Central nervous system microstimulation: Towards selective micro-neuromodulation

Electrical stimulation technologies capable of modulating neural activity are well established for neuroscientific research and neurotherapeutics. Recent micro-neuromodulation experimental results continue to explain neural processing complexity and suggest the potential for assistive technologies capable of restoring or repairing of basic function. Nonetheless, performance is dependent upon the specificity of the stimulation. Increasingly specific stimulation is hypothesized to be achieved by progressively smaller interfaces. Miniaturization is a current focus of neural implants due to improvements in mitigation of the body's foreign body response. It is likely that these exciting technologies will offer the promise to provide large-scale micro-neuromodulation in the future. Here, we highlight recent successes of assistive technologies through bidirectional neuroprostheses currently being used to repair or restore basic brain functionality. Furthermore, we introduce recent neuromodulation technologies that might improve the effectiveness of these neuroprosthetic interfaces by increasing their chronic stability and microstimulation specificity. We suggest a vision where the natural progression of innovative technologies and scientific knowledge enables the ability to selectively micro-neuromodulate every neuron in the brain

Kohti yhteisiä tavoitteita : GAS-koulutuksen arviointihankkeen loppuraportti

Goal Attaiment Scaling eli GAS on tavoiteasetannan menetelmä, jonka avulla pyritään ottamaan asiakkaan arki kuntoutuksen lähtökohdaksi. GAS-koulutusta avokuntoutuksen ammattihenkilöille on toteutettu 15 ammattikorkeakoulussa eri puolilla Suomea vuodesta 2011 alkaen. Tämän arviointitutkimuksen tarkoituksena oli selvittää, miten koulutuksen suorittaneet ammattilaiset käyttävät GAS-menetelmää ja minkälaisena he kokevat sen käytettävyyden ja hyödynnettävyyden. Lisäksi haluttiin kartoittaa sekä koulutuksiin osallistuneiden että kouluttajien näkemyksiä GAS-menetelmästä ja -koulutuksesta ja sen kehittämistarpeista. Tutkimuksen aineisto koottiin GAS-koulutukseen osallistuneille kuntoutusammattilaisille kohdennetulla sähköisellä kyselyllä ja GAS-kouluttajien haastatteluilla. Kyselyn vastaajista (n = 178) suurin osa ilmoitti kuntoutujien osallistuvan tavoitteiden asettamiseen ja yli puolet vastaajista koki menetelmän parantaneen kuntoutujien kuntoutusmotivaatiota. Yhteistyö hoitovastuutahon kanssa GAStavoitteiden suunnittelussa ja asettamisessa on vastausten perusteella melko vähäistä. Vajaa puolet vastaajista arvioi GAS-menetelmän käyttöönoton lisänneen tai syventäneen moniammatillista yhteistyötä. Tarkasteltaessa GAS-menetelmän hallintaa havaittiin, että koulutukseen osallistuneilla näyttäisi olevan vaikeuksia lähtö- ja tavoitetason määrittelyssä, indikaattorien sanallistamisessa sekä T-scoren ymmärtämisessä. Noin kaksi kolmasosaa vastaajista arvioi GAS-koulutuksen vastanneen odotuksia, mutta kaiken kaikkiaan koulutustyytyväisyyden suhteen ammattikorkeakoulukohtaiset erot olivat suuria tilastollisesti merkitsevällä tasolla. Avoimissa vastauksissa teemoiksi nousivat moniammatillisuus ja ammattikohtaisuus koulutuksen toteutuksessa, kuntoutujiin liittyvät haasteet sekä kouluttajien GAS-osaaminen. Kouluttajien haastatteluissa esille nousivat koulutukseen osallistuneiden vastustavat ennakkoasenteet, moniammatillisen työskentelyn puute arjessa, totutuista rooleista poisoppiminen, vaikeus asettaa arkielämälähtöisiä ja tarkoituksenmukaisia tavoitteita sekä se, että kuntoutukselta puuttuu usein kokonaistavoite. Kouluttajat olivat syventäneet ja laajentaneet koulutussisältöjä ja muokanneet välitehtäviä kukin omalla tavallaan ja omien ryhmiensä tarpeista lähtien, joten GAS-koulutuksen yhdenmukaisuudesta ei voitane puhua. Raportin yhteenvetona kuvataan hyvän GAS-koulutuskäytännön elementit

Distinct Metabolomic Profile Because of Gestational Diabetes and its Treatment Mode in Women with Overweight and Obesity

