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2.
Front Physiol ; 12: 695431, 2021.
Article in English | MEDLINE | ID: mdl-34776991

ABSTRACT

Correlated, spontaneous neural activity is known to play a necessary role in visual development, but the higher-order statistical structure of these coherent, amorphous patterns has only begun to emerge in the past decade. Several computational studies have demonstrated how this endogenous activity can be used to train a developing visual system. Models that generate spontaneous activity analogous to retinal waves have shown that these waves can serve as stimuli for efficient coding models of V1. This general strategy in development has one clear advantage: The same learning algorithm can be used both before and after eye-opening. This same insight can be applied to understanding LGN/V1 spontaneous activity. Although lateral geniculate nucleus (LGN) activity has been less discussed in the literature than retinal waves, here we argue that the waves found in the LGN have a number of properties that fill the role of a training pattern. We make the case that the role of "innate learning" with spontaneous activity is not only possible, but likely in later stages of visual development, and worth pursuing further using an efficient coding paradigm.

3.
PLoS Comput Biol ; 17(9): e1009456, 2021 09.
Article in English | MEDLINE | ID: mdl-34570753

ABSTRACT

A number of neuroimaging techniques have been employed to understand how visual information is transformed along the visual pathway. Although each technique has spatial and temporal limitations, they can each provide important insights into the visual code. While the BOLD signal of fMRI can be quite informative, the visual code is not static and this can be obscured by fMRI's poor temporal resolution. In this study, we leveraged the high temporal resolution of EEG to develop an encoding technique based on the distribution of responses generated by a population of real-world scenes. This approach maps neural signals to each pixel within a given image and reveals location-specific transformations of the visual code, providing a spatiotemporal signature for the image at each electrode. Our analyses of the mapping results revealed that scenes undergo a series of nonuniform transformations that prioritize different spatial frequencies at different regions of scenes over time. This mapping technique offers a potential avenue for future studies to explore how dynamic feedforward and recurrent processes inform and refine high-level representations of our visual world.


Subject(s)
Brain Mapping/methods , Electroencephalography/statistics & numerical data , Visual Pathways/physiology , Adolescent , Brain Mapping/instrumentation , Brain Mapping/statistics & numerical data , Computational Biology , Electrodes , Electroencephalography/instrumentation , Female , Functional Neuroimaging/statistics & numerical data , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging/statistics & numerical data , Male , Photic Stimulation , Spatio-Temporal Analysis , Visual Cortex/physiology , Young Adult
4.
Neuroimage ; 201: 116027, 2019 11 01.
Article in English | MEDLINE | ID: mdl-31325643

ABSTRACT

Our understanding of information processing by the mammalian visual system has come through a variety of techniques ranging from psychophysics and fMRI to single unit recording and EEG. Each technique provides unique insights into the processing framework of the early visual system. Here, we focus on the nature of the information that is carried by steady state visual evoked potentials (SSVEPs). To study the information provided by SSVEPs, we presented human participants with a population of natural scenes and measured the relative SSVEP response. Rather than focus on particular features of this signal, we focused on the full state-space of possible responses and investigated how the evoked responses are mapped onto this space. Our results show that it is possible to map the relatively high-dimensional signal carried by SSVEPs onto a 2-dimensional space with little loss. We also show that a simple biologically plausible model can account for a high proportion of the explainable variance (~73%) in that space. Finally, we describe a technique for measuring the mutual information that is available about images from SSVEPs. The techniques introduced here represent a new approach to understanding the nature of the information carried by SSVEPs. Crucially, this approach is general and can provide a means of comparing results across different neural recording methods. Altogether, our study sheds light on the encoding principles of early vision and provides a much needed reference point for understanding subsequent transformations of the early visual response space to deeper knowledge structures that link different visual environments.


