RESUMEN
BACKGROUND: We aim to evaluate practice and understand the impact of the first wave of the SARS-CoV-2 pandemic on heart transplantation in the UK. METHODS: A retrospective review of the UK Transplant Registry (UKTR) and a national survey of UK heart transplant centers have been performed. The early pandemic period is defined here as 1 March to 31 May 2020. RESULTS: There was geographic variation in the prevalence of COVID-19 across the UK. All centers reported adaptations to maintain the safety of their staff, candidate, and recipient populations. The number of donors fell by 31% during the early pandemic period. Heart utilization increased to 35%, compared to 26% during the same period of 2019. The number of heart transplants was well maintained, across all centers, with 38 performed, compared to 41 during the same period of 2019, with no change in 30-day survival. Twenty-seven heart transplant recipients with confirmed COVID-19 infection were reported during the study period. CONCLUSION: All UK heart transplant centers have successfully adapted their programs to overcome the challenges of staff redeployment and ICU and hospital resource limitation, associated with the pandemic, whilst continuing heart transplant activity. On-going evaluation of practice changes, with sharing of lessons learned, is required as the pandemic continues.
Asunto(s)
COVID-19 , Trasplante de Corazón , Humanos , Pandemias , Estudios Retrospectivos , SARS-CoV-2 , Reino Unido/epidemiologíaRESUMEN
BACKGROUND: Lung transplantation is particularly susceptible to the impact of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, and evaluation of changes to practice is required to inform future decision-making. METHODS: A retrospective review of the UK Transplant Registry (UKTR) and national survey of UK lung transplant centers has been performed. RESULTS: There was geographic variation in the prevalence of COVID-19 infection across the UK. The number of donors fell by 48% during the early pandemic period. Lung utilization fell to 10% (compared with 24% for the same period of 2019). The number of lung transplants performed fell by 77% from 53, March to May 2019, to 12. Seven (58%) of these were performed in a single-center, designated "COVID-light." The number of patients who died on the lung transplant waiting list increased, compared to the same period of 2019 (p = .0118). Twenty-six lung transplant recipients with confirmed COVID-19 infection were reported during the study period. CONCLUSION: As the pandemic continues, reviewing practice and implementing the lessons learned during this period, including the use of robust donor testing strategies and the provision of "COVID-light" hospitals, are vital in ensuring the safe continuation of our lung transplant program.
Asunto(s)
COVID-19/epidemiología , Trasplante de Pulmón , Pandemias , Sistema de Registros , Donantes de Tejidos , Receptores de Trasplantes/estadística & datos numéricos , Listas de Espera , Comorbilidad , Femenino , Humanos , Enfermedades Pulmonares/epidemiología , Enfermedades Pulmonares/cirugía , Masculino , Estudios Retrospectivos , SARS-CoV-2 , Reino Unido/epidemiologíaRESUMEN
The rise of the multiracial population has been met with a growing body of research examining multiracial face perception. A common method for creating multiracial face stimuli in past research has been mathematically averaging two monoracial "parent" faces of different races to create computer-generated multiracial morphs, but conclusions from research using morphs will only be accurate to the extent that morphs yield perceptual decisions similar to those that would be made with real multiracial faces. The current studies compared race classifications of real and morphed multiracial face stimuli. We found that oval-masked morphed faces were classified as multiracial significantly more often than oval-masked real multiracial faces (Studies 1 and 2), but at comparable levels to unmasked real multiracial faces (Study 2). Study 3 examined factors that could explain differences in how morphs and real multiracial faces are categorized and pointed to the potential role that unusualness/distinctiveness might play.
