Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Σάββατο 9 Ιουλίου 2016
Cladophialophora bantiana osteomyelitis in a renal transplant patient
Publication date: Available online 9 July 2016
Source:Medical Mycology Case Reports
Author(s): Stefanie Desmet, Liesbeth Smets, Katrien Lagrou, Inge Derdelinckx, Jeroen Neyt, Johan Maertens, Raf Sciot, Philip Demaerel, Bert Bammens
Cladophialophora bantiana is a neurotropic dematiaceous fungus which rarely causes disseminated disease. We report a case of proven C. bantiana osteomyelitis in a renal transplant recipient, complicated with probable cerebral disease. Stable disease was reached after combined antifungal therapies, immune enhancement and amputation of the infected lower limb.
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Reflux and Voice Disorders: Have We Established Causality?
Abstract
Purpose of Review
A trend of attributing abnormal voice changes to reflux has gained momentum among medical professionals over the last few decades. Evidence supporting the connection between reflux and voice and the use of anti-reflux medication in patients with dysphonia is conflicting and deserves careful examination. In the current health care environment, it is important that medical decisions be based on science rather than anecdote and practice patterns. The goal of this review is to investigate the evidence linking reflux and voice changes. Specifically, this association will be examined in the context of the Bradford Hill criteria to determine what evidence exists for a causal relationship between this exposure (reflux) and outcome (voice change).
Summary
Using the Bradford Hill criteria as a rubric, the evidence toward causality between reflux and voice is insufficient. The most compelling data derived from animal studies show biological plausibility, since an acidic environment does induce mucosal changes. However, evidence from human studies is largely associative. To date, neither clinical trials nor comparative observational studies have been able to demonstrate a strong dose–response relationship between reflux and voice disorders, temporality (reflux precedes dysphonia), consistent treatment effects, or strength of association between anti-reflux treatment and improved voice among patients with presumed laryngopharyngeal reflux (LPR). Nonetheless, a relationship does exist between LPR and voice and it deserves careful consideration. However, the strength and nature of that association remain unclear.
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Temporal dynamics of brain activation during 40 minutes of pleasant touch
Publication date: 1 October 2016
Source:NeuroImage, Volume 139
Author(s): Uta Sailer, Chantal Triscoli, Gisela Häggblad, Paul Hamilton, Håkan Olausson, Ilona Croy
IntroductionTouch is important for individuals' subjective well-being, is typically rewarding, and is one of few sensory stimuli which are experienced as pleasant for a rather long time. This study tracked brain activation during slow stroking stimulation of the arm that was applied continuously for 40min - a much longer time than what previous studies have investigated.Methods25 subjects were stroked for 40min with a soft brush while they were scanned with functional Magnetic Resonance Imaging, and rated the perceived pleasantness of the brush stroking. Two resting baselines were included. Whole brain-based analyses investigated the neural response to long-lasting stroking.ResultsStroking was perceived as pleasant throughout scanning and activated areas that were previously found to be involved in the processing of pleasant touch. Activation in primary somatosensory cortex (S1) and S2, subdivision OP1, decreased over time, whereas activation in orbito-frontal gyrus (OFC) and putamen strongly increased until reaching a plateau after approximately 20min. Similarly, functional connectivity of posterior insula with middle cingulate and striatal regions increased over time.DiscussionLong-lasting stroking was processed in similar areas as shorter-lasting stroking. The decreased activation in somatosensory cortices over time may represent stimulus habituation, whereas increased activation in OFC and putamen may relate to the stimulation's subjective reward value. This involvement of reward-related brain circuits can facilitate maintenance of long-lasting social touch interactions.
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fMRI mapping of the visual system in the mouse brain with interleaved snapshot GE-EPI
Publication date: 1 October 2016
Source:NeuroImage, Volume 139
Author(s): Arun Niranjan, Isabel N. Christie, Samuel G. Solomon, Jack A. Wells, Mark F. Lythgoe
The use of functional magnetic resonance imaging (fMRI) in mice is increasingly prevalent, providing a means to non-invasively characterise functional abnormalities associated with genetic models of human diseases. The predominant stimulus used in task-based fMRI in the mouse is electrical stimulation of the paw. Task-based fMRI in mice using visual stimuli remains underexplored, despite visual stimuli being common in human fMRI studies. In this study, we map the mouse brain visual system with BOLD measurements at 9.4T using flashing light stimuli with medetomidine anaesthesia. BOLD responses were observed in the lateral geniculate nucleus, the superior colliculus and the primary visual area of the cortex, and were modulated by the flashing frequency, diffuse vs focussed light and stimulus context. Negative BOLD responses were measured in the visual cortex at 10Hz flashing frequency; but turned positive below 5Hz. In addition, the use of interleaved snapshot GE-EPI improved fMRI image quality without diminishing the temporal contrast-noise-ratio. Taken together, this work demonstrates a novel methodological protocol in which the mouse brain visual system can be non-invasively investigated using BOLD fMRI.
