Teamwork reduces physiological stress in junior surgeons

Objective: The quality of teamwork depends not only on communication skills but also on team familiarity and hierarchical structures. The aim of the present study is to evaluate the physiological impact of close teamwork between senior and junior surgeons performing elective open abdominal surgery for six months in stable teams. Methods: Physiological measurements of the main and junior surgeons were taken in a total of 40 procedures. Cumulative stress was assessed by the mea- surements of urine catecholamines (Adrenaline, Noradrenaline, Dopamine, Metanephrine, Normetanephrine). Heart rate variability was measured to assess temporal aspects of stress. The procedures were observed by a trained team of work psychologists. Direct observations of distractors, team inter- actions and communication were performed. Specific questionnaires were filled by members of the surgical team that include surgeons, nurses and anesthetists. Results: In junior surgeons, physiological stress is reduced over a period of close collaboration. Case-related communication is not stressful. However, tension within the surgical team is associated with increased levels of cat- echolamine in the urine of the senior surgeon. The difficulty of the oper- ation impacts on heart-rate variability of the junior but not of the senior surgeon. Conclusion: Junior surgeons may require months of teamwork within one stable team in order to reduce levels of physiological stress. Senior surgeons are more resistant to stressful clinical situations compared to junior surgeons but are vulnerable to tension within the surgical team.

Physiological responses of red mangroves to the climate in the Florida Everglades

This manuscript reports the findings of physiological studies of red mangrove (Rhizophora mangle L.) conducted from June to August 2001 and from May to June 2003 in the Florida Everglades. In situ physiological measurements were made using environmentally controlled gas exchange systems. The field investigations were carried out to define how regional climate constrains mangrove physiology and ecosystem carbon assimilation. In addition, maximum carboxylation and photosynthetic active radiation (PAR) limited carbon assimilation capacities were investigated during the summer season to evaluate whether ecophysiological models developed for mesophyte plant species can be applied to mangroves. Under summertime conditions in the Florida Everglades, maximum foliar carbon dioxide (CO2) assimilation rates reached 18 μmol CO2 m−2 s−1. Peak molar stomatal conductance to water vapor (H2O) diffusion reached 300 mmol H2O m−2 s−1. Maximum carboxylation and PAR‐limited carbon assimilation rates at the foliage temperature of 30°C attained 76.1 ± 23.4 μmol CO2 m−2 s−1 and 128.1 ± 32.9 μmol (e−) m−2 s−1, respectively. Environmental stressors such as the presence of hypersaline conditions and high solar irradiance loading (>500 W m−2 or >1000 μmoles of photons m−2 s−1 of PAR) imposed sharp reductions in carbon assimilation rates and suppressed stomatal conductance. On the basis of both field observations and model analyses, it is also concluded that existing ecophysiological models need to be modified to consider the influences of hypersaline and high radiational loadings on the physiological responses of red mangroves.

Driving performance on monotonous roads

Driving on motorways has largely been reduced to a lane-keeping task with cruise control. Rapidly, drivers are likely to get bored with such a task and take their attention away from the road. This is of concern in terms of road safety – particularly for professional drivers - since inattention has been identified as one of the main contributing factors to road crashes and is estimated to be involved in 20 to 30% of these crashes. Furthermore, drivers are not aware that their vigilance level has decreased and that their driving performance is impaired. Intelligent Transportation System (ITS) intervention can be used as a countermeasure against vigilance decrement. This paper aims to identify a variety of metrics impacted during monotonous driving - ranging from vehicle data to physiological variables - and relate them to two monotonous factors namely the monotony of the road design (straightness) and the monotony of the environment (landscape, signage, traffic). Data are collected in a driving simulator instrumented with an eye tracking system, a heart rate monitor and an electrodermal activity device (N=25 participants). The two monotonous factors are varied (high and low) leading to the use of four different driving scenarios (40 minutes each). We show with Generalised Linear Mixed Models that driver performance decreases faster when the road is monotonous. We also highlight that road monotony impairs a variety of driving performance and vigilance measures, ranging from speed, lateral position of the vehicle to physiological measurements such as heart rate variability, blink frequency and electrodermal activity. This study informs road designers of the importance of having a varied road environment. It also provides a range of metrics that can be used to detect in real-time the impairment of driving performance on monotonous roads. Such knowledge could result in the development of an in-vehicle device warning drivers at early signs of driving performance impairment on monotonous roads.