Subject(s)
Brain Mapping/methods , Evoked Potentials, Visual/physiology , Spatial Analysis , Adolescent , Adult , Female , Humans , Male , Models, Theoretical , Young Adult
5.
Arch Dis Child Fetal Neonatal Ed ; 104(6): F624-F630, 2019 Nov.
Article in English | MEDLINE | ID: mdl-30842208

ABSTRACT

OBJECTIVE: To investigate socioeconomic inequalities in cause-specific stillbirth and neonatal mortality to identify key areas of focus for future intervention strategies to achieve government ambitions to reduce mortality rates. DESIGN: Retrospective cohort study. SETTING: England, Wales, Scotland and the UK Crown Dependencies. PARTICIPANTS: All singleton births between 1 January 2014 and 31 December 2015 at ≥24 weeks' gestation. MAIN OUTCOME MEASURE: Cause-specific stillbirth or neonatal death (0-27 days after birth) per 10 000 births by deprivation quintile. RESULTS: Data on 5694 stillbirths (38.1 per 10 000 total births) and 2368 neonatal deaths (15.9 per 10 000 live births) were obtained from Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK). Women from the most deprived areas were 1.68 (95% CI 1.56 to 1.81) times more likely to experience a stillbirth and 1.67 (95% CI 1.48 to 1.87) times more likely to experience a neonatal death than those from the least deprived areas, equating to an excess of 690 stillbirths and 231 neonatal deaths per year associated with deprivation. Small for gestational age (SGA) unexplained antepartum stillbirth was the greatest contributor to excess stillbirths accounting for 33% of the deprivation gap in stillbirths. Congenital anomalies accounted for the majority (59%) of the deprivation gap in neonatal deaths, followed by preterm birth not SGA (24-27 weeks, 27%). CONCLUSIONS: Cause-specific mortality rates at a national level allow identification of key areas of focus for future intervention strategies to reduce mortality. Despite a reduction in the deprivation gap for stillbirths and neonatal deaths, public health interventions should primarily focus on socioeconomic determinants of SGA stillbirth and congenital anomalies.


Subject(s)
Cause of Death/trends , Health Status Disparities , Infant Mortality/trends , Stillbirth/epidemiology , Congenital Abnormalities/mortality , Gestational Age , Humans , Infant , Infant, Extremely Premature , Infant, Newborn , Infant, Small for Gestational Age , Perinatal Mortality/trends , Retrospective Studies , United Kingdom/epidemiology
6.
Arterioscler Thromb Vasc Biol ; 38(7): 1594-1606, 2018 07.
Article in English | MEDLINE | ID: mdl-29724818

ABSTRACT

OBJECTIVE: Reduced blood flow and tissue oxygen tension conditions result from thrombotic and vascular diseases such as myocardial infarction, stroke, and peripheral vascular disease. It is largely assumed that while platelet activation is increased by an acute vascular event, chronic vascular inflammation, and ischemia, the platelet activation pathways and responses are not themselves changed by the disease process. We, therefore, sought to determine whether the platelet phenotype is altered by hypoxic and ischemic conditions. APPROACH AND RESULTS: In a cohort of patients with metabolic and peripheral artery disease, platelet activity was enhanced, and inhibition with oral antiplatelet agents was impaired compared with platelets from control subjects, suggesting a difference in platelet phenotype caused by the disease. Isolated murine and human platelets exposed to reduced oxygen (hypoxia chamber, 5% O2) had increased expression of some proteins that augment platelet activation compared with platelets in normoxic conditions (21% O2). Using a murine model of critical limb ischemia, platelet activity was increased even 2 weeks postsurgery compared with sham surgery mice. This effect was partly inhibited in platelet-specific ERK5 (extracellular regulated protein kinase 5) knockout mice. CONCLUSIONS: These findings suggest that ischemic disease changes the platelet phenotype and alters platelet agonist responses because of changes in the expression of signal transduction pathway proteins. Platelet phenotype and function should, therefore, be better characterized in ischemic and hypoxic diseases to understand the benefits and limitations of antiplatelet therapy.