ObjectiveWhether the presence of gestational diabetes (GDM) and its treatment mode influence the serum metabolic profile in women with overweight or obesity was studied.MethodsThe serum metabolic profiles of 352 women with overweight or obesity participating in a mother‐infant clinical study were analyzed with a targeted NMR approach (at 35.1 median gestational weeks). GDM was diagnosed with a 2‐hour 75‐g oral glucose tolerance test.ResultsThe metabolomic profile of the women with GDM (n = 100) deviated from that of women without GDM (n = 252). Differences were seen in 70 lipid variables, particularly higher concentrations of very low‐density lipoprotein particles and serum triglycerides were related to GDM. Furthermore, levels of branched‐chain amino acids and glycoprotein acetylation, a marker of low‐grade inflammation, were higher in women with GDM. Compared with women with GDM treated with diet only, the women treated with medication (n = 19) had higher concentrations of severalizes of VLDL particles and their components, leucine, and isoleucine, as well as glycoprotein acetylation.ConclusionsA clearly distinct metabolic profile was detected in GDM, which deviated even more if the patient was receiving medical treatment. This suggests a need for more intense follow‐up and therapy for women with GDM during pregnancy and postpartum to reduce their long‐term adverse health risks.</p

The biological activity of serum bacterial lipopolysaccharides associates with disease activity and likelihood of achieving remission in patients with rheumatoid arthritis

Peer reviewe

Molecular organization of the tear fluid lipid layer

The tear fluid protects the corneal epithelium from drying out as well as from invasion by pathogens. It also provides cell nutrients. Similarly to lung surfactant, it is composed of an aqueous phase covered by a lipid layer. Here we describe the molecular organization of the anterior lipid layer of the tear film. Artificial tear fluid lipid layers (ATFLLs) composed of egg yolk phosphatidylcholine (60 mol %), free fatty acids (20 mol %), cholesteryl oleate (10 mol %), and triglycerides (10 mol %) were deposited on the air-water interface and their physico-chemical behavior was compared to egg-yolk phosphatidylcholine monolayers by using Langmuir-film balance techniques, x-ray diffraction, and imaging techniques as well as in silico molecular level simulations. At low surface pressures, ATFLLs were organized at the air-water interface as heterogeneous monomolecular films. Upon compression the ATFLLs collapsed toward the air phase and formed hemispherelike lipid aggregates. This transition was reversible upon relaxation. These results were confirmed by molecular-level simulations of ATFLL, which further provided molecular-scale insight into the molecular distributions inside and dynamics of the tear film. Similar type of behavior is observed in lung surfactant but the folding takes place toward the aqueous phase. The results provide novel information of the function of lipids in the tear fluid

The biological activity of serum bacterial lipopolysaccharides associates with disease activity and likelihood of achieving remission in patients with rheumatoid arthritis

Peer reviewe

Efficacy of Fish Oil and/or Probiotic Intervention on the Incidence of Gestational Diabetes Mellitus in an At-Risk Group of Overweight and Obese Women: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial

OBJECTIVE To assess whether the risk of gestational diabetes mellitus (GDM) may be lowered and glucose metabolism improved by daily administration of fish oil and/or probiotic supplements in overweight and obese pregnant women.RESEARCH DESIGN AND METHODS We randomized in a double-blind manner 439 women (mean 13.9 ± 2.1 gestational weeks [gw]) into four intervention groups: fish oil + placebo, probiotics + placebo, fish oil + probiotics, and placebo + placebo. Fish oil (1.9 g docosahexaenoic acid and 0.22 g eicosapentaenoic acid) and probiotic supplements (Lactobacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each) were provided for daily consumption from randomization beyond delivery. Primary outcomes were the incidence of GDM diagnosed with oral glucose tolerance test targeted at 24–28 gw and the change in fasting glucose between randomization and late pregnancy (mean 35.2 ± 0.9 gw). Insulin concentration, insulin resistance HOMA2-IR index, and pregnancy outcomes were determined, as were adverse effects related to the intervention. Analyses were by intent to treat.RESULTS No differences were found among the intervention groups in the maternal and neonatal pregnancy outcomes or side effects related to the intervention (P > 0.05). The proportion of women with GDM (94 of 377; fish oil + placebo, 23 of 96, 24.0%; probiotics + placebo, 25 of 99, 25.3%; fish oil + probiotics, 26 of 91, 28.6%; and placebo + placebo, 20 of 91, 22.0%) or the change in glucose, insulin, or HOMA2-IR (n = 364) did not differ among the intervention groups (P > 0.11 for all comparisons).CONCLUSIONS An intervention with fish oil and/or probiotics during pregnancy seemed to be both safe and well tolerated but conferred no benefits in lowering the risk of GDM or improving glucose metabolism in overweight and obese women.</div

