Physiological Disturbances Research Articles

Factors associated with readmissions in psychiatric inpatient care: a prospective cohort study based on hospital registers

BackgroundReadmissions in psychiatric inpatient care may reflect problems in the provision of care, but the underlying factors are not well known. We examined the associations of patient characteristics (sociodemographic factors, diagnoses), treatment (duration, previous episodes, neuromodulation) and ward overload with psychiatric inpatient readmissions and multiple readmissions in Finland.MethodsWe used a routinely collected data pool from one hospital district and followed all 2052 hospitalizations that started in 2018. The outcomes were readmission within 30 days and one year, and among those with readmission, the number of readmissions.ResultsOf the patients, 11% had readmission within 30 days and 33% had readmission within one year. Women, those with previous hospitalizations, those with an ICD-10 diagnosis from the ‘behavioural syndromes associated with physiological disturbances and physical factors / disorders of adult personality and behaviour’ group, those with a diagnosis from the ‘neurotic, stress-related and somatoform disorders’ group, those with psychotic disorders, and those who received neuromodulation treatment were more likely to have readmissions. Having a diagnosis of ‘disorders of psychological development’ or ‘behavioural and emotional disorders with onset usually occurring in childhood and adolescence’ was associated with a lower likelihood of readmission. The duration of treatment and ward overload during the index period were not associated with readmission.ConclusionsThe findings of this study suggest possible risk factors for readmission and can be used to plan psychiatric care. To some degree, the risk factors varied between different readmission types. It is important to examine whether there are unmet treatment needs in psychiatric inpatient care for children and adolescents.

Quieting the neonatal intensive care unit: A quality improvement initiative.

The neonatal intensive care unit (NICU) is vital for preterm infants but is often plagued by harmful noise levels. Excessive noise, ranging from medical equipment to conversations, poses significant health risks, including hearing impairment and neurodevelopmental issues. The American Academy of Pediatrics recommends strict sound limits to safeguard neonatal well-being. Strategies such as education, environmental modifications, and quiet hours have shown to reduce noise levels. However, up to 60% of the noises remain avoidable. High noise exposure exacerbates physiological disturbances, impacting vital functions and long-term neurological outcomes. Effective noise reduction in the NICU is crucial for promoting optimal neonatal development. To measure the sound levels in a NICU and reduce ambient sound levels by at least 10% from baseline. A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical college. Baseline noise levels were recorded continuously using a sound level meter. The interventions included targeted education, environmental modifications, and organizational changes, and were implemented through three rapid Plan-Do-Study-Act (PDSA) cycles. Weekly feedback and monitoring were conducted, and statistical process control charts were used for analysis. The mean noise values were compared using the paired t-test. The baseline mean ambient noise level in the NICU was 67.8 dB, which decreased to 50.5 dB after the first cycle, and further decreased to 47.4 dB and 51.2 dB after subsequent cycles. The reduction in noise levels was 21% during the day and 28% at night, with an overall decrease of 25% from baseline. The most significant reduction occurred after the first PDSA cycle (mean difference of -17.3 dB, P < 0.01). Peak noise levels decreased from 110 dB to 88.24 dB after the intervention. A multifaceted intervention strategy reduced noise in the NICU by 25% over 4 months. The success of this initiative emphasizes the significance of comprehensive interventions for noise reduction.

Gibberellin Inhibitors Molecules as a Safeguard against Secondary Growth in Garlic Plants

Secondary growth in garlic depreciates its visual aspect and thereby renders the crop unviable for trade. Therefore, farmers commonly reduce fertilization and impose drought and oxidative stress caused by high-dose pesticides to reduce secondary growth in garlic plants. However, these procedures can be considered adverse, unhealthy, and environmentally inappropriate. To remedy this scenario, we investigated whether spraying growth inhibitors would prevent secondary growth in garlic plants. First, we evaluated the effects of abscisic acid, trinexapac-ethyl, chlormequat chloride, and paclobutrazol treatments on garlic plants grown in polyethylene tanks (250 m3). We then analyzed the effects of deficit irrigation combined with the application of trinexapac-ethyl (sprayed two or three times) and the application of trinexapac-ethyl, chlormequat chloride, or paclobutrazol alone (each sprayed two or three times) on garlic plants grown in the field, comparing them with the effects of deficit irrigation (control treatment) alone. The in-field experiment was replicated with the following treatments: control (deficit irrigation) and trinexapac-ethyl (sprayed two or three times) treatments. We analyzed the physiological, biometric, and production parameters affecting secondary growth in garlic plants. We observed that trinexapac-ethyl could efficiently regulate secondary growth without causing physiological disturbances in garlic plants. Our results provide valuable information that will contribute to the development of a sustainable technique to replace the current practices used by farmers to prevent secondary growth in garlic plants.