Subject(s)
Blood Platelets/metabolism , Hypoxia/blood , Ischemia/blood , Oxygen/blood , Peripheral Arterial Disease/blood , Platelet Activation , Animals , Blood Platelets/drug effects , Case-Control Studies , Critical Illness , Disease Models, Animal , Humans , Hypoxia/physiopathology , Ischemia/drug therapy , Ischemia/physiopathology , Male , Mice, Inbred C57BL , Mice, Knockout , Mitogen-Activated Protein Kinase 7/blood , Mitogen-Activated Protein Kinase 7/genetics , Peripheral Arterial Disease/drug therapy , Peripheral Arterial Disease/physiopathology , Phenotype , Platelet Activation/drug effects , Platelet Aggregation Inhibitors/therapeutic use , Pneumonectomy , Signal Transduction
7.
J Pediatr ; 193: 85-92.e1, 2018 02.
Article in English | MEDLINE | ID: mdl-29254758

ABSTRACT

OBJECTIVES: To explore patterns of comorbidity in cognitive and behavioral outcomes at 2 years' corrected age among children born late or moderately preterm (LMPT) and to identify predictors of different patterns of comorbidity. STUDY DESIGN: Geographical, prospective population-based cohort study of 1139 infants born LMPT (320/7 to 366/7 weeks' gestation) and 1255 infants born at term (370/7 to 426/7 weeks' gestation). Parent questionnaires were obtained to identify impaired cognitive and language development, behavioral problems, delayed social-emotional competence, autistic features, and clinically significant eating difficulties at 24 months corrected age for 638 (57%) children born LMPT and 765 (62%) children born at term. RESULTS: Latent class analysis revealed 2 profiles of development among the term group: optimal (84%) and a profile of social, emotional, and behavioral impairments termed "nonoptimal" (16%). These 2 profiles were also identified among the LMPT group (optimal: 67%; nonoptimal: 26%). In the LMPT group, a third profile was identified (7%) that was similar to the phenotype previously identified in infants born very preterm. Nonwhite ethnicity, socioeconomic risk, and not receiving breast milk at hospital discharge were risk factors for nonoptimal outcomes in both groups. Male sex, greater gestational age, and pre-eclampsia were only associated with the preterm phenotype. CONCLUSIONS: Among children born LMPT with parent-reported cognitive or behavioral impairments, most had problems similar to the profile of difficulties observed in children born at term. A smaller proportion of children born LMPT had impairments consistent with the "very preterm phenotype" which are likely to have arisen through a preterm pathway. These results suggest that prematurity may affect development through several etiologic pathways in the late and moderately preterm population.


Subject(s)
Child Development , Infant, Premature/growth & development , Neurodevelopmental Disorders/epidemiology , Premature Birth , Child, Preschool , Cohort Studies , Comorbidity , Female , Gestational Age , Humans , Infant , Infant, Newborn , Male , Neurodevelopmental Disorders/etiology , Phenotype , Prospective Studies , Risk Factors , Surveys and Questionnaires
9.
Immunol Res ; 65(5): 1089-1094, 2017 10.
Article in English | MEDLINE | ID: mdl-28914425

ABSTRACT

Platelet factor 4 (PF4) is a megakaryocyte-/platelet-derived chemokine with diverse functions as a regulator of vascular and immune biology. PF4 has a central role in vessel injury responses, innate immune cell responses, and T-helper cell differentiation. We have now discovered that PF4 has a direct role in B cell differentiation in the bone marrow. Mice lacking PF4 (PF4-/- mice) had fewer developing B cells in the bone marrow beginning after the pre-pro-B cell stage of differentiation. In vitro, PF4 increased the differentiation of hematopoietic progenitors to B cell lineage cells, indicating that PF4 has a direct effect on B cell differentiation. STAT5 activation is essential in early B cell development and PF4 increased the phosphorylation of STAT5. Taken together, these data demonstrate that PF4 has an important role in increasing B cell differentiation in the bone marrow environment.


