FMRI resting slow fluctuations correlate with the activity of fast cortico-cortical physiological connections

Recording of slow spontaneous fluctuations at rest using functional magnetic resonance imaging (fMRI) allows distinct long-range cortical networks to be identified. The neuronal basis of connectivity as assessed by resting-state fMRI still needs to be fully clarified, considering that these signals are an indirect measure of neuronal activity, reflecting slow local variations in de-oxyhaemoglobin concentration. Here, we combined fMRI with multifocal transcranial magnetic stimulation (TMS), a technique that allows the investigation of the causal neurophysiological interactions occurring in specific cortico-cortical connections. We investigated whether the physiological properties of parieto-frontal circuits mapped with short-latency multifocal TMS at rest may have some relationship with the resting-state fMRI measures of specific resting-state functional networks (RSNs). Results showed that the activity of fast cortico-cortical physiological interactions occurring in the millisecond range correlated selectively with the coupling of fMRI slow oscillations within the same cortical areas that form part of the dorsal attention network, i.e., the attention system believed to be involved in reorientation of attention. We conclude that resting-state fMRI ongoing slow fluctuations likely reflect the interaction of underlying physiological cortico-cortical connections

Determinants of potential drug–drug interaction associated dispensing in community pharmacies in the Netherlands

OBJECTIVE: There are many drug–drug interactions (D–DI) of which some may cause severe adverse patient outcomes. Dispensing interacting drug combinations should be avoided when the risks are higher than the benefits. The objective of this study was to identify determinants of dispensing undesirable interacting drug combinations by community pharmacies in the Netherlands. METHODS: A total of 256 Dutch community pharmacies were selected, based on the dispensing of 11 undesirable interacting drug combinations between January 1st, 2001 and October 31st, 2002. These pharmacies were sent a questionnaire by the Inspectorate for Health Care (IHC) concerning their process and structure characteristics. MAIN OUTCOME MEASURE: The number of times the 11 undesirable interacting drug combinations were dispensed. RESULTS: Two hundred and forty-six questionnaires (response rate 96.1%) were completed. Dispensing determinants were only found for the D–DI between macrolide antibiotics and digoxin but not for the other 10 D–DIs. Pharmacies using different medication surveillance systems differed in the dispensing of this interacting drug combination, and pharmacies, which were part of a health care centre dispensed this interacting drug combination more often. CONCLUSION: Medication surveillance in Dutch community pharmacies seems to be effective. Although for most D–DIs no determinants were found, process and structure characteristics may have consequences for the dispensing of undesirable interacting drug combinations

Attachment as an organizer of behavior: implications for substance abuse problems and willingness to seek treatment

BACKGROUND: Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. METHODS: Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208). The Semi-Structured Assessment of the Genetics of Alcohol-II [41] was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; [16]]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. RESULTS: Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. CONCLUSION: The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery

Extending Epigenesis: From Phenotypic Plasticity to the Bio-Cultural Feedback

The paper aims at proposing an extended notion of epigenesis acknowledging an actual causal import to the phenotypic dimension for the evolutionary diversification of life forms. Section 1 offers introductory remarks on the issue of epigenesis contrasting it with ancient and modern preformationist views. In Section 2 we propose to intend epigenesis as a process of phenotypic formation and diversification a) dependent on environmental influences, b) independent of changes in the genomic nucleotide sequence, and c) occurring during the whole life span. Then, Section 3 focuses on phenotypic plasticity and offers an overview of basic properties (like robustness, modularity and degeneracy) that allows biological systems to be evolvable – i.e. to have the potentiality of producing phenotypic variation. Successively (Section 4), the emphasis is put on environmentally-induced modification in the regulation of gene expression giving rise to phenotypic variation and diversification. After some brief considerations on the debated issue of epigenetic inheritance (Section 5), the issue of culture (kept in the background of the preceding sections) is considered. The key point is that, in the case of humans and of the evolutionary history of the genus Homo at least, the environment is also, importantly, the cultural environment. Thus, Section 6 argues that a bio-cultural feedback should be acknowledged in the “epigenic” processes leading to phenotypic diversification and innovation in Homo evolution. Finally, Section 7 introduces the notion of “cultural neural reuse”, which refers to phenotypic/neural modifications induced by specific features of the cultural environment that are effective in human cultural evolution without involving genetic changes. Therefore, cultural neural reuse may be regarded as a key instance of the bio-cultural feedback and ultimately of the extended notion of epigenesis proposed in this work

Fast reproducible identification and large-scale databasing of individual functional cognitive networks

<p>Abstract</p> <p>Background</p> <p>Although cognitive processes such as reading and calculation are associated with reproducible cerebral networks, inter-individual variability is considerable. Understanding the origins of this variability will require the elaboration of large multimodal databases compiling behavioral, anatomical, genetic and functional neuroimaging data over hundreds of subjects. With this goal in mind, we designed a simple and fast acquisition procedure based on a 5-minute functional magnetic resonance imaging (fMRI) sequence that can be run as easily and as systematically as an anatomical scan, and is therefore used in every subject undergoing fMRI in our laboratory. This protocol captures the cerebral bases of auditory and visual perception, motor actions, reading, language comprehension and mental calculation at an individual level.</p> <p>Results</p> <p>81 subjects were successfully scanned. Before describing inter-individual variability, we demonstrated in the present study the reliability of individual functional data obtained with this short protocol. Considering the anatomical variability, we then needed to correctly describe individual functional networks in a voxel-free space. We applied then non-voxel based methods that automatically extract main features of individual patterns of activation: group analyses performed on these individual data not only converge to those reported with a more conventional voxel-based random effect analysis, but also keep information concerning variance in location and degrees of activation across subjects.</p> <p>Conclusion</p> <p>This collection of individual fMRI data will help to describe the cerebral inter-subject variability of the correlates of some language, calculation and sensorimotor tasks. In association with demographic, anatomical, behavioral and genetic data, this protocol will serve as the cornerstone to establish a hybrid database of hundreds of subjects suitable to study the range and causes of variation in the cerebral bases of numerous mental processes.</p