The Prevalence of Low Energy Availability in Cross-Country Skiers during the Annual Cycle.

A sustained mismatch between energy intake (EI) and exercise energy expenditure (EEE) can lead to Low Energy Availability (LEA), as well as health and performance impairments characteristic of Relative Energy Deficiency in Sport (RED-S). Research in females has identified specific LEA cut-points for the risks of developing physiological and performance disturbances. Cut-points in males have yet to be evaluated; therefore, this study examined the prevalence of LEA in highly trained male cross-country skiers. The key purpose of this study was to analyze EI, resting energy expenditure (REE), EEE, and energy availability (EA) in highly trained cross-country skiers during the preparation and competition periods. The secondary objective of our study was to evaluate the relative contribution of fats and carbohydrates to EI, REE, and EEE. EI was determined by an estimated 24 h diet recall method, REE was assessed by indirect calorimetry, and EEE was estimated from heart rate in 27 cross-country skiers. EI amounted to 4050 ± 797 kcal/day on a typical training day (TD) and 5986 ± 924 kcal/day (p < 0.001) on a typical competition day (CD). REE on TDs (2111 ± 294 kcal/day or 30 ± 6 kcal/day/kg) was higher (p < 0.05) than on CDs (1891 ± 504 kcal/day or 27 ± 7 kcal/day/kg). The EA in the athletes was <15 kcal∙kg FFM-1·d-1 on TDs and <65 kcal∙kg FFM-1·d-1 on CDs. EI was not optimal, as indicated by low EA throughout TDs (June). This could be associated with insufficient EI along with a high amount of EEE (3690.7 ± 485.2 kcal/day). During the transition from TD to CD, an increase in the contribution of fats to EI and EEE was observed in cross-country skiers. The conception of LEA and REDs and their potential implication for performance is underestimated among coaches and athletes. The importance of appropriate dietary strategies is essential to ensure that enough calories are consumed to support efficient training.

Toxicological insight of metiram: immuno-oxidative, neuro-behavioral, and hemato-biochemical changes during acute exposure of Nile tilapia (Oreochromis niloticus)

BackgroundThe inappropriate use of pesticides including fungicides creates severe biological hazards that can endanger fish health and impede sustainable aquaculture.ObjectiveThis study investigated the negative impacts of metiram (MET), a fungicide on the health status of Nile tilapia (Oreochromis niloticus) for a 96-hour duration as an acute exposure in a static renewal system.MethodsThree hundred fish (average body weight: 37.50 ± 0.22 g) were assigned into six groups (50 fish/group) with five replicates (10 fish/replicate). Fish were exposed to various six concentrations (0, 1.5, 3, 4.5, 6, and 7.5 mg/L) of MET as a water exposure to for 96-hour without water exchange. The fish’s behavior, clinical signs, and mortalities were documented every day of the exposure period. Additionally, MET’s impact on blood profile, stress biomarkers, hepato-renal functions, immune-antioxidant status, and brain biomarker were closely monitored.ResultsThe lethal concentration (LC50) of MET estimated using Finney’s probit technique was 3.77 mg/L. The fish’s behavior was severely impacted by acute MET exposure, as clear by an increase in surfacing, loss of equilibrium, unusual swimming, laterality, abnormal movement, and a decline in aggressive behaviors. The survivability and hematological indices (white and red blood cell count, differential white blood cell count, hematocrit value, and hemoglobin) were significantly reduced in a concentration-dependent manner following MET exposure. Acute exposure to MET (1.5–7.5 mg/L) incrementally increased stress biomarkers (nor-epinephrine, cortisol, and glucose), lipid peroxides (malondialdehyde), and brain oxidative DNA damage biomarker (8-hydroxy-2-deoxyguanosine). A hepato-renal dysfunction by MET exposure (4.5–7.5 mg/L) was evidenced by the significant increase in the alanine and aspartate aminotransferases and creatinine values. Moreover, a substantial decline in the immune parameters (lysozyme, complement 3, serum bactericidal activity, and antiprotease activity) and antioxidant variables (total antioxidant capacity, superoxide dismutase, and glutathione peroxidase) resulted from acute MET exposure.ConclusionAccording to these findings, the 96-hour LC50 of MET in Nile tilapia was 3.77 mg/L. MET exposure triggered toxicity in Nile tilapia, as seen by alterations in fish neuro-behaviors, immune-antioxidant status, hepato-renal functioning, and signifying physiological disturbances. This study emphasizes the potential ecological dangers provoked by MET as an environmental contaminant to aquatic systems. However, the long-term MET exposure is still needed to be investigated.