Subject(s)
B-Lymphocytes/immunology , B-Lymphocytes/physiology , Bone Marrow Cells/physiology , Platelet Factor 4/metabolism , Animals , Cell Differentiation , Cell Lineage , Cells, Cultured , Lymphocyte Activation , Mice , Mice, Inbred C57BL , Mice, Knockout , STAT5 Transcription Factor/metabolism
10.
J Vis ; 17(9): 9, 2017 08 01.
Article in English | MEDLINE | ID: mdl-28813565

ABSTRACT

In this article, we explore two forms of selectivity in sensory neurons. The first we call classic selectivity, referring to the stimulus that optimally stimulates a neuron. If a neuron is linear, then this stimulus can be determined by measuring the response to an orthonormal basis set (the receptive field). The second type of selectivity we call hyperselectivity; it is either implicitly or explicitly a component of several models including sparse coding, gain control, and some linear-nonlinear models. Hyperselectivity is unrelated to the stimulus that maximizes the response. Rather, it refers to the drop-off in response around that optimal stimulus. We contrast various models that produce hyperselectivity by comparing the way each model curves the iso-response surfaces of each neuron. We demonstrate that traditional sparse coding produces such curvature and increases with increasing degrees of overcompleteness. We demonstrate that this curvature produces a systematic misestimation of the optimal stimulus when the neuron's receptive field is measured with spots or gratings. We also show that this curvature allows for two apparently paradoxical results. First, it allows a neuron to be very narrowly tuned (hyperselective) to a broadband stimulus. Second, it allows neurons to break the Gabor-Heisenberg limit in their localization in space and frequency. Finally, we argue that although gain-control models, some linear-nonlinear models, and sparse coding have much in common, we believe that this approach to hyperselectivity provides a deeper understanding of why these nonlinearities are present in the early visual system.


Subject(s)
Models, Neurological , Neurons/physiology , Visual Cortex/physiology , Animals , Humans , Photic Stimulation/methods
12.
Immunol Res ; 65(4): 828-840, 2017 08.
Article in English | MEDLINE | ID: mdl-28378118

ABSTRACT

MicroRNAs (miRNAs) are major regulators of cell responses, particularly in stressed cell states and host immune responses. Some miRNAs have a role in pathogen defense, including regulation of immune responses to Plasmodium parasite infection. Using a nonlethal mouse model of blood stage malaria infection, we have found that miR-451-/- mice infected with Plasmodium yoelii XNL cleared infection at a faster rate than did wild-type (WT) mice. MiR-451-/- mice had an increased leukocyte response to infection, with the protective phenotype primarily driven by CD4+ T cells. WT and miR-451-/- CD4+ T cells had similar activation responses, but miR-451-/- CD4+ cells had significantly increased proliferation, both in vitro and in vivo. Myc is a miR-451 target with a central role in cell cycle progression and cell proliferation. CD4+ T cells from miR-451-/- mice had increased postactivation Myc expression. RNA-Seq analysis of CD4+ cells demonstrated over 5000 differentially expressed genes in miR-451-/- mice postinfection, many of which are directly or indirectly Myc regulated. This study demonstrates that miR-451 regulates T cell proliferative responses in part via a Myc-dependent mechanism.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , Malaria/immunology , MicroRNAs/genetics , Plasmodium yoelii/immunology , Proto-Oncogene Proteins c-myc/metabolism , Animals , Cell Cycle , Cell Proliferation , Cells, Cultured , Humans , Lymphocyte Activation , Mice , Mice, Inbred C57BL , Mice, Knockout , Proto-Oncogene Proteins c-myc/genetics , Up-Regulation
13.
PLoS One ; 11(9): e0160638, 2016.
Article in English | MEDLINE | ID: mdl-27631377

