Improving the care of individuals with schizophrenia and substance use disorders: consensus recommendations.
National attention continues to focus on the need to improve care for individuals with co-occurring mental illnesses and substance use disorders, as emphasized in the 2003 President's New Freedom Commission Report on Mental Health and recent publications from the Substance Abuse and Mental Health Services Administration (SAMHSA). These reports document the need for best practice recommendations that can be translated into routine clinical care. Although efforts are underway to synthesize literature in this area, few focused recommendations are available that include expert opinion and evidence-based findings on the management of specific co-occurring disorders, such as schizophrenia and addiction. In response to the need for user-friendly recommendations on the treatment of schizophrenia and addiction, a consensus conference of experts from academic institutions and state mental health systems was organized to 1) frame the problem from clinical and systems-level perspectives; 2) identify effective and problematic psychosocial, pharmacological, and systems practices; and 3) develop a summary publication with recommendations for improving current practice. The results of the consensus meeting served as the foundation for this publication, which presents a broad set of recommendations for clinicians who treat individuals with schizophrenia. "Integrated treatment" is the new standard for evidence-based treatment for this population and recommendations are given to help clinicians implement such integrated treatment. Specific recommendations are provided concerning screening for substance use disorders in patients with schizophrenia, assessing motivation for change, managing medical conditions that commonly occur in patients with dual diagnoses (e.g., cardiovascular disease, liver complications, lung cancer, HIV, and hepatitis B or C infections) and selecting the most appropriate medications for such patients to maximize safety and minimize drug interactions, use of evidence-based psychosocial interventions for patients with dual diagnoses (e.g., Dual Recovery Therapy, modified cognitive-behavioral therapy, modified motivational enhancement therapy, and the Substance Abuse Management Module), and key pharmacotherapy principles for treating schizophrenia, substance use disorders, and comorbid anxiety, depression, and sleep problems in this population. Finally the article reviews programmatic and systemic changes needed to overcome treatment barriers and promote the best outcomes for this patient population. An algorithm summarizing the consensus recommendations is provided in an appendix.


Applying the silkworm model for the search of immunosuppressants.
Various stresses (high temperature, starvation, or sublethal Cryptococcal infection) increased the susceptibility of silkworms to bacterial infection by up to 100-fold, confirming the stress-induced immunosuppression reported in a range of species. When the silkworm was injected with a steroidal drug, betamethasone (1 mg/larva), the susceptibility of the silkworm to bacterial infection increased about 100-fold. This indicates that the immune function of the silkworm can be suppressed by a known compound that shows immunosuppressive effects in humans. We further tested the immunosuppressive effect of the culture supernatants (acetone extracts) of soil bacteria, and 24 out of 193 isolates showed the immunosuppressive activity. These results suggest that it is possible to search for immunosuppressive agents targeting innate immunity by using a silkworm bacterial infection model as a screening system, and that there may be candidate compounds for immunosuppressive agents among the substances produced by soil bacteria.


[Effects of a training of power and balance on the use of mechanical restraint among in-patients with dementia].
Patients with dementia are most frequently affected by mechanical restraint in psychiatric hospitals, most frequently due to falls. There is evidence for beneficial effects of a training of power and balance on the frequency of falls in residential homes. An adapted training of power and balance was developed by specialists of training in sports. In 2007, 159 patients with dementia were trained. The frequency and duration of mechanical restraint was compared with a control group of a different hospital (n = 217) and the patients treated in the year before (n = 164). The percentage of patients with mechanical restraint and the mean duration of restraint per admission were significantly lower than in the control group. However, only a non-significant reduction could be achieved in comparison with the patients treated in the year before without an increase of falls. A considerable reduction of the use of mechanical restraint in patients with dementia is feasible. An unequivocal association with the training could not be confirmed due to other influencing factors.


The relationship history calendar: improving the scope and quality of data on youth sexual behavior.
Most survey data on sexual activities are obtained via face-to-face interviews, which are prone to misreporting of socially unacceptable behaviors. Demographers have developed various private response methods to minimize social desirability bias and improve the quality of reporting; however, these methods often limit the complexity of information collected. We designed a life history calendar-the Relationship History Calendar (RHC)-to increase the scope of data collected on sexual relationships and behavior while enhancing their quality. The RHC records detailed, 10-year retrospective information on sexual relationship histories. The structure and interview procedure draw on qualitative techniques, which could reduce social desirability bias. We compare the quality of data collected with the RHC with a standard face-to-face survey instrument through a field experiment conducted among 1,275 youth in Kisumu, Kenya. The results suggest that the RHC reduces social desirability bias and improves reporting on multiple measures, including higher rates of abstinence among males and multiple recent sexual partnerships among females. The RHC fosters higher levels of rapport and respondent enjoyment, which appear to be the mechanisms through which social desirability bias is minimized. The RHC is an excellent alternative to private response methods and could potentially be adapted for large-scale surveys.


Kinect-based system for automated control of terrestrial insect biobots.
Centimeter scale mobile biobots offer unique advantages in uncertain environments. Our previous experimentation has demonstrated neural stimulation techniques in order to control the motion of Madagascar hissing cockroaches. These trials relied on stimulation by a human operator using a remote control. We have developed a Kinect-based system for computer operated automatic control of cockroaches. Using image processing techniques and a radio transmitter, this platform both detects the position of the roach biobot and sends stimulation commands to an implanted microcontroller-based receiver. The work presented here enables repeatable experimentation and allows precise quantification of the line following capabilities of the roach biobot. This system will help refine our model for the stimulation response of the insect and improve our ability to direct them in increasingly dynamic situations.


Reno-protective mechanisms of epoxyeicosatrienoic acids in cardiovascular disease.
Cardiovascular disease (CVD) is the leading cause of mortality worldwide, and it is well known that end-stage renal disease (ESRD) is a profound consequence of the progression of CVD. Present treatments only slow CVD progression to ESRD, and it is imperative that new therapeutic strategies are developed to prevent the incidence of ESRD. Because epoxyeicosatrienoic acids (EETs) have been shown to elicit reno-protective effects in hypertensive animal models, the current review will focus on addressing the reno-protective mechanisms of EETs in CVD. The cytochrome P-450 epoxygenase catalyzes the oxidation of arachidonic acid to EETs. EETs have been identified as endothelium-derived hyperpolarizing factors (EDHFs) with vasodilatory, anti-inflammatory, antihypertensive, and antiplatelet aggregation properties. EETs also have profound effects on vascular migration and proliferation and promote angiogenesis. The progression of CVD has been linked to decreased EETs levels, leading to the concept that EETs should be therapeutically targeted to prevent end-organ damage associated with CVD. However, EETs are quickly degraded by the enzyme soluble epoxide hydrolase (sEH) to their less active diols, dihydroxyeicosatrienoic acids (DHETs). As such, one way to increase EETs level is to inhibit their degradation to DHETs by using sEH inhibitors. Inhibition of sEH has been shown to effectively reduce blood pressure and organ damage in experimental models of CVD. Another approach to target EETs is to develop EET analogs with improved solubility and resistance to auto-oxidation and metabolism by sEH. For example, stable ether EET analogs dilate afferent arterioles and lower blood pressure in hypertensive rodent animal models. EET agonists also improve insulin signaling and vascular function in animal models of metabolic syndrome.


Concentration of elements in mitotic chromatin as measured by x-ray microanalysis.
Unfixed frozen-dried and uncoated tissue sections of the mouse duodenum were placed on carbon planchets and analyzed in a scanning electron microscope fitted with energy dispersive X-ray equipment. Computer analysis of the X-ray spectra allowed elemental microanalysis of the nucleus, cytoplasm, and mitotic chromatin regions in the cryptal and villus enterocytes. The peak to continuum ratio of S, Cl, K, and Ca were higher in mitotic chromatin than any of the other sites measured. The redistribution of Ca at mitosis is postulated to help explain both chromosome condensation and assembly of the mitotic spindle apparatus.


Cost-effectiveness of echocardiography to identify intracardiac thrombus among patients with first stroke or transient ischemic attack.
Echocardiography to select stroke patients for targeted treatments, such as anticoagulation (AC), to reduce recurrent stroke risk is controversial. The authors' objective was to evaluate the cost-effectiveness of imaging strategies that use transthoracic (TTE) and transesophageal (TEE) echocardiography for identifying intracardiac thrombus in new stroke patients. Model-based cost-effectiveness analysis of 7 echocardiographic imaging strategies and 2 nontesting strategies with model parameters based on systematic evidence review related to effectiveness of echocardiography in newly diagnosed ischemic stroke patients (white males aged 65 years in base case). Primary outcome was cost per quality-adjusted life year (QALY). All strategies containing TTE were dominated by others and were eliminated from the analysis. Assuming that AC reduces recurrent stroke risk from intracardiac thrombus by 43% over 1 year, TEE generated a cost per QALY of $137,000 (relative to standard treatment) among patients with 5% thrombus prevalence. Cost per QALY dropped to $50,000 in patients with at least 15% intracardiac thrombus prevalence, or, if an 86% relative risk reduction with AC is assumed, in patients with thrombus prevalence of at least 6%. Probabilistic analyses indicate considerable uncertainty around the cost-effectiveness of echocardiography across a wide range of intracardiac thrombus prevalence (pretest probability). Current evidence on cost-effectiveness is insufficient to justify widespread use of echocardiography in stroke patients. Additional research on recurrent stroke risk in patients with intracardiac thrombus and on the efficacy of AC in reducing that risk may contribute to a better understanding of the circumstances under which echocardiography will be cost-effective.


Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaïve patients with malignant pleural mesothelioma: results of the International Expanded Access Program.
Previously published results from a randomized phase III study of pemetrexed plus cisplatin in patients with malignant pleural mesothelioma (MPM) demonstrated a significant survival benefit and higher response rate compared with cisplatin. Although pemetrexed was under review by regulatory agencies, an International Expanded Access Program (EAP) provided more than 3000 mesothelioma patients with access to single-agent pemetrexed or pemetrexed in combination with cisplatin or carboplatin in 13 countries. This manuscript reports the safety and efficacy data from the nonrandomized open-label study in chemonaïve patients receiving pemetrexed plus platinum under the EAP. Patients with histologically confirmed MPM, not amenable to curative surgery, received pemetrexed 500 mg/m in combination with either cisplatin 75 mg/m or carboplatin AUC 5, once every 21 days with standard premedication. Efficacy data were recorded at the end of study participation. A total of 1704 chemonaïve patients received pemetrexed plus cisplatin (n = 843) or pemetrexed plus carboplatin (n = 861) and were evaluated for safety. The efficacy evaluable population consisted of 745 patients in the pemetrexed plus cisplatin group and 752 patients in the pemetrexed plus carboplatin group for whom physician-reported tumor response was available. The pemetrexed plus cisplatin group demonstrated a response rate of 26.3% compared with 21.7% for the pemetrexed plus carboplatin group, with similar 1-year survival rates (63.1% versus 64.0%) and median time to progressive disease (7 months versus 6.9 months). The most common grade 3/4 hematologic toxicity was neutropenia in 23.9% of the pemetrexed plus cisplatin group and 36.1% of the pemetrexed plus carboplatin group. This large EAP confirmed the activity of pemetrexed plus cisplatin and pemetrexed plus carboplatin in chemonaïve patients with MPM, demonstrating clinically similar time to progressive disease and 1-year survival rates.


Exposure to mercury and aluminum in early life: developmental vulnerability as a modifying factor in neurologic and immunologic effects.
Currently, ethylmercury (EtHg) and adjuvant-Al are the dominating interventional exposures encountered by fetuses, newborns, and infants due to immunization with Thimerosal-containing vaccines (TCVs). Despite their long use as active agents of medicines and fungicides, the safety levels of these substances have never been determined, either for animals or for adult humans—much less for fetuses, newborns, infants, and children. I reviewed the literature for papers reporting on outcomes associated with (a) multiple exposures and metabolism of EtHg and Al during early life; (b) physiological and metabolic characteristics of newborns, neonates, and infants relevant to xenobiotic exposure and effects; (c) neurobehavioral, immunological, and inflammatory reactions to Thimerosal and Al-adjuvants resulting from TCV exposure in infancy. Immunological and neurobehavioral effects of Thimerosal-EtHg and Al-adjuvants are not extraordinary; rather, these effects are easily detected in high and low income countries, with co-exposure to methylmercury (MeHg) or other neurotoxicants. Rigorous and replicable studies (in different animal species) have shown evidence of EtHg and Al toxicities. More research attention has been given to EtHg and findings have showed a solid link with neurotoxic effects in humans; however, the potential synergic effect of both toxic agents has not been properly studied. Therefore, early life exposure to both EtHg and Al deserves due consideration.


Intra-genotypic diversity of archival G4P[8] human rotaviruses from Washington, DC.
Group A human rotaviruses (RVs) remain the most frequently detected viral agents associated with acute gastroenteritis in infants and young children. Despite their medical importance, relatively few complete genome sequences have been determined for commonly circulating G/P-type strains (i.e., G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8]). In the current study, we sequenced the genomes of 11 G4P[8] isolates from stool specimens that were collected in Washington, DC during the years of 1974-1991. We found that the VP7-VP4-VP6-VP1-VP2-VP3-NSP1-NSP2-NSP3-NSP4-NSP5/6-encoding genes of all 11 G4P[8] RVs have the genotypes of G4-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. By constructing phylogenetic trees for each gene, extensive intra-genotypic diversity was revealed among the G4P[8] RVs, and new sub-genotype gene alleles were identified. Several of these alleles are nearly identical to those of G3P[8] isolates previously sequenced from this same Washington, DC collection, strongly suggesting that the RVs underwent gene reassortment. On the other hand, we observed that some G4P[8] RVs exhibit completely different allele-based genome constellations, despite being collected during the same epidemic season; there was no evidence of gene reassortment between these strains. This observation extends our previous findings and supports the notion that stable, genetically-distinct clades of human RVs with the same G/P-type can co-circulate in a community. Interestingly, the sub-genotype gene alleles found in some of the DC RVs share a close evolutionary relationship with genes of more contemporary human strains. Thus, archival human RVs sequenced in this study might represent evolutionary precursors to modern-day strains.


Multi-focus plasmonic lens design based on holography.
Multi-focus plasmonic lens with metallic nanoslits of variant widths have great potential applications in optical interconnection, integrated optics and nanophotonics. But the design method with simulated annealing algorithm or Yang-Gu algorithm requires complex calculation and multi focuses are limited to be set on the same output plane. In this paper, we propose a design method based on holography. The desired light field distribution and the incident plane wave can be treated as object wave and reference wave, respectively. So the calculation is relative simple and multi focuses can be located in different output plane. Numerical simulation of multi-focus lens design is performed through finite-difference time-domain (FDTD) method and the result confirms the feasibility of our method.


Palladium-catalyzed aerobic dehydrogenation of substituted cyclohexanones to phenols.
Aromatic molecules are key constituents of many pharmaceuticals, electronic materials, and commodity plastics. The utility of these molecules directly reflects the identity and pattern of substituents on the aromatic ring. Here, we report a palladium(II) catalyst system, incorporating an unconventional ortho-dimethylaminopyridine ligand, for the conversion of substituted cyclohexanones to the corresponding phenols. The reaction proceeds via successive dehydrogenation of two saturated carbon-carbon bonds of the six-membered ring and uses molecular oxygen as the hydrogen acceptor. This reactivity demonstrates a versatile and efficient strategy for the synthesis of substituted aromatic molecules with fundamentally different selectivity constraints from the numerous known synthetic methods that rely on substitution of a preexisting aromatic ring.


A Tailored Multivariate Mixture Model for Detecting Proteins of Concordant Change Among Virulent Strains of Clostridium Perfringens.
Necrotic enteritis (NE) is a serious disease of poultry caused by the bacterium C. perfringens. To identify proteins of C. perfringens that confer virulence with respect to NE, the protein secretions of four NE disease-producing strains and one baseline non-disease-producing strain of C. perfringens were examined. The problem then becomes a clustering task, for the identification of two extreme groups of proteins that were produced at either concordantly higher or concordantly lower levels across all four disease-producing strains compared to the baseline, when most of the proteins do not exhibit significant change across all strains. However, the existence of some nuisance proteins of discordant change may severely distort any biologically meaningful cluster pattern. We develop a tailored multivariate clustering approach to robustly identify the proteins of concordant change. Using a three-component normal mixture model as the skeleton, our approach incorporates several constraints to account for biological expectations and data characteristics. More importantly, we adopt a sparse mean-shift parameterization in the reference distribution, coupled with a regularized estimation approach, to flexibly accommodate proteins of discordant change. We explore the connections and differences between our approach and other robust clustering methods, and resolve the issue of unbounded likelihood under an eigenvalue-ratio condition. Simulation studies demonstrate the superior performance of our method compared with a number of alternative approaches. Our protein analysis along with further biological investigations may shed light on the discovery of the complete set of virulence factors in NE.


Pituitary growth hormone (GH) secretion is partially rescued in HIV-infected patients with GH deficiency (GHD) compared to hypopituitary patients.
Biochemical growth hormone deficiency is prevalent among human immunodeficiency virus-infected patients, but if this condition is clinically relevant remains challenging. The aim is to prospectively compare the growth hormone deficiency/insulin-like growth factor-1 status of 71 human immunodeficiency virus-infected patients with impaired growth hormone response to growth hormone releasing hormone + Arginine with that of 65 hypopituitary patients affected by a true growth hormone deficiency secondary to pituitary disease. The main outcomes were: basal serum growth hormone, insulin-like growth factor-1, insulin-like growth factor binding protein 3, growth hormone peak and area under the curve after growth hormone response to growth hormone releasing hormone + Arginine test, body mass index, waist and hip circumference, and body composition by dual energy X-ray absorptiometry. Insulin-like growth factor-1 binding protein 3, basal growth hormone (p < 0.005), growth hormone peak and area under the curve after growth hormone response to growth hormone releasing hormone + Arginine, waist to hip ratio, insulin-like growth factor-1, fasting glucose, insulin, and triglycerides (p < 0.0001) were lower in hypopituitary than human immunodeficiency virus-infected patients. Total and trunk fat mass by dual energy X-ray absorptiometry were higher in hypopituitary than in human immunodeficiency virus-infected patients (p < 0.0001). In all the patients total body fat was associated with both growth hormone peak and area under the curve at stepwise linear regression analysis. The degree of growth hormone deficiency is more severe in hypopituitary than in human immunodeficiency virus-infected patients, suggesting that the function of growth hormone/insulin-like growth factor-1 axis is partially rescued in the latter thanks to a preserved pituitary secretory reserve. Data from the current study suggest that human immunodeficiency virus-infected patients with peak growth hormone < 9 mg/L may have partial growth hormone deficiency and clinicians should be cautious before prescribing recombinant human growth hormone replacement treatment to patients living with human immunodeficiency virus.


Chronic Disease Self-Management Education (CDSME) Program Delivery and Attendance among Urban-Dwelling African Americans.
Older African Americans carry a disproportionate share of chronic diseases. The purpose of this study was to identify the characteristics of urban-dwelling African Americans with chronic disease participating in Chronic Disease Self-Management Education (CDSME) programs and to examine factors related to successful program completion (i.e., attending at least four of the six sessions). Data were analyzed from 11,895 African Americans who attended a CDSME program at one of the five leading delivery sites (i.e., senior center, health care organization, residential facility, community location, faith-based organization). Logistic regression analyses were used to assess the associations of demographic, delivery site, and neighborhood characteristics with CDSME program successful completion. Approximately, half of the African American participants were aged 65-79 years, 83% were female, and 92% lived alone. Approximately, 44% of participants had three or more chronic conditions and 35% resided in an impoverished area (i.e., 200% below federal poverty level). Successful completion of the CDSME program was associated with being between the ages of 50-64 and 65-79 years, being female, living alone, living in an impoverished community, and attending a CDSME program at a residential facility or community center. Findings highlight the unique patterns of attendance and delivery within the context of self-management interventions among this unique and traditionally underserved target population. Understanding such patterns can inform policy and practice efforts to engage more organizations in urban areas to increase CDSME program adoption. Particularly, employing strategies to implement CDSME programs across all delivery site types may increase reach to African American participants.


