Intravenous magnesium sulphate effect on maternal serum and amniotic fluid cytokines levels in preterm labour patients.

Our objective was to evaluate the effect of intravenous magnesium sulphate administration to patients with preterm labour on maternal serum and amniotic fluid IL-1beta, IL-6, IL-10 and TNFalpha concentrations. Thirty-six patients at 24-34 weeks of singleton gestation, who presented with contractions (> or = 8 in 60 min) had amniocentesis to rule out intrauterine infection. The patients received intravenous MgSO4 for tocolysis. Twenty-six patients had amniocentesis performed before initiation of MgSO4 (controls) while 10 others had the procedure during tocolytic therapy (study patients). Magnesium, IL-1beta, IL-6, TNFalpha and IL-10 concentrations were measured. Study and control groups were statistically compared using Student t test. Mean magnesium levels were significantly higher in the study group (P < 0.01). There were no significant differences between the cytokines levels in maternal serum and in amniotic fluid between the groups. Our results suggest that the mechanism of magnesium as a tocolytic agent may not be mediated via the examined cytokines.     

Indomethacin therapy and fetal urine production in twins with polyhydramnios.

Indomethacin has been used in twins with polyhydramnios to decrease amniotic fluid volume. Under therapy, a marked reduction of both fetuses' urine production has been demonstrated within 24 hours concomitant with maternal symptomatic relief. Discontinuation of therapy was associated with a rapid increase in fetal urine production. The clinical observation indicates that the benefit of indomethacin in prolonging such pregnancies is most probably the result of relief of polyhydramnios through decreased fetal urine production.     

Muscle-epidermis interactions affect exoskeleton patterning in Caenorhabditis elegans.

The C. elegans hypodermis is a single epithelial cell layer separated from the musculature by a thin basement membrane on its basal surface. The hypodermis secretes the extracellular material of the cuticle from its apical surface. The regulation of cuticle synthesis and apical secretion is not well understood. UNC-95 is a component of the muscle dense bodies and M-lines, which are integrin-based adhesion complexes required for force transduction to the cuticle. Using gene expression profiling and in vivo assays, we show that, in unc-95 mutant worms, there is an increase in expression levels of a group of hypodermal and pharyngeal genes related to cuticle structure and molting. Moreover, the cuticle structure of unc-95 mutant adult is impaired. Our findings suggest that aberrant force transduction from the structurally impaired muscle attachments across the basement membrane to the underlying hypodermis elicits intercellular signaling that plays a role in regulating cuticle synthesis and patterning.     

Checkpoint Blockade Immunotherapy Induces Dynamic Changes in PD-1−CD8+ Tumor-Infiltrating T Cells

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Normal heterophoric changes: 20 years' follow-up

Background: Evaluation of changes in the heterophoric condition of 100 normal individuals over a 20-year period. Methods: A reprospective study was undertaken. Charts of 100 normal men were reviewed. Individual changes in the heterophoric status were recorded over a 20-year period. The average value of the phoria at age 18–22 years was compared with the average value at age 34–38 years. Measurements were taken for near and distance fixation. No one was heterotropic. Changes in convergence and accommodation were also calculated. Results: A 0.9 ± 1.7 prism diopter increase in esophoria for distance fixation and a 0.6±2.5 prism diopter increase in exophoria for near fixation were found. These changes were statistically significant (P<0.001 andP<0.02 respectively). The near point of convergence receded by 0.5 ± 1.1 cm (P<0.001), and a decrease in accommodation over time of 2.8 ± 1.4 diopters was found (P<0.001). Conclusion: An increase in esophoria for distance fixation and a exophoria for near fixation was found in a 20-year follow-up of 100 normal subjects.     

Languages and future-oriented economic behavior—Experimental evidence for causal effects

Studies have shown that the use of languages which grammatically associate the future and the present tends to correlate with more future-oriented behavior. We take an experimental approach to go beyond correlation. We asked bilingual research participants, people fluent in two languages (12 language pairs) which differ in the way they encode time, to make a set of future-oriented economic decisions. We find that participants addressed in a language in which the present and the future are marked more distinctly tended to value future events less than participants addressed in a language in which the present and the future are similarly marked. In an additional experiment, bilingual research participants (seven language pairs) were asked to choose whether they wish to complete a more enjoyable task first or later (delayed gratification). When addressed in a language in which the present and the future are marked more distinctly, participants tended to prefer immediate gratification more than when addressed in a language in which the present and the future are marked less distinctly. We shed light on the mechanism in a within-person experiment in which bilingual research participants (nine language pairs) were asked to spatially mark the distance between the present and the future. When participants were addressed in a language in which the present and the future are marked more distinctly, they tended to express more precise temporal beliefs compared with when addressed in a language in which the present and the future are marked less distinctly.