ABSTRACT

Thrombosis-associated pathologies, such as myocardial infarction and stroke, are major causes of morbidity and mortality worldwide. Because platelets are necessary for hemostasis and thrombosis, platelet directed therapies must balance inhibiting platelet function with bleeding risk. Glutamate receptor interacting protein 1 (GRIP1) is a large scaffolding protein that localizes and organizes interacting proteins in other cells, such as neurons. We have investigated the role of GRIP1 in platelet function to determine its role as a molecular scaffold in thrombus formation. Platelet-specific GRIP1-/- mice were used to determine the role of GRIP1 in platelets. GRIP1-/- mice had normal platelet counts, but a prolonged bleeding time and delayed thrombus formation in a FeCl3-induced vessel injury model. In vitro stimulation of WT and GRIP1-/- platelets with multiple agonists showed no difference in platelet activation. However, in vivo platelet rolling velocity after endothelial stimulation was significantly greater in GRIP1-/- platelets compared to WT platelets, indicating a potential platelet adhesion defect. Mass spectrometry analysis of GRIP1 platelet immunoprecipitation revealed enrichment of GRIP1 binding to GPIb-IX complex proteins. Western blots confirmed the mass spectrometry findings that GRIP1 interacts with GPIbα, GPIbß, and 14-3-3. Additionally, in resting GRIP1-/- platelets, GPIbα and 14-3-3 have increased interaction compared to WT platelets. GRIP1 interactions with the GPIb-IX binding complex are necessary for normal platelet adhesion to a stimulated endothelium.


Subject(s)
Carrier Proteins/physiology , Nerve Tissue Proteins/physiology , Platelet Adhesiveness/physiology , Animals , Carrier Proteins/genetics , Humans , Mice , Mice, Knockout , Nerve Tissue Proteins/genetics
14.
Vision Res ; 120: 74-92, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26902730

ABSTRACT

From the earliest stages of sensory processing, neurons show inherent non-linearities: the response to a complex stimulus is not a sum of the responses to a set of constituent basis stimuli. These non-linearities come in a number of forms and have been explained in terms of a number of functional goals. The family of spatial non-linearities have included interactions that occur both within and outside of the classical receptive field. They include, saturation, cross orientation inhibition, contrast normalization, end-stopping and a variety of non-classical effects. In addition, neurons show a number of facilitatory and invariance related effects such as those exhibited by complex cells (integration across position). Here, we describe an approach that attempts to explain many of the non-linearities under a single geometric framework. In line with Zetzsche and colleagues (e.g., Zetzsche et al., 1999) we propose that many of the principal non-linearities can be described by a geometry where the neural response space has a simple curvature. In this paper, we focus on the geometry that produces both increased selectivity (curving outward) and increased tolerance (curving inward). We demonstrate that overcomplete sparse coding with both low-dimensional synthetic data and high-dimensional natural scene data can result in curvature that is responsible for a variety of different known non-classical effects including end-stopping and gain control. We believe that this approach provides a more fundamental explanation of these non-linearities and does not require that one postulate a variety of explanations (e.g., that gain must be controlled or the ends of lines must be detected). In its standard form, sparse coding does not however, produce invariance/tolerance represented by inward curvature. We speculate on some of the requirements needed to produce such curvature.


Subject(s)
Neurons/physiology , Visual Cortex/physiology , Visual Pathways/physiology , Humans , Nerve Net/physiology
15.
Am J Clin Nutr ; 103(2): 406-14, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26718420

ABSTRACT

BACKGROUND: Very preterm (<32 wk of gestation) infants are at increased risk of eating difficulties compared with their term-born peers. Little is known about the impact of late and moderately preterm (LMPT; 32-36 wk of gestation) birth on eating difficulties in early childhood. OBJECTIVES: The aims were to assess the prevalence of eating difficulties in infants born LMPT at 2 y corrected age and to explore the impact of neonatal and neurodevelopmental factors. DESIGN: A geographic population-based cohort of 1130 LMPT and 1255 term-born controls was recruited at birth. The parents of 651 (59%) LMPT and 771 (62%) term-born infants completed questionnaires at 2 y corrected age to assess neurodevelopmental outcomes. Parents also completed a validated questionnaire to assess eating behaviors in 4 domains: refusal/picky eating, oral motor problems, oral hypersensitivity, and eating behavior problems. Infants with scores >90th percentile were classified with eating difficulties in each domain. Neonatal data were collected at discharge, and sociodemographic information was collected via maternal interview. Poisson regression was used to assess between-group differences in eating difficulties and to explore associations with neonatal factors and neurodevelopmental outcomes at 2 y of age. RESULTS: In unadjusted analyses, LMPT infants were at increased risk of refusal/picky eating (RR: 1.53; 95% CI: 1.03, 2.25) and oral motor problems (RR: 1.62; 95% CI: 1.06, 2.47). Prolonged nasogastric feeding >2 wk (RR: 1.87; 95% CI: 1.07, 3.25), behavior problems (RR: 2.95; 95% CI: 1.93, 4.52), and delayed social competence (RR: 2.28; 95% CI: 1.49, 3.48) were independently associated with eating difficulties in multivariable analyses. After adjustment for these factors, there was no excess of eating difficulties in LMPT infants. CONCLUSIONS: Infants born LMPT are at increased risk of oral motor and picky eating problems at 2 y corrected age. However, these are mediated by other neurobehavioral sequelae in this population. This trial was registered on the UK Clinical Research Network Portfolio at http://public.ukcrn.org.uk/search/ as UKCRN Study ID 7441.


