Combination of diffusion tensor and functional magnetic resonance imaging during recovery from the vegetative state.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background The rate of recovery from the vegetative state (VS) is low. Currently, little is known of the mechanisms and cerebral changes that accompany those relatively rare cases of good recovery. Here, we combined functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to study the evolution of one VS patient at one month post-ictus and again twelve months later when he had recovered consciousness. Methods fMRI was used to investigate cortical responses to passive language stimulation as well as task-induced deactivations related to the default-mode network. DTI was used to assess the integrity of the global white matter and the arcuate fasciculus. We also performed a neuropsychological assessment at the time of the second MRI examination in order to characterize the profile of cognitive deficits. Results fMRI analysis revealed anatomically appropriate activation to speech in both the first and the second scans but a reduced pattern of task-induced deactivations in the first scan. In the second scan, following the recovery of consciousness, this pattern became more similar to that classically described for the default-mode network. DTI analysis revealed relative preservation of the arcuate fasciculus and of the global normal-appearing white matter at both time points. The neuropsychological assessment revealed recovery of receptive linguistic functioning by 12-months post-ictus. Conclusions These results suggest that the combination of different structural and functional imaging modalities may provide a powerful means for assessing the mechanisms involved in the recovery from the VS.Published versio

HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors

Combination antiretroviral therapy (CART) has greatly reduced medical morbidity and mortality with HIV infection, but high rates of HIV-associated neurocognitive disorders (HAND) continue to be reported. Because large HIV-infected (HIV+) and uninfected (HIV−) groups have not been studied with similar methods in the pre-CART and CART eras, it is unclear whether CART has changed the prevalence, nature, and clinical correlates of HAND. We used comparable methods of subject screening and assessments to classify neurocognitive impairment (NCI) in large groups of HIV + and HIV − participants from the pre-CART era (1988–1995; N = 857) and CART era (2000–2007; N = 937). Impairment rate increased with successive disease stages (CDC stages A, B, and C) in both eras: 25%, 42%, and 52% in pre-CART era and 36%, 40%, and 45% in CART era. In the medically asymptomatic stage (CDC-A), NCI was significantly more common in the CART era. Low nadir CD4 predicted NCI in both eras, whereas degree of current immunosuppression, estimated duration of infection, and viral suppression in CSF (on treatment) were related to impairment only pre-CART. Pattern of NCI also differed: pre-CART had more impairment in motor skills, cognitive speed, and verbal fluency, whereas CART era involved more memory (learning) and executive function impairment. High rates of mild NCI persist at all stages of HIV infection, despite improved viral suppression and immune reconstitution with CART. The consistent association of NCI with nadir CD4 across eras suggests that earlier treatment to prevent severe immunosuppression may also help prevent HAND. Clinical trials targeting HAND prevention should specifically examine timing of ART initiation

Bacterial Cooperation Causes Systematic Errors in Pathogen Risk Assessment due to the Failure of the Independent Action Hypothesis

The Independent Action Hypothesis (IAH) states that pathogenic individuals (cells, spores, virus particles etc.) behave independently of each other, so that each has an independent probability of causing systemic infection or death. The IAH is not just of basic scientific interest; it forms the basis of our current estimates of infectious disease risk in humans. Despite the important role of the IAH in managing disease interventions for food and water-borne pathogens, experimental support for the IAH in bacterial pathogens is indirect at best. Moreover since the IAH was first proposed, cooperative behaviors have been discovered in a wide range of microorganisms, including many pathogens. A fundamental principle of cooperation is that the fitness of individuals is affected by the presence and behaviors of others, which is contrary to the assumption of independent action. In this paper, we test the IAH in Bacillus thuringiensis (B.t), a widely occurring insect pathogen that releases toxins that benefit others in the inoculum, infecting the diamondback moth, Plutella xylostella. By experimentally separating B.t. spores from their toxins, we demonstrate that the IAH fails because there is an interaction between toxin and spore effects on mortality, where the toxin effect is synergistic and cannot be accommodated by independence assumptions. Finally, we show that applying recommended IAH dose-response models to high dose data leads to systematic overestimation of mortality risks at low doses, due to the presence of synergistic pathogen interactions. Our results show that cooperative secretions can easily invalidate the IAH, and that such mechanistic details should be incorporated into pathogen risk analysis

A sample coordination method to monitor totals of environmental variables

A new sampling strategy for design-based environmental monitoring is proposed. It has the potential to produce superior estimators for totals of environmental variables and their changes over time. In the strategy, we combine two concepts known as spatially balanced sampling and coordination of samples. Spatially balanced sampling can provide superior estimators of totals, while coordination of samples over time is often used to improve estimators of change. Compared with reference strategies, we show that the new strategy can improve the precision of the estimators of totals and their change simultaneously. A forest inventory application is used to illustrate the new strategy and the results can be summarized as (i) using auxiliary information to spread the sample can improve the estimators of totals; (ii) a positive coordination of the samples reduced the variance of the estimator of change by more than 37% compared with independent samples; and (iii) a high overlap between successive samples does not guarantee a good estimator of change. The presented strategy can be used to develop more efficient environmental monitoring programs

Sodium in Drinking Water and Arizona Domestic Wells

Table salt (sodium chloride) has been used to preserve and season food since ancient times. We need sodium to regulate our body’s water balance and muscle function. However, studies have shown that too much sodium intake may be bad for your heart health and is linked with high blood pressure. High levels of total dissolved solids (TDS), which include sodium, are common in Arizona’s water resources. Therefore, we should be aware of our sodium consumption from foods and drinking water sources. Sodium in drinking water may be significant in your diet. But this depends on the amount of sodium in the water, how much you drink daily, and if you are on a sodium restricted diet

Radon in Drinking Water and Arizona Domestic Wells

Radon is an odorless gas usually found in water that comes into contact with uranium bearing minerals. Radon is a radioactive gas that can cause cancer when it is breathed into the lungs or absorbed in the stomach from water. Home owners can be exposed to radon gas if it seeps into basements or through concrete pads and when it is released from the water supply. If high levels of radon are present in the well water, well owners will be exposed to radon gas as they shower, clean, and flush toilets and when they drink the well water. In addition to testing for radioactive chemicals such as gross-alpha radiation and uranium, private well owners should also test their indoor air and their well water for radon

Arizona Wells: Maintaining and Troubleshooting Wells

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