Neural Connections between the Nervus Intermedius and the Facial and Vestibulocochlear Nerves in the Cerebellopontine Angle: An Anatomic Study

Purpose Unexpected clinical outcomes following transection of single nerves of the internal acoustic meatus have been reported. Therefore, this study aimed to investigate interneural connections between the nervus intermedius and the adjacent nerves in the cerebellopontine angle. Methods On 100 cadaveric sides, dissections were made of the facial/vestibulocochlear complex in the cerebellopontine angle with special attention to the nervus intermedius and potential connections between this nerve and the adjacent facial or vestibulocochlear nerves. Results A nervus intermedius was identified on all but ten sides. Histologically confirmed neural connections were found between the nervus intermedius and either the facial or vestibulocochlear nerves on 34 % of sides. The mean diameter of these small interconnecting nerves was 0.1 mm. The fiber orientation of these nerves was usually oblique (anteromedial or posterolateral) in nature, but 13 connections traveled anteroposteriorly. Connecting fibers were single on 81 % of sides, doubled on 16 %, and tripled on 3 %, six sides had connections both with the facial nerve anteriorly and the vestibular nerves posteriorly. On 6.5 % of sides, a connection was between the nervus intermedius and cochlear nerve. For vestibular nerve connections with the nervus intermedius, 76 % were with the superior vestibular nerve and 24 % with the inferior vestibular nerve. Conclusions Knowledge of the possible neural interconnections found between the nervus intermedius and surrounding nerves may prove useful to surgeons who operate in these regions so that inadvertent traction or transection is avoided. Additionally, unanticipated clinical presentations and exams following surgery may be due to such neural interconnections

Engraftment of neural stem cells in the treatment of spinal cord injury

AbstractSpinal cord injury is one of the main causes of disability in the young population. Based on the underlying pathological changes, many modalities of treatments have been trialed. However, the most promising so far, has been the replacement of lost cellular elements, using stem cells and non-stem cells transplantation. The route of cellular administration and engraftment into the site of injury is an important determining factor for functional outcome, and should be chosen to be safe and efficacious in human patients. Herein, we will review the underlying changes following spinal cord injury, and the possible routes of cellular transplantation

Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts

Background: Phenotypes of childhood-onset asthma are characterized by distinct trajectories and functional features. For atopy, definition of phenotypes during childhood is less clear. Objective: We sought to define phenotypes of atopic sensitization over the first 6 years of life using a latent class analysis (LCA) integrating 3 dimensions of atopy: allergen specificity, time course, and levels of specific IgE (sIgE). Methods: Phenotypes were defined by means of LCA in 680 children of the Multizentrische Allergiestudie (MAS) and 766 children of the Protection against allergy: Study in Rural Environments (PASTURE) birth cohorts and compared with classical nondisjunctive definitions of seasonal, perennial, and food sensitization with respect to atopic diseases and lung function. Cytokine levels were measured in the PASTURE cohort. Results: The LCA classified predominantly by type and multiplicity of sensitization (food vs inhalant), allergen combinations, and sIgE levels. Latent classes were related to atopic disease manifestations with higher sensitivity and specificity than the classical definitions. LCA detected consistently in both cohorts a distinct group of children with severe atopy characterized by high seasonal sIgE levels and a strong propensity for asthma; hay fever; eczema; and impaired lung function, also in children without an established asthma diagnosis. Severe atopy was associated with an increased IL-5/IFN-gamma ratio. A path analysis among sensitized children revealed that among all features of severe atopy, only excessive sIgE production early in life affected asthma risk. Conclusions: LCA revealed a set of benign, symptomatic, and severe atopy phenotypes. The severe phenotype emerged as a latent condition with signs of a dysbalanced immune response. It determined high asthma risk through excessive sIgE production and directly affected impaired lung function.Peer reviewe

The impact of urbanisation on community structure, gene abundance and transcription rates of microbes in upland swamps of Eastern Australia.