MALDI Imaging Mass Spectrometry as a Lipidomic Approach to Heart Valve Research.
Valvular disease is characterized in part by lipid deposition, but systematic analysis of the patterns of global lipid expression in healthy and diseased valve tissues are unknown. This is due in part to tissue limitations for lipidomic preparations and technologies for evaluating lipid distribution in tissues. The study aim was to examine the application of matrixassisted laser desorption ionization imaging mass spectrometry (MALDI IMS) to the aortic valve during development and disease, as an approach to detect and map lipids and ultimately better understand valve structure and function. Established MALDI IMS strategies were applied to thin tissue sections of heart valves to map lipids to corresponding morphological features. Healthy prenatal and adult ovine aortic valve tissues were evaluated using the developed techniques. Lipid expression levels were compared between prenatal and adult valves using Wilcoxon rank sum testing and area under the receiver operating curves. A classification algorithm was used to determine distinct lipid signatures in adult extracellular matrix (ECM) substructures, including fibrosa and spongiosa layers. Lipid patterns were examined in heart valve tissue from pediatric patients with congenital aortic valve stenosis (CAVS). Lipid levels were decreased in adult ovine aortic valves when compared with prenatal valves. Classification algorithms applied to lipid signatures reported distinct lipid signatures mapping to ECM substructures in the adult aortic valve, but could not distinguish amorphous structures at pre-natal day 5. In CAVS, the in-situ lipid aggregation of distinct lipid species showed unique patterning both concurrent and divergent with ECM disarray. Fatty acid content varied between normal and diseased human aortic valves. MALDI IMS provides a new and useful approach to evaluate lipid biology in heart valve tissue. These findings define a role for lipid regulation in aortic valve development and demonstrate patterns of lipid deregulation in congenital disease.


The potent and broadly neutralizing human dengue virus-specific monoclonal antibody 1C19 reveals a unique cross-reactive epitope on the bc loop of domain II of the envelope protein.
Following natural dengue virus (DENV) infection, humans produce some antibodies that recognize only the serotype of infection (type specific) and others that cross-react with all four serotypes (cross-reactive). Recent studies with human antibodies indicate that type-specific antibodies at high concentrations are often strongly neutralizing in vitro and protective in animal models. In general, cross-reactive antibodies are poorly neutralizing and can enhance the ability of DENV to infect Fc receptor-bearing cells under some conditions. Type-specific antibodies at low concentrations also may enhance infection. There is an urgent need to determine whether there are conserved antigenic sites that can be recognized by cross-reactive potently neutralizing antibodies. Here, we describe the isolation of a large panel of naturally occurring human monoclonal antibodies (MAbs) directed to the DENV domain II fusion loop (FL) envelope protein region from subjects following vaccination or natural infection. Most of the FL-specific antibodies exhibited a conventional phenotype, characterized by low-potency neutralizing function and antibody-dependent enhancing activity. One clone, however, recognized the bc loop of domain II adjacent to the FL and exhibited a unique phenotype of ultrahigh potency, neutralizing all four serotypes better than any other previously described MAb recognizing this region. This antibody not only neutralized DENV effectively but also competed for binding against the more prevalent poor-quality antibodies whose binding was focused on the FL. The 1C19 human antibody could be a promising component of a preventative or therapeutic intervention. Furthermore, the unique epitope revealed by 1C19 suggests a focus for rational vaccine design based on novel immunogens presenting cross-reactive neutralizing determinants. With no effective vaccine available, the incidence of dengue virus (DENV) infections worldwide continues to rise, with more than 390 million infections estimated to occur each year. Due to the unique roles that antibodies are postulated to play in the pathogenesis of DENV infection and disease, there is consensus that a successful DENV vaccine must protect against all four serotypes. If conserved epitopes recognized by naturally occurring potently cross-neutralizing human antibodies could be identified, monovalent subunit vaccine preparations might be developed. We characterized 30 DENV cross-neutralizing human monoclonal antibodies (MAbs) and identified one (1C19) that recognized a novel conserved site, known as the bc loop. This antibody has several desirable features, as it neutralizes DENV effectively and competes for binding against the more common low-potency fusion loop (FL) antibodies, which are believed to contribute to antibody-mediated disease. To our knowledge, this is the first description of a potent serotype cross-neutralizing human antibody to DENV.


Blood plasma lipidomic signature of epicardial fat in healthy obese women.
A lipidomic approach was employed in a clinically well-defined cohort of healthy obese women to explore blood lipidome phenotype ascribed to body fat deposition, with emphasis on epicardial adipose tissue (EAT). The present investigation delivered a lipidomics signature of epicardial adiposity under healthy clinical conditions using a cohort of 40 obese females (age: 25-45 years, BMI: 28-40 kg/m(2) ) not showing any metabolic disease traits. Lipidomics analysis of blood plasma was employed in combination with in vivo quantitation of mediastinal fat depots by computerized tomography. All cardiac fat depots correlated to indicators of hepatic dysfunctions (ALAT and ASAT), which describe physiological connections between hepatic and cardiac steatosis. Plasma lipidomics encompassed overall levels of lipid classes, fatty acid profiles, and individual lipid species. EAT and visceral fat associated with diacylglycerols (DAG), triglycerides, and distinct phospholipid and sphingolipid species. A pattern of DAG and phosphoglycerols was specific to EAT. Human blood plasma lipidomics appears to be a promising clinical and potentially diagnostic readout for patient stratification and monitoring. Association of blood lipidomics signature to regio-specific mediastinal and visceral adiposity under healthy clinical conditions may help provide more biological insights into obese patient stratification for cardiovascular disease risks.


Deep brain stimulation for psychiatric disease: contributions and validity of animal models.
During treatment with deep brain stimulation (DBS), electrical current is delivered into the brain parenchyma through implanted electrodes. Although this technique is routinely used in the treatment of Parkinson's disease, essential tremor, and dystonia, a growing number of neuropsychiatric applications for DBS are being investigated. Investigators can use animal models of these diseases to study the mechanisms through which DBS exerts its effects, to explore new applications of this therapy, and to identify and characterize alternative stimulation targets. Here, we discuss preclinical DBS research that provides insight into the mechanisms underlying cognitive and psychiatric applications of this technique, emphasizing the predictive validity of animal models and their potential use in translational research.


Systemic exosomal siRNA delivery reduced alpha-synuclein aggregates in brains of transgenic mice.
Alpha-synuclein (α-Syn) aggregates are the main component of Lewy bodies, which are the characteristic pathological feature in Parkinson's disease (PD) brain. Evidence that α-Syn aggregation can be propagated between neurones has led to the suggestion that this mechanism is responsible for the stepwise progression of PD pathology. Decreasing α-Syn expression is predicted to attenuate this process and is thus an attractive approach to delay or halt PD progression. We have used α-Syn small interfering RNA (siRNA) to reduce total and aggregated α-Syn levels in mouse brains. To achieve widespread delivery of siRNAs to the brain we have peripherally injected modified exosomes expressing Ravies virus glycoprotein loaded with siRNA. Normal mice were analyzed 3 or 7 days after injection. To evaluate whether this approach can decrease α-Syn aggregates, we repeated the treatment using transgenic mice expressing the human phosphorylation-mimic S129D α-Syn, which exhibits aggregation. In normal mice we detected significantly reduced α-Syn messenger RNA (mRNA) and protein levels throughout the brain 3 and 7 days after treatment with RVG-exosomes loaded with siRNA to α-Syn. In S129D α-Syn transgenic mice we found a decreased α-Syn mRNA and protein levels throughout the brain 7 days after injection. This resulted in significant reductions in intraneuronal protein aggregates, including in dopaminergic neurones of the substantia nigra. This study highlights the therapeutic potential of RVG-exosome delivery of siRNA to delay and reverse brain α-Syn pathological conditions.


Empirical Evidence for Species-Specific Export of Fish Naïveté from a No-Take Marine Protected Area in a Coastal Recreational Hook and Line Fishery.
No-take marine protected areas (MPAs) are assumed to enhance fisheries catch via the "spillover" effect, where biomass is exported to adjacent exploited areas. Recent studies in spearfishing fisheries suggest that the spillover of gear-naïve individuals from protected to unprotected sites increases catch rates outside the boundaries of MPAs. Whether this is a widespread phenomenon that also holds for other gear types and species is unknown. In this study, we tested if the distance to a Mediterranean MPA predicted the degree of vulnerability to hook and line in four small-bodied coastal fish species. With the assistance of underwater video recording, we investigated the interaction effect of the distance to the boundary of an MPA and species type relative to the latency time to ingest a natural bait, which was considered as a surrogate of fish naïveté or vulnerability to fishing. Vulnerability to angling increased (i.e., latency time decreased) within and near the boundary of an MPA for an intrinsically highly catchable species (Serranus scriba), while it remained constant for an intrinsically uncatchable control species (Chromis chromis). While all of the individuals of S. scriba observed within the MPA and surrounding areas were in essence captured by angling gear, only one fifth of individuals in the far locations were captured. This supports the potential for the spillover of gear-naïve and consequently more vulnerable fish from no-take MPAs. Two other species initially characterized as intermediately catchable (Coris julis and Diplodus annularis) also had a shorter latency time in the vicinity of an MPA, but for these two cases the trend was not statistically significant. Overall, our results suggest that an MPA-induced naïveté effect may not be universal and may be confined to only intrinsically highly catchable fish species. This fact emphasizes the importance of considering the behavioural dimension when predicting the outcomes of MPAs, otherwise the effective contribution may be smaller than predicted for certain highly catchable species such as S. scriba.


