Observations on blood pressure measurements in high-school athletes

The purpose of this study is to identify possible evidence of hypertension in athletic adolescents. In addition to sex and age, the effects of various physical factors that may influence blood pressure are measured. The data were collected from the annual screening physicals of local high-school athletic program participants. Nine of the 11 measured physical factors account for 10 percent to 20 percent of the variability in blood pressure measurements. These include age, weight, height, pulse, quadriceps girth, heel cord flexibility, jump reach, hang time, and grip strength. These variables are incorporated into formulae that adjust the range of "normal" values of systolic and diastolic blood pressure to reduce the effects of these confounding factors, thereby increasing the accuracy of the "normal" or "hypertensive" determination for each individual.     

Containing SARS-CoV-2 in hospitals facing finite PPE,limited testing,and physical space variability: Navigating resource constrained enhanced traffic control bundling

The COVID-19 outbreak has led to a focus by public health practitioners and scholars on ways to limit spread while facing unprecedented challenges and resource constraints. Recent COVID-19-specific enhanced Traffic Control Bundling (eTCB) recommendations provide a cogent framework for managing patient care pathways and reducing health care worker (HCW) and patient exposure to SARS-CoV-2. eTCB has been applied broadly and has proven to be effective in limiting fomite and droplet transmissions in hospitals and between hospitals and the surrounding community. At the same time, resource constrained conditions involving limited personal protective equipment (PPE), low testing availability, and variability in physical space can require modifications in the way hospitals implement eTCB. While eTCB has come to be viewed as a standard of practice, COVID-19 related resource constraints often require hospital implementation teams to customize eTCB solutions. We provide and describe a cross-functional, collaborative on-the-ground adaptive application of eTCB initially piloted at two hospitals and subsequently reproduced at 16 additional hospitals and health systems in the US to date. By effectively facilitating eTCB deployment, hospital leaders and practitioners can establish clearer ‘zones of risk’ and related protective practices that prevent transmission to HCWs and patients. We outline key insights and recommendations gained from recent implementation under the aforementioned constraints and a cross-functional team process that can be utilized by hospitals to most effectively adapt eTCB under resource constraints.     

Study protocol for a multisite randomized controlled trial of an internet and mobile‐based intervention for preventing and reducing perinatal depressive symptoms

Nearly 20% of women in the United States experience clinically significant depressive symptoms during pregnancy or the postpartum period. These women may benefit from easily accessible, nonpharmacologic, and inexpensive self‐management approaches, such as via internet and mobile‐based interventions, to prevent development of symptoms and/or intervene with current symptoms. This paper summarizes the research protocol of a nationally‐funded large‐scale randomized controlled study to evaluate “Mamma Mia,” a self‐guided program with 44 modules that women use throughout pregnancy to 6 months postpartum. The program contains a novel combination of components designed to enable women to enhance self‐efficacy, emotional self‐regulation, and perceived social support. The overall goal of this three‐arm longitudinal randomized controlled trial is to evaluate the effects and mechanisms of this self‐management approach in diverse women in the U.S. (n = 1950). Enrolled pregnant women will be randomly assigned to one of three groups: (1) “Mamma Mia” alone, which is self‐guided; (2) “Mamma Mia Plus” in which participants engage in the “Mamma Mia” modules plus receive brief guided support from a registered nurse; or (3) usual prenatal/postpartum care. The first specific aim is to evaluate effects by group on the primary outcome of interest, depressive symptoms, over time. The second aim is to evaluate effects by group on subjective well‐being, anxiety, and stress. Using a conceptual framework based upon Individual and Family Self‐Management Theory, the third aim is to evaluate possible mediators (self‐efficacy, emotion self‐regulation, perceived support) and possible moderators (e.g., race/ethnicity, type of healthcare clinician) of this self‐management approach.     

Analysis of folylpoly-γ-glutamate synthetase gene expression in human B-precursor ALL and T-lineage ALL cells

Background  

Expression of folylpoly-γ-glutamate synthetase (FPGS) gene is two- to three-fold higher in B-precursor ALL (Bp- ALL) than in T-lineage ALL (T-ALL) and correlates with intracellular accumulation of methotrexate (MTX) polyglutamates and lymphoblast sensitivity to MTX. In this report, we investigated the molecular regulatory mechanisms directing FPGS gene expression in Bp-ALL and T-ALL cells.     

