The Neurological Traces of Look-Alike Avatars

We designed an observational study where participants (n = 17) were exposed to pictures and look-alike avatars pictures of themselves, a familiar friend or an unfamiliar person. By measuring participants’ brain activity with electroencephalography (EEG), we found face-recognition event related potentials (ERPs) in the visual cortex, around 200–250 ms, to be prominent for the different familiarity levels. A less positive component was found for self-recognized pictures (P200) than pictures of others, showing similar effects in both real faces and look-alike avatars. A rapid adaptation in the same component was found when comparing the neural processing of avatar faces vs. real faces, as if avatars in general were assimilated as real face representations over time. ERP results also showed that in the case of the self-avatar, the P200 component correlated with more complex conscious encodings of self-representation, i.e., the difference in voltage in the P200 between the self-avatar and the self-picture was reduced in participants that felt the avatar looked like them. This study is put into context within the literature of self-recognition and face recognition in the visual cortex. Additionally, the implications of these results on look-alike avatars are discussed both for future virtual reality (VR) and neuroscience studies

Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: a systematic guideline review and expert consensus

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.The complexity and heterogeneity of patients with multimorbidity and polypharmacy renders traditional disease-oriented guidelines often inadequate and complicates clinical decision making. To address this challenge, guidelines have been developed on multimorbidity or polypharmacy. To systematically analyse their recommendations, we conducted a systematic guideline review using the Ariadne principles for managing multimorbidity as analytical framework. The information synthesis included a multistep consensus process involving 18 multidisciplinary experts from seven countries. We included eight guidelines (four each on multimorbidity and polypharmacy) and extracted about 250 recommendations. The guideline addressed (i) the identification of the target population (risk factors); (ii) the assessment of interacting conditions and treatments: medical history, clinical and psychosocial assessment including physiological status and frailty, reviews of medication and encounters with healthcare providers highlighting informational continuity; (iii) the need to incorporate patient preferences and goal setting: eliciting preferences and expectations, the process of shared decision making in relation to treatment options and the level of involvement of patients and carers; (iv) individualized management: guiding principles on optimization of treatment benefits over possible harms, treatment communication and the information content of medication/care plans; (v) monitoring and follow-up: strategies in care planning, self-management and medication-related aspects, communication with patients including safety instructions and adherence, coordination of care regarding referral and discharge management, medication appropriateness and safety concerns. The spectrum of clinical and self-management issues varied from guiding principles to specific recommendations and tools providing actionable support. The limited availability of reliable risk prediction models, feasible interventions of proven effectiveness and decision aids, and limited consensus on appropriate outcomes of care highlight major research deficits. An integrated approach to both multimorbidity and polypharmacy should be considered in future guidelines.Journal of Internal MedicineKarolinska Institutet Strategic Research Area in Epidemiology (SfoEpi

Tamoxifen accelerates the repair of demyelinated lesions in the central nervous system.

Enhancing central nervous system (CNS) myelin regeneration is recognized as an important strategy to ameliorate the devastating consequences of demyelinating diseases such as multiple sclerosis. Previous findings have indicated that myelin proteins, which accumulate following demyelination, inhibit remyelination by blocking the differentiation of rat oligodendrocyte progenitor cells (OPCs) via modulation of PKCα. We therefore screened drugs for their potential to overcome this differentiation block. From our screening, tamoxifen emerges as a potent inducer of OPC differentiation in vitro. We show that the effects of tamoxifen rely on modulation of the estrogen receptors ERα, ERβ, and GPR30. Furthermore, we demonstrate that administration of tamoxifen to demyelinated rats in vivo accelerates remyelination. Tamoxifen is a well-established drug and is thus a promising candidate for a drug to regenerate myelin, as it will not require extensive safety testing. In addition, Tamoxifen plays an important role in biomedical research as an activator of inducible genetic models. Our results highlight the importance of appropriate controls when using such models.This work was supported by grants from Wings for Life and the UK Multiple Sclerosis Society. M.R.N.K. holds an NIHR CL award and a Sir David and Isobel Walker fellowship. G.A.G. was supported by CONICYT (Becas Chile) scholarship, and M.P.H. was supported by a Sir David and Isobel Walker studentship. Research in the author’s laboratory is supported by a core support grant from the Wellcome Trust and MRC to the Wellcome Trust Medical Research Council Cambridge Stem Cell Institut

Green Health in Guatemala - How can we build mutual trust and partnerships for developing local medicines’ evidence-base and potential?