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A multi-time-point modality-agnostic patch-based method for lesion filling in multiple sclerosis
Publication date: 1 October 2016
Source:NeuroImage, Volume 139
Author(s): Ferran Prados, Manuel Jorge Cardoso, Baris Kanber, Olga Ciccarelli, Raju Kapoor, Claudia A.M. Gandini Wheeler-Kingshott, Sebastien Ourselin
Multiple sclerosis lesions influence the process of image analysis, leading to tissue segmentation problems and biased morphometric estimates. Existing techniques try to reduce this bias by filling all lesions as normal-appearing white matter on T1-weighted images, considering each time-point separately. However, due to lesion segmentation errors and the presence of structures adjacent to the lesions, such as the ventricles and deep grey matter nuclei, filling all lesions with white matter-like intensities introduces errors and artefacts. In this paper, we present a novel lesion filling strategy inspired by in-painting techniques used in computer graphics applications for image completion. The proposed technique uses a five-dimensional (5D), patch-based (multi-modality and multi-time-point), Non-Local Means algorithm that fills lesions with the most plausible texture. We demonstrate that this strategy introduces less bias, fewer artefacts and spurious edges than the current, publicly available techniques. The proposed method is modality-agnostic and can be applied to multiple time-points simultaneously. In addition, it preserves anatomical structures and signal-to-noise characteristics even when the lesions are neighbouring grey matter or cerebrospinal fluid, and avoids excess of blurring or rasterisation due to the choice of the segmentation plane, shape of the lesions, and their size and/or location.
Graphical abstract
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Multi-compartment microscopic diffusion imaging
Publication date: 1 October 2016
Source:NeuroImage, Volume 139
Author(s): Enrico Kaden, Nathaniel D. Kelm, Robert P. Carson, Mark D. Does, Daniel C. Alexander
This paper introduces a multi-compartment model for microscopic diffusion anisotropy imaging. The aim is to estimate microscopic features specific to the intra- and extra-neurite compartments in nervous tissue unconfounded by the effects of fibre crossings and orientation dispersion, which are ubiquitous in the brain. The proposed MRI method is based on the Spherical Mean Technique (SMT), which factors out the neurite orientation distribution and thus provides direct estimates of the microscopic tissue structure. This technique can be immediately used in the clinic for the assessment of various neurological conditions, as it requires only a widely available off-the-shelf sequence with two b-shells and high-angular gradient resolution achievable within clinically feasible scan times. To demonstrate the developed method, we use high-quality diffusion data acquired with a bespoke scanner system from the Human Connectome Project. This study establishes the normative values of the new biomarkers for a large cohort of healthy young adults, which may then support clinical diagnostics in patients. Moreover, we show that the microscopic diffusion indices offer direct sensitivity to pathological tissue alterations, exemplified in a preclinical animal model of Tuberous Sclerosis Complex (TSC), a genetic multi-organ disorder which impacts brain microstructure and hence may lead to neurological manifestations such as autism, epilepsy and developmental delay.
Graphical abstract
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The imitation game: Effects of social cues on ‘imitation’ are domain-general in nature
Source:NeuroImage, Volume 139
Author(s): Lauren E. Marsh, Geoffrey Bird, Caroline Catmur
Imitation has been hailed as 'social glue', facilitating rapport with others. Previous studies suggest that social cues modulate imitation but the mechanism of such modulation remains underspecified. Here we examine the locus, specificity, and neural basis of the social control of imitation. Social cues (group membership and eye gaze) were manipulated during an imitation task in which imitative and spatial compatibility could be measured independently. Participants were faster to perform compatible compared to incompatible movements in both spatial and imitative domains. However, only spatial compatibility was modulated by social cues: an interaction between group membership and eye gaze revealed more spatial compatibility for ingroup members with direct gaze and outgroup members with averted gaze. The fMRI data were consistent with this finding. Regions associated with the control of imitative responding (temporoparietal junction, inferior frontal gyrus) were more active during imitatively incompatible compared to imitatively compatible trials. However, this activity was not modulated by social cues. On the contrary, an interaction between group, gaze and spatial compatibility was found in the dorsolateral prefrontal cortex in a pattern consistent with reaction times. This region may be exerting control over the motor system to modulate response inhibition.
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Marking clips for tumour-bed localization as a cause of chronic sinus formation and pain after breast conservation surgery for cancer: A case series of 4 patients
The Association of Breast Surgeons recommends the intra-operative placement of six paired surgical vessel ligation clips to allow accurate tumour bed localization during breast conserving surgery (BCS) to facilitate delivery of adjuvant radiotherapy. Little has been published regarding wound complications secondary to foreign-body reaction to titanium clips used for this purpose. We describe a series of four patients who developed delayed chronic wound complications following BCS, including non-healing ulcers, sinus formation and chronic pain.
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Hand Trauma: A prospective observational study reporting diagnostic concordance in emergency hand trauma which supports centralised service improvements
Hand injuries are common, contributing up to 30% of accident and emergency (A&E) attendances. The aim of this study was to prospectively analyse the pathological demographic of hand injuries, and compare clinical with intra-operative findings, in a level 1 trauma centre Hand Trauma Unit with direct A&E links. The null hypothesis was that no differences would be demonstrated between clinical and intra-operative findings (100% diagnostic concordance).
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Fusion Lymphoplasty for Diameter Approximation in Lymphatic Supermicrosurgery using Two Lymphatic Vessels for a Larger Recipient Vein
Lymphovenous shunt operations are used to treat compression-refractory progressive lymphedema. Among them, supermicrosurgical lymphaticovenular anastomosis (LVA), or lymphatic supermicrosurgery, is becoming popular with its effectiveness and minimal invasiveness.1,2 It is important to find a lymphatic vessel with abundant lymph flow and a nearby vein with diameter similar to the lymphatic vessel.2,3 Although detection of lymphatic vessels suitable for LVA is assisted with the use of indocyanine green lymphography navigation, it is sometimes difficult to find a size-matched recipient vein near the lymphatic vessel.
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“Flap on Flap” – A technique to cover the exposed pedicle of free muscle flaps
We read the article by Meyer et al. titled ''Results of combined vascular reconstruction by means of AV-Loops and free flap transfer in patients with soft tissue defects'' with great interest1. We congratulate the authors for adding sound scientific evidence supporting the use of vein loops in microvascular reconstruction. In our unit, we use AV loops in the reconstruction of post-traumatic limb defects when the length of the flap pedicle falls short. In certain situations, the AV loop itself stays exposed or gets compressed.
