Development of the Endocardium

The endocardium, the endothelial lining of the heart, plays complex and critical roles in heart development, particularly in the formation of the cardiac valves and septa, the division of the truncus arteriosus into the aortic and pulmonary trunks, the development of Purkinje fibers that form the cardiac conduction system, and the formation of trabecular myocardium. Current data suggest that the endocardium is a regionally specialized endothelium that arises through a process of de novo vasculogenesis from a distinct population of mesodermal cardiogenic precursors in the cardiac crescent. In this article, we review recent developments in the understanding of the embryonic origins of the endocardium. Specifically, we summarize vasculogenesis and specification of endothelial cells from mesodermal precursors, and we review the transcriptional pathways involved in these processes. We discuss the lineage relationships between the endocardium and other endothelial populations and between the endocardium and the myocardium. Finally, we explore unresolved questions about the lineage relationships between the endocardium and the myocardium. One of the central questions involves the timing with which mesodermal cells, which arise in the primitive streak and migrate to the cardiac crescent, become committed to an endocardial fate. Two competing conceptual models of endocardial specification have been proposed. In the first, mesodermal precursor cells in the cardiac crescent are prespecified to become either endocardial or myocardial cells, while in the second, fate plasticity is retained by bipotential cardiogenic cells in the cardiac crescent. We propose a third model that reconciles these two views and suggest future experiments that might resolve this question

Quality assessment of work recovery activities: Guidance for recovering from work-related demands

The proposed study is designed to test a revised work recovery process model and gather data to provide guidance for work recovery activities based on their recovery quality value. Using an integrated and modified model of the stress-recovery process, recovery quality will be measured in terms of potential for psychological detachment, mastery, and control, with relaxation serving as an outcome state associated with the proposed three core recovery mechanisms. Underlying theoretical frameworks such as the Conservation of Resources Theory, the Effort-Recovery Model, and the Job-Demands Resource model served as the foundation to describe the importance of recovering depleted resources. Past research suggests active forms of recovery in natural environments hold the greatest potential for work recovery, but research has been limited to broad activity category classifications. In this study we take a more holistic approach to identifying specific recovery activities and their associated recovery experience quality by asking participants to list, rank order, and provide quality-related details regarding their three most common recovery activities. A variety of analyses will be used to compare average ratings of recovery quality elements and identify common recovery themes

MEF2C regulates outflow tract alignment and transcriptional control of Tdgf1

Congenital heart defects are the most common birth defects in humans, and those that affect the proper alignment of the outflow tracts and septation of the ventricles are a highly significant cause of morbidity and mortality in infants. A late differentiating population of cardiac progenitors, referred to as the anterior second heart field (AHF), gives rise to the outflow tract and the majority of the right ventricle and provides an embryological context for understanding cardiac outflow tract alignment and membranous ventricular septal defects. However, the transcriptional pathways controlling AHF development and their roles in congenital heart defects remain incompletely elucidated. Here, we inactivated the gene encoding the transcription factor MEF2C in the AHF in mice. Loss of Mef2c function in the AHF results in a spectrum of outflow tract alignment defects ranging from overriding aorta to double-outlet right ventricle and dextro-transposition of the great arteries. We identify Tdgf1, which encodes a Nodal co-receptor (also known as Cripto), as a direct transcriptional target of MEF2C in the outflow tract via an AHFrestricted Tdgf1 enhancer. Importantly, both the MEF2C and TDGF1 genes are associated with congenital heart defects in humans. Thus, these studies establish a direct transcriptional pathway between the core cardiac transcription factor MEF2C and the human congenital heart disease gene TDGF1. Moreover, we found a range of outflow tract alignment defects resulting from a single genetic lesion, supporting the idea that AHF-derived outflow tract alignment defects may constitute an embryological spectrum rather than distinct anomalies

Prospects for the cavity-assisted laser cooling of molecules

Cooling of molecules via free-space dissipative scattering of photons is thought not to be practicable due to the inherently large number of Raman loss channels available to molecules and the prohibitive expense of building multiple repumping laser systems. The use of an optical cavity to enhance coherent Rayleigh scattering into a decaying cavity mode has been suggested as a potential method to mitigate Raman loss, thereby enabling the laser cooling of molecules to ultracold temperatures. We discuss the possibility of cavity-assisted laser cooling particles without closed transitions, identify conditions necessary to achieve efficient cooling, and suggest solutions given experimental constraints. Specifically, it is shown that cooperativities much greater than unity are required for cooling without loss, and that this could be achieved via the superradiant scattering associated with intracavity self-localization of the molecules. Particular emphasis is given to the polar hydroxyl radical (OH), cold samples of which are readily obtained from Stark deceleration.Comment: 18 pages, 10 figure

Large-scale discovery of enhancers from human heart tissue.

