The Effects of Slow Deep Breathing on Measures of Microvascular and Autonomic Function in an Irritable Bowel Syndrome Population

Irritable Bowel Syndrome (IBS) is a functional disorder linked to disruptions in autonomic nervous system regulation, which could impair vascular homeostasis. Studies have shown that slow, deep breathing reduces muscle sympathetic nerve activity and arterial stiffness; however, its effects on autonomic regulation in adults with IBS have not been previously investigated. Moreover, the effects of breathing on microvascular endothelium function are unknown. PURPOSE: To investigate the effects of slow, deep breathing on measures of autonomic function and microvascular endothelial function in adults with IBS. METHODS: Adults (ages 18-65 years) with a formal diagnosis of IBS were enrolled and randomized to 4-week controlled breathing or time-control conditions. The experimental group followed a 20-minute slow, deep breathing video 4 to 6 days per week while the control group maintained their regular activity. To assess autonomic function, heart rate variability (HRV) and exercise heart rate recovery (HRR) were measured at baseline and week 4. The HRV test was accompanied by respiration rate measurements to ensure no significant deviations in respiration occurred between assessments as this could impact HRV. Exercise HRR was assessed 30, 60, and 120 seconds following a Balke treadmill VO2 max test. Laser Doppler flowmetry was assessed at baseline (33°C) and in response to local heating up to 43.5°C while blood pressure was measured throughout for the calculation of cutaneous vascular conductance (CVC). RESULTS: Of the 14 participants enrolled, 12 (n=6 for control and experimental groups) completed the study. At baseline, age (p = 0.47) and body mass index (p=0.14) were similar between groups. Respiration rate was similar between HRV assessments in both groups. In the experimental group, %CVC max significantly increased (p = 0.027) at week 4 while HRR was unchanged. A tendency toward a time by group interaction was observed for HRV low frequency to high frequency (LF/HF) ratio (p = 0.066) with slight reductions in the breathing group and increases in the control group. In the control group, %CVC max and HRR were unaltered, though HRR at 120 seconds tended to improve (p=0.08). CONCLUSIONS: Preliminary results from this ongoing study suggest that microvascular endothelial function can improve with 4 weeks of slow, deep breathing exercises in adults with IBS. These alterations in vascular function were unaccompanied by significant changes in autonomic function though trends were observed in HRV. Results show that slow, deep breathing is a viable alternative to physical exercise for improving microvascular function. Findings also suggest that this intervention could result in improved sympathovagal balance in adults with IBS and potentially other individuals with functional disorders

BioMagResBank

The BioMagResBank (BMRB: www.bmrb.wisc.edu) is a repository for experimental and derived data gathered from nuclear magnetic resonance (NMR) spectroscopic studies of biological molecules. BMRB is a partner in the Worldwide Protein Data Bank (wwPDB). The BMRB archive consists of four main data depositories: (i) quantitative NMR spectral parameters for proteins, peptides, nucleic acids, carbohydrates and ligands or cofactors (assigned chemical shifts, coupling constants and peak lists) and derived data (relaxation parameters, residual dipolar couplings, hydrogen exchange rates, pKa values, etc.), (ii) databases for NMR restraints processed from original author depositions available from the Protein Data Bank, (iii) time-domain (raw) spectral data from NMR experiments used to assign spectral resonances and determine the structures of biological macromolecules and (iv) a database of one- and two-dimensional 1H and 13C one- and two-dimensional NMR spectra for over 250 metabolites. The BMRB website provides free access to all of these data. BMRB has tools for querying the archive and retrieving information and an ftp site (ftp.bmrb.wisc.edu) where data in the archive can be downloaded in bulk. Two BMRB mirror sites exist: one at the PDBj, Protein Research Institute, Osaka University, Osaka, Japan (bmrb.protein.osaka-u.ac.jp) and the other at CERM, University of Florence, Florence, Italy (bmrb.postgenomicnmr.net/). The site at Osaka also accepts and processes data depositions

What is the future of targeted therapy in rheumatology: biologics or small molecules?