The implementation of access and benefit-sharing (ABS) protocols and especially the Nagoya Protocol has created new hurdles for collaborations around Indigenous Traditional Knowledge and international collaborations. Overall, these frameworks push for the development of novel collaborative North-South agendas in order to improve the fair distribution of benefits. The Green Health project (Guatemala) aims to implement a culturally pertinent and mutually accepted framework for sustainable use, access and benefit-sharing (ABS) of traditional medicinal plants. It involves developing a consensus among indigenous groups, government officials, industry, and academia. We describe steps undertaken to design and implement an intercultural transdisciplinary process that promotes trust building and advances herbal medicine research in a respectful and innovative way. This involves joint definition of goals and methods. The consortium co-researched Q’eqchi’ Maya traditional medicine, collected voucher specimens of medicinal plants with traditional healers, identified their taxa, and later developed a literature-based evaluation identifying species for potential product development. No samples for further research and development are collected. By applying the emic-etic concept, the project was able to understand the main drivers of each stakeholder and the associated obstacles for reaching an ABS agreement. This results in the emergence of potential new drivers for developing evidence-based herbal medicine from the perspective of academia, policy and cooperation and grass-roots indigenous movements

Effect of Human Burn Wound Exudate on Pseudomonas aeruginosa Virulence.

Burn wound sepsis is currently the main cause of morbidity and mortality after burn trauma. Infections by notorious pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii impair patient recovery and can even lead to fatality. In this study, we investigated the effect of burn wound exudates (BWEs) on the virulence of those pathogens. BWEs were collected within 7 days after burn trauma from 5 burn patients. We first monitored their effect on pathogen growth. In contrast to A. baumannii and S. aureus, P. aeruginosa was the only pathogen able to grow within these human fluids. Expression of typical virulence factors such as pyocyanin and pyoverdine was even enhanced compared the levels seen with standard laboratory medium. A detailed chemical composition analysis of BWE was performed, which enabled us to determine the major components of BWE and underline the metabolic modifications induced by burn trauma. These data are essential for the development of an artificial medium mimicking the burn wound environment and the establishment of an in vitro system to analyze the initial steps of burn wound infections. IMPORTANCE Microbial infection of severe burn wounds is currently a major medical challenge. Of the infections by bacteria able to colonize such injuries, those by Pseudomonas aeruginosa are among the most severe, causing major delays in burn patient recovery or leading to fatal issues. In this study, we investigated the growth properties of several burn wound pathogens in biological fluids secreted from human burn wounds. We found that P. aeruginosa strains were able to proliferate but not those of the other pathogens tested. In addition, burn wound exudates (BWEs) stimulate the expression of virulence factors in P. aeruginosa. The chemical composition analysis of BWEs enabled us to determine the major components of these fluids. These data are essential for the development of an artificial medium mimicking the burn wound environment and for in vitro analysis of the initial step in the development of burn wound infections

What two models may teach us about duality violations in QCD

Though the operator product expansion is applicable in the calculation of current correlation functions in the Euclidean region, when approaching the Minkowskian domain, violations of quark-hadron duality are expected to occur, due to the presence of bound-state or resonance poles. In QCD finite-energy sum rules, contour integrals in the complex energy plane down to the Minkowskian axis have to be performed, and thus the question arises what the impact of duality violations may be. The structure and possible relevance of duality violations is investigated on the basis of two models: the Coulomb system and a model for light-quark correlators which has already been studied previously. As might yet be naively expected, duality violations are in some sense "maximal" for zero-width bound states and they become weaker for broader resonances whose poles lie further away from the physical axis. Furthermore, to a certain extent, they can be suppressed by choosing appropriate weight functions in the finite-energy sum rules. A simplified Ansatz for including effects of duality violations in phenomenological QCD sum rule analyses is discussed as well.Comment: 17 pages, 6 figures; version to appear in JHE

Pharmacists in Pharmacovigilance: Can Increased Diagnostic Opportunity in Community Settings Translate to Better Vigilance?