Effects of weed control and fertilization at early establishment on tree nitrogen and water use in an exotic F1 hybrid pine of subtropical Australia

Purpose We investigated the effects of weed control and fertilization at early establishment on foliar stable carbon (δ13C) and nitrogen (N) isotope (δ15N) compositions, foliar N concentration, tree growth and biomass, relative weed cover and other physiological traits in a 2-year old F1 hybrid (Pinus elliottii var. elliottii (Engelm) × Pinus caribaea var. hondurensis (Barr. ex Golf.)) plantation grown on a yellow earth in southeast Queensland of subtropical Australia. Materials and methods Treatments included routine weed control, luxury weed control, intermediate weed control, mechanical weed control, nil weed control, and routine and luxury fertilization in a randomised complete block design. Initial soil nutrition and soil fertility parameters included (hot water extractable organic carbon (C) and total nitrogen (N), total C and N, C/N ratio, labile N pools (nitrate (NO3 −) and ammonium (NH4 +)), extractable potassium (K+)), soil δ15N and δ13C. Relative weed cover, foliar N concentrations, tree growth rate and physiological parameters including photosynthesis, stomatal conductance, photosynthetic nitrogen use efficiency, foliar δ15N and foliar δ13C were also measured at early establishment. Results and discussion Foliar N concentration at 1.25 years was significantly different amongst the weed control treatments and was negatively correlated to the relative weed cover at 1.1 years. Foliar N concentration was also positively correlated to foliar δ15N and foliar δ13C, tree height, height growth rates and tree biomass. Foliar δ15N was negatively correlated to the relative weed cover at 0.8 and 1.1 years. The physiological measurements indicated that luxury fertilization and increasing weed competition on these soils decreased leaf xylem pressure potential (Ψxpp) when compared to the other treatments. Conclusions These results indicate how increasing N resources and weed competition have implications for tree N and water use at establishment in F1 hybrid plantations of southeast Queensland, Australia. These results suggest the desirability of weed control, in the inter-planting row, in the first year to maximise site N and water resources available for seedling growth. It also showed the need to avoid over-fertilisation, which interfered with the balance between available N and water on these soils.

Dendritic atrophy constricts functional maps in resonance and impedance properties of hippocampal model neurons

A gradient in the density of hyperpolarization-activated cyclic-nucleotide gated (HCN) channels is necessary for the emergence of several functional maps within hippocampal pyramidal neurons. Here, we systematically analyzed the impact of dendritic atrophy on nine such functional maps, related to input resistance and local/transfer impedance properties, using conductance-based models of hippocampal pyramidal neurons. We introduced progressive dendritic atrophy in a CA1 pyramidal neuron reconstruction through a pruning algorithm, measured all functional maps in each pruned reconstruction, and arrived at functional forms for the dependence of underlying measurements on dendritic length. We found that, across frequencies, atrophied neurons responded with higher efficiency to incoming inputs, and the transfer of signals across the dendritic tree was more effective in an atrophied reconstruction. Importantly, despite the presence of identical HCN-channel density gradients, spatial gradients in input resistance, local/transfer resonance frequencies and impedance profiles were significantly constricted in reconstructions with dendrite atrophy, where these physiological measurements across dendritic locations converged to similar values. These results revealed that, in atrophied dendritic structures, the presence of an ion channel density gradient alone was insufficient to sustain homologous functional maps along the same neuronal topograph. We assessed the biophysical basis for these conclusions and found that this atrophy-induced constriction of functional maps was mediated by an enhanced spatial spread of the influence of an HCN-channel cluster in atrophied trees. These results demonstrated that the influence fields of ion channel conductances need to be localized for channel gradients to express themselves as homologous functional maps, suggesting that ion channel gradients are necessary but not sufficient for the emergence of functional maps within single neurons.