Development and function of the human heart depend on the dynamic control of tissue-specific gene expression by distant-acting transcriptional enhancers. To generate an accurate genome-wide map of human heart enhancers, we used an epigenomic enhancer discovery approach and identified ∼6,200 candidate enhancer sequences directly from fetal and adult human heart tissue. Consistent with their predicted function, these elements were markedly enriched near genes implicated in heart development, function and disease. To further validate their in vivo enhancer activity, we tested 65 of these human sequences in a transgenic mouse enhancer assay and observed that 43 (66%) drove reproducible reporter gene expression in the heart. These results support the discovery of a genome-wide set of noncoding sequences highly enriched in human heart enhancers that is likely to facilitate downstream studies of the role of enhancers in development and pathological conditions of the heart

Personal and organisational health literacy in the non‐specific symptom pathway for cancer: An ethnographic study

Introduction: People being investigated for cancer face a wealth of complex information. Non‐specific symptom pathways (NSS) were implemented in the United Kingdom in 2017 to address the needs of patients experiencing symptoms such as weight loss, fatigue or general practitioner ‘gut feeling’, who did not have streamlined pathways for cancer investigation. This study aimed to explore the health literacy skills needed by patients being investigated for cancer in NSS pathways. Methods: This study employed ethnographic methods across four hospitals in England, including interviews, patient shadowing and clinical care observations, to examine NSS pathways for cancer diagnosis. We recruited 27 patients who were shadowed and interviewed during their care. We also interviewed 27 professionals. The analysis focused on patient communication and understanding, drawing on the concepts of personal and organisational health literacy. Results: Our analysis derived six themes highlighting the considerable informational demands of the NSS pathway. Patients were required to understand complex blood tests and investigations in primary care and often did not understand why they were referred. The NSS pathway itself was difficult to understand with only a minority of patients appreciating that multiple organs were being investigated for cancer. The process of progressing through the pathway was also difficult to understand, particularly around who was making decisions and what would happen next. The results of investigations were complex, often including incidental findings. Patients whose persistent symptoms were not explained were often unsure of what to do following discharge. Conclusion: We have identified several potential missed opportunities for organisations to support patient understanding of NSS pathways which could lead to inappropriate help‐seeking post‐discharge. Patients' difficulties in comprehending previous investigations and findings could result in delays, overtesting or inadequately targeted investigations, hindering the effective use of their medical history. Third, patients' limited understanding of their investigations and results may impede their ability to engage in patient safety by reporting potential care errors. Patient or Public Contribution: Patient, public, clinical and policy representatives contributed to developing the research objectives through a series of meetings and individual conversations in preparation for the study. We have held several events in which patients and the public have had an opportunity to give feedback about our results, such as local interest groups in North London and academic conferences. A clinical contributor (J.‐A. M.) was involved in data analysis and writing the manuscript

Increased proinflammatory responses from asthmatic human airway smooth muscle cells in response to rhinovirus infection

BACKGROUND: Exacerbations of asthma are associated with viral respiratory tract infections, of which rhinoviruses (RV) are the predominant virus type. Airway smooth muscle is important in asthma pathogenesis, however little is known about the potential interaction of RV and human airway smooth muscle cells (HASM). We hypothesised that rhinovirus induction of inflammatory cytokine release from airway smooth muscle is augmented and differentially regulated in asthmatic compared to normal HASM cells. METHODS: HASM cells, isolated from either asthmatic or non-asthmatic subjects, were infected with rhinovirus. Cytokine production was assayed by ELISA, ICAM-1 cell surface expression was assessed by FACS, and the transcription regulation of IL-6 was measured by luciferase activity. RESULTS: RV-induced IL-6 release was significantly greater in HASM cells derived from asthmatic subjects compared to non-asthmatic subjects. This response was RV specific, as 5% serum- induced IL-6 release was not different in the two cell types. Whilst serum stimulated IL-8 production in cells from both subject groups, RV induced IL-8 production in only asthmatic derived HASM cells. The transcriptional induction of IL-6 was differentially regulated via C/EBP in the asthmatic and NF-κB + AP-1 in the non-asthmatic HASM cells. CONCLUSION: This study demonstrates augmentation and differential transcriptional regulation of RV specific innate immune response in HASM cells derived from asthmatic and non-asthmatics, and may give valuable insight into the mechanisms of RV-induced asthma exacerbations

