Dietary Prebiotics and Bioactive Milk Fractions Improve NREM Sleep, Enhance REM Sleep Rebound and Attenuate the Stress-Induced Decrease in Diurnal Temperature and Gut Microbial Alpha Diversity.

Severe, repeated or chronic stress produces negative health outcomes including disruptions of the sleep/wake cycle and gut microbial dysbiosis. Diets rich in prebiotics and glycoproteins impact the gut microbiota and may increase gut microbial species that reduce the impact of stress. This experiment tested the hypothesis that consumption of dietary prebiotics, lactoferrin (Lf) and milk fat globule membrane (MFGM) will reduce the negative physiological impacts of stress. Male F344 rats, postnatal day (PND) 24, received a diet with prebiotics, Lf and MFGM (test) or a calorically matched control diet. Fecal samples were collected on PND 35/70/91 for 16S rRNA sequencing to examine microbial composition and, in a subset of rats; Lactobacillus rhamnosus was measured using selective culture. On PND 59, biotelemetry devices were implanted to record sleep/wake electroencephalographic (EEG). Rats were exposed to an acute stressor (100, 1.5 mA, tail shocks) on PND 87 and recordings continued until PND 94. Test diet, compared to control diet, increased fecal Lactobacillus rhamnosus colony forming units (CFU), facilitated non-rapid eye movement (NREM) sleep consolidation (PND 71/72) and enhanced rapid eye movement (REM) sleep rebound after stressor exposure (PND 87). Rats fed control diet had stress-induced reductions in alpha diversity and diurnal amplitude of temperature, which were attenuated by the test diet (PND 91). Stepwise multiple regression analysis revealed a significant linear relationship between early-life Deferribacteres (PND 35) and longer NREM sleep episodes (PND 71/72). A diet containing prebiotics, Lf and MFGM enhanced sleep quality, which was related to changes in gut bacteria and modulated the impact of stress on sleep, diurnal rhythms and the gut microbiota

Stress and Exercise

Age-related immunological and endocrinological changes may have implications for resilience to stress in older adults. We hypothesise that the combination of adrenopause and immunesenescence may leave this population particularly vulnerable to the negative effects of stress on immunity. We propose that exercise may be an effective intervention to limit the impact of stress on immunity in chronically stressed older populations

PCN74 Cost-Effectiveness of Radium-223 Dichloride (Radium-223) In Alsympca: A Cost-Effectiveness Analysis of Radium-223+Best Standard of Care (Bsoc) Compared With Placebo+Bsoc In Treatment of Castration-Resistant Prostate Cancer (Crpc) And Symptomatic Bone Metastases In Canada

Current models of sexual functioning imply an important role for both automatic and controlled appraisals. Accordingly, it can be hypothesized that erectile dysfunction may be due to the automatic activation of negative appraisals at the prospect of sexual intercourse. However, previous research showed that men with sexual dysfunction exhibited relatively strong automatic sex-positive instead of sex-negative associations. This study tested the robustness of this unexpected finding and, additionally, examined the hypothesis that perhaps more specific sex-failure versus sex-success associations are relevant in explaining sexual dysfunction and distress. Male urological patients (N = 70), varying in level of sexual functioning and distress, performed two Single-Target Implicit Association Tests (ST-IATs) to assess automatic associations of visual erotic stimuli with attributes representing affective valence (“liking”; positive versus negative) and sexual success versus sexual failure. Consistent with the earlier findings, the lower the scores on sexual functioning, the stronger the automatic sex-positive associations. This association was independent of explicit associations and most prominent in the younger age group. Automatic sex-positive and sex-failure associations showed independent relationships with sexual distress. The relationship between sexual distress and sex-failure associations is consistent with the view that automatic associations with failure may contribute to sexual distress

Stakeholder Perceptions of Point-of-Care Ultrasound Implementation in Resource-Limited Settings