Functional morphology of cephalopod gills

There is a wealth of literature dealing with fish gills (Review, see Hoar & Randall, 1984), yet hardly anything is known about the gills of cephalopods. This is rather surprising considering the commercial importance of the cephalopods. In view of the paucity of information available it was necessary to start by establishing the morphology of the gills. This is covered in the first section of this thesis. Of all the cephalopods, Octopus vulgaris was singled out for more detailed investigation (see chapters 2 & 3) as its physiology is comparatively well understood (Wells, 1978). The gills of cephalopods are the major sites for respiratory gaseous exchange. It follows that their dimensions might be expected to govern their potential for absorbing oxygen. Section two deals with the morphometries of cephalopod gills, and predicted values are compared with physiological measurements of oxygen uptake for four representative The final section describes the physiological experiments I performed on octopuses. These experiments were designed to find out whether the animals could regulate the gills' potential to take up oxygen through changes to the gills themselves.

Anatomical identification of extracellularly recorded cells in large-scale multielectrode recordings.

This study combines for the first time two major approaches to understanding the function and structure of neural circuits: large-scale multielectrode recordings, and confocal imaging of labeled neurons. To achieve this end, we develop a novel approach to the central problem of anatomically identifying recorded cells, based on the electrical image: the spatiotemporal pattern of voltage deflections induced by spikes on a large-scale, high-density multielectrode array. Recordings were performed from identified ganglion cell types in the macaque retina. Anatomical images of cells in the same preparation were obtained using virally transfected fluorescent labeling or by immunolabeling after fixation. The electrical image was then used to locate recorded cell somas, axon initial segments, and axon trajectories, and these signatures were used to identify recorded cells. Comparison of anatomical and physiological measurements permitted visualization and physiological characterization of numerically dominant ganglion cell types with high efficiency in a single preparation.

Physiologie des émotions : l’effet des stimuli relationnels et de la qualité affective des schémas relationnels sur les réactions physiologiques associées à des émotions de valence positive et négative

La littérature sur l’électrophysiologie des émotions ne semble pas trouver de consensus. Certaines études démontrent que les gens réagissent davantage à des stimuli de valence positive, tandis que d’autres concluent le contraire. L’objectif principal de ce mémoire est de vérifier les effets de la variable relationnelle sur les réactions physiologiques de sujets issus de la population étudiante. C’est-à-dire, les réactions physiologiques sont-elles influencées uniquement par la valence affective des différentes émotions ou s’ils sont également influencés par le contexte relationnel des stimuli? Le second objectif du projet de recherche proposé est de vérifier s’il existe un effet d’interaction entre la qualité affective des schémas relationnels des participants et la nature relationnelle ou non des stimuli. Pour ce faire, le rythme cardiaque a été pris sur 16 sujets divisés en 2 groupes, basés sur leurs résultats au TAT, analysés sur l’échelle de la tonalité affective du SCORS. Finalement, un troisième objectif est de comparer l’expérience subjective des participants aux mesures physiologiques obtenues. Les résultats démontrent que les gens réagissent davantage aux scénarios non relationnels que ceux relationnels. De plus, les grandes tailles d’effet des deux groupes (tonalité affective haute et basse) semblent indiquer l’importance de prendre en considération cette variable dans de futures recherches. Finalement, d’autres études, notamment avec de plus grands échantillons, seront nécessaires pour montrer l’importance de la qualité relationnelle dans l’expérience émotive.

Analyse de l'effet de la contamination du sol sur la croissance et la physiologie de 11 cultivars de Salix