Short-Term Neurologic Complications in Patients Undergoing Extracorporeal Membrane Oxygenation Support: A Review on Pathophysiology, Incidence, Risk Factors, and Outcomes.

Regardless of the type, extracorporeal membrane oxygenation (ECMO) requires the use of large intravascular cannulas and results in multiple abnormalities including non-physiologic blood flow, hemodynamic perturbation, rapid changes in blood oxygen and carbon dioxide levels, coagulation abnormalities, and a significant systemic inflammatory response. Among other sequelae, neurologic complications are an important source of mortality and long-term morbidity. The frequency of neurologic complications varies and is likely underreported due to the high mortality rate. Neurologic complications in patients supported by ECMO include ischemic and hemorrhagic stroke, hypoxic brain injury, intracranial hemorrhage, and brain death. In addition to the disease process that necessitates ECMO, cannulation strategies and physiologic disturbances influence neurologic outcomes in this high-risk population. For example, the overall documented rate of neurologic complications in the venovenous ECMO population is lower, but a higher rate of intracranial hemorrhage exists. Meanwhile, in the venoarterial ECMO population, ischemia and global hypoperfusion seem to compose a higher percentage of neurologic complications. In what follows, the literature is reviewed to discuss the pathophysiology, incidence, risk factors, and outcomes related to short-term neurologic complications in patients supported by ECMO.

Transcriptomic Change in the Effects of Dichloroquinolinic Acid on the Development and Growth of Nicotiana tabacum

Dichloroquinolinic acid is a hormone-type herbicide widely used to control barnyard grass during crop cultivation. However, it can seriously inhibit the growth of susceptible crops, including tobacco, because it degrades slowly under field conditions. Additionally, the mechanism by which it damages crops is unclear. More specifically, the transcriptional changes in plants induced by dichloroquinolinic acid remain unknown. In this study, differentially expressed genes (DEGs) in tobacco treated with dichloroquinolinic acid (varying concentrations and durations) were analyzed and validated to explore the global transcriptome changes. The number of DEGs, which were determined according to the FPKM, varied from 758 to 21,340. The KEGG analysis revealed that many DEGs were involved in starch and sucrose metabolism, phenylpropanoid biosynthesis, photosynthesis, porphyrin and chlorophyll metabolism, and glutathione metabolism. Transcriptomic analyses indicated that dichloroquinolinic acid can inhibit tobacco growth by inhibiting photosynthesis and storage of energy. We discovered that the toxicity mechanism of the hormone herbicide dichloroquinolinic acid differs from that of high concentrations of IAA (Indoleacetic acid), despite studies confirming that the effects of hormone herbicides are consistent with the physiological disturbances and growth inhibition exhibited by plants in IAA overdose. Particularly, dichloroquinolinic acid suppresses photosynthesis while high concentration IAA stimulates nucleotide synthesis and photosynthesis. More importantly, we found by editing the IAA-responsive gene IAA16, tobacco could develop resistance to dichloroquinolinic acid. The results will help clarify plant responses to hormone-type herbicides at the transcriptional level, thereby providing insights into the diversity in the gene’s response to herbicides, the molecular targets of hormone-type herbicides, and the mechanism underlying the susceptibility of tobacco to dichloroquinolinic acid. Accordingly, this study may be helpful for future research to enhance crop resistance to herbicides residues.

