100 research outputs found

    Refractory Status Epilepticus in Genetic Epilepsy-Is Vagus Nerve Stimulation an Option?

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    Refractory and super-refractory status epilepticus (RSE, SRSE) are severe conditions that can have long-term neurological consequences with high morbidity and mortality rates. The usefulness of vagus nerve-stimulation (VNS) implantation during RSE has been documented by anecdotal cases and in systematic reviews; however, the use of VNS in RSE has not been widely adopted. We successfully implanted VNS in two patients with genetic epilepsy admitted to hospital for SRSE; detailed descriptions of the clinical findings and VNS parameters are provided. Our patients were implanted 25 and 58 days after status epilepticus (SE) onset, and a stable remission of SE was observed from the seventh and tenth day after VNS implantation, respectively, without change in anti-seizure medication. We used a fast ramp-up of stimulation without evident side effects. Our results support the consideration of VNS implantation as a safe and effective adjunctive treatment for SRSE

    Antiviral mechanisms of two broad-spectrum monoclonal antibodies for rabies prophylaxis and therapy

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    Rabies is an acute and lethal encephalomyelitis caused by lyssaviruses, among which rabies virus (RABV) is the most prevalent and important for public health. Although preventable through the post-exposure administration of rabies vaccine and immunoglobulins (RIGs), the disease is almost invariably fatal since the onset of clinical signs. Two human neutralizing monoclonal antibodies (mAbs), RVC20 and RVC58, have been shown to be effective in treating symptomatic rabies. To better understand how these mAbs work, we conducted structural modeling and in vitro assays to analyze their mechanisms of action, including their ability to mediate Fc-dependent effector functions. Our results indicate that both RVC20 and RVC58 recognize and lock the RABV-G protein in its pre-fusion conformation. RVC58 was shown to neutralize more potently the extra-cellular virus, while RVC20 mainly acts by reducing viral spreading from infected cells. Importantly, RVC20 was more effective in promoting effector functions compared to RVC58 and 17C7-RAB1 mAbs, the latter of which is approved for human rabies post-exposure treatment. These results provide valuable insights into the multiple mechanisms of action of RVC20 and RVC58 mAbs, offering relevant information for the development of these mAbs as treatment for human rabies

    Prácticas de riesgo para transmisión de VIH en estudiantes de medicina de Latinoamérica y el Caribe, 2017

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    El objetivo del trabajo fue determinar las prácticas de riesgo para transmisión de VIH en estudiantes de medicina de Latinoamérica y el Caribe durante los meses de Enero a Febrero de 2017. Se realizó un estudio observacional, descriptivo de corte transversal, con muestreo no probabilístico por conveniencia en estudiantes de medicina de Latinoamérica y el Caribe, desde enero a febrero de 2017. Se escogió a estudiantes de medicina del primer al séptimo año de la carrera. Se procedió a la publicación en redes sociales del cuestionario electrónico mediante Google Doc©. Los resultados se expresan en tablas de frecuencias. Fueron incluidos 638 estudiantes de medicina, teniendo el 67,08% (428) una edad comprendida entre 20 a 24 años. Del total de encuestados el 56,02% ha practicado sexo anal, 88,65% ha practicado sexo oral, y 57,06% sexo vaginal en los últimos 6 meses. El 24,43% de los encuestados nunca ha utilizado condón durante sus relaciones sexuales. El 3,49% han pagado alguna vez por sexo, 27,57% ha ingerido alcohol durante las relaciones sexuales y 4,36% ha mantenido relaciones sexuales con usuarios de drogas intravenosas mientras que 63,88% nunca se ha hecho una prueba rápida para VIH. Las prácticas de riesgos más frecuentes fueron la baja utilización de condón durante la última relación sexual, la utilización de alcohol durante la relación sexual y la baja realización de prueba para VIH

    The Superoanterior Fasciculus (SAF): A Novel White Matter Pathway in the Human Brain?

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    Fiber tractography (FT) using diffusion magnetic resonance imaging (dMRI) is widely used for investigating microstructural properties of white matter (WM) fiber-bundles and for mapping structural connections of the human brain. While studying the architectural configuration of the brain’s circuitry with FT is not without controversy, recent progress in acquisition, processing, modeling, analysis, and visualization of dMRI data pushes forward the reliability in reconstructing WM pathways. Despite being aware of the well-known pitfalls in analyzing dMRI data and several other limitations of FT discussed in recent literature, we present the superoanterior fasciculus (SAF), a novel bilateral fiber tract in the frontal region of the human brain that—to the best of our knowledge—has not been documented. The SAF has a similar shape to the anterior part of the cingulum bundle, but it is located more frontally. To minimize the possibility that these FT findings are based on acquisition or processing artifacts, different dMRI data sets and processing pipelines have been used to describe the SAF. Furthermore, we evaluated the configuration of the SAF with complementary methods, such as polarized light imaging (PLI) and human brain dissections. The FT results of the SAF demonstrate a long pathway, consistent across individuals, while the human dissections indicate fiber pathways connecting the postero-dorsal with the antero-dorsal cortices of the frontal lobe

    The rise of China in the international trade network: a community core detection approach

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    Theory of complex networks proved successful in the description of a variety of static networks ranging from biology to computer and social sciences and to economics and finance. Here we use network models to describe the evolution of a particular economic system, namely the International Trade Network (ITN). Previous studies often assume that globalization and regionalization in international trade are contradictory to each other. We re-examine the relationship between globalization and regionalization by viewing the international trade system as an interdependent complex network. We use the modularity optimization method to detect communities and community cores in the ITN during the years 1995-2011. We find rich dynamics over time both inter- and intra-communities. Most importantly, we have a multilevel description of the evolution where the global dynamics (i.e., communities disappear or reemerge) tend to be correlated with the regional dynamics (i.e., community core changes between community members). In particular, the Asia-Oceania community disappeared and reemerged over time along with a switch in leadership from Japan to China. Moreover, simulation results show that the global dynamics can be generated by a preferential attachment mechanism both inter- and intra- communities

    World input-output network

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    Production systems, traditionally analyzed as almost independent national systems, are increasingly connected on a global scale. Only recently becoming available, the World Input-Output Database (WIOD) is one of the first efforts to construct the global multi-regional input-output (GMRIO) tables. By viewing the world input-output system as an interdependent network where the nodes are the individual industries in different economies and the edges are the monetary goods flows between industries, we analyze respectively the global, regional, and local network properties of the so-called world input-output network (WION) and document its evolution over time. At global level, we find that the industries are highly but asymmetrically connected, which implies that micro shocks can lead to macro fluctuations. At regional level, we find that the world production is still operated nationally or at most regionally as the communities detected are either individual economies or geographically well defined regions. Finally, at local level, for each industry we compare the network-based measures with the traditional methods of backward linkages. We find that the network-based measures such as PageRank centrality and community coreness measure can give valuable insights into identifying the key industries
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