Asunto(s)
Reconocimiento Facial , Grupos Raciales , Humanos , Proyectos de InvestigaciónRESUMEN
Background Resuscitation guidelines recommend that chest compressions be performed over the lower sternum. Current computed tomography and magnetic resonance imaging studies suggest that the current area of compression does not target the left ventricle (LV). Using transthoracic ultrasound, we sought to identify potential anatomic landmarks that would result in compressions over the LV in the majority of our study participants. Methodology We recruited 64 healthy men and women (over the age of 40) from the Simulated Patient Program at the University of Saskatchewan. Using ultrasound, we identified the LV and the associated surface anatomy in terms of intercostal space (ICS) and parasternal or mid-clavicular lines. We also collected biometric data including body mass index, chest circumference, and the corresponding inter-nipple line ICS. Results The LV was located along the left sternal border in 62 (96.9%) participants. The most frequent LV location was along the left sternal border at the sixth ICS in 26 (40.6%) participants, with 13 (20.3%) at the fifth and 10 (15.6%) participants at the seventh ICS. In two (3.1%) participants, the LV was found along the mid-clavicular zone at the fifth ICS. The area from the fifth to seventh ICS on the left sternal border, typically covered by an adult palm centered at the sixth ICS, overlaid 49 of 64 (76.6%, 95% confidence interval [CI]: 64.3-86.2%) identified LV locations. By comparison, centering the heel of the palm over the inter-nipple line at the left sternal border would cover the LV in 46 (71.9%, 95% CI: 59.2-82.4%) participants. Conclusions A novel area of compression over the left sternal border at the inter-nipple line would result in compressions over the LV in nearly three-quarters of our study participants. Future research should investigate whether this proposed area of compression is applicable to a broader population including those with cardiac and thoracic disease.
RESUMEN
Background Despite automated defibrillation and compression-first resuscitation, out-of-hospital cardiac arrest (OHCA) survival remains low. Resuscitation guidelines recommend that chest compressions should be done over the lower half of the sternum, but evidence indicates that this is often associated with outflow obstruction. Emerging studies suggest that compression directly over the left ventricle (LV) may improve survival and outcomes, but rapid and reliable localization of the LV is a major obstacle for those first responding to OHCA. This study aimed to determine if a simplified, easy-to-use ultrasound device (bladder scanner) can reliably locate the heart when applied over the intercostal spaces of the anterior thorax in supine patients. Furthermore, we sought to describe the association between largest scan volumes and underlying cardiac anatomy with particular attention to the long axis of the LV. Methodology We recruited healthy male and female volunteers over 40 years of age. Using a bladder scanner to evaluate the left sternal border and mid-clavicular lines, we determined the maximal scan volumes at 10 intercostal spaces for each participant. Cardiac ultrasound was then used to evaluate the corresponding underlying cardiac anatomy and determine the area overlying the long-axis view of the LV. Descriptive statistics (means with standard deviations [SD], medians with interquartile ranges, and frequencies with proportions) were used to quantify demographic information, typical scan volumes across the chest, the frequencies of the best long-axis LV view location. This was then repeated for left sternal border assessments only. Kappa was determined when evaluating agreement between the largest left sternal border scan volume and the best long-axis LV view location. Results The long-axis LV was the predominant structure underlying the largest scan volume in 39/51 (76.5%) patients. When limited to left sternal border volumes only, the long axis of the LV was underlying the maximum volume intercostal space in 46/51 (90.2%; 95% confidence interval [CI]: 78.6%, 96.7%). The largest left sternal border scan volumes were located over the best long-axis LV view in 39/51 (76.5%, 95% CI: 62.5%, 87.2%) of the study participants with a Kappa statistic of 0.68 (95% CI: 0.52, 0.84; p < 0.0001). Conclusions In this cross-sectional study of healthy volunteers, an easy-to-use ultrasound device (bladder scanner) was able to reliably localize the heart. Largest scan volumes over the left sternal border showed substantial agreement with the intercostal space overlying the long axis of the LV. Further investigations are warranted to determine if such localization is reliable in cardiac arrest patients.
RESUMEN
An imbalance in cortical excitation and inhibition (E/I) may underlie both social and non-social symptoms of autism spectrum conditions (ASC). Recent work suggests that an E/I imbalance may underlie some of the sensory differences that are characteristic of ASCs such as anomalous perception. Binocular rivalry dynamics are thought to reflect the balance of E/I in the brain and could serve as a behavioural biomarker for ASC. Previous studies of clinical ASC populations have found a slower rate of binocular rivalry transitions; increased duration of the mixed percept and reduced perceptual suppression. There are some mixed reports of altered rivalry dynamics in the neurotypical population with high self-reported levels of autistic traits. Therefore, we used simple grating stimuli to measure binocular rivalry dynamics in a sample of seventy-nine adults aged 18-55 years. We additionally measured the level of autistic traits with the AQ-10 and used CAPS as a measure of anomalous perception. Bayesian correlations showed that those with higher AQ scores had a slower rate of perceptual switching and a longer mixed percept duration. Significant regression models with CAPS and AQ score revealed that AQ score was a significant predictor of switch rate and mixed percept duration, whereas CAPS was not. We also report that CAPS significantly predicted perceptual suppression, whereas AQ score did not. Overall, our findings suggest that in a non-clinical population, autistic traits are a predictor of binocular rivalry dynamics and the cortical E/I imbalance thought to underlie symptoms of ASC may extend to the broader phenotype.