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“A picture says a thousand words” – Novel teaching model for interdigitating flaps in syndactyly
Syndactyly is a congenital deformity of the hand resulting in the fusion of two or more digits. The most common surgically corrective techniques use interdigitating ulnar and radially based Z-flaps. Such interdigitating flaps can be challenging to convey to patient, parent and junior surgeon alike. The authors propose a simple and educationally effective method of demonstrating such flaps in syndactyly, utilising a single 10 x 10cm sheet of DuoDERM (ConvaTec). This method allows three dimensional demonstration of the flaps, can be easily cut with scissors, mobilised and will then adhere into place with appearances and handling properties similar to skin.
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Forehead flap with contralateral eyelids and canthal transposition in periorbital reconstruction
Wide excision for malignant skin tumor in the periorbital area can become the more demanding reconstruction procedure since tumor resection may result in combined medial canthal and eyelids defects, destruction of the lacrimal ducts and even deep defects with orbital extension. Traditional methods for reconstruction include skin grafts, local and distant flaps and free flaps, which option having its pros and cons.1 The forehead flap has been used extensively in nasal and periocular reconstruction mainly because the proximity of the flap, the easy arc of rotation, and the rich blood supply.
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Outcome in patient-specific PEEK cranioplasty: A two-center cohort study of 40 implants
The best material choice for cranioplasty following craniectomy remains subject to discussion. Complication rates after cranioplasty tend to be high. Computer-assisted 3-dimensional modeling of polyetheretherketone (PEEK) was recently introduced for cranial reconstruction. The aim of this study was to evaluate patient- and surgery-related characteristics and risk factors that predispose patients to cranioplasty complications.
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The effect of low hemoglobin levels on outcomes of radiotherapy following microscopically complete resection of locally advanced SCCHN: implications for the future
This study investigated the prognostic implications of pre-radiotherapy hemoglobin levels after microscopically complete (R0) resection of locally advanced squamous cell carcinoma of the head-and-neck (SCCHN) and reviewed the question "should anemia be corrected?". A total of 225 patients receiving R0-resection and postoperative irradiation were retrospectively evaluated. Pre-radiotherapy hemoglobin levels (<12 vs. ≥12 g/dl) plus eight factors (T-/N-category, AJCC-stage, performance score, gender, age, tumor site, histologic grading) were analyzed for locoregional control and survival.
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Simultaneous Maxillo-mandibular Distraction in Early Adolescence as a Single Treatment Modality for Durable Correction of Type II Unilateral Hemifacial Microsomia: Follow-up Till Completion of Growth
Timing of surgical intervention in hemifacial microsomia (HFM) is controversial. Although mandibular osteodistraction in childhood for HFM is popular, recent data for single-stage distraction in growing HFM patients demonstrated long-term relapse. Literature suggests that adolescents in the late mixed dentition age or permanent dentition age (11 to 16-year-old) had more stable outcomes post-distraction than younger children. We present favorable experience using single-treatment simultaneous maxillo-mandibular distraction in early adolescent Pruzansky-Kaban type II HFM patients.
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Spontaneity of smile after facial paralysis rehabilitation when using a non-facial donor nerve
The current focus in dynamic reanimation of facial paralysis lies not only in restoring movement but also regaining smile spontaneity. It has been argued that a spontaneous smile can only be achieved using the contralateral facial nerve as donor via cross-face nerve grafting. Techniques based on the motor nerve to the masseter, however, have shown good rates of spontaneity as well.
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Biopathological Significance of TLR9 Expression in Cancer Cells and Tumor Microenvironment Across Invasive Breast Carcinomas Subtypes
Abstract
Toll-like receptors (TLRs) are pattern recognition receptors mainly expressed by cells of the immune system but also by epithelial tumor cells. Little is known about expression patterns of TLR genes in breast tumors, and their clinical significance is unclear. The aim of our study was to investigate expression of TLRs pathway components in pre-invasive breast lesions and invasive breast carcinomas (IBCs). We used RT-PCR assays to quantify mRNA levels of the 10 TLR genes and genes involved in TLR pathways in 350 breast tumors from patients with known clinical/pathological status and long-term outcome. Sets of 158 breast samples were also analyzed by immunochemistry including; 40 early noninvasive breast lesions, 38 IBCs and 80 triple negative carcinomas subtype (TNCs). We identified TLR9 as the major TLR gene family member upregulated in breast tumors and more particularly in TNCs. Immunohistochemical studies demonstrated that TLR9 protein was expressed in tumor epithelial and stromal cells of the TLR9 mRNA-overexpressing tumors. TLR9 overexpression appears very early during breast carcinogenesis. High TLR9 levels were associated with favorable outcome in the TNC sub-group. TLR9 overexpression was associated with alterations of down-stream components of the TLR9 signaling pathway, epithelio-mesenchymal transition (EMT) induction and EGFR pathway deregulation. TNCs with TLR9 overexpression were significantly correlated with development of a fibrous and inflammatory microenvironment with variable status of nuclear phosphoSTAT3. Our results suggest that TLR9 could play a role in TNC carcinogenesis and could be useful as predictive biomarker and therapeutic target.
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In memoriam: Professor Irena Hausmanowa-Petrusewicz (1917–2015)
Professor Irena Hausmanowa-Petrusewicz, one of the most distinguished Polish neurologists, a leader in the field of neuromuscular diseases and electromyography whose contribution was well recognized in international neurological society, passed away on July 7th, 2015.