Nearly half of the world lacks access to diagnostic imaging. Point of care ultrasound (POCUS) is a versatile and relatively affordable imaging modality that offers promise as a means of bridging the radiology gap and improving care in low resource settings. Methods: We performed semi-structured interviews of key stakeholders at two diverse hospitals where POCUS implementation programs had recently been conducted: one in a rural private hospital in Haiti and the other in a public referral hospital in Malawi. Questions regarding the clinical utility of POCUS, as well as barriers and facilitators of its implementation, were asked of study participants. Using the Framework Method, analysis of interview transcripts was guided by the WHO ASSURED criteria for point of care diagnostics. Results: Fifteen stakeholders with diverse roles in POCUS implementation were interviewed. Interviewees from both sites considered POCUS a valuable diagnostic tool that improved clinical decisions. They perceived barriers to adequate training as one of the most important remaining barriers to POCUS implementation. Conclusions: In spite of the increasing affordability and portability of ultrasounds devices, there are still important barriers to the implementation of POCUS in resource-limited settings

Malvina Reynolds Sings the Truth: : Psychoanalytic Truth, the Post-Truth Era, and History as a Series of Psychoanalytic Sessions

This article showcases a psychoanalytic context for the idea of historical truth as presented in Malvina Reynolds’s album, Malvina Reynolds Sings the Truth (1967). It highlights music’s role as a narrative record of traumatic experiences and its importance within a therapeutic experience at the societal level. The album itself serves as a case study for socio-political topics such as climate change, racism, anti-intellectualism, and religious extremism—issues as critical today as they were in the 1960s. The article highlights music analysis’s dialogue with the psychoanalytic literature, interprets the album as an analytic construction from a single cultural psychoanalytic session, and locates it within a longitudinal study of cultural pathologies manifest in different eras. It demonstrates music’s importance in society’s healing process from traumatic experiences and concludes that music, popular music in particular, seems to have progressed toward more truth-telling and direct engagement with traumatic historical and cultural experiences. Songs as truth-seeking, historical, and narrative records are certainly not new, but their acceptance in popular circles has increased, pointing toward more potential for society to grapple with some of these psychoanalytic issues

Cathelicidin suppresses lipid accumulation and hepatic steatosis by inhibition of the CD36 receptor.

Background and objectivesObesity is a global epidemic which increases the risk of the metabolic syndrome. Cathelicidin (LL-37 and mCRAMP) is an antimicrobial peptide with an unknown role in obesity. We hypothesize that cathelicidin expression correlates with obesity and modulates fat mass and hepatic steatosis.Materials and methodsMale C57BL/6 J mice were fed a high-fat diet. Streptozotocin was injected into mice to induce diabetes. Experimental groups were injected with cathelicidin and CD36 overexpressing lentiviruses. Human mesenteric fat adipocytes, mouse 3T3-L1 differentiated adipocytes and human HepG2 hepatocytes were used in the in vitro experiments. Cathelicidin levels in non-diabetic, prediabetic and type II diabetic patients were measured by enzyme-linked immunosorbent assay.ResultsLentiviral cathelicidin overexpression reduced hepatic steatosis and decreased the fat mass of high-fat diet-treated diabetic mice. Cathelicidin overexpression reduced mesenteric fat and hepatic fatty acid translocase (CD36) expression that was reversed by lentiviral CD36 overexpression. Exposure of adipocytes and hepatocytes to cathelicidin significantly inhibited CD36 expression and reduced lipid accumulation. Serum cathelicidin protein levels were significantly increased in non-diabetic and prediabetic patients with obesity, compared with non-diabetic patients with normal body mass index (BMI) values. Prediabetic patients had lower serum cathelicidin protein levels than non-diabetic subjects.ConclusionsCathelicidin inhibits the CD36 fat receptor and lipid accumulation in adipocytes and hepatocytes, leading to a reduction of fat mass and hepatic steatosis in vivo. Circulating cathelicidin levels are associated with increased BMI. Our results demonstrate that cathelicidin modulates the development of obesity

A preferred vision for administrating secondary schools : a reflective essay

The mission and. vision of the American public school system must promote the individual success of each of its students. School districts throughout the country are as unique as the students that attend them; just as the needs of each school system are unique. The physical structure and climate vary from district to district, and state to state. The dynamics of the educational system are too great to box up and label one district as the model for all others use as a pattern. However, there are important elements that create school districts that are higher achieving than others. The quality of the administration and especially the principal is one of the essential characteristics of high performing schools

