPS score inter‐observer reliability was excellent (n = 59 horses; n = 102 pain scores; weighted kappa 0.863). CPS score and [cortisol] were positively associated at the most painful time point (P < 0.001) and at all data time points (P < 0.001). No significant association was found between CPS score and [ACTH]. [ACTH] was associated with [cortisol] (P = 0.034) when all time points were analysed but not when only the most painful point was analysed. The significant correlation identified between CPS score and [cortisol] in medical and surgical colic cases provides physiological validation of pain scores as a marker of underlying stress in horses with colic

Designing multiplayer games to facilitate emergent social behaviours online

This paper discusses an exploratory case study of the design of games that facilitate spontaneous social interaction and group behaviours among distributed individuals, based largely on symbolic presence 'state' changes. We present the principles guiding the design of our game environment: presence as a symbolic phenomenon, the importance of good visualization and the potential for spontaneous self-organization among groups of people. Our game environment, comprising a family of multiplayer 'bumper-car' style games, is described, followed by a discussion of lessons learned from observing users of the environment. Finally, we reconsider and extend our design principles in light of our observations

Technocamps: Advancing Computer Science Education in Wales

Computer science education in the UK has undergone substantial scrutiny over the past five years. In particular, from September 2014, we have seen the implementation and delivery of a new computing curriculum in England. However, in Wales -- one of the four devolved nation in the UK -- numerous political, geographical and socio-technical issues have hindered any substantive educational policy or curriculum reform for computer science. This is despite the widespread efforts to address the failings of computer science education in schools since at least 2003 through Technocamps, a pan-Wales university-based schools outreach programme.In this paper we outline the history (and pre-history) of Technocamps, contextualised by the devolved nature of education in the UK, positioning Wales with its specific issues and challenges. Furthermore, we present evidence both in support of this university engagement and intervention model as well as its wider positive effect on promoting and supporting computer science education in Wales, a nation about to take its first steps on the path of a large-scale national curriculum review and significant educational reform

Impact of the Covid-19 Pandemic on ALS Care in the UK

The Covid-19 pandemic has impacted healthcare. Our aim was to identify how amyotrophic lateral sclerosis (ALS) care in the UK has been affected by the pandemic by exploring the experiences of people living with ALS (plwALS), healthcare professionals (HCPs) working with plwALS, and ALS care centers. Three surveys were carried out to explore the experiences of plwALS, HCPs and ALS care centers during the pandemic. Quantitative data were analyzed using descriptive and inferential statistics and triangulated with the qualitative data which were analyzed thematically. Responses from 53 plwALS, 73 HCPs and 23 ALS care centers were analyzed. Five main themes were identified: keeping safe, losses, negative emotions, delivering care and alternative care delivery in a pandemic. PlwALS and HCPs felt that care was sub-optimal as a result of the pandemic. Changes to care included longer waiting times and face-to-face appointments being canceled or replaced by virtual consultations. While benefits of virtual consultations were reported, concerns were raised about incomplete clinical assessments and the disruption of provision of testing and interventions. ALS care has changed as a result of the pandemic. Patients have had a lack of face-to-face contact with HCPs and have experienced delays to investigations and treatments. PlwALS and HCPs were concerned about the impact of this change, but the long-term implications remain unclear. We propose recommendations for HCPs caring for plwALS, that will promote continuity of evidenced based care in the context of a pandemic

ERK1/2 signaling dominates over RhoA signaling in regulating early changes in RNA expression induced by endothelin-1 in neonatal rat cardiomyocytes