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Impact of Cognition on Burn Inpatient Rehabilitation Outcomes
A significant proportion of burn injury patients are admitted to inpatient rehabilitation facilities (IRFs). There is increasing interest in the use of functional variables, such as cognition, in predicting IRF outcomes. Cognitive impairment is an important cause of disability in the burn injury population, yet its relationship to IRF outcomes has not been studied.
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Comparing the Course of Mental Health over the First Year after Stroke with Healthy Controls in Colombia, South America
Stroke is a primary cause of death and disability in upper-middle income countries such as Colombia. Given the lack of comprehensive rehabilitation for stroke patients in Colombia, there is a need to assess longitudinal mental health problems post-stroke in this region.
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Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis
Abstract
Aim
The aim of this systematic review and meta-analysis was to compare, in the lower third molar surgery, the osteotomy techniques with rotary instruments and piezoelectric motors.
Methods
An electronic search was conducted using the following databases: Pubmed, Web of Science, and the Cochrane Oral Health Group Trials Register. Inclusion criteria were: studies in humans, randomized or nonrandomized, comparing the extraction of third molars that required osteotomy and/or odontosection with rotary instrument and osteotomy and/or odontosection with piezoelectric motor assistance. The analysis and inclusion of articles was performed by two reviewers independently. An evaluation of the quality of articles and data extraction was carried out.
Results
From a total of nine hundred seventy four (974) trials, eleven articles were included in the qualitative analysis, and seven were included in the quantitative analysis. Rotary instruments were faster than the piezoelectric surgery (95 % CI 0.34 to 1.16). The piezoelectric surgery showed better results when compared with roatry instruments when trismus was assessed in 2 (95 % CI 0.65 to 1.69), 3 (95 % CI 0.63 to 1.67) and 5 (95 % CI 0.03 to 2.26) days after surgery. Seven days after surgery, there were no differences between the techniques (95 % CI (−0.022) to (−1.49)).
Conclusion
The piezoelectric surgery was effective in reducing pain, swelling and trismus in third molar surgery, but the same requires greater surgical time than the rotary instruments.
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Tooth Ache to Leprosy! Importance of Revisiting Diagnosis
Abstract
Atypical facial pain can be dreadful for the patient, and treating it can be an arduous task for the clinician, unless the diagnosis is constantly revisited.
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Diclofenac Transdermal Patch: A Potential Ingress to Maxillofacial Surgery
Abstract
Purpose
To evaluate the analgesic efficacy of a diclofenac transdermal patch with diclofenac intra muscular injection in the immediate postoperative period in patients undergoing major oral surgical procedures.
Materials and Methods
Subjects who underwent bijaw surgeries for surgical correction of various dentofacial deformities were included. Sixty such patients who belonged to the above entity were randomly categorized into two groups from Jan 2012–Aug 2015. Group A (study group) received a single dose of 100 mg transdermal diclofenac patch, Group B (control group) received 75 mg intramuscular diclofenac and tramadol HCl 2 mg/kg body wt was used as rescue analgesic in the immediate post operative phase. The analgesic efficacy of the drugs are evaluated on periodic patient's perception of pain in the immediate postoperative phase of 2nd, 6th, 12th, 24th and 48 hours.
Results
The mean VAS score in Group A was 2, mean duration of analgesia was 16 h 9 min, and in Group B the mean VAS score was 4, duration of analgesia was 8 h and 4 min. Tramadol HCl was given as rescue analgesia in 22 % (6) of patients belonging to Group A. None of the patients from both the groups reported local complications.
Conclusion
A noninvasive application of a single dose of 100 mg transdermal diclofenac patch is more effective than intramuscular diclofenac (75 mg) in the immediate post operative phase, without any significant side-effects is a novel ingress into the field of oral and maxillofacial surgery for post operative pain management.
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IgE-dependent mechanism and successful desensitization of erythritol allergy
Erythritol, a 4-carbon sugar alcohol, is widely used as a food and drug additive because of its chemical inertness, sweetness, and nontoxic nature. It is also contained in natural foods, such as fruits and mushrooms, and fermented foods, such as soy sauce.1 We previously described a female patient who experienced many episodes of anaphylaxis; she was diagnosed as having an erythritol allergy using a skin prick test, basophil activation test (BAT) using the CD203c expression, and oral food challenge (OFC).
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Patient reported quality of life after helical IMRT based concurrent chemoradiation of locally advanced anal cancer
Concurrent chemoradiation (CCRT) is the standard treatment for locally advanced anal canal carcinoma, although treatment-related side effects can affect patient quality of life (QOL). The purpose was to prospectively evaluate the effects of Tomotherapy (HT) based CCRT on patient reported QOL in locally advanced anal cancer.
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Estimating the probability of underdosing microscopic brain metastases with hippocampal-sparing whole-brain radiation
Whole-brain radiation for brain metastases can result in cognitive side effects. Hippocampal-sparing techniques have been developed to decrease morbidity, but they carry the risk of underdosing lesions near the hippocampus due to the unavoidable dose gradient from the hippocampal surface to the prescription isodose surface. This study examines the impact of variable levels of hippocampal sparing on the underdosing of potential brain metastases.
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PrPc deficiency and dasatinib protect mouse intestines against radiation injury by inhibiting of c-Src
Despite extensive study of the contribution of cell death and apoptosis to radiation-induced acute intestinal injury, our knowledge of the signaling mechanisms involved in epithelial barrier dysfunction remains inadequate. Because PrPc plays a key role in intestinal homeostasis by renewing epithelia, we sought to study its role in epithelial barrier function after irradiation.