The Temperate Highland Peat Swamps on Sandstone of the Sydney Basin occur in the headwaters of Sydney's drinking water catchments and are listed as endangered ecosystems, yet they have suffered habitat losses and degradation due to human impacts such as urbanisation. Despite ongoing efforts to restore and better protect upland swamps, they remain poorly understood, potentially hindering the effectiveness of management efforts. Essential to overall ecosystem function and the provision of services for human and environmental benefit are the microbial component of wetland ecosystems. In the case of these swamps, the microbes, have not yet been studied. Here, we investigated differences in the microbial community of upland swamps in urbanised catchments compared to swamps from natural catchments in the Blue Mountains. A total of twelve swamps were sampled, six from within urbanised catchments and six with intact vegetation catchments, to compare sediment conditions and microbial community and genes expression and abundances. Catchment impervious area and number of stormwater drains entering a swamp, indicators for urbanisation, positively correlated with the pH and ammonium concentration of swamp sediment. Community analysis of the 16S rRNA gene (T-RFLP, qPCR) revealed the elevated pH of urbanised swamps coincided with changes to the abundance of bacteria and archaea. Furthermore, RT-qPCR revealed genes involved in carbon cycling (mcrA & pmoA) were more likely to be found in urbanised swamps. Taken together, our results indicate that urbanisation of the Blue Mountains is impacting the environmental services provided by the microbial community of upland swamps in the Sydney Basin

Nonlethal Levels of Zeaxanthin Inhibit Cell Migration, Invasion, and Secretion of MMP-2 via NF- κ

Zeaxanthin at nonlethal dosages (3–10 μM) significantly inhibited the cell migration of cultured uveal melanoma cells (C918 cell line) as determined by wound healing assay and Boyden chamber assay. Matrigel invasion assay showed that cell invasion of uveal melanoma cells could be significantly inhibited by zeaxanthin. Secretion of MMP-2 by melanoma cells was significantly inhibited by zeaxanthin in a dose-dependent manner as measured by ELISA kit. Zeaxanthin also significantly inhibited the NF-κB levels in nuclear extracts of the UM cells, which is the upstream of the MMP-2 secretion. These results suggest that zeaxanthin might be a potentially therapeutic approach in the prevention of metastasis in uveal melanoma

Inexpensive, non-invasive biomarkers predict Alzheimer transition using machine learning analysis of the Alzheimer's Disease Neuroimaging (ADNI) database.

The Alzheimer's Disease Neuroimaging (ADNI) database is an expansive undertaking by government, academia, and industry to pool resources and data on subjects at various stage of symptomatic severity due to Alzheimer's disease. As expected, magnetic resonance imaging is a major component of the project. Full brain images are obtained at every 6-month visit. A range of cognitive tests studying executive function and memory are employed less frequently. Two blood draws (baseline, 6 months) provide samples to measure concentrations of approximately 145 plasma biomarkers. In addition, other diagnostic measurements are performed including PET imaging, cerebral spinal fluid measurements of amyloid-beta and tau peptides, as well as genetic tests, demographics, and vital signs. ADNI data is available upon review of an application. There have been numerous reports of how various processes evolve during AD progression, including alterations in metabolic and neuroendocrine activity, cell survival, and cognitive behavior. Lacking an analytic model at the onset, we leveraged recent advances in machine learning, which allow us to deal with large, non-linear systems with many variables. Of particular note was examining how well binary predictions of future disease states could be learned from simple, non-invasive measurements like those dependent on blood samples. Such measurements make relatively little demands on the time and effort of medical staff or patient. We report findings with recall/precision/area under the receiver operator curve after application of CART, Random Forest, Gradient Boosting, and Support Vector Machines, Our results show (i) Random Forests and Gradient Boosting work very well with such data, (ii) Prediction quality when applied to relatively easily obtained measurements (Cognitive scores, Genetic Risk and plasma biomarkers) achieve results that are competitive with magnetic resonance techniques. This is by no means an exhaustive study, but instead an exploration of the plausibility of defining a series of relatively inexpensive, broad population based tests

