Cardiac asystole at birth: Is hypovolemic shock the cause?

A birth involving shoulder dystocia can rapidly deteriorate—from a fetus with a reassuring tracing in the minutes before birth, to a neonate needing aggressive resuscitation. Infants experiencing a traumatic birth involving shoulder dystocia may be severely compromised, even when the preceding labor was uncomplicated. This paper presents two cases in which infants had normal heart beats recorded 5–10 min before birth and were born with cardiac asystole following shoulder dystocia. Often, in cases of shoulder dystocia, infants shift blood to the placenta due to the tight compressive squeeze of the body in the birth canal (along with cord compression) and thereby may be born hypovolemic. Our hypothesis is that the occurrence of sudden cardiac asystole at birth is due to extreme hypovolemic shock secondary to the loss of blood. At birth, the sudden release of pressure on the infant’s body results in hypoperfusion resulting in low central circulation and blood pressure. Severe hypovolemic shock from these effects leads to sudden cardiac arrest. Immediate cord clamping maintains the hypovolemic state by preventing the physiologic and readily available placental blood from returning to the infant. Loss of this blood initiates an inflammatory response leading to seizures, hypoxic-ischemic encephalopathy, and brain damage or death. Animal studies have shown that human umbilical stem cells injected into a rat’s abdomen after induced brain damage, can protect the rat’s brain from developing permanent injury. To prevent damage to newborns, the infant must receive the blood volume and stem cells lost at the time of descent and immediate cord clamping. Recommended countermeasures for research include: (1) resuscitation at the perineum with intact cord; or (2) milking the cord before clamping; or (3) autologous transfusion of placenta blood after the birth; or (4) rapid transfusion of O negative blood after birth and before seizures begin

Experimental determination of the degree of quantum polarisation of continuous variable states

We demonstrate excitation-manifold resolved polarisation characterisation of continuous-variable (CV) quantum states. In contrast to traditional characterisation of polarisation that is based on the Stokes parameters, we experimentally determine the Stokes vector of each excitation manifold separately. Only for states with a given photon number does the methods coincide. For states with an indeterminate photon number, for example Gaussian states, the employed method gives a richer and more accurate description. We apply the method both in theory and in experiment to some common states to demonstrate its advantages.Comment: 5 page

Conditionals and the Hierarchy of Causal Queries

Recent studies indicate that indicative conditionals like "If people wear masks, the spread of Covid-19 will be diminished" require a probabilistic dependency between their antecedents and consequents to be acceptable (Skovgaard-Olsen et al., 2016). But it is easy to make the slip from this claim to the thesis that indicative conditionals are acceptable only if this probabilistic dependency results from a causal relation between antecedent and consequent. According to Pearl (2009), understanding a causal relation involves multiple, hierarchically organized conceptual dimensions: prediction, intervention, and counterfactual dependence. In a series of experiments, we test the hypothesis that these conceptual dimensions are differentially encoded in indicative and counterfactual conditionals. If this hypothesis holds, then there are limits as to how much of a causal relation is captured by indicative conditionals alone. Our results show that the acceptance of indicative and counterfactual conditionals can become dissociated. Furthermore, it is found that the acceptance of both is needed for accepting a causal relation between two co-occurring events. The implications that these findings have for the hypothesis above, and for recent debates at the intersection of the psychology of reasoning and causal judgment, are critically discussed. Our findings are consistent with viewing indicative conditionals as answering predictive queries requiring evidential relevance (even in the absence of direct causal relations). Counterfactual conditionals in contrast target causal relevance, specifically. Finally, we discuss the implications our results have for the yet unsolved question of how reasoners succeed in constructing causal models from verbal descriptions

Integrating research evidence and physical activity policy making-REPOPA project

Evidence shows that regular physical activity is enhanced by supporting environment. Studies are needed to integrate research evidence into health enhancing, cross-sector physical activity (HEPA) policy making. This article presents the rationale, study design, measurement procedures and the initial results of the first phase of six European countries in a five-year research project (2011–2016), REsearch into POlicy to enhance Physical Activity (REPOPA). REPOPA is programmatic research; it consists of linked studies; the first phase studied the use of evidence in 21 policies in implementation to learn more in depth from the policy making process and carried out 86 qualitative stakeholder interviews. The second, ongoing phase builds on the central findings of the first phase in each country; it consists of two sets of interventions: game simulations to study cross-sector collaboration and organizational change processes in the use of evidence and locally tailored interventions to increase knowledge integration. The results of the first two study phases will be tested and validated among policy makers and other stakeholders in the third phase using a Delphi process. Initial results from the first project phase showed the lack of explicit evidence use in HEPA policy making. Facilitators and barriers of the evidence use were the availability of institutional resources and support but also networking between researchers and policy makers. REPOPA will increase understanding use of research evidence in different contexts; develop guidance and tools and establish sustainable structures such as networks and platforms between academics and policy makers across relevant sectors

A polyphenol-enriched diet and Ascaris suum infection modulate mucosal immune responses and gut microbiota composition in pigs

<div><p>Polyphenols are a class of bioactive plant secondary metabolites that are thought to have beneficial effects on gut health, such as modulation of mucosal immune and inflammatory responses and regulation of parasite burdens. Here, we examined the interactions between a polyphenol-rich diet supplement and infection with the enteric nematode <i>Ascaris suum</i> in pigs. Pigs were fed either a basal diet or the same diet supplemented with grape pomace (GP), an industrial by-product rich in polyphenols such as oligomeric proanthocyanidins. Half of the animals in each group were then inoculated with <i>A</i>. <i>suum</i> for 14 days to assess parasite establishment, acquisition of local and systemic immune responses and effects on the gut microbiome. Despite <i>in vitro</i> anthelmintic activity of GP-extracts, numbers of parasite larvae in the intestine were not altered by GP-supplementation. However, the bioactive diet significantly increased numbers of eosinophils induced by <i>A</i>. <i>suum</i> infection in the duodenum, jejunum and ileum, and modulated gene expression in the jejunal mucosa of infected pigs. Both GP-supplementation and <i>A</i>. <i>suum</i> infection induced significant and apparently similar changes in the composition of the prokaryotic gut microbiota, and both also decreased concentrations of isobutyric and isovaleric acid (branched-chain short chain fatty acids) in the colon. Our results demonstrate that while a polyphenol-enriched diet in pigs may not directly influence <i>A</i>. <i>suum</i> establishment, it significantly modulates the subsequent host response to helminth infection. Our results suggest an influence of diet on immune function which may potentially be exploited to enhance immunity to helminths.</p></div