Asunto(s)
Trastorno Autístico/psicología , Percepción Visual , Adolescente , Adulto , Trastorno Autístico/fisiopatología , Encéfalo/fisiopatología , Excitabilidad Cortical , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inhibición Neural , Autoinforme , Adulto JovenRESUMEN
It has been suggested that individual differences in cortical excitability leading to disruption of the timing and integration of sensory information processing may explain why some people have out of body experiences (OBE) in the absence of any known pathological or psychiatric condition. Here we recorded EEG from people who either had, or had not experienced an OBE in order to investigate the neural dynamics of OBE in the non-clinical population. A screening questionnaire was completed by 551 people, 24% of whom reported having at least one OBE. Participants who were free of any psychiatric or neurological diagnoses, including migraines, were invited to take part in subsequent EEG recording. EEG data were obtained from 19 people who had had an OBE and 20 who had not. Amplitude of the visual P1 ERP deflection and consistency of alpha-band phase locking were significantly reduced in the participants who had had an OBE. We did not find any group differences in resting state power or in visually induced gamma oscillations. These results provide support for the claim that cortical differences, particularly with respect to the timing of visual information processing, may give rise to OBE in clinically healthy individuals. To our knowledge, this study is the first to compare EEG variables obtained from people who have, and have not, had an OBE.
Asunto(s)
Imagen Corporal , Encéfalo/fisiopatología , Potenciales Evocados/fisiología , Alucinaciones/fisiopatología , Adolescente , Adulto , Electroencefalografía , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Selective attention is atypical in individuals with autism spectrum conditions. Evidence suggests this is also the case for those with high levels of autistic traits. Here we investigated the neural basis of spatial attention in those with high and low levels of self-reported autistic traits via analysis of ERP deflections associated with covert attention, target selection and distractor suppression (the N2pc, NT and PD). Larger N2pc and smaller PD amplitude was observed in those with high levels of autistic traits. These data provide neural evidence for differences in spatial attention, specifically, reduced distractor suppression in those with high levels of autistic traits, and may provide insight into the experience of perceptual overload often reported by individuals on the autism spectrum.
Asunto(s)
Atención/fisiología , Trastorno Autístico/diagnóstico , Electroencefalografía/métodos , Potenciales Evocados/fisiología , Autoinforme , Conducta Espacial/fisiología , Adulto , Trastorno Autístico/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estimulación Luminosa/métodos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The phytohormone abscisic acid (ABA) is important for growth, development and stress responses in plants. Recent research has identified ABA receptors and signalling components that regulate seed germination and stomatal closure. However, proteins that regulate ABA signalling remain poorly understood. Here we use a forward-genetic screen to identify rbm25-1 and rbm25-2, two Arabidopsis mutants with increased sensitivity to growth inhibition by ABA. Using RNA-seq, we found that RBM25 controls the splicing of many pre-mRNAs. The protein phosphatase 2C HAB1, a critical component in ABA signalling, shows a dramatic defect in pre-mRNA splicing in rbm25 mutants. Ectopic expression of a HAB1 complementary DNA derived from wild-type mRNAs partially suppresses the rbm25-2 mutant phenotype. We suggest that RNA splicing is of particular importance for plant response to ABA and that the splicing factor RBM25 has a critical role in this response.
