Source analyses of axial and vestibular evoked potentials associated with brainstem-spinal reflexes show cerebellar and cortical contributions

In this work we examine the possible neural basis for two brainstem-spinal reflexes using source analyses of brain activity recorded over the cortex and posterior fossa. In a sample of 5 healthy adult subjects, using axial and vestibular stimulation by means of applied impulsive forces, evoked potentials were recorded with 63 channels using a 10 % cerebellar extension montage. In parallel, EMG was recorded from soleus and tibialis anterior muscles and accelerometry from the lower leg. Recordings over the cerebellum (ECeG) confirmed the presence of short latency (SL) potentials and these were associated with changes in high-frequency power. The SL responses to the two stimulus modalities differed in that the axial stimulation produced an initial pause and then a burst in the high-frequency ECeG, followed by excitation/inhibition in soleus while vestibular stimulation produced an initial burst then a pause, followed by inhibition/excitation in soleus. These short latency responses were followed by longer latency N1/P2/N2 responses in the averaged EEG, which were maximal at FCz. Brain Electrical Source Analysis (BESA) demonstrated both cerebellar and cerebral cortical contributions to the short-latency responses and primarily frontal cortex contributions to the long-latency EPs. The latency and polarity of the SL EPs, in conjunction with changes in high-frequency spontaneous activity, are consistent with cerebellar involvement in the control of brainstem-spinal reflexes. The early involvement of frontal cortex and subsequent later activity may be an indicator of the activation of the cortical motor-related system for rapid responses which may follow the reflexive components. These findings provide evidence of the feasibility of non-invasive electrophysiology of the human cerebellum and have demonstrated cerebellar and frontal activations associated with postural-related stimuli

Easy access to nucleophilic boron through diborane to magnesium boryl metathesis

Organoboranes are some of the most synthetically valuable and widely used intermediates in organic and pharmaceutical chemistry. Their synthesis, however, is limited by the behaviour of common boron starting materials as archetypal Lewis acids such that common routes to organoboranes rely on the reactivity of boron as an electrophile. While the realization of convenient sources of nucleophilic boryl anions would open up a wealth of opportunity for the development of new routes to organoboranes, the synthesis of current candidates is generally limited by a need for highly reducing reaction conditions. Here, we report a simple synthesis of a magnesium boryl through the heterolytic activation of the B–B bond of bis(pinacolato)diboron, which is achieved by treatment of an easily generated magnesium diboranate complex with 4-dimethylaminopyridine. The magnesium boryl is shown to act as an unambiguous nucleophile through its reactions with iodomethane, benzophenone and N,N′-di-isopropyl carbodiimide and by density functional theory

The coordination chemistry of the neutral tris-2-pyridyl silicon ligand [PhSi(6-Me-2-py)3]

Producción CientíficaDifficulties in the preparation of neutral ligands of the type [RSi(2-py)3] (where 2-py is an unfunctionalised 2-pyridyl ring unit) have thwarted efforts to expand the coordination chemistry of ligands of this type. However, simply switching the pyridyl substituents to 6-methyl-pyridyl groups (6-Me-2-py) in the current paper has allowed smooth, high-yielding access to the [PhSi(6-Me-2-py)3] ligand (1), and the first exploration of its coordination chemistry with transition metals. The synthesis, single-crystal X-ray structures and solution dynamics of the new complexes [{PhSi(6-Me-2-py)3}CuCH3CN][PF6], [{PhSi(6-Me-2-py)3}CuCH3CN][CuCl2], [{PhSi(6-Me-2-py)3}FeCl2], [{PhSi(6-Me-2-py)3}Mo(CO)3] and [{PhSi(6-Me-2-py)3}CoCl2] are reported. The paramagnetic Fe2+ and Co2+ complexes show strongly shifted NMR resonances for the coordinated pyridyl units due to large Fermi-contact shifts. However, magnetic anisotropy also leads to considerable pseudo-contact shifts so that both contributions have to be included in the paramagnetic NMR analysis.The Leverhulme Trust (Grant for DSW and RG-R, postdoctoral funding for ALC, RGP-2017-146Ministerio de Economía, Industria y Competitividad - Agencia Estatal de Investigación (AEI)European Social Fund (ESF)Ramón y Cajal contract (RG-R, RYC-2015–19035