Tuning the singlet fission relevant energetic levels of quinoidal bithiophene compounds by means of backbone modifications and functional group introduction.
Efficient singlet fission (SF) has been obtained in quinoidal bithiophene, end-capped with dicyanomethylene groups (QBT). However, QBT suffers from low triplet state energy [E(T1)] because of its biradicaloid nature, which results in a great driving force for SF but also a large loss of energy during the SF process. This is not favorable for the application of SF in solar cells. Modifications to the molecular structure of QBT were performed to optimize the SF relevant excited state energy levels and its diradical character in the present study. This includes chalcogen replacement, the fusing of the heterocyclic ring between the two thiophene rings, and the introduction of side substituents. Detailed analysis focused on the correlation between the molecular structure of the QBT derivatives and their diradical character y0, bond length alternation (BLA), molecular orbitals, and SF relevant excited state energy levels. The results show that electron-donating substituents, particularly groups introduced at the inner β-positions of the thiophene ring, can increase E(T1) and reduce the energy loss of SF significantly under the premise of exothermic SF. These results would be beneficial to the development of new SF candidates for application in solar cells.


Progress in cancer chemoprevention: perspectives on agent selection and short-term clinical intervention trials.
The basic cancer-related chemical and biological sciences, pathology, and epidemiology have contributed to the understanding that antimutagenesis and antiproliferation are the important general mechanisms of chemoprevention and to the development of antimutagenic and anti-proliferative agents as potential chemopreventive drugs. These disciplines have also provided the biochemical and histopathological bases for identifying intermediate biomarkers that can be used as surrogate end points for cancer incidence in clinical chemoprevention trials and for selecting cohorts for these trials. Particularly important as histological biomarkers of cancer are the cytonuclear morphological and densitometric changes that define intraepithelial neoplasia (IEN). IEN changes are on the causal pathway to cancer. They may serve as target lesions in Phase II chemoprevention trials and as standards against which other earlier cellular and molecular biomarkers can be evaluated. Strategies for the clinical evaluation of chemopreventive agents have been defined for seven targets--colorectal, prostate, lung, breast, bladder, oral, and cervical cancers. Cohorts have been identified for short-term Phase II trials that investigate the effects of chemopreventive agents on IEN and on earlier biomarkers. Patients with adenomas serve as a cohort for trials in colon. One cohort for Phase II trials in prostate is patients with early stage cancers scheduled for prostatectomy; another is patients with prostatic intraepithelial neoplasia (without prostatic carcinoma). Patients treated for lung cancer are at high risk for bronchial dysplasia and second cancers; such patients are a cohort for Phase II trials in lung cancer. Presurgical breast cancer patients and patients with ductal or lobular carcinoma in situ are cohorts for studies in breast. Patients with superficial bladder cancers (Ta/T1 with or without carcinoma in situ) are cohorts for studies of chemoprevention in bladder, and patients with dysplastic oral leukoplakia are evaluated for chemoprevention of oral cancers. Cervical intraepithelial neoplasia is a prototype IEN, and patients with cervical intraepithelial neoplasia are a cohort for studies of cervical cancer.


Dietary intake and anthropometry of Korean elderly people: a literature review.
The health status of elderly people is an important issue in Korea due to the expansion of the elderly population. However, data on their nutritional status are limited. This review aims to give an overview of the dietary intake and anthropometry of Korean elderly people based on studies published, mainly in local journals in Korea. In total 18 studies were reviewed. Mean calcium and vitamin A intakes were inadequate, namely less than 67% of the Korean recommended daily allowances, in all groups of Korean elderly people. The intake of both nutrients was lower in urban elderly with a low income and in rural elderly (200-496 g/day of calcium and 117-281 retinol equivalents/day). In particular, "low income" urban elderly people had a low energy intake (less than 5300 kJ/day) with an inadequate intake of iron, thiamin, riboflavin and niacin in addition to calcium and vitamin A. In urban areas underweight (body mass index <20 kg/m2) occurred in 7-31% of "all income" groups, whereas it occurred in 15-42% of "low income" groups. Rural elderly people showed a higher proportion of underweight (37% for men and 38% for women) as well as the lowest body mass index (21.0 kg/m2 for men and 21.3 kg/m2 for women). In conclusion, an inadequate intake of several micronutrients in old age, mostly calcium and vitamin A, is a matter of concern in Korea. This was observed most frequently in elderly people with a low income. In this group an inadequate intake of micronutrients is likely to be caused by a low energy intake.


Important roles of enthalpic and entropic contributions to CO2 capture from simulated flue gas and ambient air using mesoporous silica grafted amines.
The measurement of isosteric heats of adsorption of silica supported amine materials in the low pressure range (0-0.1 bar) is critical for understanding the interactions between CO2 and amine sites at low coverage and hence to the development of efficient amine adsorbents for CO2 capture from flue gas and ambient air. Heats of adsorption for an array of silica-supported amine materials are experimentally measured at low coverage using a Calvet calorimeter equipped with a customized dosing manifold. In a series of 3-aminopropyl-functionalized silica materials, higher amine densities resulted in higher isosteric heats of adsorption, clearly showing that the density/proximity of amine sites can influence the amine efficiency of adsorbents. In a series of materials with fixed amine loading but different amine types, strongly basic primary and secondary amine materials are shown to have essentially identical heats of adsorption near 90 kJ/mol. However, the adsorption uptakes vary substantially as a function of CO2 partial pressure for different primary and secondary amines, demonstrating that entropic contributions to adsorption may play a key role in adsorption at secondary amine sites, making adsorption at these sites less efficient at the low coverages that are important to the direct capture of CO2 from ambient air. Thus, while primary amines are confirmed to be the most effective amine types for CO2 capture from ambient air, this is not due to enhanced enthalpic contributions associated with primary amines over secondary amines, but may be due to unfavorable entropic factors associated with organization of the second alkyl chain on the secondary amine during CO2 adsorption. Given this hypothesis, favorable entropic factors may be the main reason primary amine based adsorbents are more effective under air capture conditions.


Native and unfolded cytochrome c--comparison of dynamics using 2D-IR vibrational echo spectroscopy.
Unfolded vs native CO-coordinated horse heart cytochrome c (h-cyt c) and a heme axial methionine mutant cyt c552 from Hydrogenobacter thermophilus ( Ht-M61A) are studied by IR absorption spectroscopy and ultrafast 2D-IR vibrational echo spectroscopy of the CO stretching mode. The unfolding is induced by guanidinium hydrochloride (GuHCl). The CO IR absorption spectra for both h-cyt c and Ht-M61A shift to the red as the GuHCl concentration is increased through the concentration region over which unfolding occurs. The spectra for the unfolded state are substantially broader than the spectra for the native proteins. A plot of the CO peak position vs GuHCl concentration produces a sigmoidal curve that overlays the concentration-dependent circular dichroism (CD) data of the CO-coordinated forms of both Ht-M61A and h-cyt c within experimental error. The coincidence of the CO peak shift curve with the CD curves demonstrates that the CO vibrational frequency is sensitive to the structural changes induced by the denaturant. 2D-IR vibrational echo experiments are performed on native Ht-M61A and on the protein in low- and high-concentration GuHCl solutions. The 2D-IR vibrational echo is sensitive to the global protein structural dynamics on time scales from subpicosecond to greater than 100 ps through the change in the shape of the 2D spectrum with time (spectral diffusion). At the high GuHCl concentration (5.1 M), at which Ht-M61A is essentially fully denatured as judged by CD, a very large reduction in dynamics is observed compared to the native protein within the approximately 100 ps time window of the experiment. The results suggest the denatured protein may be in a glassy-like state involving hydrophobic collapse around the heme.


Avoiding Catch-22: validating the PainDETECT in a in a population of patients with chronic pain.
Neuropathic pain is defined as pain caused by a lesion or disease of the somatosensory nervous system and is a major therapeutic challenge. Several screening tools have been developed to help physicians detect patients with neuropathic pain. These have typically been validated in populations pre-stratified for neuropathic pain, leading to a so called "Catch-22 situation:" "a problematic situation for which the only solution is denied by a circumstance inherent in the problem or by a rule". The validity of screening tools needs to be proven in patients with pain who were not pre-stratified on basis of the target outcome: neuropathic pain or non-neuropathic pain. This study aims to assess the validity of the Dutch PainDETECT (PainDETECT-Dlv) in a large population of patients with chronic pain. A cross-sectional multicentre design was used to assess PainDETECT-Dlv validity. Included where patients with low back pain radiating into the leg(s), patients with neck-shoulder-arm pain and patients with pain due to a suspected peripheral nerve damage. Patients' pain was classified as having a neuropathic pain component (yes/no) by two experienced physicians ("gold standard"). Physician opinion based on the Grading System was a secondary comparison. In total, 291 patients were included. Primary analysis was done on patients where both physicians agreed upon the pain classification (n = 228). Compared to the physician's classification, PainDETECT-Dlv had a sensitivity of 80% and specificity of 55%, versus the Grading System it achieved 74 and 46%. Despite its internal consistency and test-retest reliability the PainDETECT-Dlv is not an effective screening tool for a neuropathic pain component in a population of patients with chronic pain because of its moderate sensitivity and low specificity. Moreover, the indiscriminate use of the PainDETECT-Dlv as a surrogate for clinical assessment should be avoided in daily clinical practice as well as in (clinical-) research. Catch-22 situations in the validation of screening tools can be prevented by not pre-stratifying the patients on basis of the target outcome before inclusion in a validation study for screening instruments. The protocol was registered prospectively in the Dutch National Trial Register: NTR 3030 .


MCM7 amplification and overexpression promote cell proliferation, colony formation and migration in esophageal squamous cell carcinoma by activating the AKT1/mTOR signaling pathway.
The roles and mechanisms of mini-chromosome maintenance complex component 7 (MCM7) amplification and overexpression in esophageal carcinogenesis were investigated. By analyzing the TCGA datasets, we found that MCM7 was amplified in approximately 12% of esophageal squamous cell carcinomas (ESCCs), and in more than 4% of head and neck squamous cell carcinomas and stomach carcinomas. Overexpression of MCM7 was further verified in three independent GEO datasets of esophageal cancer. Knockdown of MCM7 using two siRNAs significantly inhibited cell proliferation, colony formation and migration of KYSE510 and EC9706 cells in vitro. Noteworthy, we further found that silencing of MCM7 suppressed the phosphorylation of AKT1 and mTOR both in KYSE510 and EC9706 cells, and reduced the cell cycle regulatory proteins cyclin D1, cyclin E2 and CDK2. Taken together, our findings suggested that MCM7 promoted tumor cell proliferation, colony formation and migration of ESCC cells via activating AKT1/mTOR signaling pathway.