Mon mémoire de maîtrise a été réalisé dans le cadre du projet Génorem (www.genorem.ca), un projet multidisciplinaire qui réunit différents chercheurs de l'Université de Montréal et de l'Université McGill dans le but d'améliorer les techniques utilisées en bioremédiation. Dans le cadre de l'étude, des saules à croissance rapide (Salix sp.) ont été utilisés comme plantes modèles dans l'étude. Ainsi, 11 cultivars de saule ont été suivis afin de déterminer leur potentiel à produire un bon rendement de biomasse, à tolérer des conditions de stress sévère causé par la présence de HAPs (hydrocarbures aromatiques polycycliques) , BPCs (biphényles polychlorés) et d'hydrocarbures pétroliers C10-C50. L'expérimentation consistait en une plantation de saule à forte densité qui a été mise en place en 2011 sur le site d'une ancienne industrie de pétrochimie à Varennes, dans le sud du Québec. Les boutures des génotypes sélectionnés ont été plantées sur une superficie d'environ 5000 m2. Les plantes ont été suivies pendant les deux saisons de croissance suivant le recépage et une série de paramètres de croissance et de mesures physiologiques ont été récoltés (surface foliaire, taux de chlorophylle, conductance stomatique et statut nutritionnel) dans le but d'évaluer et de comparer les performances de chaque génotype sur un sol pollué. Les analyses statistiques ont démontré que le cultivar S. miyabeana (SX61) était le meilleur producteur de biomasse sur le site contaminé, tandis que S. nigra (S05) et S. acutifolia (S54) présentaient la meilleure capacité photosynthétique. S. dasyclados (SV1), S. purpurea (‘Fish Creek’) et S. caprea (S365) ont semblé particulièrement affectés par la présence de contaminants. La capacité d'établissement et la croissance de S. nigra (S05), S. eriocephala (S25) and S. purpurea x S. miyabeana (‘Millbrook’) indiquent une tolérance globale supérieure à la pollution . Cette analyse comparative des différentes réponses physiologiques des saules cultivés sur un sol contaminé pourra guider le processus de sélection de plantes et les techniques de bioremédiation dans les futurs projets de phytoremédiation.

Regulated irrigation of woody ornamentals to improve plant quality and precondition against drought stress

Regulated irrigation has the potential to improve crop quality in woody ornamentals by reducing excessive vigour and promoting a more compact habit. This research aimed to compare the effectiveness and the mode of action of two techniques, regulated deficit irrigation (RDI) and partial root drying (PRD), when applied to container-grown ornamentals through drip irrigation. Results showed that RDI and PRD reduced growth in Cotinus coggygria 'Royal Purple', but in Forsythia x intermedia 'Lynwood', significant reductions were recorded only with RDI. Physiological measurements in Forsythia indicated that reductions in stomatal conductance (g(s)) occurred in both treatments, but those in the RDI tended to be more persistent. Reduced g(s) in PRD was consistent with the concept that chemical signals from the root can regulate stomatal aperture alone; however, the data also suggested that optimising the growth reduction required a moderate degree of shoot water deficit (i.e. a hydraulic signal to be imposed). As RDI was associated with tissue water deficit, it was used in a second experiment to determine the potential of this technique to precondition container-grown plants against subsequent drought stress (e.g. during retail stages or after planting out). Speed of acclimation would be important in a commercial context, and the results demonstrated that both slow and rapid imposition of RDI enabled Forsythia plants to acclimate against later drought events. This article discusses the potential to both improve ornamental plant quality and enhance tolerance to subsequent adverse conditions through controlled, regulated irrigation.

The manipulation of progesterone profiles during progesterone + estradiol timed ai protocols in dairy cattle: effects on fertility

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Analysis of Phenotypic Variation in Childhood Wheezing Disorders

Recurrent wheezing or asthma is a common problem in children that has increased considerably in prevalence in the past few decades. The causes and underlying mechanisms are poorly understood and it is thought that a numb er of distinct diseases causing similar symptoms are involved. Due to the lack of a biologically founded classification system, children are classified according to their observed disease related features (symptoms, signs, measurements) into phenotypes. The objectives of this PhD project were a) to develop tools for analysing phenotypic variation of a disease, and b) to examine phenotypic variability of wheezing among children by applying these tools to existing epidemiological data. A combination of graphical methods (multivariate co rrespondence analysis) and statistical models (latent variables models) was used. In a first phase, a model for discrete variability (latent class model) was applied to data on symptoms and measurements from an epidemiological study to identify distinct phenotypes of wheezing. In a second phase, the modelling framework was expanded to include continuous variability (e.g. along a severity gradient) and combinations of discrete and continuo us variability (factor models and factor mixture models). The third phase focused on validating the methods using simulation studies. The main body of this thesis consists of 5 articles (3 published, 1 submitted and 1 to be submitted) including applications, methodological contributions and a review. The main findings and contributions were: 1) The application of a latent class model to epidemiological data (symptoms and physiological measurements) yielded plausible pheno types of wheezing with distinguishing characteristics that have previously been used as phenotype defining characteristics. 2) A method was proposed for including responses to conditional questions (e.g. questions on severity or triggers of wheezing are asked only to children with wheeze) in multivariate modelling.ii 3) A panel of clinicians was set up to agree on a plausible model for wheezing diseases. The model can be used to generate datasets for testing the modelling approach. 4) A critical review of methods for defining and validating phenotypes of wheeze in children was conducted. 5) The simulation studies showed that a parsimonious parameterisation of the models is required to identify the true underlying structure of the data. The developed approach can deal with some challenges of real-life cohort data such as variables of mixed mode (continuous and categorical), missing data and conditional questions. If carefully applied, the approach can be used to identify whether the underlying phenotypic variation is discrete (classes), continuous (factors) or a combination of these. These methods could help improve precision of research into causes and mechanisms and contribute to the development of a new classification of wheezing disorders in children and other diseases which are difficult to classify.

