Increased resting cerebral blood flow in adult Fabry disease: MRI arterial spin labeling study

OBJECTIVE: To assess resting cerebral blood flow (CBF) in the whole-brain and cerebral white matter (WM) and gray matter (GM) of adults with Fabry disease (FD), using arterial spin labeling (ASL) MRI, and to investigate CBF correlations with WM hyperintensity (WMH) volume and the circulating biomarker lyso-Gb3. METHODS: This cross-sectional, case-control study included 25 patients with genetically confirmed FD and 18 age-matched healthy controls. We quantified resting CBF using Quantitative Signal Targeting With Alternating Radiofrequency Labeling of Arterial Regions (QUASAR) ASL MRI. We measured WMH volume using semiautomated software. We measured CBF in regions of interest in whole-brain, WM, and deep GM, and assessed correlations with WMH volume and plasma lyso-Gb3. RESULTS: The mean age (% male) for FD and healthy controls was 42.2 years (44%) and 37.1 years (50%). Mean whole-brain CBF was 27.56 mL/100 mL/min (95% confidence interval [CI] 23.78-31.34) for FD vs 22.39 mL/100 mL/min (95% CI 20.08-24.70) for healthy controls, p = 0.03. In WM, CBF was higher in FD (22.42 mL/100 mL/min [95% CI 17.72-27.12] vs 16.25 mL/100 mL/min [95% CI 14.03-18.48], p = 0.05). In deep GM, CBF was similar between groups (40.41 mL/100 mL/min [95% CI 36.85-43.97] for FD vs 37.46 mL/100 mL/min [95% CI 32.57-42.35], p = 0.38). In patients with FD with WMH (n = 20), whole-brain CBF correlated with WMH volume (r = 0.59, p = 0.006), not with plasma lyso-Gb3. CONCLUSION: In FD, resting CBF is increased in WM but not deep GM. In FD, CBF correlates with WMH, suggesting that cerebral perfusion changes might contribute to, or result from, WM injury

The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

Purpose: Selective Decontamination of the Digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the Theoretical Domains Framework (TDF) to assess ICU clinicians’ views about SDD in regions with limited or no adoption of SDD. Materials and Methods: Participants were health professionals with ‘decisional authority’ for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDDadoption, delivery and further SDD research were explored. Directed content analysis of interview data identified sub-themes which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored. Results: 141 participants provided interview data. Fifty-six sub-themes were identified; 46 were common across regions. Beliefs about consequences was the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as worry, anxiety and fear when discussing potential antibiotic resistance associated with SDD. Conclusions: We identified salient beliefs, barriers and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty and concern that SDD evokes

New Strategies for Research in Clinical Practice: A focus on self–harm.

This article suggests new ways of approaching clinical-based research in an era of evidence-based practice. Using the example of self-harm, we identify three distinct problems with current dominant approaches to research in this area. These include insufficient clarity about target issues, an overreliance on predetermined outcomes which prioritise behavioural measures (such as self-harm cessation) and an undue focus on treatment techniques. We argue that clinical research requires flexible, user-centred and practice-based methods, informed by a focus on principles instead of techniques. Therefore, we outline key practice-based principles that we argue need to be embedded within clinical research strategies. We then demonstrate how traditional behavioural approaches to research can be enriched with more qualitative cognitive and emotionally based data. We conclude that such strategies provide thickened, meaningful and context-specific research which is more relevant for service commissioners, clinicians and service users

Functional Characterization of the Dendritically Localized mRNA Neuronatin in Hippocampal Neurons

Local translation of dendritic mRNAs plays an important role in neuronal development and synaptic plasticity. Although several hundred putative dendritic transcripts have been identified in the hippocampus, relatively few have been verified by in situ hybridization and thus remain uncharacterized. One such transcript encodes the protein neuronatin. Neuronatin has been shown to regulate calcium levels in non-neuronal cells such as pancreatic or embryonic stem cells, but its function in mature neurons remains unclear. Here we report that neuronatin is translated in hippocampal dendrites in response to blockade of action potentials and NMDA-receptor dependent synaptic transmission by TTX and APV. Our study also reveals that neuronatin can adjust dendritic calcium levels by regulating intracellular calcium storage. We propose that neuronatin may impact synaptic plasticity by modulating dendritic calcium levels during homeostatic plasticity, thereby potentially regulating neuronal excitability, receptor trafficking, and calcium dependent signaling

Computational Propaganda in Europe, the U.S., and China

The following sections are included: The Rise of Computational Propaganda Computational Propaganda in the U.S. and Europe Chinese Computational Propaganda How Does Technology and Society Enable Computational Propaganda? Conclusion Reference

Harmonious communitarianism or a rational public sphere: a content analysis of the differences between comments on news stories on Weibo and Facebook

In studying online political communication in China, many researchers apply theories generated in the West (particularly that of the public sphere) without questioning their applicability in the Chinese context. Others argue that new theories must be generated from the ground up, often basing these theories on traditional Chinese philosophies. However, the applicability of these approaches remains unproven. This research uses a content analysis to compare comments on news stories on Chinese and Western social media sites. It finds that there is little evidence to support either the use of public sphere theory in China or the use of traditional conceptions of Eastern styles of communication. Chinese netizens were no more subtle or harmonious (if anything, they were more divisive) and were less likely to talk with others, attempt to understand others’ opinions or attempt to work towards consensus or resolution. Based on these findings, I propose that future research should attempt to build more appropriate theories based on an understanding of how political ideas are actually produced, transmitted and received in society, rather than continuing to apply foreign or ancient theoretical frameworks without a critical interrogation of their applicability in their context of application