Immunofluorescence Protocol for Characterization of Platelet and Leukocyte Binding in Extracorporeal Membrane Oxygenation (ECMO) Circuits.

The continuous contact between blood and the foreign surface of the extracorporeal membrane oxygenation (ECMO) circuit contributes to hemostatic, inflammatory, and other physiological disturbances observed during ECMO. Although previous studies have extensively investigated blood samples from patients on ECMO, cell adsorption to the ECMO circuit as an additional factor that could potentially influence clinical outcomes, has largely been overlooked. Here we provide a detailed immunofluorescence (IF) protocol designed to characterize cellular binding on ECMO circuits collected from patients. Extracorporeal membrane oxygenation circuits were collected from three pediatric patients and an albumin primed-only ECMO circuit was used as control. Circuit samples from five different sites within each ECMO circuit were collected and processed for the IF protocol. CD14 and CD42a antibodies were used to identify platelets and leukocytes bound to each ECMO circuit sample and images captured using inverted fluorescence microscopy. The protocol enables the comprehensive characterization of platelet and leukocyte binding to ECMO circuits collected from patients, which could in turn extend our knowledge of the characteristics of circuit binding and may provide guidance for improved ECMO circuit design.

Assessing the Impact of Hexavalent Chromium (Cr VI) at Varied Concentrations on Spirulina platensis for Growth, Metal Sorption, and Photosynthetic Responses.

Spirulina platensis, a photosynthetic cyanobacterium, has garnered attention for its potential role in environmental remediation due to its ability to absorb and metabolize toxic heavy metals. Understanding its response toward toxicity of one of the most common contaminants, Cr(VI) is crucial for assessing its efficacy in bioremediation efforts. This study aims to investigate the physiological and biochemical responses of Spirulina platensis to varying concentrations of Cr(VI) from 0.5 to 5ppm, shedding light on its potential as a bioindicator for environmental contamination and its suitability for bioremediation purposes. The impact of Cr(VI) on cell density, biosorption, pigment levels, nutrient content, fluorescence response, and photosynthetic efficiency was examined. The study revealed a gradual reduction in cell density, biomass production, and biosorption efficiency with increasing Cr(VI) concentrations. Pigment levels, carbohydrate, protein, and lipid content showed significant decreases, indicating physiological stress. Fluorescence response and photosynthetic efficiency were also adversely affected, suggesting alterations in electron transfer dynamics. A threshold for chromium toxicity was observed at 0.5ppm, beyond which significant physiological disturbances occurred. This investigation highlights the sensitivity of Spirulina platensis to Cr(VI) toxicity and its potential as a bioindicator for heavy metal contamination. Metal sorption was highest in 0.5ppm Cr(VI) with 56.56% removal. Notably, at lower concentrations, Cr(VI) acted as an intermediate electron acceptor, enhancing the electron transport chain and potentially increasing biomass under controlled conditions. The findings underscore the importance of understanding the mechanisms underlying heavy metal stress in microalgae for effective environmental remediation strategies. The research highlights the dual role of chromium(VI) in influencing S. platensis, depending on the concentration, and underscores the importance of understanding metal ion interactions with photosynthetic organisms for potential applications in bioremediation.

Dynamic impacts of short-term bath administration of enrofloxacin on juvenile black seabream Acanthopagrus schlegelii

Dynamic impacts of short-term enrofloxacin (ENR) exposure on juvenile marine fish are not well understood, and the underlying mechanisms remain unclear. We therefore investigated the accumulation and elimination of ENR in the liver of juvenile black seabream Acanthopagrus schlegelii. Meanwhile, the dynamic alterations of biochemical parameters and liver transcriptomes after short-term bath immersion and withdrawal treatment were explored. The results indicated that the contents of ENR in the liver were significantly increased after bath administration for 24 h, and then quickly declined to very low concentrations along with the decontamination time increasing. Judging from the changes in biochemical indicators and liver transcriptomic alterations, 0.5 and 1 mg/L ENR exposure for 24 h triggered oxidative stress, impairment of immune system, as well as aberrant lipid metabolism via differential molecular pathways. Interestingly, biochemical and transcriptome analysis as well as integrated biomarker response (IBR) values showed that more significant changes appeared in 1 mg/L ENR group at decontamination periods, which indicated that the impact of high dose ENR on juvenile A. schlegelii may persist even after depuration for 7 days. These results revealed that the risk of short-term bath of 1 mg/L ENR should not be overlooked even after depuration period. Therefore, attention should be paid to the dosage control when administering the drug to juvenile A. schlegelii, and the restoration of physiological disturbance may be an important factor in formulating a reasonable treatment plan.