A General, Rhodium-Catalyzed, Synthesis of Deuterated Boranes and N-Methyl Polyaminoboranes

The rhodium complex [Rh(Ph2PCH2CH2CH2PPh2)(η6‐FC6H5)][BArF4], 2, catalyzes BH/BD exchange between D2 and the boranes H3B⋅NMe3, H3B⋅SMe2 and HBpin, facilitating the expedient isolation of a variety of deuterated analogues in high isotopic purities, and in particular the isotopologues of N‐methylamine‐borane: R3B⋅NMeR2 1‐dx (R=H, D; x=0, 2, 3 or 5). It also acts to catalyze the dehydropolymerization of 1‐dx to give deuterated polyaminoboranes. Mechanistic studies suggest a metal‐based polymerization involving an unusual hybrid coordination insertion chain‐growth/step‐growth mechanism

Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal

Background: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This study aimed to identify and critically appraise clinical practice guidelines for foot and ankle management in RA. Methods: Guidelines were identified electronically and through hand searching. Search terms 'rheumatoid arthritis', 'clinical practice guidelines' and related synonyms were used. Critical appraisal and quality rating were conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: Twenty-four guidelines were included. Five guidelines were high quality and recommended for use. Five high quality and seven low quality guidelines were recommended for use with modifications. Seven guidelines were low quality and not recommended for use. Five early and twelve established RA guidelines were recommended for use. Only two guidelines were foot and ankle specific. Five recommendation domains were identified in both early and established RA guidelines. These were multidisciplinary team care, foot healthcare access, foot health assessment/review, orthoses/insoles/splints, and therapeutic footwear. Established RA guidelines also had an 'other foot care treatments' domain. Conclusions: Foot and ankle management for RA features in many clinical practice guidelines recommended for use. Unfortunately, supporting evidence in the guidelines is low quality. Agreement levels are predominantly 'expert opinion' or 'good clinical practice'. More research investigating foot and ankle management for RA is needed prior to inclusion in clinical practice guidelines

Prospects for progress on health inequalities in England in the post-primary care trust era : professional views on challenges, risks and opportunities

Background - Addressing health inequalities remains a prominent policy objective of the current UK government, but current NHS reforms involve a significant shift in roles and responsibilities. Clinicians are now placed at the heart of healthcare commissioning through which significant inequalities in access, uptake and impact of healthcare services must be addressed. Questions arise as to whether these new arrangements will help or hinder progress on health inequalities. This paper explores the perspectives of experienced healthcare professionals working within the commissioning arena; many of whom are likely to remain key actors in this unfolding scenario. Methods - Semi-structured interviews were conducted with 42 professionals involved with health and social care commissioning at national and local levels. These included representatives from the Department of Health, Primary Care Trusts, Strategic Health Authorities, Local Authorities, and third sector organisations. Results - In general, respondents lamented the lack of progress on health inequalities during the PCT commissioning era, where strong policy had not resulted in measurable improvements. However, there was concern that GP-led commissioning will fare little better, particularly in a time of reduced spending. Specific concerns centred on: reduced commitment to a health inequalities agenda; inadequate skills and loss of expertise; and weakened partnership working and engagement. There were more mixed opinions as to whether GP commissioners would be better able than their predecessors to challenge large provider trusts and shift spend towards prevention and early intervention, and whether GPs’ clinical experience would support commissioning action on inequalities. Though largely pessimistic, respondents highlighted some opportunities, including the potential for greater accountability of healthcare commissioners to the public and more influential needs assessments via emergent Health & Wellbeing Boards. Conclusions - There is doubt about the ability of GP commissioners to take clearer action on health inequalities than PCTs have historically achieved. Key actors expect the contribution from commissioning to address health inequalities to become even more piecemeal in the new arrangements, as it will be dependent upon the interest and agency of particular individuals within the new commissioning groups to engage and influence a wider range of stakeholders.</p

The Enactment of Professional Learning Policies: Performativity and Multiple Ontologies

While teacher learning has become a locus of school reform across many international settings, there is relatively little examination of the idiosyncratic ways in which policy discourses on teacher learning are enacted in schools. In this paper, we aim to investigate how these policy discourses are translated and configured into practices and thus, enacted into concrete realities. Using the conceptual notion of multiple ontologies proposed by Mol (1999; 2004), we argue that teacher learning is actualized in a multiplicity of socio-material entanglements, not as a single reality, but as a multiplicity of realities that coexist, simultaneously, in the mesh of assemblages that we call “school”. In this study, we describe and trace how particular socio-material configurations of teacher learning produce concrete realities of practice that mobilize and generate specific networked effects. We conclude that the postulation of multiple ontologies of teacher learning prompts a shift in how policy makers could conceive of and develop strategies aimed at transforming teaching practices