Examining the role of genetic risk and longitudinal transmission processes underlying maternal parenting and psychopathology and children’s ADHD symptoms and aggression: utilizing the advantages of a prospective adoption design

Although genetic factors may contribute to initial liability for ADHD onset, there is growing evidence of the potential importance of the rearing environment on the developmental course of ADHD symptomatology. However, associations between family-level variables (maternal hostility, maternal depressive symptoms) and child behaviors (developmental course of ADHD and aggression) may be explained by genes that are shared by biologically related parents and children. Furthermore, ADHD symptoms and aggression commonly co-occur: it is important to consider both simultaneously to have a better understanding of processes underlying the developmental course of ADHD and aggression. To addresses these issues, we employed a longitudinal genetically sensitive parent–offspring adoption design. Analyses were conducted using Cohort I (n = 340) of the Early Growth and Development Study with cross-validation analyses conducted with Cohort II (n = 178). Adoptive mother hostility, but not depression, was associated with later child ADHD symptoms and aggression. Mothers and their adopted children were genetically unrelated, removing passive rGE as a possible explanation. Early child impulsivity/activation was associated with later ADHD symptoms and aggression. Child impulsivity/activation was also associated with maternal hostility, with some evidence for evocative gene-environment correlation processes on adoptive mother depressive symptoms. This study provides novel insights into family-based environmental influences on child ADHD and aggression symptoms, independent of shared parental genetic factors, implications of which are further explicated in the discussion

Medication safety in public pharmacies; heading toward a risk model based on indicators for dispensing of risky combinations of medicines

De Inspectie voor de Gezondheidszorg (IGZ) zoekt naar nieuwe en efficientere manieren van toezicht op zorginstellingen, waaronder ook openbare apotheken. In dat kader wordt een beslissingsondersteunend risicomodel ontwikkeld, waarmee de IGZ die apotheken kan detecteren waar de kans op risico's voor de gezondheid van de patient het grootst is, en waar zij dus haar toezicht op moet richten. In dit onderzoek is bekeken of er kenmerken met betrekking tot de werkwijze en organisatie van openbare apotheken te vinden zijn die samenhangen met de mate waarin zij een tiental risicovolle combinaties van geneesmiddelen afleveren. Aflevering van risicovolle combinaties van geneesmiddelen zegt namelijk iets (maar overigens niet alles) over de medicatieveiligheid in openbare apotheken. In een steekproef van 246 apotheken is over een bepaalde periode het aantal afleveringen van deze 10 combinaties bepaald. Dit is afgezet tegen een groot aantal proces- en structuurkenmerken dat door middel van een internet-enquete onder de betreffende apotheken is verzameld. Slechts voor een van de 10 combinaties werden significante verbanden gevonden tussen ongewenste aflevering en proces- en structuurkenmerken. Men name kenmerken omtrent de organisatie van medicatiebewaking en de afhandeling van bewakingssignalen hebben een voorspellende waarde. Daarmee vormen deze kenmerken voor de inspectie bruikbare risico-indicatoren bij het bepalen van haar toezichtstrategie ten aanzien van openbare apotheken.Abstract not availableIG

Medication safety in public pharmacies; heading toward a risk model based on indicators for dispensing of risky combinations of medicines

De Inspectie voor de Gezondheidszorg (IGZ) zoekt naar nieuwe en efficientere manieren van toezicht op zorginstellingen, waaronder ook openbare apotheken. In dat kader wordt een beslissingsondersteunend risicomodel ontwikkeld, waarmee de IGZ die apotheken kan detecteren waar de kans op risico's voor de gezondheid van de patient het grootst is, en waar zij dus haar toezicht op moet richten. In dit onderzoek is bekeken of er kenmerken met betrekking tot de werkwijze en organisatie van openbare apotheken te vinden zijn die samenhangen met de mate waarin zij een tiental risicovolle combinaties van geneesmiddelen afleveren. Aflevering van risicovolle combinaties van geneesmiddelen zegt namelijk iets (maar overigens niet alles) over de medicatieveiligheid in openbare apotheken. In een steekproef van 246 apotheken is over een bepaalde periode het aantal afleveringen van deze 10 combinaties bepaald. Dit is afgezet tegen een groot aantal proces- en structuurkenmerken dat door middel van een internet-enquete onder de betreffende apotheken is verzameld. Slechts voor een van de 10 combinaties werden significante verbanden gevonden tussen ongewenste aflevering en proces- en structuurkenmerken. Men name kenmerken omtrent de organisatie van medicatiebewaking en de afhandeling van bewakingssignalen hebben een voorspellende waarde. Daarmee vormen deze kenmerken voor de inspectie bruikbare risico-indicatoren bij het bepalen van haar toezichtstrategie ten aanzien van openbare apotheken