Weight gain and body composition during pregnancy: A randomized pilot trial with probiotics and/or fish oil

We evaluated the effects of fish oil and/or probiotic supplementation in a randomized placebo-controlled intervention pilot trial on gestational weight gain (GWG) and body composition. Additionally, the influence of gestational diabetes (GDM) on GWG and body composition was assessed. We randomized 439 overweight or obese women (mean 13.9±2.1 gestational weeks) into four intervention groups: fish oil+placebo, probiotics+placebo, fish oil+probiotics and placebo+placebo. Fish oil (1.9g docosahexaenoic acid and 0.22g eicosapentaenoic acid) and probiotic supplements (Lactobacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 CFU each) were consumed daily from randomization until delivery. GDM was diagnosed with 2-hour 75g oral glucose tolerance test. Body composition was measured with air displacement plethysmography at randomization and in late pregnancy (mean 35.2±0.9 gestational weeks). Fish oil and/or probiotic intervention did not influence mean GWG or change in body fat mass or body fat percentage of the women (p>0.17 for all comparisons). Body composition in early pregnancy did not differ between the women who did or did not develop GDM (adjusted p>0.23). Compared to the normoglycemic women (n=278), women diagnosed with GDM (n=119) gained less weight (7.7±0.4kg vs. 9.3±0.4kg, adjusted mean difference -1.66 [-2.52, -0.80],p</p

Metagenomics analysis of gut microbiota in response to diet intervention and gestational diabetes in overweight and obese women: a randomised, double-blind, placebo-controlled clinical trial

Objective: Gut microbiota and diet are known to contribute to human metabolism. We investigated whether the metagenomic gut microbiota composition and function changes over pregnancy are related to gestational diabetes mellitus (GDM) and can be modified by dietary supplements, fish oil and/or probiotics.Design: The gut microbiota of 270 overweight/obese women participating in a mother-infant clinical study were analysed with metagenomics approach in early (mean gestational weeks 13.9) and late (gestational weeks 35.2) pregnancy. GDM was diagnosed with a 2 hour 75 g oral glucose tolerance test.Results: Unlike women with GDM, women without GDM manifested changes in relative abundance of bacterial species over the pregnancy, particularly those receiving the fish oil + probiotics combination. The specific bacterial species or function did not predict the onset of GDM nor did it differ according to GDM status, except for the higher abundance of Ruminococcus obeum in late pregnancy in the combination group in women with GDM compared with women without GDM. In the combination group, weak decreases over the pregnancy were observed in basic bacterial housekeeping functions.Conclusions: The specific gut microbiota species do not contribute to GDM in overweight/obese women. Nevertheless, the GDM status may disturb maternal gut microbiota flexibility and thus limit the capacity of women with GDM to respond to diet, as evidenced by alterations in gut microbiota observed only in women without GDM. These findings may be important when considering the metabolic complications during pregnancy, but further studies with larger populations are called for to verify the findings.</p

Food Supplement Use Differs from the Recommendations in Pregnant Women: A Multinational Survey

The aim was to investigate, among pregnant women, (1) the use of food supplements and (2) the awareness of food supplement recommendations and beliefs about food supplement use in four European countries: Finland, Italy, Poland, and the United Kingdom. The participants (n = 1804) completed an online questionnaire with predefined statements. Daily intakes of vitamins and minerals were calculated using uploaded pictures or weblinks of the supplement packages. Country differences were assessed. Most participants (91%) used at least one food supplement during pregnancy. A prenatal multivitamin was the most commonly used supplement type (84% of the users), and 75% of the participants thought consumption of multivitamin is recommended. Of the participants, 81% knew that folic acid is recommended during pregnancy while 58% knew the recommendation for vitamin D. In 19% of the supplement users, the daily safe upper intake limit of at least one nutrient was exceeded. Nevertheless, most participants agreed that they knew which supplements (91%) and doses of supplements (87%) needed to be used during pregnancy. To conclude, the majority of the participants used food supplements, but lower proportions knew and adhered to the recommended intakes. Between-country differences were observed in the use and knowledge of and beliefs regarding supplements. The results suggest a need for assessment and monitoring of supplement use in antenatal care to ensure appropriate use