Proton Density-weighted Spinal fMRI Comparison between Sensorimotor Task and Acupoint Stimulation

Proton density-weighted fMRI studies have been carried out in spinal cord in the current study. We compared the spinal cord activation produced by handgripping sensorimotor task and electro-acupuncture stimulation. Activation was detected in both cases localized at spinal levels C6-C7 (11/14 in sensorimotor and 7/11 in acupuncture stimulation). It was observed that the amount of activation in sensorimotor task was in general greater than in electroacupuncture stimulation. The percentage signal changes were found to be similar. Our results indicate that proton density-weighted fMRI in low field MRI system can be used for sensorimotor and acupuncture pathway research.published_or_final_versio

Use of functional MRI to evaluate correlation between acupoints and brain cortex activites: comparison between conventional and electrical acupuncture

The use of acupuncture therapy in various functional disorders goes back several thousand years in China. Recendy, acupuncture becomes a 'hot' topic in the functional Magnetic Resonance (MR) imaging research studies [1-4]. A majority of these research projects is to study die correlation between the acupuncture points (acupoints) and die corresponding brain cortices, either by conventional acupuncture, electro-acupuncture or laser acupuncture. Cho et al reported mat by stimulating die vision-related acupoints (BL60, BL65, BL66, BL67) at the lateral side of die foot, neural response (i.e. high signal) was obtained at die visual cortex [1]. In this study, we verified Cho et al acupoints using conventional acupuncture and electro-acupuncture.published_or_final_versio

The pharmacological regulation of cellular mitophagy

Small molecules are pharmacological tools of considerable value for dissecting complex biological processes and identifying potential therapeutic interventions. Recently, the cellular quality-control process of mitophagy has attracted considerable research interest; however, the limited availability of suitable chemical probes has restricted our understanding of the molecular mechanisms involved. Current approaches to initiate mitophagy include acute dissipation of the mitochondrial membrane potential (ΔΨm) by mitochondrial uncouplers (for example, FCCP/CCCP) and the use of antimycin A and oligomycin to impair respiration. Both approaches impair mitochondrial homeostasis and therefore limit the scope for dissection of subtle, bioenergy-related regulatory phenomena. Recently, novel mitophagy activators acting independently of the respiration collapse have been reported, offering new opportunities to understand the process and potential for therapeutic exploitation. We have summarized the current status of mitophagy modulators and analyzed the available chemical tools, commenting on their advantages, limitations and current applications

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Cyber attacks and political events: the case of the Occupy Central Campaign

This series vol. entitled: Critical Infrastructure Protection IX: 9th IFIP 11.10 International Conference, ICCIP 2015, Arlington, VA, USA, March 16-18, 2015, Revised Selected PapersOccupy Central was a Hong Kong civil disobedience campaign that began in September 2014 with the goal of forcing Mainland China to allow Hong Kong to implement genuine universal suffrage as demanded by Hong Kong residents. The campaign initially encouraged citizens to block the Central District, Hong Kong’s financial center. However, as the campaign evolved, large protests were organized all over Hong Kong. While vigorous clashes occurred between Occupy Central protesters and police officers on the streets of Hong Kong, cyber attacks were launched quietly by supporters of both sides against each other’s assets. The cyber weapons included mobile applications with malware for surveillance, tools for launching distributed denial-of-service (DDoS) attacks and sophisticated phishing emails with advanced persistent threat functionality. This chapter presents information about cyber attacks related to the Occupy Central campaign and classifies the attacks based on their purpose, techniques, targets and propagation. Based on the attack classification and timeline, a framework is provided that helps predict attack patterns and behavior in order to prevent or mitigate attacks launched during similar political events

TLR10 plays a regulatory role in Type 1 interferon responses upon polyinosinic: polycytidylic acid activation

Posters: no. 17

Proton density change in spinal cord fMRI induced by acupoint stimulation

It has been reported that signal change can be detected in proton density-weighted functional imaging in both the brain and the spinal cord. This effect was attributed to extravascular proton density change during neuronal activation. In this study, the effect of sensorimotor deficit-implicated acupoints stimulation (LI4 and LI11) was used as stimulus on 11 volunteers. During stimulation, 8 out of 11 subjects had consistent functional activations in C6-C7. Bilateral activation pattern was common. Our findings show that sensorimotor deficit-implicated acupoints can modulate the activities in the spinal cord