Background: Until late in the 20th century, the therapy of rheumatic diseases relied on the use of drugs that had been developed through empirical approaches without detailed understanding of the molecular mechanisms involved. That approach changed with the introduction of biologic therapeutics at the end of the 20th century and by the recent development of small-molecule inhibitors of intracellular signal transduction pathways. Here we compare and discuss the advantages and disadvantages of those two groups of targeted anti-inflammatory therapeutics.Discussion: TNF-blocking biologic agents were introduced into the therapy of rheumatoid arthritis and other autoimmune and inflammatory diseases in the late 1990s. Further biologic agents targeting cytokine networks or specific lymphocyte subsets have since been added to the armamentarium of anti-rheumatic therapy. During the last few years, another wave of novel discoveries led to the development of a new class of small molecule anti-inflammatory compounds targeting intracellular signal transduction molecules, such as tyrosine kinases. In all those cases, the specific targets of the drugs are well defined and significant knowledge about their role in the disease pathomechanism is available, qualifying them for being targeted therapeutics for inflammatory rheumatic diseases. While both groups of targeted therapeutics offer significant clinical benefit, they clearly differ in several aspects, such as the localization of their targets, their route of administration and target specificity, as well as technical details such as manufacturing procedures and cost basis. In this debate paper, we compare the advantages and disadvantages of the two different approaches, aiming to shed light on the possible future of targeted therapies.Summary: Biologic therapeutics and small-molecule inhibitors both have significant advantages and disadvantages in the therapy of rheumatic diseases. The future of targeted therapies is one of the most exciting questions of current rheumatology research and therapy. © 2014 Mócsai et al.; licensee BioMed Central Ltd

Who will care for the women?

Over 20 million people today, including children, working-age disabled, and elderly persons, require some sort of assistance to live safely. Largely because women live longer than men, well into the ages when the probability of needing care increases, 70 percent of elderly people who need long-term care are women. Furthermore, most long-term care is provided by women, mainly as unpaid care in the home, or as low-paid care in institutions and community settings (Stone & Weiner 2001). The United States faces a severe long-term care crisis because of the nation\u27s inability to plan for the changing demographic balance. The crisis in long term care has two problems: a) that we are putting too many resources into institutional care relative to home- and community-based care and relying too heavily on unpaid care in the home to meet the real needs of the aging population, and b) that we do not, and increasingly will not, have enough people to provide for the volume of care that will be needed in the coming decades. This chapter begins with a description of the long-term care system in the United States – what long-term care is, who needs it, in what settings it is provided, and who pays for it. Using the author\u27s analysis of a national survey of caregivers conducted by the National Alliance for Caregiving and the AARP in 2003 along with other sources, this section shows that a substantial portion of the people who need long-term care rely on unpaid care from family and friends, mainly women. When people do receive paid care, almost half – mostly women -- receive it in institutional settings. The discussion demonstrates that women are far more likely to end up in institutions than men, even controlling for age and level of impairment. It then argues that, for a number of reasons, states and the federal government will have to respond to the preferences of consumers for home- and community-based care

Human and mouse essentiality screens as a resource for disease gene discovery.

The identification of causal variants in sequencing studies remains a considerable challenge that can be partially addressed by new gene-specific knowledge. Here, we integrate measures of how essential a gene is to supporting life, as inferred from viability and phenotyping screens performed on knockout mice by the International Mouse Phenotyping Consortium and essentiality screens carried out on human cell lines. We propose a cross-species gene classification across the Full Spectrum of Intolerance to Loss-of-function (FUSIL) and demonstrate that genes in five mutually exclusive FUSIL categories have differing biological properties. Most notably, Mendelian disease genes, particularly those associated with developmental disorders, are highly overrepresented among genes non-essential for cell survival but required for organism development. After screening developmental disorder cases from three independent disease sequencing consortia, we identify potentially pathogenic variants in genes not previously associated with rare diseases. We therefore propose FUSIL as an efficient approach for disease gene discovery

America's Rural Hospitals: A Selective Review of 1980s Research

We review 1980s research on American rural hospitals within the context of a decade of increasing restrictiveness in the reimbursement and operating environments. Areas addressed include rural hospital definitions, organizational and financial performance, and strategic management activities. The latter category consists of hospital closure, diversification and vertical integration, swing-bed conversion, sole community provider designation, horizontal integration and multihospital system affiliation, marketing, and patient retention. The review suggests several research needs, including: developing more meaningful definitions of rural hospitals, engaging in methodologically sound work on the effects of innovative programs and strategic management activities—including conversion of the facility itself—on rural hospital performance, and completing studies of the effects of rural hospital closure or conversion on the health of the communities served.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74857/1/j.1748-0361.1990.tb00682.x.pd

Natalie D\u27Alessandro Interview for the Veterans\u27 Voices Project

Natalie D\u27Alessandro accepted a commission in the United States Air Force on May 24, 2004. She served with the 960th Airborne Air Control Squadron and the 552nd Air Control Wing in Florida, Oklahoma, and Ohio. D\u27Alessandro participated in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), and was awarded the Air Medal, the Aerial Achievement Medal, the Air Force Commendation Medal with 2 Oak Leaves, the Global War on Terrorism Service Medal, and the Global War on Terror Expeditionary Medal. D\u27Alessandro left the Air Force on March 1, 2012 at the rank of Captain.https://corescholar.libraries.wright.edu/veterans_voices/1049/thumbnail.jp