CABIN: collective analysis of biological interaction networks.
The importance of understanding biological interaction networks has fueled the development of numerous interaction data generation techniques, databases and prediction tools. However, not all prediction tools and databases predict interactions with one hundred percent accuracy. Generation of high-confidence interaction networks formulates the first step towards deciphering unknown protein functions, determining protein complexes and inventing drugs. The CABIN: Collective Analysis of Biological Interaction Networks software is an exploratory data analysis tool that enables analysis and integration of interactions evidence obtained from multiple sources, thereby increasing the confidence of computational predictions as well as validating experimental observations. CABIN has been written in Java and is available as a plugin for Cytoscape--an open source network visualization tool.


Ex vivo expansion of human T cells for adoptive immunotherapy using the novel Xeno-free CTS Immune Cell Serum Replacement.
The manufacture of clinical grade cellular products for adoptive immunotherapy requires ex vivo culture and expansion of human T cells. One of the key components in manufacturing of T cell therapies is human serum (HS) or fetal bovine serum (FBS), which can potentially expose immunotherapy recipient to adventitious infectious pathogens and are thus considered as non-cGMP compliant for adoptive therapy. Here we describe a novel xeno-free serum replacement (SR) with defined components that can be reproducibly used for the production of clinical grade T-cell therapies in combination with several different cell culture media. Dynabeads CD3/CD28 Cell Therapy System (CTS)-activated or antigen-specific T cells expanded using the xeno-free SR, CTS Immune Cell SR, showed comparable growth kinetics observed with cell culture media supplemented with HS or FBS. Importantly the xeno-free SR supplemented medium supported the optimal expansion of T cells specific for subdominant tumour-associated antigens and promoted expansion of T cells with central memory T-cell phenotype, which is favourable for in vivo survival and persistence following adoptive transfer. Furthermore, T cells expanded using xeno-free SR medium were highly amenable to lentivirus-mediated gene transduction for potential application for gene-modified T cells. Taken together, the CTS Immune Cell SR provides a novel platform strategy for the manufacture of clinical grade adoptive cellular therapies.


Catalytic function of the mycobacterial binuclear iron monooxygenase in acetone metabolism.
Mycobacteria such as Mycobacterium smegmatis strain mc(2)155 and Mycobacterium goodii strain 12523 are able to grow on acetone and use it as a source of carbon and energy. We previously demonstrated by gene deletion analysis that the mimABCD gene cluster, which encodes a binuclear iron monooxygenase, plays an essential role in acetone metabolism in these mycobacteria. In the present study, we determined the catalytic function of MimABCD in acetone metabolism. Whole-cell assays were performed using Escherichia coli cells expressing the MimABCD complex. When the recombinant E. coli cells were incubated with acetone, a product was detected by gas chromatography (GC) analysis. Based on the retention time and the gas chromatography-mass spectrometry (GC-MS) spectrum, the reaction product was identified as acetol (hydroxyacetone). The recombinant E. coli cells produced 1.02 mM of acetol from acetone within 24 h. Furthermore, we demonstrated that MimABCD also was able to convert methylethylketone (2-butanone) to 1-hydroxy-2-butanone. Although it has long been known that microorganisms such as mycobacteria metabolize acetone via acetol, this study provides the first biochemical evidence for the existence of a microbial enzyme that catalyses the conversion of acetone to acetol.


ICTV virus taxonomy profile: Sarthroviridae.
The family Sarthroviridae includes a single genus, Macronovirus, which in turn includes a single species, Macrobrachium satellite virus 1. Members of this species, named extra small virus, are satellite viruses of Macrobrachium rosenbergii nodavirus, an unclassified virus related to members of the family Nodaviridae. Both viruses have isometric, spherical virions, infect giant freshwater prawns and together cause white tail disease, which is responsible for mass mortalities and severe economic losses in hatcheries and farms. Infection is caused by both vertical and horizontal transmission of virus. Aquatic insects act as a carrier to transmit the disease in prawns. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Sarthroviridae, which is available at www.ictv.global/report/sarthroviridae.


The Caudate Nucleus Mediates Learning of Stimulus-Control State Associations.
A longstanding dichotomy in cognitive psychology and neuroscience pits controlled, top-down driven behavior against associative, bottom-up driven behavior, where cognitive control processes allow us to override well-learned stimulus-response (S-R) associations. By contrast, some previous studies have raised the intriguing possibility of an integration between associative and controlled processing in the form of stimulus-control state (S-C) associations, the learned linkage of specific stimuli to particular control states, such as high attentional selectivity. The neural machinery mediating S-C learning remains poorly understood, however. Here, we combined human functional magnetic resonance imaging (fMRI) with a previously developed Stroop protocol that allowed us to dissociate reductions in Stroop interference based on S-R learning from those based on S-C learning. We modeled subjects' acquisition of S-C and S-R associations using an associative learning model and then used trial-by-trial S-C and S-R prediction error (PE) estimates in model-based behavioral and fMRI analyses. We found that PE estimates derived from S-C and S-R associations accounted for the reductions in behavioral Stroop interference effects in the S-C and S-R learning conditions, respectively. Moreover, model-based fMRI analyses identified the caudate nucleus as the key structure involved in selectively updating stimulus-control state associations. Complementary analyses also revealed a greater reliance on parietal cortex when using the learned S-R versus S-C associations to minimize Stroop interference. These results support the emerging view that generalizable control states can become associated with specific bottom-up cues, and they place the caudate nucleus of the dorsal striatum at the center of the neural stimulus-control learning machinery. Previous behavioral studies have demonstrated that control states, for instance, heightened attentional selectivity, can become directly associated with, and subsequently retrieved by, particular stimuli, thus breaking down the traditional dichotomy between top-down and bottom-up driven behavior. However, the neural mechanisms underlying this type of stimulus-control learning remain poorly understood. We therefore combined noninvasive human neuroimaging with a task that allowed us to dissociate the acquisition of stimulus-control associations from that of stimulus-response associations. The results revealed the caudate nucleus as the key brain structure involved in selectively driving stimulus-control learning. These data represent the first identification of the neural mechanisms of stimulus-specific control associations, and they significantly extend current conceptions of the type of learning processes mediated by the caudate.


Bedside therapeutic experiences with horizontal canal benign paroxysmal positional vertigo (cupulolithiasis).
After forced prolonged position type one (FPP-one) and the appropriate repositioning maneuvers, or FPP-two, 95.45% of patients with cupulolithiasis of the horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV).were symptom-free. To treat patients with cupulolithiasis of the HSC-BPPV. This was a prospective study including 22 subjects with HSC-BPPV (cupulolithiasis) based on apogeotropic direction-changing positional nystagmus (apo-DCPN). Patients adopted FPP-one, which means lying down on the side of the weaker nystagmus during nightly rest for 2 weeks. If apo-DCPN persisted, subjects adopted type two FPP (FPP-two), which means lying on the strongest nystagmus side during nightly rest for 2 weeks. No vertigo or nystagmus was observed in 15 subjects after FPP-one. One subject experienced geotropic DCPN (geo-DCPN), two subjects had posterior BPPV, and another had superior BPPV. Three subjects had persistent apo-DCPN and they were subjected to FPP-two. After that, no vertigo or nystagmus was detected in two subjects. Apo-DCPN persisted in the other remaining subject after FPP-two.


Disclosure of HIV status to sex partners among HIV-infected men and women in Cape Town, South Africa.
This study examines factors influencing HIV sero-status disclosure to sex partners among a sample of 630 HIV-infected men and women with recent sexual contact attending anti-retroviral therapy (ART) clinics in Cape Town, South Africa, with a focus on sex partner type, HIV-related stigma, and ART as potential correlates. About 20% of the sample had not disclosed their HIV status to their most recent sex partners. HIV disclosure to sex partner was more likely among participants who had a steady sex partner [Adjusted odds ratio (AOR) = 2.7; 95% CI: 1.6-4.6], had a partner with known-HIV status [AOR = 7.8; 95% CI: 3.2-18.7]; perceived less stigma [AOR = 1.9; 95% CI: 1.2-2.9]; and were on ART [AOR = 1.6; 95% CI: 1.1-2.3]. Stratified analyses by the type of sex partner further reveals that stigma and ART were significantly associated with HIV disclosure within steady relationships but were not significant correlates of HIV disclosure with casual sex partners. The findings support a positive prevention strategy that emphasizes increased access to ART, and behavioral interventions to reduce casual sex partnerships for persons who are HIV-positive. Mitigating the influence of HIV stigma on HIV status disclosure particularly within steady sex partnerships is also important and may be accomplished through individual and couple counseling.


[Effect of aging on attention to the lateral visual field: The use of a visual statistical learning paradigm].
We investigated characteristics of spatial attentional bias in the elderly with the use of a visual statistical learning paradigm. Triplets consisting of pictures that appeared in the same consecutive order were simultaneously presented to the left (LVF) and right visual-field (RVF) across a center fixation point. In the learning phase, both younger (N = 40) and older (N = 40) adults were instructed to attend to either the LVF or RVF and to perform a 1-back task on the visual-field. The test phase was conducted immediately after the learning phase. Implicit memory for the sequential order of the triplets was tested using a speed detection task. Younger adults showed visual statistical learning for both the attended and unattended triplets. The elderly who directed attention towards the LVF showed visual statistical learning not for the attended triplets presented in the LVF, but rather the unattended triplets presented in the RVF. These findings suggest that the elderly show a stronger visuospatial attention bias to the right visual-field, with a decline in executive function compared to younger adults.