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Analysis of Brain Mitochondria Using Serial Block-Face Scanning Electron Microscopy
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Does One Size Fit All? Nosological, Clinical, and Scientific Implications of Variations in PTSD Criterion A
Source:Journal of Anxiety Disorders
Author(s): Jacob Y. Stein, Dayna V. Wilmot, Zahava Solomon
Posttraumatic stress disorder (PTSD) is a psychiatric pathology wherein the precipitating traumatic event is essential for diagnostic eligibility (Criterion A). This link is substantiated throughout PTSD's development as a diagnosis. However, while traumatic events may vary considerably, this variation currently bears nearly no implications for psychiatric nosology. Consequently, PTSD remains a semi-unified diagnostic construct, consisting of no Criterion-A-determined subtypes of adult PTSD. The question addressed by the current paper is then does one size truly fit all? Making an argument for the negative, the paper briefly reviews complex PTSD (CPTSD), ongoing traumatic stress response (OTSR), and cumulative traumas, all of which are exemplars wherein Criterion A specification is crucial for understanding the emerging symptomatology and for devising appropriate interventions. Indicating several overlooked discrepancies in the PTSD literature, the paper urges for the necessity of a more fine-grained differential diagnostic subtyping of PTSD, wherein posttraumatic reactions are more closely associated with their precipitating traumatic events. The paper concludes by suggesting diagnostic, clinical and societal implications, as well as proposing directions for future research.
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Fear-relevant illusory correlations in different fears and anxiety disorders: a review of the literature
Source:Journal of Anxiety Disorders
Author(s): Julian Wiemer, Paul Pauli
Fearful individuals often overestimate the relationship between fear-relevant stimuli and aversive consequences. Such fear-relevant illusory correlations (ICs)1 might be involved in the maintenance of anxiety disorders. In this literature review, we found clear evidence that ICs are present and enhanced in fear of animals. We also revealed some evidence for ICs related to fear of flying, social anxiety, contamination fear, panic disorder, and post-traumatic stress disorder, but with considerably less clarity. Fear-relevant ICs seem to be best explained by both a priori expectancies and biased encoding of the experienced associations. Studies to date suggest that one important biased encoding process is the enhanced aversiveness/salience of fear-relevant outcomes. Future studies may improve insight by developing more reliable IC measures and testing the effect of encoding processes on treatment outcomes.
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Improvements in Emotion Regulation Following Repetitive Transcranial Magnetic Stimulation for Generalized Anxiety Disorder
Source:Journal of Anxiety Disorders
Author(s): Gretchen J. Diefenbach, Michal Assaf, John W. Goethe, Ralitza Gueorguieva, David F. Tolin
Generalized anxiety disorder (GAD) is characterized by emotion regulation difficulties, which are associated with abnormalities in neural circuits encompassing fronto-limbic regions including the dorsolateral prefrontal cortex (DLPFC). The aim of this study was to determine whether DLPFC neuromodulation improves emotion regulation in patients with GAD. This is a secondary analysis from a randomized-controlled trial comparing 30 sessions of low-frequency right-sided active (n=13) versus sham (n=12, sham coil) repetitive transcranial magnetic stimulation (rTMS) at the right DLPFC in patients with GAD. Results indicated statistically significant improvements in self-reported emotion regulation difficulties at posttreatment and 3-month follow-up in the active group only. Improvements were found primarily in the domains of goal-directed behaviors and impulse control and were significantly associated with a global clinician rating of improvement. These preliminary results support rTMS as a treatment for GAD and suggest improved emotion regulation as a possible mechanism of change.
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Alcohol misuse in emerging adulthood: Association of dopamine and serotonin receptor genes with impulsivity-related cognition
Source:Addictive Behaviors, Volume 63
Author(s): Talia E. Leamy, Jason P. Connor, Joanne Voisey, Ross McD. Young, Matthew J. Gullo
Impulsivity predicts alcohol misuse and risk for alcohol use disorder. Cognition mediates much of this association. Genes also account for a large amount of variance in alcohol misuse, with dopamine and serotonin receptor genes of particular interest, because of their role in motivated behavior. The precise psychological mechanisms through which such genes confer risk is unclear. Trait impulsivity conveys risk for alcohol misuse by influencing two distinct domains of cognition: beliefs about the reinforcing effects of alcohol consumption (positive alcohol expectancy) and the perceived ability to resist it (drinking refusal self-efficacy). This study investigated the effect of the dopamine-related polymorphism in the DRD2/ANKK1 gene (rs1800497) and a serotonin-related polymorphism in the HTR2A gene (rs6313) on associations between impulsivity, cognition, and alcohol misuse in 120 emerging adults (18–21years). HTR2A predicted lower positive alcohol expectancy, higher refusal self-efficacy, and lower alcohol misuse. However, neither polymorphism moderated the linkages between impulsivity, cognition, and alcohol misuse. This is the first report of an association between HTR2A and alcohol-related cognition. Theoretically-driven biopsychosocial models have potential to elucidate the specific cognitive mechanisms through which distal risk factors like genes and temperament affect alcohol misuse in emerging adulthood.