Subject(s)
Child Development , Feeding and Eating Disorders of Childhood/etiology , Neurogenesis , Pregnancy, Prolonged/physiopathology , Premature Birth/physiopathology , Child, Preschool , Cohort Studies , England/epidemiology , Feeding and Eating Disorders of Childhood/epidemiology , Female , Follow-Up Studies , Humans , Infant, Newborn , Infant, Postmature , Infant, Premature , Male , Nutrition Surveys , Parents , Poisson Distribution , Pregnancy , Prevalence , Prospective Studies , Risk Factors
16.
J Dev Behav Pediatr ; 36(9): 690-9, 2015.
Article in English | MEDLINE | ID: mdl-26461097

ABSTRACT

OBJECTIVE: To assess behavioral outcomes and social competence at 2 years of age in infants born late and moderately preterm (LMPT; 32-36 wk gestation). METHOD: One thousand one hundred and thirty LMPT infants and 1255 term-born (≥37 wk) controls were recruited at birth to a prospective geographical population-based study. Parents completed the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 2 years corrected age to assess infants' behavior problems and social competence. Cognitive development was assessed using the Parent Report of Children's Abilities-Revised. Parent questionnaires at 2 years were completed for 638 (57%) LMPT and 765 (62%) term-born infants. Group differences in the prevalence of behavior problems and delayed social competence between LMPT infants and term-born controls were adjusted for age, sex, small-for-gestational-age, socioeconomic status and cognitive impairment. RESULTS: Late and moderately preterm infants were at significantly increased risk of delayed social competence compared with term-born controls (26.4% vs. 18.4%; adjusted-relative risk [RR] 1.28; 95% CI, 1.03-1.58), but there was no significant group difference in the prevalence of behavior problems (21.0% vs. 17.6%; adjusted-RR 1.13, 0.89-1.42). Non-white ethnicity (RR 1.68, 1.26-2.24), medium (RR 1.60, 1.14-2.24) and high (RR 1.98, 1.41-2.75) socioeconomic risk and recreational drug use during pregnancy (RR 1.70, 1.03-2.82) were significant independent predictors of delayed social competence in LMPT infants. CONCLUSION: Birth at 32 to 36 weeks of gestation confers a specific risk for delayed social competence at 2 years of age. This may be indicative of an increased risk for psychiatric disorders later in childhood.


Subject(s)
Infant, Premature/psychology , Social Skills , Child Development , Child, Preschool , Female , Gestational Age , Humans , Infant , Male , Premature Birth/psychology , Prospective Studies , Risk Factors
17.
Arch Dis Child Fetal Neonatal Ed ; 100(6): F486-91, 2015 Nov.
Article in English | MEDLINE | ID: mdl-25972442