A Drosophila DEG/ENaC channel subunit is required for male response to female pheromones

Odorants and pheromones as well as sweet- and bitter-tasting small molecules are perceived through activation of G protein-coupled chemosensory receptors. In contrast, gustatory detection of salty and sour tastes may involve direct gating of sodium channels of the DEG/ENaC family by sodium and hydrogen ions, respectively. We have found that ppk25, a Drosophila melanogaster gene encoding a DEG/ENaC channel subunit, is expressed at highest levels in the male appendages responsible for gustatory and olfactory detection of female pheromones: the legs, wings, and antennae. Mutations in the ppk25 gene reduce or even abolish male courtship response to females in the dark, conditions under which detection of female pheromones is an essential courtship-activating sensory input. In contrast, the same mutations have no effect on other behaviors tested. Importantly, ppk25 mutant males that show no response to females in the dark execute all of the normal steps of courtship behavior in the presence of visible light, suggesting that ppk25 is required for activation of courtship behavior by chemosensory perception of female pheromones. Finally, a ppk25 mutant allele predicted to encode a truncated protein has dominant-negative properties, suggesting that the normal Ppk25 protein acts as part of a multiprotein complex. Together, these results indicate that ppk25 is necessary for response to female pheromones by D. melanogaster males, and suggest that members of the DEG/ENaC family of genes play a wider role in chemical senses than previously suspected.     

Physiological and biomechanical responses while running with and without a stroller

AIM: This study examined the effects of pushing a jogging stroller on biomechanical and physiological variables. The hypothesis was that running with a stroller for 30 minutes would shorten stride length and increase physiological indices of exercise. METHODS: Experimental design: this was a repeated measures design. Setting: participants were recruited from road races in the Dallas/Fort Worth, TX area. Graded exercise tests were performed in a laboratory setting, field tests were performed on a 400 m all-weather outdoor track. Participants: 5 males and 5 females were assessed. Interventions: participants performed a graded exercise test and 2 field tests. The 1st field test involved running at 75% VO2max for 30 minutes without a stroller and the 2nd involved running at the same speed with the stroller. Measures: VO2, stride length, heart rate, lactate, ventilation, and RPE were evaluated. RESULTS: No differences for VO2 or stride length were evident. Heart rate (p=0.0001), lactate concentration (p=0.025), ventilation (p=0.009), and RPE (p=0.002) increased from 10 to 30 minutes while running with the stroller. Heart rate (p=0.002), lactate concentration (p=0.0001), ventilation (p=0.006), and RPE (p=0.001) were significantly higher while running with the stroller after 30 minutes compared to running without it. CONCLUSION: These results indicate that pushing a stroller affects some indices of exercise intensity while running. Gait does not change. These data do not support an association between stroller use during running and an increase risk of orthopedic injury. Further studies should examine these variables at lower intensities that are run by most recreational joggers.     

Cerebral blood flow effects of acute intravenous heroin administration.

We examined acute effects of intravenous diacetylmorphine (heroin) administration - which induces a characteristic biphasic response: A short rush-sensation associated with intense pleasurable feelings followed by a subjectively different period of euphoria on cerebral blood flow. This was assessed in nine male heroin dependent patients participating in a heroin maintenance program in a setting resembling everyday pattern of heroin abuse. 99mTc-HMPAO was administered 45 s (rush) and 15 min (euphoria) after administration of i.v. heroin and 45 s after administration of saline (placebo). Plasma concentration of diacetylmorphine and its metabolites were measured with high-pressure liquid chromatography (HPLC). Compared to the euphoria condition, rush was associated with blood flow increase in the left posterior cerebellar lobe, left anterior cingulate gyrus and right precuneus. Our results are in line with recent reports indicating that the cerebellum is an important component in functional brain systems subserving sensory and motor integration, learning, modulation of affect, motivation and social behaviour, which all play important roles in reinforcing properties of opioids.     

Asymmetric extraction treatment of a Class II Division 1 subdivision left malocclusion with anterior and posterior crossbites.

This case was chosen by the CDABO student case selection committee for publication in the AJO/DO. (Am J Orthod Dentofacial Orthop 1999;115:410-7)     

The UHP ultrasound protocol: a novel ultrasound approach to the empiric evaluation of the undifferentiated hypotensive patient.

This report describes a novel sonographic protocol for the evaluation of the undifferentiated hypotensive patient. This protocol combines components of 3 sonographic applications: free fluid, cardiac, and abdominal aorta into a single protocol. We believe this protocol and its underlying principles should be a routine part of the empiric evaluation of the patient with undifferentiated hypotension or pulseless electrical activity.