Do languages affect the attitudes, preferences, and behaviors of the people who speak them?Numerous studies have documented correlations between the linguistic features and grammatical structures of languages and the attitudes, preferences, and behaviors of the people who speak them. Thus, for example, it has been shown that speakers of languages with different structures and features differ accordingly in their processing of colors, future-oriented economic behavior, and gendered attitudes (1–8). However, evidence for the causal effects of the features and structure of languages on attitudes, preferences, and behaviors is harder to establish. It is a challenge to demonstrate empirically that using a specific language can affect and not just merely reflect or correlate with the way we perceive the world. Indeed, scholars across several disciplines have debated, and continue to debate, the relationship between language and thought (8). Some have argued that languages do not restrict people’s perceptions and behavior (9), whereas others (who subscribe to the linguistic relativity hypothesis) have asserted that speakers of languages develop language-specific schemas and structures which affect their perceptions and behavior (10–18).We contribute to this long-standing debate by providing evidence for the causal impact of the encoding of time in the language spoken on the intertemporal economic choices that people make and on the precision of their temporal beliefs. Our findings suggest that perceptions of time are differently embedded in languages and can impact everyday human behavior.Languages vary in the ways in which they encode time. In some languages, like German, the same grammatical tense is often used to refer to both present and future events (“futureless languages”; “weak-FTR languages”). Other languages, like English and French, have the obligatory grammatical marking of the future tense (“futured languages”; “strong-FTR languages”).^*Studies based on survey data show that the use of futureless [weak future time reference (weak-FTR)] languages, which grammatically associate the future and the present, tends to correlate with more future-oriented behavior on the part of people and organizations. Thus, for example, across and within countries, speakers of such languages save more, retire with more accumulated wealth, smoke less, practice safer sex, are less obese, and care more about the environment (1, 19–26).Why would speakers of weak-FTR languages express more future-oriented economic behavior?One possible explanation is that consistently speaking about future events in the present tense can make the future seem more immediate and less distant (the “distance hypothesis”). Thus, the speakers of weak-FTR languages may tend to view the future as less distant and as a result value future rewards more than the speakers of languages in which the present and the future are distinctly marked (26)(1).Another possible explanation is that because weak-FTR languages do not obligate speakers to mark present and future events differently, speakers of these languages might not think as precisely about the temporal distance of future events as speakers of strong future time reference (strong-FTR) languages (the “precision hypothesis”). In other words, speakers of weak-FTR languages might less finely divide the temporal space between the present and the future than speakers of strong-FTR languages. As a result, speakers of weak-FTR languages may tend to more fuzzily distinguish between the present and the future. Relatedly, speakers of weak-FTR languages might vary more in their temporal beliefs compared with speakers of strong-FTR languages. Because people’s time discounting function tends to be convex, speakers of weak-FTR languages may therefore tend to discount future rewards less than speakers of strong-FTR languages, individually or on average (26). Fig. 1 illustrates the two hypotheses (for a similar illustration, see ref. 26, figure 2.1).Open in a separate windowFig. 1.Time discounting and the “distance” and “precision” hypotheses.Note that perceptions of distance and the precision of temporal beliefs might be directly activated by the linguistic future time reference (FTR) or indirectly activated by the evocation of the cultural beliefs about time associated with the language and its FTR. In other words, being addressed in a strong-FTR language might directly affect people’s perception of how distant the future is or how precise their temporal beliefs are. Alternatively, being addressed in a strong-FTR language might indirectly activate cultural beliefs about time associated with the language that might result in viewing the future as more distant or expressing more precise temporal beliefs.Finally, a third possible explanation for the correlation found between languages and future-oriented economic behavior is that cultural differences regarding time preferences across and within countries (27) might be reflected both in the languages spoken and in the observed differences in the speakers’ future economic behavior (the “correlation hypothesis”).Although survey data do provide the opportunity to identify correlations between the way in which a language encodes time and the future-oriented economic behavior of the people who speak it, it is hard to use it as a means of determining a “causal effect” between the language spoken and future-oriented economic behavior. In other words, it is nearly impossible to hold constant the unmeasured cultural differences, across and within countries, that might be reflected both in the language spoken and in the observed differences in the future economic behavior of its speakers. Indeed, following Chen’s (1) research, some studies have argued that the research merely shows that the languages we speak reflect the societies and cultures in which we live but does not show that the languages we speak influence our perceptions and behaviors (28–31).Weighing in on the debate, Sutter et al. (32) studied differences in the intertemporal choices of children living in a bilingual city where about half of the inhabitants spoke German (a weak-FTR language) and the other half spoke Italian (a strong-FTR language). Using an intertemporal choice experiment, they found that German-speaking primary school children were more likely than their