The efficiency of chlorophyll fluorescence as a selection criterion for salinity and climate aridity tolerance in barley genotypes.

In the Near East and North Africa (NENA) region, crop production is being affected by various abiotic factors, including freshwater scarcity, climate, and soil salinity. As a result, farmers in this region are in search of salt-tolerant crops that can thrive in these harsh environments, using poor-quality groundwater. The main staple food crop for most of the countries in this region, Tunisia included, is barley. The present study was designed to investigate the sensitivity and tolerance of six distinct barley genotypes to aridity and salinity stresses in five different natural field environments by measuring their photosynthetic activity. The results revealed that tolerant genotypes were significantly less affected by these stress factors than sensitive genotypes. The genotypes that were more susceptible to salinity and aridity stress exhibited a significant decline in their photosynthetic activity. Additionally, the fluorescence yields in growth phases J, I, and P declined significantly in the order of humid environment (BEJ), semi-arid site (KAI), and arid environment (MED) and became more significant when salt stress was added through the use of saline water for irrigation. The stress adversely affected the quantum yield of primary photochemistry (φP0), the quantum yield of electron transport (φE0), and the efficiency by trapped excitation (ψ0) in the vulnerable barley genotypes. Moreover, the performance index (PI) of the photosystem II (PSII) was found to be the most distinguishing parameter among the genotypes tested. The PI of sensitive genotypes was adversely affected by aridity and salinity. The PI of ICARDA20 and Konouz decreased by approximately 18% and 33%, respectively, when irrigated with non-saline water. The reduction was even greater, reaching 39%, for both genotypes when irrigated with saline water. However, tolerant genotypes Souihli and Batini 100/1B were less impacted by these stress factors.The fluorescence study provided insights into the photosynthetic apparatus of barley genotypes under stress. It enabled reliable salinity tolerance screening. Furthermore, the study confirmed that the chlorophyll a fluorescence induction curve had an inflection point (step K) even before the onset of visible signs of stress, indicating physiological disturbances, making chlorophyll fluorescence an effective tool for identifying salinity tolerance in barley.

NOSOLOGICAL STRUCTURE OF IN-PATIENT PSYCHIATRIC CARE PROVISION IN THE POLTAVA REGION IN 2023

Introduction. The importance of safeguarding mental health and providing high-quality psychiatric care became increasingly urgent following the onset of full-scale war in Ukraine. Currently, a strategy to transfer psychiatric care from specialized institutions to primary care is being implemented. Therefore, analyzing the nosological distribution of referrals to a psychiatric hospital during martial law is an extremely urgent issue. The aim of this study is to investigate the nosological structure of hospitalizations at the Communal Enterprise “Regional Institution of Mental Psychiatric Care of the Poltava Regional Council” in 2023. Results and their discussion. Schizophrenia remains the leading diagnosis among patients receiving inpatient psychiatric care. The second place is taken by neurotic, stress-related, and somatoform disorders. In third place are organic, including symptomatic, mental disorders, with vascular dementia being the leading primary diagnosis among patients with organic, including symptomatic, mental disorders. Among the substances causing mental and behavioral disorders due to the use of psychoactive substances, alcohol ranks first. Paranoid schizophrenia is the leading diagnosis in patients with schizophrenia, schizotypal states, and delusional disorders. Recurrent depressive disorder is the most common among affective disorders. Adjustment disorders occupy the first place in the structure of the incidence of neurotic, stress-related, and somatoform disorders. Among the behavioral syndromes associated with physiological disturbances and physical factors, anorexia nervosa is the most common. Emotionally unstable personality disorder is most common among patients with disorders of adult personality and behavior. Mild mental retardation is more common than others. Childhood autism has the largest share in the incidence structure of disorders of psychological development. Among behavioral and emotional disorders with onset usually occurring in childhood and adolescence, the most common are mixed disorders of conduct and emotions. Conclusion. The obtained results can be used in planning and forecasting the provision of inpatient psychiatric care to patients during the wartime.