The pharmacy profession has undergone substantial change over the last two to three decades. Whilst medicine supply still remains a central function, pharmacist’s roles and responsibilities have become more clinic and patient focused. In the community (primary care), pharmacists have become important providers of healthcare as Western healthcare policy advocates patient self-care. This has resulted in pharmacists taking on greater responsibility in managing minor illness and the delivery of public health interventions. These roles require pharmacists to more fully use their clinical skills, and often involve diagnosis and therapeutic management. Community pharmacists are now, more than ever before, in a position to identify, record and report medication safety incidents. However, current research suggests that diagnostic ability of community pharmacists is questionable and they infrequently report to local or national schemes. The aim of this paper is to highlight current practice and suggest ways in which community pharmacy can more fully contribute to patient safety

Circle of Willis variation in a complex stroke presentation: a case report

BACKGROUND: The impact of circle of Willis anatomical variation upon the presentation of stroke is probably underrecognised. CASE PRESENTATION: A 63-year-old right-handed woman developed a left hemiparesis and right leg weakness sequentially following a road traffic accident (RTA). Despite initial concern about the possibility of cervical spinal cord injury, the final diagnosis was bilateral artery-to-artery embolic cerebral infarction with dominant right internal carotid artery. CONCLUSION: The case illustrates the complex presentation of stroke as a pseudo-cervical cord lesion and the impact of circle of Willis anatomical variation upon the expression of large vessel cerebrovascular disease

Association of VAV2 and VAV3 polymorphisms with cardiovascular risk factors

Hypertension, diabetes and obesity are cardiovascular risk factors closely associated to the development of renal and cardiovascular target organ damage. VAV2 and VAV3, members of the VAV family proto-oncogenes, are guanosine nucleotide exchange factors for the Rho and Rac GTPase family, which is related with cardiovascular homeostasis. We have analyzed the relationship between the presence of VAV2 rs602990 and VAV3 rs7528153 polymorphisms with cardiovascular risk factors and target organ damage (heart, vessels and kidney) in 411 subjects. Our results show that being carrier of the T allele in VAV2 rs602990 polymorphism is associated with an increased risk of obesity, reduced levels of ankle-brachial index and diastolic blood pressure and reduced retinal artery caliber. In addition, being carrier of T allele is associated with increased risk of target organ damage in males. On the other hand, being carrier of the T allele in VAV3 rs7528153 polymorphism is associated with a decreased susceptibility of developing a pathologic state composed by the presence of hypertension, diabetes, obesity or cardiovascular damage, and with an increased risk of developing altered basal glycaemia. This is the first report showing an association between VAV2 and VAV3 polymorphisms with cardiovascular risk factors and target organ damage

Activated Magnetospheres of Magnetars

Like the solar corona, the external magnetic field of magnetars is twisted by surface motions of the star. The twist energy is dissipated over time. We discuss the theory of this activity and its observational status. (1) Theory predicts that the magnetosphere tends to untwist in a peculiar way: a bundle of electric currents (the "j-bundle") is formed with a sharp boundary, which shrinks toward the magnetic dipole axis. Recent observations of shrinking hot spots on magnetars are consistent with this behavior. (2) Continual discharge fills the j-bundle with electron-positron plasma, maintaining a nonthermal corona around the neutron star. The corona outside a few stellar radii strongly interacts with the stellar radiation and forms a "radiatively locked" outflow with a high e+- multiplicity. The locked plasma annihilates near the apexes of the closed magnetic field lines. (3) New radiative-transfer simulations suggest a simple mechanism that shapes the observed X-ray spectrum from 0.1 keV to 1 MeV: part of the thermal X-rays emitted by the neutron star are reflected from the outer corona and then upscattered by the inner relativistic outflow in the j-bundle, producing a beam of hard X-rays.Comment: 23 pages, 7 figures; review chapter in the proceedings of ICREA Workshop on the High-Energy Emission from Pulsars and Their Systems, Sant Cugat, Spain, April 201