Biogeochemical indicators of elevated nitrogen deposition in semiarid Mediterranean ecosystems

Nitrogen (N) deposition has doubled the natural N inputs received by ecosystems through biological N fixation and is currently a global problem that is affecting the Mediterranean regions. We evaluated the existing relationships between increased atmospheric N deposition and biogeochemical indicators related to soil chemical factors and cryptogam species across semiarid central, southern, and eastern Spain. The cryptogam species studied were the biocrust-forming species Pleurochaete squarrosa (moss) and Cladonia foliacea (lichen). Sampling sites were chosen in Quercus coccifera (kermes oak) shrublands and Pinus halepensis (Aleppo pine) forests to cover a range of inorganic N deposition representative of the levels found in the Iberian Peninsula (between 4.4 and 8.1 kg N ha(-1) year(-1)). We extended the ambient N deposition gradient by including experimental plots to which N had been added for 3 years at rates of 10, 20, and 50 kg N ha(-1) year(-1). Overall, N deposition (extant plus simulated) increased soil inorganic N availability and caused soil acidification. Nitrogen deposition increased phosphomonoesterase (PME) enzyme activity and PME/nitrate reductase (NR) ratio in both species, whereas the NR activity was reduced only in the moss. Responses of PME and NR activities were attributed to an induced N to phosphorus imbalance and to N saturation, respectively. When only considering the ambient N deposition, soil organic C and N contents were positively related to N deposition, a response driven by pine forests. The PME/NR ratios of the moss were better predictors of N deposition rates than PME or NR activities alone in shrublands, whereas no correlation between N deposition and the lichen physiology was observed. We conclude that integrative physiological measurements, such as PME/NR ratios, measured on sensitive species such as P. squarrosa, can provide useful data for national-scale biomonitoring programs, whereas soil acidification and soil C and N storage could be useful as additional corroborating ecosystem indicators of chronic N pollution.

Arterial stiffness and arteriovenous fistula failure of maturation

PURPOSE: Increased arterial stiffness is a common finding in patients with end-stage renal disease. Following creation of an arteriovenous fistula (AVF), appropriate dilation of the feeding artery must occur to facilitate AVF maturation. Arterial stiffness may impair the arterial dilation required to facilitate AVF development and contribute to subsequent failure to mature (FTM). The aim of this pilot study was to investigate the association between measurements of central and peripheral arterial stiffness, and AVF FTM.

METHODS: Patients undergoing AVF creation in a single centre (Belfast City Hospital, UK) between January and December 2015 were invited to have their carotid-femoral pulse wave velocity (PWV), brachial-radial PWV and augmentation index (AI) measured prior to AVF creation. Subsequent AVF outcomes were identified.

RESULTS: Fifty-nine patients who had an AVF procedure were included in the final analysis (mean age 62 years); 50.8% had diabetes mellitus. The mean pre-operative arterial diameter for all AVFs was 3.9 mm. Average values for carotid-femoral PWV were 9.5 m/s, brachial-radial PWV 7.7 m/s and AI 25.6%. Using logistic regression, these arterial stiffness parameters did not predict AVF FTM: carotid-femoral PWV (P = 0.20), brachial-radial PWV (P = 0.13), AI (P = 0.50).

CONCLUSIONS: This is the largest study to date exploring the association between arterial stiffness and AVF FTM. The measured central and peripheral arterial stiffness parameters were not associated with AVF FTM. Further research is needed to define if non-invasive arterial physiological measurements would be clinically useful in the prediction of AVF FTM.