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Discovery of antifungal constituents from the Miao medicinal plant Isodon flavidus
Publication date: 15 September 2016
Source:Journal of Ethnopharmacology, Volume 191
Author(s): Ji-Xin Li, Qi-Ji Li, Yi-Fu Guan, Xun Song, Ya-Hua Liu, Jing-Jie Zhang, Wan-Fei Li, Jiang Du, Min Zhu, Jeffrey A. Banas, Xiao-Nian Li, Lu-Tai Pan, Hong-Jie Zhang
Ethnopharmacological relevanceLeigong Mountain is an area in the Southwest of China where there is a high incidence rate of athlete's foot, but the Miao people, a Chinese minority who reside in this mountainous area have suffered less from this disease due to their use of the herbal medicine Isodon flavidus (Hand.-Mazz.) H. Hara.Aim of the studyThe present study is to identify the active chemical constituents responsible for antifungal effects of the folk medicine plant.Materials and methodsThe natural compounds were separated from the methanol extract of the twigs and leaves of I. flavidus by phytochemical study using chromatographic methods, and their chemical structures were determined by analysis of the spectroscopic data including 1D and 2D NMR spectra. The absolute configuration of fladin A (1) was further confirmed by X-ray crystallographic analysis. The compounds were evaluated for their antifungal activity against the athlete's foot fungus Trichophyton rubrum. They were further evaluated for their antimicrobial and anti-biofilm activity against the dental pathogens Streptococcus mutans, Porphyromonas gingivalis and Candida albicans.ResultsPhytochemical and biological studies of I. flavidus led to the discovery of two antifungal compounds, fladin A (1) and lophanic acid (2). Fladin A (1) is a novel diterpene with an unprecedented cyclic ether group formed between C-4 and C-9. Lophanic acid (2) displayed inhibition activity against the athlete's foot fungus Trichophyton rubrum with an MIC value of 7.8μg/mL, and fladin A (1) also showed inhibition activity against the fungus with a MIC value of 62.5μg/mL.ConclusionsOur identification of two antifungal compounds provided strong evidence for the Miao people to use I. flavidus as a medicinal plant for treatment of athlete's foot disease. The very different chemical structures of the active compounds from those in the market presents them as potential antifungal lead compounds for follow-up study.
Graphical abstract
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Microbubble assisted polyhydroxybutyrate production in Escherichia coli
One of the potential limitations of large scale aerobic Escherichia coli fermentation is the need for increased dissolved oxygen for culture growth and bioproduct generation. As culture density increases the poor...
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A Method to Quantify Visual Information Processing in Children Using Eye Tracking
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HSV-Mediated Transgene Expression of Chimeric Constructs to Study Behavioral Function of GPCR Heteromers in Mice
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Inter-comparison of model-simulated and satellite-retrieved componential aerosol optical depths in China
Publication date: September 2016
Source:Atmospheric Environment, Volume 141
Author(s): Shenshen Li, Chao Yu, Liangfu Chen, Jinhua Tao, Husi Letu, Wei Ge, Yidan Si, Yang Liu
China's large aerosol emissions have major impacts on global climate change as well as regional air pollution and its associated disease burdens. A detailed understanding of the spatiotemporal patterns of aerosol components is necessary for the calculation of aerosol radiative forcing and the development of effective emission control policy. Model-simulated and satellite-retrieved aerosol components can support climate change research, PM2.5 source appointment and epidemiological studies. This study evaluated the total and componential aerosol optical depth (AOD) from the GEOS-Chem model (GC) and the Global Ozone Chemistry Aerosol Radiation and Transport model (GOCART), and the Multiangle Imaging Spectroradiometer (MISR) from 2006 to 2009 in China. Linear regression analysis between the GC and AErosol RObotic NETwork (AERONET) in China yielded similar correlation coefficients (0.6 daily, 0.71 monthly) but lower slopes (0.41 daily, 0.58 monthly) compared with those in the U.S. This difference was attributed to GC's underestimation of water-soluble AOD (WAOD) west of the Heihe-Tengchong Line, the dust AOD (DAOD) in the fall and winter, and the soot AOD (SAOD) throughout the year and throughout the country. GOCART exhibits the strongest dust estimation capability among all datasets. However, the GOCART soot distribution in the Northeast and Southeast has significant errors, and its WAOD in the polluted North China Plain (NCP) and the South is underestimated. MISR significantly overestimates the water-soluble aerosol levels in the West, and does not capture the high dust loadings in all seasons and regions, and the SAOD in the NCP. These discrepancies can mainly be attributed to the uncertainties in the emission inventories of both models, the poor performance of GC under China's high aerosol loading conditions, the omission of certain aerosol tracers in GOCART, and the tendency of MISR to misidentify dust and non-dust mixtures.
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Development and application of a high resolution hybrid modelling system for the evaluation of urban air quality
Source:Atmospheric Environment, Volume 141
Author(s): N. Pepe, G. Pirovano, G. Lonati, A. Balzarini, A. Toppetti, G.M. Riva, M. Bedogni
A hybrid modelling system (HMS) was developed to provide hourly concentrations at the urban local scale. The system is based on the combination of a meteorological model (WRF), a chemical and transport eulerian model (CAMx), which computes concentration levels over the regional domains, and a lagrangian dispersion model (AUSTAL2000), accounting for dispersion phenomena within the urban area due to local emission sources; a source apportionment algorithm is also included in the HMS in order to avoid the double counting of local emissions.The HMS was applied over a set of nested domains, the innermost covering a 1.6 × 1.6 km2 area in Milan city center with 20 m grid resolution, for NOX simulation in 2010. For this paper the innermost domain was defined as "local", excluding usual definition of urban areas. WRF model captured the overall evolution of the main meteorological features, except for some very stagnant situations, thus influencing the subsequent performance of regional scale model CAMx. Indeed, CAMx was able to reproduce the spatial and temporal evolution of NOX concentration over the regional domain, except a few episodes, when observed concentrations were higher than 100 ppb. The local scale model AUSTAL2000 provided high-resolution concentration fields that sensibly mirrored the road and traffic pattern in the urban domain. Therefore, the first important outcome of the work is that the application of the hybrid modelling system allowed a thorough and consistent description of urban air quality. This result represents a relevant starting point for future evaluation of pollution exposure within an urban context.However, the overall performance of the HMS did not provide remarkable improvements with respect to stand-alone CAMx at the two only monitoring sites in Milan city center. HMS results were characterized by a smaller average bias, that improved about 6–8 ppb corresponding to 12–13% of the observed concentration, but by a lower correlation, that worsened around 1–3% (e.g. from 0.84 to 0.81 at Senato site), due to the concentration peaks produced by AUSTAL2000 during nighttime stable conditions. Additionally, the HMS results showed that it was unable to correctly take into account some local scale features (e.g. urban canyon effects), pointing out that the emission spatialization and time modulation criteria, especially those from road traffic, need further improvement.Nevertheless, a second important outcome of the work is that some of the most relevant discrepancies between modelled and observed concentrations were not related to the horizontal resolution of the dispersion models but to larger scale meteorological features not captured by the meteorological model, especially during winter period. Finally, the estimated contribution of the local emission sources accounted on the annual average for about 25–30% of the computed concentration levels in the innermost urban domain. This confirmed that the whole Milan urban area as well as the outside background areas, accounting all sources outside the innermost domain, play a key role on air quality. The result suggests that strictly local emission policies could have a limited and indecisive effect on urban air quality, although this finding could be partially biased by model underestimation of the observed concentration.