Asunto(s)
Ácido Abscísico/metabolismo , Proteínas de Arabidopsis/genética , Fosfoproteínas Fosfatasas/genética , Proteínas con Motivos de Reconocimiento de ARN/genética , ARN Mensajero/metabolismo , Secuencias de Aminoácidos , Arabidopsis , Proteínas de Arabidopsis/metabolismo , Isoleucina , Mutación , Fosfoproteínas Fosfatasas/metabolismo , Prolina , Empalme del ARN/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Análisis de Secuencia de ARN , TriptófanoRESUMEN
BACKGROUND: Cardiac Rehabilitation (CR) programs are the most cost-effective measure for reducing morbidity associated with Coronary Vascular Disease (CVD). To be more effective there is a need to understand what influences the maintenance of healthy behaviors. This study identifies similar and different influences in CR of the United Kingdom (UK) and New Zealand (NZ). METHODS: A retrospective study. Participants had previously been discharged from CR for 6 to 12+ months within the UK (n = 22) and NZ (n = 21). Participant's attended a focus group. Discussions were digitally recorded, transcribed then thematically analyzed. The CR programs were observed over 2 months to enable comment on findings relating to 'theory in practice.' RESULTS: Similar positive patient experiences influencing behavior between groups and countries were; support, education, positive attitude, and motivation. Companionship and exercising alongside people with similar health problems was the major determinant for positive exercise behavior. Barriers to maintaining exercise included; physical disabilities, time constraints, and weather conditions. NZ participants were more affected by external factors (eg, opportunity, access, and time). CONCLUSION: Both CR programs were successful in facilitating the maintenance of healthy lifestyles. Exercising with other cardiac patients for support in a structured environment was the strongest influence in maintaining healthy lifestyles beyond CR programs.
Asunto(s)
Terapia Conductista , Rehabilitación Cardiaca , Terapia por Ejercicio , Conductas Relacionadas con la Salud , Evaluación del Resultado de la Atención al Paciente , Anciano , Comparación Transcultural , Ejercicio Físico , Femenino , Grupos Focales , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Motivación , Nueva Zelanda , Satisfacción Personal , Estudios Retrospectivos , Resultado del Tratamiento , Reino UnidoRESUMEN
Efficient visual search necessitates perception of items in the visual array, rapid classification of items as either targets or distractors, and the selection of target items. Individuals vary in the speed with which they perform these operations and can detect targets within cluttered arrays, as shown in visual search tasks. Individuals with autism spectrum disorders (ASD) show particular strengths in visual search. The aim of the current study was to develop an understanding the origin of individual variability in visual search by delineating the processes involved in feature-based target detection, and establishing which, if any, of these processes predict search efficiency. EEG was recorded while participants performed a feature-based selective attention task from which the following EEG variables were computed: P1 amplitude; P1 latency; selection negativity; induced γ-band power and P3b amplitude. These variables are considered to reflect stimulus encoding, feedback amplification of attended features, cognitive utilization and resource allocation during event classification respectively. Participants also completed a separate visual search task. Regression analyses revealed that only the ERP component associated with resource allocation during event classification (P3b) significantly predicted search efficiency. These data suggest that individual variability in visual search is related to a reduction in modulation of attention allocation to visual features. Implications for the understanding of superior visual search in individuals with ASD are discussed.
Asunto(s)
Atención/fisiología , Conducta de Elección/fisiología , Potenciales Evocados Visuales/fisiología , Percepción Visual/fisiología , Análisis de Varianza , Electroencefalografía , Femenino , Humanos , Masculino , Orientación/fisiología , Estimulación Luminosa , Valor Predictivo de las Pruebas , Tiempo de Reacción , Análisis de RegresiónRESUMEN
During embryogenesis the central and peripheral nervous systems arise from a neural precursor population, neurectoderm, formed during gastrulation. We demonstrate the differentiation of mouse embryonic stem cells to neurectoderm in culture, in a manner which recapitulates embryogenesis, with the sequential and homogeneous formation of primitive ectoderm, neural plate and neural tube. Formation of neurectoderm occurs in the absence of extraembryonic endoderm or mesoderm and results in a stratified epithelium of cells with morphology, gene expression and differentiation potential consistent with positionally unspecified neural tube. Differentiation of this population to homogeneous populations of neural crest or glia was also achieved. Neurectoderm formation in culture allows elucidation of signals involved in neural specification and generation of implantable cell populations for therapeutic use.