Plasticity of cardiorespiratory neural processing: classification and computational functions

Neural plasticity, or malleability of neuronal structure and function, is an important attribute of the mammalian forebrain and is generally thought to be a kernel of biological intelligence. In this review, we examine some reported manifestations of neural plasticity in the cardiorespiratory system and classify them into four functional categories, integral; differential; memory; and statistical-type plasticity. At the cellular and systems level the myriad forms of cardiorespiratory plasticity display emergent and self-organization properties, use- and disuse-dependent and pairing-specific properties, short-term and long-term potentiation or depression, as well as redundancy in series or parallel structures, convergent pathways or backup and fail-safe surrogate pathways. At the behavioral level, the cardiorespiratory system demonstrates the capability of associative and nonassociative learning, classical and operant conditioning as well as short-term and long-term memory. The remarkable similarity and consistency of the various types of plasticity exhibited at all levels of organization suggest that neural plasticity is integral to cardiorespiratory control and may subserve important physiological functions.     

Heterogeneous Helicobacter pylori isolates from H. pylori-infected couples in Taiwan

Helicobacter pylori strain diversity was investigated in 55 H. pylori seropositive couples in Taiwan in biopsy samples from the antrum and corpus. Two DNA typing methods were used to characterize 90 isolates from 25 couples. In only 1 of the 25 couples was the same strain colonized from both partners. Comparison of isolates from 2 sites in each of 40 patients showed that 9 pairs were distinct but might be related. Peptic ulcer occurred in 77.8% of these 9 patients compared with 29% of 31 patients with the same predominant strain in 2 biopsies (P=.025). Random amplified polymorphic DNA and sequence analyses of 2 closely related isolates from 1 patient support the hypothesis that development of genetic diversity of H. pylori results from horizontal genetic exchange during long-term colonization of mixed bacterial populations.     

Validation of the Chinese version of the Canadian Haemophilia Outcomes‐Kids' Life Assessment Tool (the CHO‐KLAT)

It is important to assess the health‐related quality of life outcomes of boys in China, but there are no tools validated for this purpose. The objective of the study was to assess the validity of the Simplified Chinese version of the CHO‐KLAT_2.0. We recruited 60 boys with either haemophilia A (HA) or haemophilia B (HB) and their parents from four regions in China, and assessed the validity of CHO‐KLAT compared to the PedsQL. All participants complete the CHO‐KLAT a second time 1–2 weeks later to assess reliability. The boys ranged in age from 7 to 18 (mean = 12.4; SD = 3.03) years. The severity distribution was: mild (9), moderate (10) and severe (41). On‐demand therapy was received by 26 boys, while 18 received low‐dose prophylaxis (HA: 10 IU kg^?1 2–3 times week^?1, and HB: 20 IU kg^?1 1 time week^?1). The mean CHO‐KLAT scores were 63.7 (SD = 10.6) for child‐report and 58.3 (SD = 11.4) for parent‐report. Validity was supported by a correlation of 0.67 (P < 0.0001) with the PedsQL for child‐report and 0.64 (P < 0.0001) for parent‐report. The test–retest reliability was 0.88 (95% CI: 0.82–0.94) for child‐report, and 0.90 (95% CI: 0.86–0.95) for parent‐report. Inter‐rater reliability was 0.46 (95% CI: 0.26–0.66). CHO‐KLAT scores were 11 points higher among patients who had been on prophylaxis 3 times per week for ≥24 weeks. These results confirm the reliability and validity of the Chinese version of the CHO‐KLAT. This measure is suitable for use in prospective clinical trials in boys with haemophilia in China.     

Parental perspectives on the importance and likelihood of adult outcomes for children with Autism Spectrum Disorders,Intellectual Disabilities or Multiple Disabilities

AimsThis study examined parental perspectives on the importance and likelihood of future adult outcomes for children with Autism Spectrum Disorders (ASD), Intellectual Disabilities (ID), or Multiple Disabilities (MD) and some of the factors that may affect parental aspirations.MethodsParents of 105 children with ASD, ID, or MD were presented with 21 possible future outcomes and were asked to indicate how important and how likely they considered these outcomes for their children with disabilities when they become adults.ResultsParents rated the overall likelihood of their child attaining various future outcomes significantly lower than the importance they placed on these same outcomes. They mostly valued future outcomes relating to their children's personal satisfaction, safety and security over and above those relating to social participation. Parental ratings of the importance or likelihood of outcomes did not differ across the diagnostic groups. Ratings of importance were independent of the child's age, gender, diagnosis, or severity of functioning, but likelihood ratings were significantly predicted by the children's symptom severity.ConclusionsThe implications of this study's findings for service development, intervention and transitioning planning, and treatment outcome research are discussed in relation to existing literature and the study's strengths and limitations.     

Physicians’ awareness of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer carcinomatosis

Background

Recent trials have shown that cytoreductive surgery and heated intraperitoneal chemotherapy (S+HIPEC) for colorectal cancer carcinomatosis (CRC-C) leads to 5-year, disease-free survival rates of more than 30%. Since these data represent a substantial change in the management of CRC-C, the objectives of this study were to determine physicians’ awareness of S+HIPEC for CRC-C and physician characteristics predictive of awareness of S+HIPEC for CRC-C.

Methods

This study was a mailed, cross-sectional survey of general surgeons and medical oncologists in Ontario.

Results

The response rate was 44.0% (214 of 487). Most respondents were men and younger than 50 years. There was an even split between those at academic and community hospitals. Overall, 46% of respondents were aware of S+HIPEC for CRC-C, and multivariate analysis showed that there were no physician characteristics predictive of awareness of S+HIPEC for CRC-C.

Conclusion

Physician awareness of S+HIPEC for CRC-C is low. Therefore, strategies to improve patient and physician knowledge about S+HIPEC for CRC-C are important to ensure appropriate treatment for patients.