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Characterization of fine and carbonaceous particles emissions from pelletized biomass-coal blends combustion: Implications on residential crop residue utilization in China
Source:Atmospheric Environment, Volume 141
Author(s): Yue Xu, Yan Wang, Yingjun Chen, Chongguo Tian, Yanli Feng, Jun Li, Gan Zhang
Bulk biofuel, biomass pellets and pelletized biomass-coal blends were combusted in a typical rural conventional household stove and a high-efficiency stove. Reductions in PM2.5, organic carbon (OC) and elemental carbon (EC) emissions were evaluated by comparing emission factors (EFs) among 19 combinations of biofuel/residential stove types measured using a dilution sampling system. In the low-efficiency stove, the average EFs of PM2.5, OC, and EC of biomass pellets were 2.64 ± 1.56, 0.42 ± 0.36, and 0.30 ± 0.11 g/kg, respectively, significantly lower than those burned in bulk form. EFPM2.5 and EFOC of pelletized biomass combustion in the high-efficiency stove were lower than those of the same biofuel burned in the low-efficiency stove. Furthermore, pelletized corn residue and coal blends burned in the high-efficiency stove could significantly decrease emissions. Compared with the bulk material burned in the low-efficiency stove, the reduction rates of PM2.5, OC and EC from pelletized blends in the high-efficiency stove can reach 84%, 96% and 93%, respectively. If the annually produced corn residues in 2010 had been blended with 10% anthracite coal powder and burnt as pellets, it would have reduced about 82% of PM2.5, 90–96% of OC and 81–92% of EC emission in comparison with burning raw materials in conventional household stoves. Given the low cost, high health benefit and reduction effect on atmospheric pollutants, pelletized blends could be a promising alternative to fossil fuel resources or traditional bulk biofuel.
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Spinal sagittal balance status affects postoperative actual falls and quality of life after decompression and fusion in-situ surgery in patients with lumbar spinal stenosis
Source:Clinical Neurology and Neurosurgery, Volume 148
Author(s): Byung Ho Lee, Jin-Oh Park, Hak-Sun Kim, Kyung-Soo Suk, Sang-Yoon Lee, Hwan-Mo Lee, Jae-Ho Yang, Seong-Hwan Moon
ObjectivesIt has been reported that good spinal sagittal alignment reduces the risk of fall and positive sagittal balance is the radiographic parameter that is most highly correlated with adverse health outcomes. However, no reports have demonstrated a change in risk of falling in patients with lumbar spinal stenosis (LSS) according to sagittal balance status.Patients and methodsFrom September 2013 to October 2014, 141 patients who underwent lumbar spine surgery, including decompression and fusion in-situ for LSS, were enrolled in this study. Based on sagittal balance status, patients were divided into sagittal balance (SB) and sagittal imbalance (SI) groups. Four functional mobility tests were used to evaluate the risk of falling, and a fall diary, Oswestry disability index (ODI), and the Euro-QoL 5D(EQ-5D) visual analogue scale (VAS) were utilized to assess clinical improvement.ResultsThe mean patient age was 70.1 years in the SB group (N=46) and 70.9 years in the SI group (N=95) (not significant). The mean C7PL was 7.9mm in the SB group and 66.1mm in the SI group preoperatively (p<0.05). Among the four functional tests, only postoperative SMT and STS improved significantly in the SB group (p<0.05). Patients in the SI group showed significantly improved scores for all four functional tests during postoperative follow-up (p<0.05), but their performance was still worse than patients in the SB group. Average number of falls per individual during the follow-up period was 1.1±2.5 in the SB group and 1.9±3.2 in the SI group (p<0.05). There was a significant difference in the distribution of non-fallers and fallers (single and multiple fallers) between the two groups postoperatively(p<0.05). ODI and the EQ-5D VAS showed greater improvement in the SB group than the SI group. Multiple regression analysis revealed that sagittal balance during follow-up significantly affected ODI, EQ-VAS, functional mobility tests. (p<0.05).ConclusionTherefore, when fusion surgery is planned in patients with LSS, careful consideration of sagittal balance status might be important to attain better surgical and functional outcomes and decrease the incidence of actual falls after surgical treatment.