Can a Post-Discharge Telephone Call Reduce Hospital Readmission after Colorectal Surgery? A Prospective Study

BACKGROUND: Hospital readmission after major colorectal surgery is a major economic burden and a benchmark of quality care by government agencies. We hypothesized that a post-discharge telephone follow-up (TFU) could reduce readmission after abdominal colorectal surgery. METHODS: Consecutive patients undergoing abdominal colorectal surgery over the 4-month period ending Oct 2016 were prospectively evaluated. A structured TFU call during the 4-day period after hospital discharge evaluating the patient’s clinical status and possible interventions to avoid readmission was conducted by a second-year medical student, supervised by two board certified colorectal surgeons. Readmission rates were compared to a control group undergoing abdominal colorectal surgery by the same surgeons not receiving TFU over the prior 12-month period. Low-complexity surgery was defined as small bowel resection, right colectomy, creation or revision of ileostomy or colostomy. High-complexity surgery included left or total colectomy, or proctectomy with or without diversion. Groups were compared using Fisher\u27s exact test. RESULTS: The TFU patient group (n=74) and control patient group (n=134) were well matched in all clinical and operative characteristics except for case complexity. TFU group patients were more likely to undergo low-complexity surgery (n=41;55%) compared to control group patients (n=35;26%) (p=0.001). Readmission rates in the TFU patient group (n=9; 12%) and control patient group (n=26; 19%) were comparable (p=.25). For patients undergoing high-complexity surgery, readmission rates were not statistically different between the TFU patients (n=6;18%) and control patients (n=14; 14%). For patients undergoing low-complexity surgery, readmission rates were significantly lower in the TFU patient group (n=3;7%) compared to the control patient group (n=12;34%) (p=0.004). CONCLUSIONS: A simple, post discharge medical student-led phone call signficantly reduced the rate of readmission after low-complexity but not high-complexity colorectal surgery. Readmission after high-complexity colorectal surgery appears unpreventable. We recommend early post-discharge telephone follow-up to reduce readmission after abdominal colorectal surgery

Extracellular Hsp72 concentration relates to a minimum endogenous criteria during acute exercise-heat exposure

Extracellular heat-shock protein 72 (eHsp72) concentration increases during exercise-heat stress when conditions elicit physiological strain. Differences in severity of environmental and exercise stimuli have elicited varied response to stress. The present study aimed to quantify the extent of increased eHsp72 with increased exogenous heat stress, and determine related endogenous markers of strain in an exercise-heat model. Ten males cycled for 90 min at 50% O2peak in three conditions (TEMP, 20°C/63% RH; HOT, 30.2°C/51%RH; VHOT, 40.0°C/37%RH). Plasma was analysed for eHsp72 pre, immediately post and 24-h post each trial utilising a commercially available ELISA. Increased eHsp72 concentration was observed post VHOT trial (+172.4%) (P<0.05), but not TEMP (-1.9%) or HOT (+25.7%) conditions. eHsp72 returned to baseline values within 24hrs in all conditions. Changes were observed in rectal temperature (Trec), rate of Trec increase, area under the curve for Trec of 38.5°C and 39.0°C, duration Trec ≥ 38.5°C and ≥ 39.0°C, and change in muscle temperature, between VHOT, and TEMP and HOT, but not between TEMP and HOT. Each condition also elicited significantly increasing physiological strain, described by sweat rate, heart rate, physiological strain index, rating of perceived exertion and thermal sensation. Stepwise multiple regression reported rate of Trec increase and change in Trec to be predictors of increased eHsp72 concentration. Data suggests eHsp72 concentration increases once systemic temperature and sympathetic activity exceeds a minimum endogenous criteria elicited during VHOT conditions and is likely to be modulated by large, rapid changes in core temperature

Assessing needs and fostering agricultural entrepreneurship among immigrants in several Iowa communities

Two Iowa communities learn about opportunities to support local immigrant populations with an interest in farming enterprises