Palivizumab is the only licensed respiratory syncytial virus (RSV) immunoprophylaxis (IP) available to prevent severe RSV disease in high-risk pediatric populations, including infants born at 29-34 weeks' gestational age (wGA). In 2014, the American Academy of Pediatrics (AAP) stopped recommending RSV IP use for otherwise healthy 29-34 wGA infants and stated that 29-34 wGA infants and term infants have similar RSV hospitalization (RSVH) rates. This study aimed to compare RSV IP use and RSVH rates in 29-34 wGA infants and term infants during the 3 RSV seasons before and after the 2014 AAP policy change. RSV IP use in otherwise healthy infants 29-30, 31-32, and 33-34 wGA was estimated from pharmacy or outpatient medical claims for palivizumab. RSVH rates in the first 6 months of life were calculated per 100 infant-seasons. RSVH rate ratios were used to compare preterm infants and term infants before and after the policy change. Across infant cohorts (29-34 wGA) and chronologic age groups ( less then 3 months and 3- less then 6 months), absolute decreases in RSV IP use between the combined 2011-2014 seasons and 2014-2017 seasons ranged from 7% to 38% and from 68% to 97%, respectively. Compared with 2011-2014, the RSVH risk increased 2.09-fold (P less then .001) and 1.76-fold (P less then .001) in 2014-2017 for infants born at 29-34 wGA and aged less then 6 months with commercial and Medicaid insurance, respectively. Overall, RSV IP use declined in the RSV seasons following the 2014 RSV IP policy change, and RSVH increased among 29-34 wGA infants aged less then 6 months.
Alterations in resting-state functional connectivity (rsFC) occur in the acute and chronic phases following traumatic brain injury (TBI); however, few studies have assessed long-term (>1 year) changes in rsFC.
Resting-state functional magnetic resonance imaging (
sfMRI) scans were obtained from the Federal Interagency Traumatic Brain Injury Research Informatics Systems. Patients with primarily mild TBI (n=39) completed
sfMRI scans at the sub-acute (~10days) and long-term (~18 months) phases. We examined changes in voxel-based rsFC from anterior medial prefrontal cortex (aMPFC) and posterior cingulate cortex (PCC) seeds in the default mode network (DMN) between both phases. The effect of age at the time of injury on long-term rsFC was also examined.
Increased rsFC from the aMPFC and the PCC to frontal and temporal regions was shown at ~18-months post-injury. Widespread increases in rsFC from the aMPFC and between the PCC and frontal regions were shown for younger patients at time of injury, but limited increases of rsFC were noted at ~18 months in older patients.
Long-term increases in rsFC were found following TBI, but age at the time of injury was associated with distinct rsFC profiles suggesting that younger patients show greater increases in rsFC over time.
Long-term increases in rsFC were found following TBI, but age at the time of injury was associated with distinct rsFC profiles suggesting that younger patients show greater increases in rsFC over time.This study investigated the hypothesis that β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction would be enhanced in female compared with male rats, and that endurance exercise training would augment β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction in male and female rats. Sprague-Dawley rats were randomized into sedentary (male n = 7; female n = 8) and exercise-trained (male n = 9; female n = 9) groups. Following 4 wk of exercise training or being sedentary, rats were anesthetized and surgically instrumented for stimulation of the lumbar sympathetic chain, muscle contraction and measurement of arterial blood pressure and femoral artery blood flow (FBF). Femoral vascular conductance (FVC) was calculated as FBF/mean arterial pressure. The percentage change of FVC in response to sympathetic stimulation delivered at 2 and 5 Hz was measured at rest and during contraction of the triceps surae muscles before and after β-adrenoreceptor blockade (propranolol 0.075 mg·kg-1 iv). We female rats, regardless of training status. Sympatholysis was enhanced in female, compared to male rats; however, β-adrenoreceptors were not