ABSTRACT

OBJECTIVE: This study explores the associations between lifestyle factors and late and moderate preterm birth (LMPT: 32(+0)-36(+6) weeks' gestation), a relatively under-researched group. STUDY DESIGN: A population-based case-cohort study was undertaken involving 922 LMPT and 965 term (37+ weeks' gestation) singleton live and stillbirths born between 1 September 2009 and 31 December 2010 to women residing in Leicestershire and Nottinghamshire, UK. Poisson multivariable regression models were fitted to estimate relative risks (RR) of LMPT birth associated with maternal smoking, alcohol and recreational drug use, and diet. RESULTS: Women who smoked during pregnancy were at 38% increased risk of LMPT birth compared with non-smokers (RR 1.38, 95% CI (1.04 to 1.84)). Low consumption of fruit and vegetables was associated with a 31% increased risk compared with those who reported eating higher consumption levels (RR 1.31 (1.03 to 1.66)). Women who did not have any aspects of a Mediterranean diet were nearly twice as likely to deliver LMPT compared with those whose diet included more Mediterranean characteristics (RR 1.81 (1.04 to 3.14)). Women who smoked and consumed low levels of fruit and vegetables (5% of women) were at particularly high risk (RR=1.81 (1.29 to 2.55)). There was no significant effect of alcohol or recreational drug use on LMPT birth. CONCLUSIONS: Smoking and poor diet during pregnancy, factors that strongly impact on very preterm birth, are also important at later gestations and experienced together are associated with an elevated rate of risk. Our findings suggest early cessation of smoking during pregnancy may be an effective strategy to reduce LMPT births.


Subject(s)
Alcoholism/complications , Diet/adverse effects , Pregnancy Complications , Premature Birth/etiology , Smoking/adverse effects , Substance-Related Disorders/complications , Adult , Case-Control Studies , Cohort Studies , Female , Humans , Infant, Newborn , Pregnancy , Regression Analysis , Risk Assessment , Risk Factors , United Kingdom/epidemiology
18.
Circulation ; 132(1): 47-58, 2015 Jul 07.
Article in English | MEDLINE | ID: mdl-25934838

ABSTRACT

BACKGROUND: Platelets have a pathophysiologic role in the ischemic microvascular environment of acute coronary syndromes. In comparison with platelet activation in normal healthy conditions, less attention is given to mechanisms of platelet activation in diseased states. Platelet function and mechanisms of activation in ischemic and reactive oxygen species-rich environments may not be the same as in normal healthy conditions. Extracellular regulated protein kinase 5 (ERK5) is a mitogen-activated protein kinase family member activated in hypoxic, reactive oxygen species-rich environments and in response to receptor-signaling mechanisms. Prior studies suggest a protective effect of ERK5 in endothelial and myocardial cells after ischemia. We present evidence that platelets express ERK5 and that platelet ERK5 has an adverse effect on platelet activation via selective receptor-dependent and receptor-independent reactive oxygen species-mediated mechanisms in ischemic myocardium. METHODS AND RESULTS: Using isolated human platelets and a mouse model of myocardial infarction (MI), we found that platelet ERK5 is activated post-MI and that platelet-specific ERK5(-/-) mice have less platelet activation, reduced MI size, and improved post-MI heart function. Furthermore, the expression of downstream ERK5-regulated proteins is reduced in ERK5(-/-) platelets post-MI. CONCLUSIONS: ERK5 functions as a platelet activator in ischemic conditions, and platelet ERK5 maintains the expression of some platelet proteins after MI, leading to infarct expansion. This demonstrates that platelet function in normal healthy conditions is different from platelet function in chronic ischemic and inflammatory conditions. Platelet ERK5 may be a target for acute therapeutic intervention in the thrombotic and inflammatory post-MI environment.


Subject(s)
Blood Platelets/enzymology , Mitogen-Activated Protein Kinase 7/biosynthesis , Myocardial Infarction/enzymology , Myocardial Infarction/pathology , Platelet Activation/physiology , Animals , Humans , Mice , Mice, Inbred C57BL , Mice, Knockout , Mitogen-Activated Protein Kinase 7/deficiency , Oxidation-Reduction
19.
Arch Dis Child Fetal Neonatal Ed ; 100(6): F479-85, 2015 Nov.
Article in English | MEDLINE | ID: mdl-25834169