Comparison of serious adverse reactions between thalidomide and lenalidomide: analysis in the French Pharmacovigilance database.
Thalidomide and lenalidomide are structural analogs and immunomodulatory drugs. Lenalidomide appears to have a different safety profile than thalidomide and could be less toxic, and as far as we know, we did not found any study comparing their safety profile. The objective of our study was to review and compare serious adverse drug reactions (SADRs) of thalidomide and lenalidomide spontaneously reported to the French Pharmacovigilance database. We extracted all medically confirmed spontaneous reports of SADR for lenalidomide-based regimens and thalidomide-based regimens from the French Pharmacovigilance database. A "serious" adverse drug reaction (ADR) was defined as an ADR that is fatal or life threatening, which causes hospitalization or prolongation of hospitalization, or permanent or significant disability. The study period was between marketing of 2 drugs and January 15, 2012. A total of 392 SADRs related to thalidomide-based regimens were identified in 244 patients and 377 SADRs related to lenalidomide-based regimens in 220 patients. In spite of their structural analogy, this study highlights interesting differences between lenalidomide and thalidomide's safety profile: nervous system and vascular disorders are more frequent with thalidomide-based regimens while hematologic, skin, infectious disorders and secondary primary cancers are more frequent with lenalidomide-based regimens.


Frequency and Characterization of Movement Disorders in Anti-IgLON5 Disease.
Anti-IgLON5 disease is a recently described neurological disease that shares features of autoimmunity and neurodegeneration. Abnormal movements appear to be frequent and important but have not been characterized and are under-reported. Here we describe the frequency and types of movement disorders in a series of consecutive patients with this disease. In this retrospective, observational study, the presence and phenomenology of movement disorders were assessed with a standardized clinical questionnaire. Available videos were centrally reviewed by three experts in movement disorders. Seventy two patients were included. In 41 (57%) the main reason for initial consultation was difficulty walking along with one or several concurrent movement disorders. At the time of anti-IgLON5 diagnosis, 63 (87%) patients had at least one movement disorder with a median of three per patient. The most frequent abnormal movements were gait and balance disturbances (52 patients, 72%), chorea (24, 33%), bradykinesia (20, 28%), dystonia (19, 26%), abnormal body postures or rigidity (18, 25%), and tremor (15, 21%). Other hyperkinetic movements (myoclonus, akathisia, myorhythmia, myokymia, or abdominal dyskinesias) occurred in 26 (36%) patients. The craniofacial region was one of the most frequently affected by multiple concurrent movement disorders (23 patients, 32%) including dystonia (13), myorhythmia (6), chorea (4) or myokymia (4). Considering any body region, the most frequent combination of multiple movement disorders consisted of gait instability or ataxia associated with craniofacial dyskinesias or generalized chorea observed in 31(43%) of patients. In addition to abnormal movements, 87% of patients had sleep alterations, 74% bulbar dysfunction, and 53% cognitive impairment. Fifty-five (76%) patients were treated with immunotherapy, resulting in important and sustained improvement of the movement disorders in only seven (13%) cases. Movement disorders are a frequent and leading cause of initial neurological consultation in patients with anti-IgLON5 disease. Although multiple types of abnormal movements can occur, the most prevalent are disorders of gait, generalized chorea, and dystonia and other dyskinesias that frequently affect craniofacial muscles. Overall, anti-IgLON5 disease should be considered in patients with multiple movement disorders, particularly if they occur in association with sleep alterations, bulbar dysfunction, or cognitive impairment.


Recurrent erosion of the cornea.
Altogether, 80 patients aged between 24 and 73 years with recurrent erosion of the cornea have been studied and compared with a control group of 200. The patients' erosions were divisible into macroform and microform types. The macroform occurred in 10%, the microform in 56%, and both types in the same patients in 31%. The macroform was more commonly related to trauma than the microform. However, many (40%) were spontaneous in origin. The most common cause of the initial trauma was a finger nail. The recurrences occurred at around the time of waking, either just before or just after. Difficulty in opening the eye occurred in 10%. There was little evidence of precipitating factors, but eye rubbing was admitted by 10% and barbiturates were implicated in 3%. The corneae were examined in the healed state, when a high incidence (59%) were found to have superficial corneal dystrophies of the fingerprint lines, bleb, and Bietti's lacunar (map-like) types. These are considered individually, particular attention being paid to the distinction between the various types of line resembling the fingerprint line. Epithelial microcysts were also a common finding (59%) and were sometimes of the Cogan type. In only 11% of patients were there no corneal signs in the healed state. The need for careful examination of the cornea by retroillumination, using both the iris and the fundus, is stressed. The control group, in contrast, showed a very low incidence of dystrophies and cysts. Treatment was given initially with either drops or ointment and no differences in healing were found. Debridement was performed in 12 eyes as an initial treatment and also in four eyes which were not healing on medical treatment. Debridement assisted healing, but did not prevent recurrence. One eye was treated with debridement and scarification and seven with carbolization. These procedures appeared to reduce the recurrence rate. Sodium chloride ointment 5% was found useful as a prophylactic taken at bedtime, and the recurrence rate increased when it was withdrawn.


Helicobacter pylori prevalence in non-ulcer dyspepsia--ethnic and socio-economic differences.
Helicobacter pylori is an important cause of gastritis and a number of therapeutic trials suggest that it may be important in the genesis of duodenal ulcer recurrence. The reported prevalence of gastric colonisation by the organism varies considerably. The aim of this cross-sectional survey was to determine its prevalence in non-ulcer dyspeptics and to determine whether this is influenced by age, race, sex, socio-economic status, educational level and the number of persons sharing accommodation. One hundred and sixty-nine patients underwent endoscopy; biopsy specimens were taken from the antrum and H. pylori status was determined histologically. Gastric colonisation was found in 106 patients (63%). The prevalence showed a marked ethnic difference: 40% in whites and 71% in coloureds (P < 0.001). The ethnic groups were characterised by significant differences in socio-economic status (P < 10(-6)), educational level (P < 10(-6)), number of persons sharing accommodation (P < 10(-6)) and age (P < 0.001). These same differences were found when comparing the H. pylori-positive and negative groups, but were less marked and could be attributed to the marked differences between ethnic groups. We conclude that H. pylori prevalence differs between the ethnic groups studied. This may be because of varying degrees of exposure risk.


Feasibility of T1rho and T2 map magnetic resonance imaging for evaluating graft maturation after anatomic double-bundle anterior cruciate ligament reconstruction.
Although T1rho and T2 map magnetic resonance imaging (MRI) have been perceived as useful diagnostic modalities for cartilage degeneration, no studies have assessed whether these two sequences are useful for monitoring ACL graft maturation after ACL reconstruction. The present study examined whether the two sequences reflect graft function and maturation after ACL reconstruction. Twenty consecutive patients who consented to undergo MRI at 3, 6, and 12 months after double-bundle ACL reconstruction were enrolled. MRI was performed using T1 rho and T2 map sequences in a single session. Temporal changes in T1rho and T2 values of a purely tendinous portion of graft were assessed at each time point. Correlations were analyzed between T1rho or T2 map values and clinical results, including anteroposterior laxity at 2 and 4 years postoperatively, pivot shift test results at 4 years, and graft tension on second-look arthroscopy. Separate analyses were performed for the anteromedial bundle (AMB) and posterolateral bundle (PLB). T1rho sequence was able to visualize the tendinous portions of AMB and PLB more clearly than T2 map sequence even on gray-scale images. Mean T1rho and T2 map values gradually decreased during the first operative year, but the trend was more prominent and consistent for T1rho values than for T2 map values. Correlation analysis revealed that T1rho and T2 map values at 1 year correlated significantly with anteroposterior laxity at 2 and 4 years. This trend was found in both AMB and PLB. Both T1rho and T2 map values failed to exhibit a statistical correlation with arthroscopic findings of graft tension. The present study was the first trial to assess the feasibility of T1rho and T2 map sequences to objectively monitor the course of graft maturation after ACL reconstruction. Both sequences successfully detected purely tendinous portions of graft, and mean values gradually decreased during the first year postoperatively. Both values at 1 year correlated significantly with anteroposterior laxity of the knee joint at 4 years, indicating that the values reflected graft fate.


Unexpected thermal annealing effects on the viscosity of polymer nanocomposites.
The effects of thermal annealing, 12-50 K above the glass transition temperature, on the zero-shear viscosity, η, of polymer nanocomposites (PNCs) and the corresponding host polymers were studied. For all specimens, including neat and 4 wt% dioctyl phthalate (DOP)-plasticized polystyrene (PS), neat poly(methyl methacrylate) (PMMA), and PNCs containing bare and grafted silica nanoparticles in neat and DOP-plasticized PS, the η increased with time initially, and only asymptotically approached a steady-state value after thermal annealing for ∼100 to ∼200 h. We found that this phenomenon occurred regardless of the solvent used to prepare the sample although the fractional changes in η (δη/η) are visibly bigger for tetrahydrofuran (THF). Moreover, the PNCs not plasticized by DOP showed bigger δη/η than their host polymers while the plasticized ones behave essentially the same as the neat hosts. Interestingly, some unplasticized PNCs prepared from THF exhibited smaller viscosities than the host polymer, but this anomaly disappeared on thermal annealing. By correlating the viscosity measurements with the evolution of the solvent content, average NP aggregate size and the amount of adsorbed PS on silica for samples prepared from different solvents, we infer that the temporal viscosity evolution originates from out-of-equilibrium chain conformations produced during sample preparation. Because these relaxations are limited by the rearrangement of the polymer chains adsorbed on the NP or sample substrate surface, the timescales over which η changes can be much longer than the polymer reptation time, as observed.


Blackberry, black raspberry, blueberry, cranberry, red raspberry, and strawberry extracts inhibit growth and stimulate apoptosis of human cancer cells in vitro.
Berry fruits are widely consumed in our diet and have attracted much attention due to their potential human health benefits. Berries contain a diverse range of phytochemicals with biological properties such as antioxidant, anticancer, anti-neurodegerative, and anti-inflammatory activities. In the current study, extracts of six popularly consumed berries--blackberry, black raspberry, blueberry, cranberry, red raspberry and strawberry--were evaluated for their phenolic constituents using high performance liquid chromatography with ultraviolet (HPLC-UV) and electrospray ionization mass spectrometry (LC-ESI-MS) detection. The major classes of berry phenolics were anthocyanins, flavonols, flavanols, ellagitannins, gallotannins, proanthocyanidins, and phenolic acids. The berry extracts were evaluated for their ability to inhibit the growth of human oral (KB, CAL-27), breast (MCF-7), colon (HT-29, HCT116), and prostate (LNCaP) tumor cell lines at concentrations ranging from 25 to 200 micro g/mL. With increasing concentration of berry extract, increasing inhibition of cell proliferation in all of the cell lines were observed, with different degrees of potency between cell lines. The berry extracts were also evaluated for their ability to stimulate apoptosis of the COX-2 expressing colon cancer cell line, HT-29. Black raspberry and strawberry extracts showed the most significant pro-apoptotic effects against this cell line. The data provided by the current study and from other laboratories warrants further investigation into the chemopreventive and chemotherapeutic effects of berries using in vivo models.