Cardiomyocyte hypertrophy is associated with changes in gene expression. Extracellular signal-regulated kinases 1/2 (ERK1/2) and RhoA [activated by hypertrophic agonists (e.g. endothelin-1)] regulate gene expression and are implicated in the response, but their relative significance in regulating the cardiomyocyte transcriptome is unknown. Our aim was to establish the significance of ERK1/2 and/or RhoA in the early cardiomyocyte transcriptomic response to endothelin-1.Cardiomyocytes were exposed to endothelin-1 (1 h) with/without PD184352 (to inhibit ERK1/2) or C3 transferase (C3T, to inhibit RhoA). RNA expression was analyzed using microarrays and qPCR. ERK1/2 signaling positively regulated approximately 65% of the early gene expression response to ET-1 with a small (approximately 2%) negative effect, whereas RhoA signaling positively regulated approximately 10% of the early gene expression response to ET-1 with a greater (approximately 14%) negative contribution. Of RNAs non-responsive to endothelin-1, 66 or 448 were regulated by PD184352 or C3T, respectively, indicating that RhoA had a more significant effect on baseline RNA expression. mRNAs upregulated by endothelin-1 encoded a number of receptor ligands (e.g. Ereg, Areg, Hbegf) and transcription factors (e.g. Abra/Srf) that potentially propagate the response.ERK1/2 dominates over RhoA in the early transcriptomic response to endothelin-1. RhoA plays a major role in maintaining baseline RNA expression but, with upregulation of Abra/Srf by endothelin-1, RhoA may regulate changes in RNA expression over longer times. Our data identify ERK1/2 as a more significant node than RhoA in regulating the early stages of cardiomyocyte hypertrophy

Initiating the dialogue between infant mental health and family therapy: a qualitative inquiry and recommendations

This qualitative study explores infant-family mental health experts' perspectives and experiences regarding the inclusion of infants in the family therapy setting. Infant socioemotional development is relational in nature and evolves in the context of both dyadic attachment relationships and broader multi-person co-parenting systems. Given this, we sought to understand why family therapy interventions involving families with infants rarely include the infant in a triangular or family systemic approach. Interviews were completed by clinical and/or research experts whose work integrates tenets of both infant mental health (IMH) and family theory and therapy. All interviewees brought at least 5 years of expertise and were actively engaged in the field. Interviewees expressed consistent beliefs that infants have a rightful and helpful place in family therapy approaches. They maintained that infants' innate social drive and communicative capacities position them to make meaningful and clinically significant contributions within family and systemic psychotherapy contexts. Noting that infants have remained on the periphery of these practices, experts advocated expansion and greater integration between IMH and family therapy, while preserving each field's distinctive identity. Experts reported that the interplay between IMH and family therapy fields has been uni-directional as family systems concepts are embedded within IMH approaches, but few IMH premises are incorporated in mainstream family therapy practices. The disconnect was attributed to multiple factors, including graduate and professional training and theoretical, clinical, research, and sociocultural barriers, which were mutually reinforcing. Experts also identified clinical gains for both infants and family members when infants were meaningfully included in family interventions. Common ground was identified between the disciplines, with a belief that relationally distressed young children and parents are best served by clinical engagement with their network of relationships. Results call for greater collaboration between disciplines to challenge existing traditions and to more fully include infants in mainstream family therapy. Recommendations for integration of family therapy and IMH in clinical, theoretical, research, training, and sociocultural domains are offered

Ethanolamine is a novel STAT-3 dependent cardioprotective agent

Ethanolamine is a biogenic amine found naturally in the body as part of membrane lipids and as a metabolite of the cardioprotective substances, sphingosine-1-phosphate (S1P) and anandamide. In the brain, ethanolamine, formed from the breakdown of anandamide protects against ischaemic apoptosis. However, the effects of ethanolamine in the heart are unknown. Signal transducer and activator of transcription 3 (STAT-3) is a critical prosurvival factor in ischaemia/reperfusion (I/R) injury. Therefore, we investigated whether ethanolamine protects the heart via activation of STAT-3. Isolated hearts from wildtype or cardiomyocyte specific STAT-3 knockout (K/O) mice were pre-treated with ethanolamine (Etn) (0.3 mmol/L) before I/R insult. In vivo rat hearts were subjected to 30 min ischaemia/2 h reperfusion in the presence or absence of 5 mg/kg S1P and/or the FAAH inhibitor, URB597. Infarct size was measured at the end of each protocol by triphenyltetrazolium chloride staining. Pre-treatment with ethanolamine decreased infarct size in isolated mouse or rat hearts subjected to I/R but this infarct sparing effect was lost in cardiomyocyte specific STAT-3 deficient mice. Pre-treatment with ethanolamine increased nuclear phosphorylated STAT-3 [control 0.75 ± 0.08 vs. Etn 1.50 ± 0.09 arbitrary units; P < 0.05]. Our findings suggest a novel cardioprotective role for ethanolamine against I/R injury via activation of STAT-3