Cognitive impairment in heart failure

The clinical syndrome of heart failure is one of the leading causes of hospitalisation and mortality in older adults. Due to ageing of the general population and improved survival from cardiac disease the prevalence of heart failure is rising. Despite the fact that the majority of patients with heart failure are aged over 65 years old, many with multiple co-morbidities, the association between cognitive impairment and heart failure has received relatively little research interest compared to other aspects of cardiac disease. The presence of concomitant cognitive impairment has implications for the management of patients with heart failure in the community. There are many evidence based pharmacological therapies used in heart failure management which obviously rely on patient education regarding compliance. Also central to the treatment of heart failure is patient self-monitoring for signs indicative of clinical deterioration which may prompt them to seek medical assistance or initiate a therapeutic intervention e.g. taking additional diuretic. Adherence and self-management may be jeopardised by cognitive impairment. Formal diagnosis of cognitive impairment requires evidence of abnormalities on neuropsychological testing (typically a result ≥1.5 standard deviation below the age-standardised mean) in at least one cognitive domain. Cognitive impairment is associated with an increased risk of dementia and people with mild cognitive impairment develop dementia at a rate of 10-15% per year, compared with a rate of 1-2% per year in healthy controls.1 Cognitive impairment has been reported in a variety of cardiovascular disorders. It is well documented among patients with hypertension, atrial fibrillation and coronary artery disease, especially after coronary artery bypass grafting. This background is relevant to the study of patients with heart failure as many, if not most, have a history of one or more of these co-morbidities. A systematic review of the literature to date has shown a wide variation in the reported prevalence of cognitive impairment in heart failure. This range in variation probably reflects small study sample sizes, differences in the heart failure populations studied (inpatients versus outpatients), neuropsychological tests employed and threshold values used to define cognitive impairment. The main aim of this study was to identify the prevalence of cognitive impairment in a representative sample of heart failure patients and to examine whether this association was due to heart failure per se rather than the common cardiovascular co-morbidities that often accompany it such as atherosclerosis and atrial fibrillation. Of the 817 potential participants screened, 344 were included in this study. The study cohort included 196 patients with HF, 61 patients with ischaemic heart disease and no HF and 87 healthy control participants. The HF cohort consisted of 70 patients with HF and coronary artery disease in sinus rhythm, 51 patients with no coronary artery disease in sinus rhythm and 75 patients with HF and atrial fibrillation. All patients with HF had evidence of HF-REF with a LVEF <45% on transthoracic echocardiography. The majority of the cohort was male and elderly. HF patients with AF were more likely to have multiple co-morbidities. Patients recruited from cardiac rehabilitation clinics had proven coronary artery disease, no clinical HF and a LVEF >55%. The ischaemic heart disease group were relatively well matched to healthy controls who had no previous diagnosis of any chronic illness, prescribed no regular medication and also had a LVEF >55%. All participants underwent the same baseline investigations and there were no obvious differences in baseline demographics between each of the cohorts. All 344 participants attended for 2 study visits. Baseline investigations including physiological measurements, electrocardiography, echocardiography and laboratory testing were all completed at the initial screening visit. Participants were then invited to attend their second study visit within 10 days of the screening visit. 342 participants completed all neuropsychological assessments (2 participants failed to complete 1 questionnaire). A full comprehensive battery of neuropsychological assessment tools were administered in the 90 minute study visit. These included three global cognitive screening assessment tools (mini mental state examination, Montreal cognitive assessment tool and the repeatable battery for the assessment of neuropsychological status) and additional measures of executive function (an area we believe has been understudied to date). In total there were 9 cognitive tests performed. These were generally well tolerated. Data were also collected using quality of life questionnaires and health status measures. In addition to this, carers of the study participant were asked to complete a measure of caregiver strain and an informant questionnaire on cognitive decline. The prevalence of cognitive impairment varied significantly depending on the neuropsychological assessment tool used and cut-off value used to define cognitive impairment. Despite this, all assessment tools showed the same pattern of results with those patients with heart failure and atrial fibrillation having poorer cognitive performance than those with heart failure in sinus rhythm. Cognitive impairment was also more common in patients with cardiac disease (either coronary artery disease or heart failure) than age-, sex- and education-matched healthy controls, even after adjustment for common vascular risk factors.