responsible for the enhanced sympatholysis. These findings indicate that β-adrenoreceptors do not contribute to the regulation of sympathetic vasoconstriction in resting and contracting skeletal muscle and suggest that β-adrenoreceptors do not underlie sex differences in the neural control of the circulation.Muscle glycogen use and glucose uptake during cold exposure increases with shivering intensity. We hypothesized that cold exposure, with shivering, would subsequently increase glucose tolerance. Fifteen healthy men (age = 26 ± 5 yr, body mass index = 23.9 ± 2.5 kg·m-2 ) completed two experimental trials after an overnight fast. Cold exposure (10°C) was applied during the first trial, via a water-perfused suit, to induce at least 1 h of shivering in each participant. For comparison, a thermoneutral (32°C) condition was applied during the second trial, under identical conditions, for the same duration as determined during the cold exposure. After the thermal exposures, participants rested under a duvet for 90 min, which was followed by a 3-h oral glucose tolerance test. Skin temperature (means ± SE) decreased at the end of the cold exposure compared with that before (26.9 ± 0.3 vs. https://www.selleckchem.com/products/emricasan-idn-6556-pf-03491390.html 33.7 ± 0.1°C, P less then 0.001). Total energy expenditure during the 1 h of shivering was greater than that during the time-matched thermoneutral condition (619 ± 23 vs. 309 ± 7 kJ, P less then 0.001). Cold exposure increased the areas under the glucose and insulin curves by 4.8% (P = 0.066) and 24% (P = 0.112), respectively. The Matsuda and insulin-glucose indices changed after cold exposure by -21% (P = 0.125) and 30% (P = 0.100), respectively. Cold exposure did not subsequently increase glucose tolerance. Instead, the Matsuda and insulin-glucose indices suggest insulin resistance post shivering.NEW & NOTEWORTHY This is the first study to examine the effect of cold-induced shivering on subsequent glucose tolerance determined under thermoneutral conditions. Plasma glucose and insulin concentrations increased during the oral glucose tolerance test post shivering. Additionally, insulin sensitivity indices suggest insulin resistance following cold exposure. These results provide evidence for an acute post-shivering response, whereby glucose metabolism has deteriorated, contrary to the results from earlier studies on cold acclimation.
Palivizumab is the only licensed respiratory syncytial virus (RSV) immunoprophylaxis (IP) available to prevent severe RSV disease in high-risk pediatric populations, including infants born at 29-34 weeks' gestational age (wGA). In 2014, the American Academy of Pediatrics (AAP) stopped recommending RSV IP use for otherwise healthy 29-34 wGA infants and stated that 29-34 wGA infants and term infants have similar RSV hospitalization (RSVH) rates. This study aimed to compare RSV IP use and RSVH rates in 29-34 wGA infants and term infants during the 3 RSV seasons before and after the 2014 AAP policy change. RSV IP use in otherwise healthy infants 29-30, 31-32, and 33-34 wGA was estimated from pharmacy or outpatient medical claims for palivizumab. RSVH rates in the first 6 months of life were calculated per 100 infant-seasons. RSVH rate ratios were used to compare preterm infants and term infants before and after the policy change. Across infant cohorts (29-34 wGA) and chronologic age groups ( less then 3 months and 3- less then 6 months), absolute decreases in RSV IP use between the combined 2011-2014 seasons and 2014-2017 seasons ranged from 7% to 38% and from 68% to 97%, respectively. Compared with 2011-2014, the RSVH risk increased 2.09-fold (P less then .001) and 1.76-fold (P less then .001) in 2014-2017 for infants born at 29-34 wGA and aged less then 6 months with commercial and Medicaid insurance, respectively. Overall, RSV IP use declined in the RSV seasons following the 2014 RSV IP policy change, and RSVH increased among 29-34 wGA infants aged less then 6 months.
Alterations in resting-state functional connectivity (rsFC) occur in the acute and chronic phases following traumatic brain injury (TBI); however, few studies have assessed long-term (>1 year) changes in rsFC.