Local improvement of the signal-to-noise ratio for diffractive optical elements designed by unidirectional optimization methods.
We present a straightforward method to design multilevel phase-only diffractive optical elements with a locally improved signal-to-noise ratio in the reconstruction. The method is generally applicable to all unidirectional design schemes, such as direct search, simulated annealing, or genetic optimization. As the shape and the location of the desired low noise areas are supplied by a bit map file the method allows for the design of basically any two-dimensional low noise area. The improvement in the signal-to-noise ratio that may be achieved is considerable but also entails reduced diffraction efficiency. The suggested method is applied to different beam-splitter design examples. All examples are calculated with the scalar diffraction approximation in the far field.


Microbiological quality of seasoned roasted laver and potential hazard control in a real processing line.
Microbiological quality of laver, one of the edible seaweeds, has not been reported in a real processing line. Laver or supplements were collected from six manufacturers (A to F) to assess potential microbiological hazards and the critical control points in commercial processing lines. Aerobic plate counts (APC), coliform counts, Bacillus cereus, Staphylococcus aureus, and Vibrio parahaemolyticus were enumerated, and the presence of B. cereus, Listeria monocytogenes, Salmonella, S. aureus, and V. parahaemolyticus were confirmed during processing. The raw material, i.e., dried laver, had a high initial APC level (4.4 to 7.8 log CFU/g), which decreased gradually during processing (final products, 1.3 to 5.9 log CFU/g). Coliforms and B. cereus were not detected in any of the final products, but they were present in some raw materials and semiprocessed products in quantitative analysis. After enrichment for recovery of stress-injured cells, E. coli and foodborne pathogens were not detected in any samples, with the exception of B. cereus. Heat-injured and spore-forming B. cereus isolates were occasionally obtained from some of the raw materials and products after enrichment, thus B. cereus may be a potential microbiological hazard that should be controlled using strategic intervention measures. Secondary roasting (260 to 400°C, 2 to 10 s) significantly reduced the APC (maximum log reduction, 4.7 log CFU/g), and this could be a key intervention step for controlling microbiological hazards during processing (critical control point). When this step was performed appropriately, according to the processing guide for each plant, the microorganisms were inactivated more successfully in the products. This study provides scientific evidence that may facilitate the development of strategies for microbiological hazard control and hygienic management guidelines for real manufacturing plants.


Evolution of T4-related phages.
Much progress has been made in understanding T-even phage biology in the last 50 years. We now know the entire sequence of T4, encoding nearly 300 genes, only 69 of which have been shown to be essential under standard laboratory conditions; no specific function is yet known for about 140 of them. The origin of most phage genes is unclear, and only 42 genes in T4 have significant similarity to anything currently included in GenBank. Comparative analysis of related phages is now being used to gain insight into both the evolutionary origins and interrelationships of these phage genes, and the functions of their protein products. The genomes of phages isolated from Tbilisi hospitals, Long Island sewage plants, the Denver zoo, and Khabarovsk show basic similarity. However, these phages show substantial insertions and deletions in a number of regions relative to each other, and closer investigation of specific sequences often reveals much more complex relationships. There are only a few cases in T4-related phages in which there is evidence for evolution through DNA duplication. These include the fibrous products of genes 12, 34, and 37; head proteins gp23 and gp24; and the Alt enzyme and its downstream neighbors. T4 also contains 13 apparent relatives of group I and group II intron homing endonucleases. Distal portions of the tail fibers of various T-even phages contain segments closely related to tail-fiber regions of other DNA coliphages, such as Mu, P1, P2, and lambda. Horizontal gene transfer clearly emerges as a major factor in the evolution of at least the tail-fiber regions, where site-specific recombination probably is involved in the exchange of host-range determinants.


Structure-Based Analysis of the Ligand-Binding Mechanism for DhelOBP21, a C-minus Odorant Binding Protein, from Dastarcus helophoroides (Fairmaire; Coleoptera: Bothrideridae).
Odorant binding proteins (OBPs) transport hydrophobic odor molecules across the sensillar lymph to trigger a neuronal response. Herein, the Minus-C OBP (DhelOBP21) was characterized from Dastarcus helophoroides, the most important natural parasitic enemy insect that targets Monochamus alternatus. Homology modeling and molecular docking were conducted on the interaction between DhelOBP21 and 17 volatile molecules (including volatiles from pine bark, the larva of M. alternatus, and the faeces of the larva). The predicted three-dimensional structure showed only two disulfide bridges and a hydrophobic binding cavity with a short C-terminus. Ligand-binding experiments using N-phenylnaphthylamine (1-NPN) as a fluorescent probe showed that DhelOBP21 exhibited better binding affinities against those ligands with a molecular volume between 100 and 125 Å(³) compared with ligands with a molecular volume between 160 and 185 Å(³). Molecules that are too big or too small are not conducive for binding. We mutated the amino acid residues of the binding cavity to increase either hydrophobicity or hydrophilia. Ligand-binding experiments and cyber molecular docking assays indicated that hydrophobic interactions are more significant than hydrogen-bonding interactions. Although hydrogen-bond interactions could be predicted for some binding complexes, the hydrophobic interactions had more influence on binding following hydrophobic changes that affected the cavity. The orientation of ligands affects binding by influencing hydrophobic interactions. The binding process is controlled by multiple factors. This study provides a basis to explore the ligand-binding mechanisms of Minus-C OBP.


mTOR Blockade by Rapamycin in Spondyloarthritis: Impact on Inflammation and New Bone Formation in vitro and in vivo.
Introduction: Spondyloarthritis (SpA) is characterized by inflammation, articular bone erosions and pathologic new bone formation. Targeting TNFα or IL-17A with current available therapies reduces inflammation in SpA, however, treatment of the bone pathology in SpA remains an unmet clinical need. Activation of the mammalian target Of rapamycin (mTOR) promotes IL-17A expression and osteogenesis. Therefore, the inhibition of mTOR (with rapamycin) could be a promising therapeutic avenue in SpA. Objectives: To investigate the effect of blocking mTOR on inflammation, bone erosions and new bone formation in SpA. Methods: Peripheral blood mononuclear cells (PBMCs) from patients with SpA were stimulated with anti-CD3/CD28 in the presence or absence of rapamycin and the resulting cytokine expression was assessed. Fibroblast-like synoviocytes (FLS) from SpA patients were assessed for osteogenic differentiation potential in conditions with TNFα, IL-17A, or TNFα plus IL-17A, in the presence or absence of rapamycin. HLA-B27/Huβ2m transgenic rats were immunized with low dose heat-inactivated Mycobacterium tuberculosis (M. tub), treated with 1.5 mg/kg rapamycin prophylactically or therapeutically and monitored for arthritis and spondylitis. Histology and mRNA analysis were performed after 5 weeks of treatment to assess inflammation and bone pathology. Results:In vitro TNFα and IL-17A protein production by SpA PBMCs was inhibited in the presence of rapamycin. Rapamycin also inhibited osteogenic differentiation of human SpA FLS. Ex vivo analysis of SpA synovial biopsies indicated activation of the mTOR pathway in the synovial tissue of SpA patients. In vivo, prophylactic treatment of HLA-B27/Huβ2m transgenic rats with rapamycin significantly inhibited the development and severity of inflammation in peripheral joints and spine (arthritis and spondylitis), with histological evidence of reduced bone erosions and new bone formation around peripheral joints. In addition, therapeutic treatment with rapamycin significantly decreased severity of arthritis and spondylitis, with peripheral joint histology showing reduced inflammation, bone erosions and new bone formation. IL-17A mRNA expression was decreased in the metacarpophalangeal joints after rapamycin treatment. Conclusion: mTOR blockade inhibits IL-17A and TNFα production by PBMCs, and osteogenic differentiation of FLS from patients with SpA in vitro. In the HLA-B27 transgenic rat model of SpA, rapamycin inhibits arthritis and spondylitis development and severity, reduces articular bone erosions, decreases pathologic new bone formation and suppresses IL-17A expression. These results may support efforts to evaluate the efficacy of targeting the mTOR pathway in SpA patients.


Asymmetric effects of social and economic incentives on cooperation in real effort based public goods games.
Many practitioners as well as researchers explore promoting environmentally conscious behavior in the context of public goods systems. Numerous experimental studies revealed various types of incentives to increase cooperation on public goods. There is ample evidence that monetary and non-monetary incentives, such as donations, have a positive effect on cooperation in public goods games that exceeds fully rational and optimal economic decision making. Despite an accumulation of these studies, in the typical setting of these experiments participants decide on an allocation of resources to a public pool, but they never exert actual effort. However, in reality, we often observe that players' real effort is required in these public goods game situations. Therefore, more analysis is needed to draw conclusions for a wider set of incentive possibilities in situations similar to yet deviating from resource allocation games. Here we construct a real effort public goods game in an online experiment and statistically analyze the effect different types of incentives have on cooperation. In our experiment, we examine combinations of monetary and social incentives in a setting aimed closer to practical realities, such as financial costs and real effort forming part of the decision to cooperate on a public good. In our real effort public goods game participants cooperate and defect on image-scoring tasks. We find that in our setting economic and social incentives produce an asymmetric effect. Interestingly economic incentives decreased the share of highly uncooperative participants, while social incentives raised the share of highly cooperative participants.