Exploring the genetic control of sweat gland characteristics in beef cattle for enhanced heat tolerance

BackgroundThermal stress in subtropical regions is a major limiting factor in beef cattle production systems with around $369 million being lost annually due to reduced performance. Heat stress causes numerous physiological and behavioral disturbances including reduced feed intake and decreased production levels. Cattle utilize various physiological mechanisms such as sweating to regulate internal heat. Variation in these traits can help identify genetic variants that control sweat gland properties and subsequently allow for genetic selection of cattle with greater thermotolerance.MethodsThis study used 2,401 Brangus cattle from two commercial ranches in Florida. Precise phenotypes that contribute to an animal’s ability to manage heat stress were calculated from skin biopsies and included sweat gland area, sweat gland depth, and sweat gland length. All animals were genotyped with the Bovine GGP F250K, and BLUPF90 software was used to estimate genetic parameters and for Genome Wide Association Study.ResultsSweat gland phenotypes heritability ranged from 0.17 to 0.42 indicating a moderate amount of the phenotypic variation is due to genetics, allowing producers the ability to select for favorable sweat gland properties. A weighted single-step GWAS using sliding 10 kb windows identified multiple quantitative trait loci (QTLs) explaining a significant amount of genetic variation. QTLs located on BTA7 and BTA12 explained over 1.0% of genetic variance and overlap the ADGRV1 and CCDC168 genes, respectively. The variants identified in this study are implicated in processes related to immune function and cellular proliferation which could be relevant to heat management. Breed of Origin Alleles (BOA) were predicted using local ancestry in admixed populations (LAMP-LD), allowing for identification of markers’ origin from either Brahman or Angus ancestry. A BOA GWAS was performed to identify regions inherited from particular ancestral breeds that might have a significant impact on sweat gland phenotypes.ConclusionsThe results of the BOA GWAS indicate that both Brahman and Angus alleles contribute positively to sweat gland traits, as evidenced by favorable marker effects observed from both genetic backgrounds. Understanding and utilizing genetic traits that confer better heat tolerance is a proactive approach to managing the impacts of climate change on livestock farming.

Assessment of the excitation-inhibition ratio in the Fmr1 KO2 mouse using neuronal oscillation dynamics.

In vitro and ex vivo studies have shown consistent indications of hyperexcitability in the Fragile X Messenger Ribonucleoprotein 1 (Fmr1) knockout mouse model of autism spectrum disorder. We recently introduced a method to quantify network-level functional excitation-inhibition ratio from the neuronal oscillations. Here, we used this measure to study whether the implicated synaptic excitation-inhibition disturbances translate to disturbances in network physiology in the Fragile X Messenger Ribonucleoprotein 1 (Fmr1) gene knockout model. Vigilance-state scoring was used to extract segments of inactive wakefulness as an equivalent behavioral condition to the human resting-state and, subsequently, we performed high-frequency resolution analysis of the functional excitation-inhibition biomarker, long-range temporal correlations, and spectral power. We corroborated earlier studies showing increased high-frequency power in Fragile X Messenger Ribonucleoprotein 1 (Fmr1) knockout mice. Long-range temporal correlations were higher in the gamma frequency ranges. Contrary to expectations, functional excitation-inhibition was lower in the knockout mice in high frequency ranges, suggesting more inhibition-dominated networks. Exposure to the Gamma-aminobutyric acid (GABA)-agonist clonazepam decreased the functional excitation-inhibition in both genotypes, confirming that increasing inhibitory tone results in a reduction of functional excitation-inhibition. In addition, clonazepam decreased electroencephalogram power and increased long-range temporal correlations in both genotypes. These findings show applicability of these new resting-state electroencephalogram biomarkers to animal for translational studies and allow investigation of the effects of lower-level disturbances in excitation-inhibition balance.

