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Whole-cell current-clamp traces are plotted at the position in the brain slice to which the laser was targeted at the time of their measurement. Note that only perisomatic illumination in relatively close proximity to the cell body evokes action potentials. Here, in contrast, no light-evoked antidromic spikes are detected: waveforms of lightevoked (left) and spontaneous (right) action potentials at different timescales (top and bottom) are shown. Note that a slow depolarizing ramp to threshold after the onset of a light pulse (20 ms, gray bars) distinguishes light-evoked (orthodromic) from spontaneous antidromic action potentials. The bottom right panel includes for comparison traces of all 15 light-evoked action potentials (gray traces). The maps are scaled to the size of a standard barrel (thick white outline) and overlaid in order to depict the distribution of inhibitory input sources. The intensity of gray shading at each location indicates the cumulative inhibitory charge transfer. Locations of postsynaptic excitatory neurons from which those input maps were recorded are shown as white triangles and layer borders as thin white lines. Thick black outlines mark significant differences associated with whisker trimming (p < 0. No significant differences existed between control and regrowth conditions (p > 0. A principal disadvantage of the ChR2-based approach of local circuit mapping, however, is the lack of strong excitation of cells due to the low single-channel conductance of ChR2 of approximately 40 fs (Nagel et al. For example, this has prevented the use of ChR2-assisted circuit mapping in the developing neocortex. Therefore, another optogenetic approach has recently been developed that overcomes this problem by using the ion channel P2X2 (Anastasiades et al. Using this technology, connectivity patterns of interneurons could be mapped from the first postnatal day onward, revealing previously unknown principles of dynamic. At the specimen, the activating beam usually has a diameter of a few micrometers and carries 0. Turn-key solutions including laser optics and control software are also available. This problem scales with the density of optogenetically excitable cells: if a subtype is targeted that populates a circuit only sparsely, the likelihood that only a single cell is activated at every site increases. To circumvent this problem, much focus has been invested in technological development for optogenetic activation with non-linear or multi-photon optics.
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Acid Prophylaxis Drugs There is no good evidence to support the routine administration of acid prophylaxis drugs in normal labor to prevent gastric aspiration and its consequences [42]. Giving such drugs to women once a decision to give general anesthesia is made is discussed in Chapter 11. There was no statistically signi cant reduction in the number of cesarean deliveries. There was no evidence of a statistically signi cant difference in admission to the neonatal unit and in low Apgar score at ve minutes [43]. The bene ts are substantiated by the fact that several trials in nonpregnant adults demonstrate that increased uid intake improves exercise performance. The incidence of labor lasting >12 hours was decreased from 22% to about 10% [44]. Since walking does not seem to have a bene cial or detrimental effect on L&D, women can choose freely to walk or stay upright (see the section "Maternal Position") in bed during labor, whichever is more comfortable for them. There is limited information for other outcomes related to water use during the rst and second stages of labor, due to intervention and outcome variability. There is no evidence of increased adverse effects to the fetus/neonate or woman from laboring in water. Laboring in water is usually linked to midwifery care, which is associated with its own bene ts (see the section "Midwife-Led Care"). There are no trials evaluating different baths/pools, immersion in water during pregnancy, or during the third stage of labor. Therefore, routine early (or even late) amniotomy cannot be recommended as part of standard labor management and care. Women should be counseled regarding these results, and make an informed decision regarding the option of this intervention [53]. There were no differences in augmentation, cesarean section, spontaneous vaginal birth, operative vaginal birth, perinatal mortality, and admission to neonatal intensive care. Most studies, including those regarding active management, perform cervical examinations every 2 hours in labor. The risk of chorioamnionitis though increases with increasing number of examinations [58]. Oxytocin Augmentation There are no trials to evaluate the timing and dosing of oxytocin in labor in women making normal progress in labor. For women making slow progress in the rst stage of spontaneous labor, treatment with oxytocin as compared with no treatment or delayed oxytocin treatment does not result in any discernable difference in the number of cesarean sections performed, in one meta-analysis. The meta-analysis included eight appropriate studies, for a total of 1338 women with low risk singleton pregnancies at term in the active stage of labor.