Stem cell therapy for spinal cord injury: The use of oligodendrocytes and motor neurons derived from human embryonic stem cells

Over the past few years, the understanding of stem cells as a potential therapeutic source has significantly evolved, and the previous concept of irreparable neural injury is being reconsidered. Stem cells are pluripotent cells with high differentiation potential. Induced proliferation and differentiation of these cells under optimal in vitro conditions has been used to generate different transplantable cells of various types and stages of development. For spinal cord injury recovery, the human embryonic stem cells and, recently, the human induced pluripotent stem cells are used as a main source, and two major types of cells are the target: the oligodendrocytes and motor neurons. The extensive experimental research efforts have focused on translating in vitro cellular regeneration of these cells to in vivo transplantation and survival of the transplants, in order to improve clinical outcomes. In this review, we will discuss the progressive development of the cellular generation protocols and the locomotor outcome of their transplantation at sites on spinal cord injury. Keywords: Stem cells, Spinal cord injury, Oligodendrocytes, Motor neurons, Embryonic stem cells, Induced pluripotent stem cell

Mouse models of spinal cord injury and stem cell transplantation

AbstractSpinal cord injury is one of the most devastating neurologic conditions that mostly affects young, and otherwise healthy, patients. Following the primary phase of injury, deleterious secondary inflammation and vascular disruption lead to a more sustained and permanent damage. Over the years, various animal models of spinal cord injury have been developed to help understand the mechanism and the pathophysiology of injury, and to develop reliable treatment strategies. These animal models, especially for the mouse, have also become the target of stem cell therapy, which aims to replace the lost cellular element at the site of injury. In this review, we will discuss the different types of mouse models of spinal cord injury, and elaborate on the therapeutic use of stem cells transplantation

Assessing Progress Toward the Vision of a Comprehensive, Shared Electronic Care Plan: Scoping Review

BACKGROUND: Care plans are central to effective care delivery for people with multiple chronic conditions. But existing care plans-which typically are difficult to share across care settings and care team members-poorly serve people with multiple chronic conditions, who often receive care from numerous clinicians in multiple care settings. Comprehensive, shared electronic care (e-care) plans are dynamic electronic tools that facilitate care coordination and address the totality of health and social needs across care contexts. They have emerged as a potential way to improve care for individuals with multiple chronic conditions. OBJECTIVE: To review the landscape of e-care plans and care plan-related initiatives that could allow the creation of a comprehensive, shared e-care plan and inform a joint initiative by the National Institutes of Health and the Agency for Healthcare Research and Quality to develop e-care planning tools for people with multiple chronic conditions. METHODS: We conducted a scoping review, searching literature from 2015 to June 2020 using Scopus, Clinical Key, and PubMed; we also searched the gray literature. To identify initiatives potentially missing from this search, we interviewed expert informants. Relevant data were then identified and extracted in a structured format for data synthesis and analysis using an expanded typology of care plans adapted to our study context. The extracted data included (1) the perspective of the initiatives; (2) their scope, (3) network, and (4) context; (5) their use of open syntax standards; and (6) their use of open semantic standards. RESULTS: We identified 7 projects for e-care plans and 3 projects for health care data standards. Each project provided critical infrastructure that could be leveraged to promote the vision of a comprehensive, shared e-care plan. All the e-care plan projects supported both broad goals and specific behaviors; 1 project supported a network of professionals across clinical, community, and home-based networks; 4 projects included social determinants of health. Most projects specified an open syntax standard, but only 3 specified open semantic standards. CONCLUSIONS: A comprehensive, shared, interoperable e-care plan has the potential to greatly improve the coordination of care for individuals with multiple chronic conditions across multiple care settings. The need for such a plan is heightened in the wake of the ongoing COVID-19 pandemic. While none of the existing care plan projects meet all the criteria for an optimal e-care plan, they all provide critical infrastructure that can be leveraged as we advance toward the vision of a comprehensive, shared e-care plan. However, critical gaps must be addressed in order to achieve this vision