Hydrologic Variability and the Application of Index of Biotic Integrity Metrics to Wetlands: A Great Lakes Evaluation

Interest by land-management and regulatory agencies in using biological indicators to detect wetland degradation, coupled with ongoing use of this approach to assess water quality in streams, led to the desire to develop and evaluate an Index of Biotic Integrity (IBI) for wetlands that could be used to categorize the level of degradation. We undertook this challenge with data from coastal wetlands of the Great Lakes, which have been degraded by a variety of human disturbances. We studied six barrier beach wetlands in western Lake Superior, six drowned-river-mouth wetlands along the eastern shore of Lake Michigan, and six open shoreline wetlands in Saginaw Bay of Lake Huron. Plant, fish, and invertebrate communities were sampled in each wetland. The resulting data were assessed in various forms against gradients of human disturbance to identify potential metrics that could be used in IBI development. Our results suggested that the metrics proposed as potential components of an IBI for barrier beach wetlands of Lake Superior held promise. The metrics for Lake Michigan drowned-river-mouth wetlands were inconsistent in identifying gradients of disturbance; those for Lake Huron open embayment wetlands were yet more inconsistent. Despite the potential displayed by the Lake Superior results within the year sampled, we concluded that an IBI for use in Great Lakes wetlands would not be valid unless separate scoring ranges were derived for each of several sequences of water-level histories. Variability in lake levels from year to year can produce variability in data and affect the reproducibility of data collected, primarily due to extreme changes in plant communities and the faunal habitat they provide. Substantially different results could be obtained in the same wetland in different years as a result of the response to lake-level change, with no change in the level of human disturbance. Additional problems included limited numbers of comparable sites, potential lack of undisturbed reference sites, and variable effects of different disturbance types. We also evaluated our conclusions with respect to hydrologic variability and other major natural disturbances affecting wetlands in other regions. We concluded that after segregation of wetland types by geographic, geomorphic, and hydrologic features, a functional IBI may be possible for wetlands with relatively stable hydrology. However, an IBI for wetlands with unpredictable yet recurring influences of climate-induced, long-term high water periods, droughts, or drought-related fires or weather-related catastrophic floods or high winds (hurricanes) would also require differing scales of measurement for years that differ in the length of time since the last major natural disturbance. A site-specific, detailed ecological analysis of biological indicators may indeed be of value in determining the quality or status of wetlands, but we recommend that IBI scores not be used unless the scoring ranges are calibrated for the specific hydrologic history pre-dating any sampling year

Effects of β2 Agonists, Corticosteroids, and Novel Therapies on Rhinovirus-Induced Cytokine Release and Rhinovirus Replication in Primary Airway Fibroblasts

Rhinovirus-(RV-) induced asthma exacerbations account for high asthma-related health costs and morbidity in Australia. The cellular mechanism underlying this pathology is likely the result of RV-induced nuclear-factor-kappa-B-(NF-κB-) dependent inflammation. NF-κB may also be important in RV replication as inhibition of NF-κB inhibits replication of other viruses such as human immunodeficiency virus and cytomegalovirus. To establish the role of NF-κB inhibitors in RV-induced IL- 6 and IL-8 and RV replication, we used pharmacological inhibitors of NF-κB, and steroids and/or β2 agonists were used for comparison. Primary human lung fibroblasts were infected with RV-16 in the presence of NF-κB inhibitors: BAY-117085 and dimethyl fumarate; β2 agonist: salmeterol; and/or corticosteroids: dexamethasone; fluticasone. RV-induced IL-6 and IL-8 and RV replication were assessed using ELISAs and virus titration assays. RV replicated and increased IL-6 and IL-8 release. Salmeterol increased, while dexamethasone and fluticasone decreased RV-induced IL-6 and IL-8 (P<0.05). The NF-κB inhibitor BAY-117085 inhibited only RV-induced IL-6 (P<0.05) and dimethyl fumarate did not alter RV-induced IL-6 and IL-8. Dimethylfumarate increased RV replication whilst other drugs did not alter RV replication. These data suggest that inhibition of NF-κB alone is unlikely to be an effective treatment compared to current asthma therapeutics