Resting-state functional magnetic resonance imaging (
sfMRI) scans were obtained from the Federal Interagency Traumatic Brain Injury Research Informatics Systems. Patients with primarily mild TBI (n=39) completed
sfMRI scans at the sub-acute (~10days) and long-term (~18 months) phases. We examined changes in voxel-based rsFC from anterior medial prefrontal cortex (aMPFC) and posterior cingulate cortex (PCC) seeds in the default mode network (DMN) between both phases. The effect of age at the time of injury on long-term rsFC was also examined.
Increased rsFC from the aMPFC and the PCC to frontal and temporal regions was shown at ~18-months post-injury. Widespread increases in rsFC from the aMPFC and between the PCC and frontal regions were shown for younger patients at time of injury, but limited increases of rsFC were noted at ~18 months in older patients.
Long-term increases in rsFC were found following TBI, but age at the time of injury was associated with distinct rsFC profiles suggesting that younger patients show greater increases in rsFC over time.
Long-term increases in rsFC were found following TBI, but age at the time of injury was associated with distinct rsFC profiles suggesting that younger patients show greater increases in rsFC over time.This study investigated the hypothesis that β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction would be enhanced in female compared with male rats, and that endurance exercise training would augment β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction in male and female rats. Sprague-Dawley rats were randomized into sedentary (male n = 7; female n = 8) and exercise-trained (male n = 9; female n = 9) groups. Following 4 wk of exercise training or being sedentary, rats were anesthetized and surgically instrumented for stimulation of the lumbar sympathetic chain, muscle contraction and measurement of arterial blood pressure and femoral artery blood flow (FBF). Femoral vascular conductance (FVC) was calculated as FBF/mean arterial pressure. The percentage change of FVC in response to sympathetic stimulation delivered at 2 and 5 Hz was measured at rest and during contraction of the triceps surae muscles before and after β-adrenoreceptor blockade (propranolol 0.075 mg·kg-1 iv). We female rats, regardless of training status. Sympatholysis was enhanced in female, compared to male rats; however, β-adrenoreceptors were not responsible for the enhanced sympatholysis. These findings indicate that β-adrenoreceptors do not contribute to the regulation of sympathetic vasoconstriction in resting and contracting skeletal muscle and suggest that β-adrenoreceptors do not underlie sex differences in the neural control of the circulation.Muscle glycogen use and glucose uptake during cold exposure increases with shivering intensity. We hypothesized that cold exposure, with shivering, would subsequently increase glucose tolerance. Fifteen healthy men (age = 26 ± 5 yr, body mass index = 23.9 ± 2.5 kg·m-2 ) completed two experimental trials after an overnight fast. Cold exposure (10°C) was applied during the first trial, via a water-perfused suit, to induce at least 1 h of shivering in each participant. For comparison, a thermoneutral (32°C) condition was applied during the second trial, under identical conditions, for the same duration as determined during the cold exposure. After the thermal exposures, participants rested under a duvet for 90 min, which was followed by a 3-h oral glucose tolerance test. Skin temperature (means ± SE) decreased at the end of the cold exposure compared with that before (26.9 ± 0.3 vs. https://www.selleckchem.com/products/emricasan-idn-6556-pf-03491390.html 33.7 ± 0.1°C, P less then 0.001). Total energy expenditure during the 1 h of shivering was greater than that during the time-matched thermoneutral condition (619 ± 23 vs. 309 ± 7 kJ, P less then 0.001). Cold exposure increased the areas under the glucose and insulin curves by 4.8% (P = 0.066) and 24% (P = 0.112), respectively. The Matsuda and insulin-glucose indices changed after cold exposure by -21% (P = 0.125) and 30% (P = 0.100), respectively. Cold exposure did not subsequently increase glucose tolerance. Instead, the Matsuda and insulin-glucose indices suggest insulin resistance post shivering.NEW & NOTEWORTHY This is the first study to examine the effect of cold-induced shivering on subsequent glucose tolerance determined under thermoneutral conditions. Plasma glucose and insulin concentrations increased during the oral glucose tolerance test post shivering. Additionally, insulin sensitivity indices suggest insulin resistance following cold exposure. These results provide evidence for an acute post-shivering response, whereby glucose metabolism has deteriorated, contrary to the results from earlier studies on cold acclimation.
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