Italian-speaking peers to delay gratification. However, like Chen’s study, their study could not rule out the possibility that the observed differences in behavior were generated by the cultural differences between the two groups. Galor et al. (33) sought to provide evidence for the causal effect of the encoding of time in a language on its speakers’ educational attainment. To do so, they exploited variations in the native languages spoken by the children of migrants with identical ancestral countries of origin; they were able to show the significant positive effect of speaking a futureless language on educational attainment. Because the analysis compared children with the same ancestral countries of origin, the experiment’s design controlled for all the cultural differences associated with countries of origins. Yet, it is not possible to fully control for the cultural differences associated with subcultures within countries (those reflected in languages within countries).Finally, in one recent study, a different approach was taken to address the relationship between the obligation to use the future tense and future-oriented economic behavior. Instead of focusing on the distinction between strong- and weak-FTR languages, the researchers have focused on the effects of participants’ tendency to use the future tense within a language. It was found that a higher use by participants of the future tense within a language (English or Dutch) resulted in less—not more—temporal discounting (34). These interesting—within language—findings point to an additional mediating mechanism; the grammatical obligation to use the future tense in strong-FTR languages tends to oblige speakers to use terms like “will” that denote the high certainty of future events (modal notions of high certainty). As a result, speakers of strong-FTR languages may perceive the certainty of future events as greater than speakers of weak-FTR languages.We take a different methodological approach to identifying the causal effect of language on future-oriented behavior and to shed light on the mechanisms. We wish to show that the encoding of time in a language not only reflects but also generates differences in future-oriented economic behavior. Thus, we hypothesize that when people are addressed in a futured language, one that grammatically differentiates between the present and the future—i.e., it has a strong-FTR—they tend to discount future events more. This, in turn, encourages less future-oriented behavior, such as spending more in the present and preferring more immediate gratification. When people are addressed in a futureless language, one that does not differentiate grammatically between the present and the future—i.e., it has a weak-FTR—they discount the future less. This, in turn, encourages more future-oriented behavior, such as saving for the future and delaying gratification.We also wish to show that perceptions of time are differently embedded in languages and are activated when the language is spoken. In doing so, we test both the distance hypothesis and the precision hypothesis. First, we test whether when people are addressed in a futured language (a strong-FTR language), they tend to view the future as more distant compared with when addressed in a futureless language (a weak-FTR language) (the distance hypothesis). Then, we test whether when people are addressed in a futured language (a strong-FTR language), they express more precise temporal beliefs than when addressed in a futureless language (a weak-FTR language) (the precision hypothesis).To do so, we conducted three experiments. The Yale University Institutional Review Board approved all three studies. In all studies, informed consent was obtained online after participants were directed to Qualtrics. All participants consented. (All data and codes are available at (35)). The first study focused on discounting of future rewards. In a between-subject study, we asked bilingual people, fluent in two languages which differ in the way that they encode time, to make a future-oriented economic decision: Specifically, we asked participants, in one of the two languages in which they are fluent, to make a set of binary choices about whether they wished to be paid a certain amount of money earlier (today) or a larger amount of money later (the following week). We then tested whether the people randomly assigned the question in a strong-FTR language required more by way of future compensation than those asked the question in a weak-FTR language.Following the EUROTYP project (36) and Chen (1), we separated the languages we explored into two broad categories: weak- and strong-FTR. Strong-FTR languages are those that require future events to be grammatically marked when making predictions. Weak-FTR languages do not require such grammatical marking.Altogether, in the first study, we used 12 language pairs, in which one language uses the same grammatical tense for the present and the future—i.e., it has a weak-FTR—and the other has a strong-FTR.The second study focused on delayed gratification. We asked bilingual people, fluent in two languages which differ in the way in which they encode time, to fulfill two tasks; one task was presented as more enjoyable and the other as more tiring. Participants were addressed in one of the two languages in which they are fluent and asked to choose with which of the two tasks they would like to start. After fulfilling the two tasks, participants were addressed in the other language in which they are fluent and were asked to make a similar choice between two additional tasks. Altogether, in the second study, we used seven language pairs, in which one language has a weak-FTR—and the other has a strong-FTR.The third study focused on the mechanisms. In a randomized within-subject study, we asked bilingual people, fluent in two languages which differ in the way in which they encode time, to mark the distance between the present and the future: Specifically, we asked participants, in one of the two languages in which they are fluent, to spatially mark the distance between “now” and “later” and then in the other language to spatially mark the distance between “today” and “tomorrow.” Altogether, in the third study, we used eight language pairs, in which one language has a weak-FTR—and the other has a strong-FTR.     

Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease

Pruritus due to cholestatic liver disease can be particularly difficult to manage and frequently is intractable to a variety of medical therapies. The aim of our study is to evaluate the efficacy of delta-9-tetrahydrocannabinol (delta-9-THC) for intractable cholestatic related pruritus (ICRP) that has failed conventional (and unconventional) remedies. Three patients were evaluated for plasmapheresis because of ICRP. All 3 patients had previously been extensively treated with standard therapies for ICRP including: diphenhydramine, chlorpheniramine, cholestyramine, rifampicin, phenobarbital, doxepin, naltrexone, UV therapy, and topical lotions. Even multiple courses of plasmapheresis were performed without any benefit for the intractable pruritus. All patients reported significant decreases in their quality of life, including lack of sleep, depression, inability to work, and suicidal ideations. All patients were started on 5 mg of delta-9-THC (Marinol) at bedtime. All 3 patients reported a decrease in pruritus, marked improvement in sleep, and eventually were able to return to work. Resolution of depression occurred in two of three. Side effects related to the drug include one patient experiencing a disturbance in coordination. Marinol dosage was decreased to 2.5 mg in this patient with resolution of symptoms. The duration of antipruritic effect is approximately 4-6 hrs in all three patients suggesting the need for more frequent dosing. Delta-9-tetrahydrocannabinol may be an effective alternative in patients with intractable cholestatic pruritus.     

Impact of left ventricular filling properties on the benefit of exercise training in patients with advanced chronic heart failure secondary to ischemic or nonischemic cardiomyopathy

This study examined left ventricular (LV) filling properties and exercise hemodynamics noninvasively before and after an exercise training program in patients with chronic heart failure (HF). Although exercise training did not improve LV filling properties in patients with advanced HF, LV filling properties determined the hemodynamic benefit attainable from exercise in this patient group.     

Evaluation of hip flexion strength following lateral lumbar interbody fusion

Background context

Lateral interbody fusion (LIF) is a minimally invasive procedure that is designed to achieve a solid interbody fusion while minimizing the damage to the surrounding soft tissue. Although short-term results have been promising, few data have been published to date regarding its risks and complication rate.

Purpose

The aim was to evaluate the extent of injury to the psoas muscle after the LIF procedure by measuring hip flexion strength.

Study design

A prospective case series was used in the study.

Method

Hip flexion strength was measured using a handheld digital dynamometer while the patient was seated on a chair; the examiner held the device against the patient’s attempt to flex the hip. Both sides were measured to compare the operated and nonoperated psoas muscles. Each side was measured three times and the average amount (in pounds) was recorded. Measurements were done before and after surgery on Day 2-3, at 2 weeks, 6 weeks, and at 3 and 6 months.

Results

Thirty-three patients were recruited for this study. Mean preoperative hip flexion strength values were 20.7±3.47 lb and 21.3±4.31 lb for operated and nonoperated legs, respectively, with no significant difference (p=.85). With a mean of 11.2±2.24 lb postoperative measurements on Day 2, the operated side showed statistically significant reduction of strength (p=.0001). The nonoperated side was also weaker postoperatively, but not significantly (mean=19.12±1.74 lb; p=.097). From the first follow-up visit at 2 weeks, the values on the operated leg had returned to baseline values (20.6, p=.97) and were not significantly different from preoperative values on either side.

Discussion

Hip flexion was weakened immediately after the LIF procedure, which may be attributed to psoas muscle injury during the procedure. However, this damage was temporary, with almost complete return to baseline values by 2 weeks.