Diabetes mellitus, metabolic syndrome, and sleep disorders: An underestimated relationship

Abstract Diabetes mellitus (DM) is the most prevalent endocrine disorder globally. DM is under-evaluated and less efficiently managed in terms of ruling out comorbid conditions associated with it and predisposing factors resulting in poor outcomes. Sleep disorders are more common than usually diagnosed due to less awareness in the community regarding the importance of timely diagnosis and the impact of interventions related to proper sleep hygiene and sleep structure. Obstructive sleep apnea (OSA) is independently associated with cardiovascular and cardiometabolic risk in several large epidemiological studies. OSA leads to several physiological disturbances, such as intermittent hypoxia, sleep fragmentation, and an increase in autonomic tone. Metabolic syndrome (MS) is an adverse outcome that is typically associated with obesity. It is a cluster of metabolic risk factors for type 2 DM (T2DM) and cardiovascular diseases (CVDs), including central obesity, hypertension, hyperglycemia, insulin resistance, and dyslipidemia. T2DM is often associated with OSA, and a bidirectional relationship may exist between the two diseases, mediated by both weight- and physiology-dependent mechanisms. OSA is highly associated with T2DM, and treatment of OSA may have a positive impact on the cardiometabolic profile. In this review, we have attempted to summarize the impact of sleep disorders on MS and DM, and vice versa, with special emphasis on newer medical options in the management of DM and cardiometabolic syndrome.

Obesity to Type 2 Diabetes Mellitus: Importance of Longitudinal Characterization of the Progressive Phases as Identified in Rhesus Monkeys Maintained Under Constant Diet and Environmental Conditions

The complex physiological mechanisms that underlie the links between obesity and T2DM involve “adiposity-induced” alterations in beta cell function —not yet mechanistically understood. Clearly the changes in beta cell function are greatly increased during the progression of obesity, --not reduced!! AND multiorgan insulin resistance whose mechanisms are unknown (although likely reduced by weight loss). Rhesus monkeys have shown these and have provided an amazing look at the Phases that lead to T2DM. We have previously summarized, in a table of 49 variables, the many ways that the nonhuman primate rhesus monkey offers exciting opportunities for insight into these extraordinary conditions compared to the human with T2DM. The Importance of longitudinal characterization, with a number of measurements that are regularly and periodically carried out to assess longitudinally some of the pathophysiological processes that develop spontaneously and naturally in these monkeys as they progress from normal, lean, young animals to obese animals with or without various physiological disturbances undergo the aging process. Usually these disturbances develop at varying rates in different monkeys and include hypertension, hyperlipidemia, hyperinsulinemia, hyperglycemia, impaired glucose tolerance, insulin resistance, peripheral neuropathy, impaired renal clearance, and cardiovascular disease—in short, the entire syndrome that becomes manifest in aged and diabetic humans. The longitudinal studies depend specifically on regular assessment of each animal and determination of the rate at which that animal is or is not progressing in the development of pathophysiological disturbances. Identification of phases allows one to estimate where a given monkey is in regard to the progression to overt diabetes. Application to humans will greatly increase our predictive ability to understand the mechanisms underlying both obesity and T2DM. NIA NO1AG3 1012. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Physiological and developmental disturbances caused by Botryosphaeria dieback in the annual stems of grapevine.