Beyond dehydrocoupling:group 2 mediated boron-nitrogen desilacoupling

The alkaline earth bis(trimethylsilyl)amides, [Ae{N(SiMe3)2}2(THF)2] [Ae = Mg, Ca, Sr], are effective pre-catalysts for boron-nitrogen bond formation through the desilacoupling of amines, RR’NH (R = alkyl, aryl; R′ = H, alkyl, aryl), and pinBSiMe2Ph. This reactivity also yields a stoichiometric quantity of Me2PhSiH and provides the first example of a catalytic main group element-element coupling that is not dependent on the concurrent elimination of H2

The role of MYH and microsatellite instability in the development of sporadic colorectal cancer

Biallelic germline mutations in MYH are associated with colorectal neoplasms, which develop through a pathway involving somatic inactivation of APC. In this study, we investigated the incidence of the common MYH mutations in an Australian cohort of sporadic colorectal cancers, the clinicopathological features of MYH cancers, and determined whether inactivation of mismatch repair and base excision repair (BER) were mutually exclusive. The MYH gene was sequenced from lymphocyte DNA of 872 colorectal cancer patients and 478 controls. Two compound heterozygotes were identified in the cancer population and all three cancers from these individuals displayed a prominent infiltration of intraepithelial lymphocytes. In total, 11 heterozygotes were found in the cancer group and five in the control group. One tumour from an individual with biallelic germline mutation of MYH also demonstrated microsatellite instability (MSI) as a result of biallelic hypermethylation of the MLH1 promoter. Although MYH-associated cancers are rare in a sporadic colorectal population, this study shows that these tumours can develop through either a chromosomal or MSI pathway. Tumours arising in the setting of BER or mismatch repair deficiency may share a biological characteristic, which promotes lymphocytic infiltration

Development and validation of self-reported line drawings for assessment of knee malalignment and foot rotation: a cross-sectional comparative study

<p>Abstract</p> <p>Background</p> <p>For large scale epidemiological studies clinical assessments and radiographs can be impractical and expensive to apply to more than just a sample of the population examined. The study objectives were to develop and validate two novel instruments for self-reported knee malalignment and foot rotation suitable for use in questionnaire studies of knee pain and osteoarthritis.</p> <p>Methods</p> <p>Two sets of line drawings were developed using similar methodology. Each instrument consisted of an explanatory question followed by a set of drawings showing straight alignment, then two each at 7.5° angulation and 15° angulation in the varus/valgus (knee) and inward/outward (foot) directions. Forty one participants undertaking a community study completed the instruments on two occasions. Participants were assessed once by a blinded expert clinical observer with demonstrated excellent reproducibility. Validity was assessed by sensitivity, specificity and likelihood ratio (LR) using the observer as the reference standard. Reliability was assessed using weighted kappa (κ). Knee malalignment was measured on 400 knee radiographs. General linear model was used to assess for the presence of a linear increase in knee alignment angle (measured medially) from self-reported severe varus to mild varus, straight, mild valgus and severe valgus deformity.</p> <p>Results</p> <p>Observer reproducibility (κ) was 0.89 and 0.81 for the knee malalignment and foot rotation instruments respectively. Self-reported participant reproducibility was also good for the knee (κ 0.73) and foot (κ 0.87) instruments. Validity was excellent for the knee malalignment instrument, with a sensitivity of 0.74 (95%CI 0.54, 0.93) and specificity of 0.97 (95%CI 0.94, 1.00). Similarly the foot rotation instrument was also found to have high sensitivity (0.92, 95%CI 0.83, 1.01) and specificity (0.96, 95%CI 0.93, 1.00). The knee alignment angle increased progressively from self reported severe varus to mild varus, straight, mild valgus and severe valgus knee malalignment (p_trend<0.001).</p> <p>Conclusions</p> <p>The two novel instruments appear to provide a valid and reliable assessment of self-reported knee malalignment and foot rotation, and may have a practical use in epidemiological studies.</p