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Focal epileptic seizures, electroencephalography and outcome of sepsis associated encephalopathy—A pilot study
Source:Clinical Neurology and Neurosurgery, Volume 148
Author(s): I.I. Berisavac, V.V Padjen, M.D. Ercegovac, Lj.G. Beslać-Bumbaširević, P.Dj. Stanarčević, M.S. Stefanović-Budimkić, M.M. Radović, D.R. Jovanović
ObjectivesSepsis associated encephalopathy (SAE) represents a diffuse and/or multifactorial cerebral dysfunction during response to systemic infection. Study aim was to compare clinical and electroencephalogram (EEG) characteristics and intrahospital survival rate among SAE patients.Patients and methodsA prospective study, during 42 months' period, included 39 SAE patients assigned in two groups according the outcome (survival: 19, and death: 20 patients). All the patients' features were registered: demography, neurological status, infection type, seizure appearance, brain computerized tomography (CT), EEG, EEG reactivity, Glasgow Coma Score (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE II) Score. The analysis included EEGs obtained during patients' consciousness change (improvement or deterioration) and the level of consciousness during and at the end of hospitalization.ResultsSAE was detected in 29.5% of patients with encephalopathy (2.8% of all patients hospitalized). Patients with lethal outcome were more likely to be female (p=0.0011), to have focal seizures (p=0.034), lower values of GCS during hospitalization (p<0.05) and longer lasting nosocomial infections (p=0.029). At the time of clinical exacerbation, patients were more likely to have suppression on EEG and less likely theta activity. Delta waves, TW waves and suppression of EEG activity were the most common findings 24h prior to death (p=0.0004). The lack of EEG reactivity was associated with death (p=0.00043).ConclusionPresence of focal seizures, EEG suppression at the time of exacerbation in SAE elderly patients, particularly women, with longer infection duration and lower values of GCS, is associated with intrahospital death.
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WORKING MEMORY OF EMOTIONAL STIMULI: ELECTROPHYSIOLOGICAL CHARACTERIZATION
Source:Biological Psychology
Author(s): Dominique Kessel, María J. García-Rubio, E. Kirstin González, Manuel Tapia, Sara López-Martín, Francisco J. Román, Almudena Capilla, Kenia Martínez, Roberto Colom, Luis Carretié
Memorizing emotional stimuli in a preferential way seems to be one of the adaptive strategies brought on by evolution for supporting survival. However, there is a lack of electrophysiological evidence on this bias in working memory. The present study analyzed the influence of emotion on the updating component of working memory. Behavioral and electrophysiological indices were measured from a 3-back task using negative, neutral, and positive faces. Electrophysiological data evidenced an emotional influence on the working memory sensitive P3 component, which presented larger amplitudes for negative matching faces compared to neutral ones. This effect originated in the superior parietal cortex, previously reported to be involved in N-back tasks. Additionally, P3 results showed a correlation with reaction times, where higher amplitudes were associated with faster responses for negative matching faces. These findings indicate that electrophysiological measures seem to be very suitable indices of the emotional influence on working memory.
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Views on clinical trial recruitment, biospecimen collection, and cancer research: population science from landscapes of the Haudenosaunee (People of the Longhouse)
Abstract
Biomedical research in culturally distinct communities is often a challenge. Potential barriers to participation occur because science is presented in a format that lacks cultural acknowledgement. Investigations may also fail to showcase beneficial relevance to the communities or include them in true partnership. The history of biomedical research within Native American societies has been complicated by these issues. Historical trauma among many Native groups sometimes transcends into contemporary challenges in both recruitment to and participation particularly in biobanking research. The participants for this study included members of the Haudenosaunee, the People of the Longhouse. Native Americans, including the Haudenosaunee, endure some of the worst health disparities in the country. These include high rates of cancer, obesity, and diabetes which may be linked at least partially to genetic predisposition. Results from a Haudenosaunee urban population shared response on ways to improve recruitment strategies for biospecimen, cancer, and other health-related clinical trials. Mixed methods approaches were used, and community responses indicated the importance of creating trust through respectful partnership; promoting culturally appropriate recruitment materials; the need for a greater understanding of consenting and signature processes; the necessity for concise summary sheets; and a desire to have information that community member understand. Discussion items also include international Indigenous perspectives to biobanking and genetic-related health disparity research.
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Evaluation of cytological radiation damage to lymphocytes after I-131 metaiodobenzylguanidine therapy by the cytokinesis-blocked micronucleus assay
Abstract
Objective
The purpose of this study was to evaluate the degree of cytological radiation damage to lymphocytes occurring after I-131 metaiodobenzylguanidine (MIBG) therapy as determined by the cytokinesis-blocked micronucleus assay. The chromosomal damage to lymphocytes induced by I-131 in vivo should result in augmentation of the number of cells with micronuclei.
Methods
We studied 15 patients with pheochromocytoma (14/15) or ganglioneuroma (1/15), who were treated initially with 7.4 GBq of I-131-MIBG. Isolated lymphocytes collected from patients 10 days after the therapy were harvested and treated according to the cytokinesis-blocked method of Fenech and Morley. Serial blood samples were obtained periodically only from two patients for 2 years after therapy. Micronucleus number of micronuclei per 500 binucleated cells was scored by visual inspection. As controls, lymphocytes from the same patients before the therapy were also studied. In an in vitro study, lymphocytes from eight normal volunteers were exposed to doses varying from 0.5 to 2 Gy and studied with the same method.
Results
The mean number (mean ± SD) of micronuclei after treatment was significantly increased (p < 0.001) as compared to control subjects (49.4 ± 8.2 vs. 11.3 ± 6.4). Internal radiation absorbed doses estimated for the 15 patients were 1.6 ± 0.3 Gy in this external irradiation study. The frequency of micronuclei post-administration of I-131-MIBG gradually decreased to near baseline (i.e., pre-therapy) levels by 2 years.
Conclusions
The relatively low frequency of lymphocyte micronuclei induced by I-131-MIBG in vivo and reversal of the increasing frequency of lymphocyte micronuclei after therapy suggest that the short-term non-stochastic damage induced by this therapy with 7.4 GBq of I-131-MIBG in pheochromocytoma or ganglioneuroma patients is limited and reversible.
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