Botryosphaeria dieback is a grapevine trunk disease caused by fungi of the Botryosphaeriaceae family, which attacks more specifically the woody tissues. The infection leads to different symptoms including a severe form with a leaf drop as well as premature plant death. Botryosphaeria dieback causes major economic losses, since no effective treatment is yet available. A better understanding is necessary to find solutions to fight this disease. In this study, our objective was to characterize the "leaf drop" form by (1) looking for the presence of pathogens in the basal internodes of stems, (2) quantifying blocked vessels by tylosis and/or gummosis, and (3) describing the impact of the disease on vine physiology (gene expression and metabolome) and development (establishment and functioning of the cambium and phellogen) at the level of xylem and phloem of basal stem internodes. Our study has shown that Botryosphaeriaceae were present in both phloem and xylem of the basal internodes of the annual stem, with xylem vessels obturated. We have also clearly demonstrated that gene expression and metabolite profiles were strongly modified in both xylem and phloem of diseased plants. Differences in stems between healthy (control, C) and diseased (D) plants were low at flowering (vines not yet symptomatic), higher at the onset of symptom expression and still present, although less marked, at full disease expression. qRT-PCR analysis showed in both phloem and xylem an overexpression of genes involved in plant defense, and a repression of genes related to meristematic activity (i.e. vascular cambium and phellogen). Metabolomic analysis showed specific fingerprints in stems of healthy and diseased plants from the onset of symptom expression, with an increase of the level of phytoalexins and mannitol, and a decrease of 1-kestose one. At the structural level, many alterations were observed in internodes, even before the onset of symptoms: a classical obstruction of xylem vessels and, for the first time, a disorganization of the secondary phloem with an obstruction of the sieve plates by callose. The disease modifies the development of both secondary phloem (liber) and phellogen. Altogether, this study combining different approaches allowed to highlight deep vine dysfunction in the internodes at the base of stems, that may explain vine decline due to Botryosphaeria dieback.

Update on Hypermetabolism in Pediatric Burn Patients.

Despite advancements in pediatric burn care, the profound hypermetabolic response associated with severe burns remains a multifaceted challenge throughout the continuum of care. Understanding the various physiologic disturbances that constitute hypermetabolism is crucial for a thorough evaluation and for implementing appropriate surgical and nonsurgical interventions. In this article, we describe the pathophysiology and treatment of hypermetabolism in pediatric burn patients with a focus on reducing resting energy requirements, minimizing infection, and optimizing nutrition for patients undergoing frequent surgical intervention.

Endocrinopatias com impacto no sistema cardiovascular canino

The synthesis and secretion of hormones is performed by endocrine glands which, when under the effect of physiological disturbance, can result in abnormal hormonal secretion, leading to alterations in the organism's functionality, stimulus, or physiological response. Hormonal secretion at levels below or above necessary can result in cardiovascular changes that may be presented as symptoms commonly confused with behavioral characteristics, racial association, sedentary lifestyle, aging, or even nutritional management failure. Prolonged exposure to lower levels of hormonal secretion can lead the endocrine patient to develop chronic changes in cardiac functionality such as arrhythmia and bradycardia, as well as anatomical changes such as left ventricular hypertrophy and narrowing of the vena cava. Moreover, the dog may present laboratorial alterations and specific symptoms that can act as obstacles for the physiological functioning of the cardiovascular system, such as weight gain, muscle weakness, lethargy, hyperkalemia, hypercortisolemia and hyperglycemia. This paper lists the main impacts of endocrinopathies on the cardiovascular system, aiming to raise awareness among veterinarians of the importance of cardiovascular monitoring, both during and after the end of treatment or stabilization of an endocrinopathy.

Pain Philosophy: Recent Debates and Future Challenges

AbstractIn the last decades, pain has moved more and more into the foreground of philosophical discussion. Still, there exists substantial disagreement concerning the exact nature of pain. The paper provides an overview concerning central topics in recent pain philosophy, indicating remaining challenges and outlining promising directions for future research. Starting point is the assumption that broadly constructed pain episodes are composed of at least four paradigmatic components: (a) physiological disturbance, (b) phenomenal experience (sensory + affective), (c) action tendency, and (d) alteration in a broader mental network. On that basis, the paper first addresses the challenge to fathom which of these components provides the necessary and sufficient condition for an episode being a pain episode. This involves discussions on the folk concept of pain as well as the closer examination of dissociative cases in which some components are apparently absent. Second, the paper addresses the challenge to define how the relevant components relate to each other, for example, how closely the phenomenal experience of pain is bound to the presence of a particular physiological disturbance or action tendency. This debate takes place mainly in the context of strong intentionalist theories—indicative, evaluative, and imperative. Third, the paper argues for the future development of a research program that centrally resolves around the challenges that chronic pain poses. This focus may open stronger interdisciplinary connections to clinical research and practice and advance considerations on topics that have so far received insufficient attention in pain philosophy (e.g., pain‐related suffering).