ABSTRACT

OBJECTIVE: To describe neonatal outcomes and explore variation in delivery of care for infants born late (34-36  weeks) and moderately (32-33 weeks) preterm (LMPT). DESIGN/SETTING: Prospective population-based study comprising births in four major maternity centres, one midwifery-led unit and at home between September 2009 and December 2010. Data were obtained from maternal and neonatal records. PARTICIPANTS: All LMPT infants were eligible. A random sample of term-born infants (≥37 weeks) acted as controls. OUTCOME MEASURES: Neonatal unit (NNU) admission, respiratory and nutritional support, neonatal morbidities, investigations, length of stay and postnatal ward care were measured. Differences between centres were explored. RESULTS: 1146 (83%) LMPT and 1258 (79% of eligible) term-born infants were recruited. LMPT infants were significantly more likely to receive resuscitation at birth (17.5% vs 7.4%), respiratory (11.8% vs 0.9%) and nutritional support (3.5% vs 0.3%) and were less likely to be fed breast milk (64.2% vs 72.2%) than term infants. For all interventions and morbidities, a gradient of increasing risk with decreasing gestation was evident. Although 60% of late preterm infants were never admitted to a NNU, 83% required medical input on postnatal wards. Clinical management differed significantly between services. CONCLUSIONS: LMPT infants place high demands on specialist neonatal services. A substantial amount of previously unreported specialist input is provided in postnatal wards, beyond normal newborn care. Appropriate expertise and planning of early care are essential if such infants are managed away from specialised neonatal settings. Further research is required to clarify optimal and cost-effective postnatal management for LMPT babies.


Subject(s)
Delivery of Health Care/methods , Infant, Premature, Diseases/therapy , Delivery, Obstetric/methods , Female , Humans , Infant, Newborn , Infant, Premature , Length of Stay , Male , Morbidity , Pregnancy , Prospective Studies
20.
Arch Dis Child Fetal Neonatal Ed ; 100(4): F301-8, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25834170

ABSTRACT

OBJECTIVE: There is a paucity of data relating to neurodevelopmental outcomes in infants born late and moderately preterm (LMPT; 32(+0)-36(+6) weeks). This paper present the results of a prospective, population-based study of 2-year outcomes following LMPT birth. DESIGN: 1130 LMPT and 1255 term-born children were recruited at birth. At 2 years corrected age, parents completed a questionnaire to assess neurosensory (vision, hearing, motor) impairments and the Parent Report of Children's Abilities-Revised to identify cognitive impairment. Relative risks for adverse outcomes were adjusted for sex, socio-economic status and small for gestational age, and weighted to account for over-sampling of term-born multiples. Risk factors for cognitive impairment were explored using multivariable analyses. RESULTS: Parents of 638 (57%) LMPT infants and 765 (62%) controls completed questionnaires. Among LMPT infants, 1.6% had neurosensory impairment compared with 0.3% of controls (RR 4.89, 95% CI 1.07 to 22.25). Cognitive impairments were the most common adverse outcome: LMPT 6.3%; controls 2.4% (RR 2.09, 95% CI 1.19 to 3.64). LMPT infants were at twice the risk for neurodevelopmental disability (RR 2.19, 95% CI 1.27 to 3.75). Independent risk factors for cognitive impairment in LMPT infants were male sex, socio-economic disadvantage, non-white ethnicity, preeclampsia and not receiving breast milk at discharge. CONCLUSIONS: Compared with term-born peers, LMPT infants are at double the risk for neurodevelopmental disability at 2 years of age, with the majority of impairments observed in the cognitive domain. Male sex, socio-economic disadvantage and preeclampsia are independent predictors of low cognitive scores following LMPT birth.


Subject(s)
Child Development , Developmental Disabilities , Infant, Premature , Sensation Disorders , Breast Feeding , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Cognition Disorders/etiology , Cohort Studies , Developmental Disabilities/diagnosis , Developmental Disabilities/epidemiology , Developmental Disabilities/etiology , Ethnicity , Female , Gestational Age , Humans , Infant , Infant, Newborn , Male , Motor Skills , Parents , Prevalence , Prospective Studies , Risk Factors , Sensation Disorders/diagnosis , Sensation Disorders/epidemiology , Sensation Disorders/etiology , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , United Kingdom/epidemiology
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