Femoral nerve injury following a lumbar plexus blockade.
Lumbar plexus blockade (LPB) combined with sciatic nerve block (SNB) is frequently used for lower extremity surgery. Perioperative nerve injury is a rarely encountered complication of peripheral nerve blocks (PNB). Here we report a 44-year-old male patient who developed a partial femoral nerve injury (FNI) following a LPB which was performed before the surgery of a patellar fracture. The clinical and electroneuromyographic findings of the patient were recovered almost completely within the following six months. The presented case demonstrated a FNI despite the absence of any pain or paresthesia sensation, with the disappearance of motor response under 0.3 mA of neurostimulation in the experienced hands.


Natural fluorescence emission - an indirect measurement of applied ozone dosages to remove pharmaceuticals in biologically treated wastewater.
This study investigated the feasibility of UV-absorbance and fluorescence as monitoring tools for ozone dosages applied to effluents from wastewater treatment plans (WWTPs). Secondary treated effluents from five Swedish WWTPs underwent ozonation (at dosages ranging 0.5-12.0 mg O3/L) in bench-scale experiments. Correlations between ozone dosages and UV-absorbance at 254 and 272 nm were extrapolated with the first one being preferential for the wastewaters used because of its higher signal. UV-absorbance could detect differences in the applied ozone dosage as low as 1 mg/L, making it suitable to monitor effluent ozone treatment processes. Next, fluorescence was investigated at wavelength transitions that have being associated with humic-like fluorescents (Ex249Em450 and Ex335Em450) and protein-like fluorescents (Ex275Em340 and Ex231Em360 and Ex231Em315 and Ex275Em310). The Ex249Em450 transition was found to have the highest signal in all effluents and the best linear regression fitting with the ozone dosages over a wide range. However, low ozone dosages (0.5-3.0 mg O3/L), Ex335Em450 wavelength transition showed a more constant slope among the different domestic wastewater samples with slightly better R 2 values than the Ex249Em450 transition. Fluorescence removal via ozonation correlated with the pharmaceutical removal; however, the wellness of fitting was directly dependent on the pharmaceuticals' reactivity with ozone. Pharmaceuticals with moderate reactivity towards ozone appeared to be linearly correlated with the Ex249Em450 transition, while very reactive or recalcitrant pharmaceuticals had an exponential or a parabolic dependency. This means that fluorescence can potentially be used as a qualitative tool for pharmaceutical removal. Abbreviations: APIs, Active Pharmaceutical Ingredients; DOM, Dissolved organic matter; WWTPs, wastewater treatment plans; NOM, Natural organic matter; UV, Ultra-Violet light; DOC, Dissolved organic carbon.


Behavioral and Electrophysiological Correlates of Memory Binding Deficits in Patients at Different Risk Levels for Alzheimer's Disease.
Deficits in visual short-term memory (VSTM) binding have been proposed as an early and specific marker for Alzheimer's disease (AD). However, no studies have explored the neural correlates of this domain in clinical categories involving prodromal stages with different risk levels of conversion to AD. We assessed underlying electrophysiological modulations in patients with mild cognitive impairment (MCI), patients in the MCI stages of familial AD carrying the mutation E280A of the presenilin-1 gene (MCI-FAD), and healthy controls. Moreover, we compared the behavioral performance and neural correlates of both patient groups. Participants completed a change-detection VSTM task assessing recognition of changes between shapes or shape-color bindings, presented in two consecutive arrays (i.e., study and test) while event related potentials (ERPs) were recorded. Changes always occurred in the test array and consisted of new features replacing studied features (shape-only) or features swapping across items (shape-color binding). Both MCI and MCI-FAD patients performed worse than controls in the shape-color binding condition. Early electrophysiological activity (100-250 ms) was significantly reduced in both clinical groups, particularly over fronto-central and parieto-occipital regions. However, shape-color binding performance and their reduced neural correlates were similar between MCI and MCI-FAD. Our results support the validity of the VSTM binding test and their neural correlates in the early detection of AD and highlight the importance of studies comparing samples at different risk for AD conversion. The combined analysis of behavioral and ERP data gleaned with the VSTM binding task can offer a valuable memory biomarker for AD.


A sensorimotor map: modulating lateral interactions for anticipation and planning.
Experimental studies of reasoning and planned behavior have provided evidence that nervous systems use internal models to perform predictive motor control, imagery, inference, and planning. Classical (model-free) reinforcement learning approaches omit such a model; standard sensorimotor models account for forward and backward functions of sensorimotor dependencies but do not provide a proper neural representation on which to realize planning. We propose a sensorimotor map to represent such an internal model. The map learns a state representation similar to self-organizing maps but is inherently coupled to sensor and motor signals. Motor activations modulate the lateral connection strengths and thereby induce anticipatory shifts of the activity peak on the sensorimotor map. This mechanism encodes a model of the change of stimuli depending on the current motor activities. The activation dynamics on the map are derived from neural field models. An additional dynamic process on the sensorimotor map (derived from dynamic programming) realizes planning and emits corresponding goal-directed motor sequences, for instance, to navigate through a maze.


Caffeine stimulates hepatic lipid metabolism by the autophagy-lysosomal pathway in mice.
Caffeine is one of the world's most consumed drugs. Recently, several studies showed that its consumption is associated with lower risk for nonalcoholic fatty liver disease (NAFLD), an obesity-related condition that recently has become the major cause of liver disease worldwide. Although caffeine is known to stimulate hepatic fat oxidation, its mechanism of action on lipid metabolism is still not clear. Here, we show that caffeine surprisingly is a potent stimulator of hepatic autophagic flux. Using genetic, pharmacological, and metabolomic approaches, we demonstrate that caffeine reduces intrahepatic lipid content and stimulates β-oxidation in hepatic cells and liver by an autophagy-lysosomal pathway. Furthermore, caffeine-induced autophagy involved down-regulation of mammalian target of rapamycin signaling and alteration in hepatic amino acids and sphingolipid levels. In mice fed a high-fat diet, caffeine markedly reduces hepatosteatosis and concomitantly increases autophagy and lipid uptake in lysosomes. These results provide novel insight into caffeine's lipolytic actions through autophagy in mammalian liver and its potential beneficial effects in NAFLD.


Ephrin-A5 potentiates netrin-1 axon guidance by enhancing Neogenin availability.
Axonal growth cones are guided by molecular cues in the extracellular environment. The mechanisms of combinatorial integration of guidance signals at the growth cone cell membrane are still being unravelled. Limb-innervating axons of vertebrate spinal lateral motor column (LMC) neurons are attracted to netrin-1 via its receptor, Neogenin, and are repelled from ephrin-A5 through its receptor EphA4. The presence of both cues elicits synergistic guidance of LMC axons, but the mechanism of this effect remains unknown. Using fluorescence immunohistochemistry, we show that ephrin-A5 increases LMC growth cone Neogenin protein levels and netrin-1 binding. This effect is enhanced by overexpressing EphA4 and is inhibited by blocking ephrin-A5-EphA4 binding. These effects have a functional consequence on LMC growth cone responses since bath addition of ephrin-A5 increases the responsiveness of LMC axons to netrin-1. Surprisingly, the overexpression of EphA4 lacking its cytoplasmic tail, also enhances Neogenin levels at the growth cone and potentiates LMC axon preference for growth on netrin-1. Since netrins and ephrins participate in a wide variety of biological processes, the enhancement of netrin-1 signalling by ephrins may have broad implications.


Slope-based stochastic resonance: how noise enables phasic neurons to encode slow signals.
Fundamental properties of phasic firing neurons are usually characterized in a noise-free condition. In the absence of noise, phasic neurons exhibit Class 3 excitability, which is a lack of repetitive firing to steady current injections. For time-varying inputs, phasic neurons are band-pass filters or slope detectors, because they do not respond to inputs containing exclusively low frequencies or shallow slopes. However, we show that in noisy conditions, response properties of phasic neuron models are distinctly altered. Noise enables a phasic model to encode low-frequency inputs that are outside of the response range of the associated deterministic model. Interestingly, this seemingly stochastic-resonance (SR) like effect differs significantly from the classical SR behavior of spiking systems in both the signal-to-noise ratio and the temporal response pattern. Instead of being most sensitive to the peak of a subthreshold signal, as is typical in a classical SR system, phasic models are most sensitive to the signal's rising and falling phases where the slopes are steep. This finding is consistent with the fact that there is not an absolute input threshold in terms of amplitude; rather, a response threshold is more properly defined as a stimulus slope/frequency. We call the encoding of low-frequency signals with noise by phasic models a slope-based SR, because noise can lower or diminish the slope threshold for ramp stimuli. We demonstrate here similar behaviors in three mechanistic models with Class 3 excitability in the presence of slow-varying noise and we suggest that the slope-based SR is a fundamental behavior associated with general phasic properties rather than with a particular biological mechanism.


Inhibition of hyaluronan synthesis restores immune tolerance during autoimmune insulitis.
We recently reported that abundant deposits of the extracellular matrix polysaccharide hyaluronan (HA) are characteristic of autoimmune insulitis in patients with type 1 diabetes (T1D), but the relevance of these deposits to disease was unclear. Here, we have demonstrated that HA is critical for the pathogenesis of autoimmune diabetes. Using the DO11.10xRIPmOVA mouse model of T1D, we determined that HA deposits are temporally and anatomically associated with the development of insulitis. Moreover, treatment with an inhibitor of HA synthesis, 4-methylumbelliferone (4-MU), halted progression to diabetes even after the onset of insulitis. Similar effects were seen in the NOD mouse model, and in these mice, 1 week of treatment was sufficient to prevent subsequent diabetes. 4-MU reduced HA accumulation, constrained effector T cells to nondestructive insulitis, and increased numbers of intraislet FOXP3+ Tregs. Consistent with the observed effects of 4-MU treatment, Treg differentiation was inhibited by HA and anti-CD44 antibodies and rescued by 4-MU in an ERK1/2-dependent manner. These data may explain how peripheral immune tolerance is impaired in tissues under autoimmune attack, including islets in T1D. We propose that 4-MU, already an approved drug used to treat biliary spasm, could be repurposed to prevent, and possibly treat, T1D in at-risk individuals.