Hurricane Impact on Emergency Services and Use of Telehealth to Support Prehospital Care

The impact of hurricanes on emergency services is well-known. Recent history demonstrates the need for prehospital and emergency department coordination to serve communities during evacuation, storm duration, and cleanup. The use of telehealth applications may enhance this coordination while lessening the impact on health-care systems. These applications can address triage, stabilization, and diversion and may be provided in collaboration with state and local emergency management operations through various shelters, as well as during other emergency medical responses

A new framework for cortico-striatal plasticity: behavioural theory meets In vitro data at the reinforcement-action interface

Operant learning requires that reinforcement signals interact with action representations at a suitable neural interface. Much evidence suggests that this occurs when phasic dopamine, acting as a reinforcement prediction error, gates plasticity at cortico-striatal synapses, and thereby changes the future likelihood of selecting the action(s) coded by striatal neurons. But this hypothesis faces serious challenges. First, cortico-striatal plasticity is inexplicably complex, depending on spike timing, dopamine level, and dopamine receptor type. Second, there is a credit assignment problem—action selection signals occur long before the consequent dopamine reinforcement signal. Third, the two types of striatal output neuron have apparently opposite effects on action selection. Whether these factors rule out the interface hypothesis and how they interact to produce reinforcement learning is unknown. We present a computational framework that addresses these challenges. We first predict the expected activity changes over an operant task for both types of action-coding striatal neuron, and show they co-operate to promote action selection in learning and compete to promote action suppression in extinction. Separately, we derive a complete model of dopamine and spike-timing dependent cortico-striatal plasticity from in vitro data. We then show this model produces the predicted activity changes necessary for learning and extinction in an operant task, a remarkable convergence of a bottom-up data-driven plasticity model with the top-down behavioural requirements of learning theory. Moreover, we show the complex dependencies of cortico-striatal plasticity are not only sufficient but necessary for learning and extinction. Validating the model, we show it can account for behavioural data describing extinction, renewal, and reacquisition, and replicate in vitro experimental data on cortico-striatal plasticity. By bridging the levels between the single synapse and behaviour, our model shows how striatum acts as the action-reinforcement interface

Principal components analyses on males from within a season: winter (A), summer (C).

<p>Within a season, there is no significant correlation (Spearman rank) between ∑POPs in blubber (μg/g lipid) and the PC1 scores, which are responsible for 22.7% (winter, B) and 20.6% (summer, D) of the total variance in the gene expression profiles. Symbols: red—Barataria Bay, blue—Chandeleur Sound, brown—Mississippi Sound.</p

Seasonal Variation in the Skin Transcriptome of Common Bottlenose Dolphins (<i>Tursiops truncatus - Fig 2 </i>) from the Northern Gulf of Mexico

<p>A. Principal component analysis on all 94 microarrays shows complete separation of winter samples from all others, with no apparent segregation according to location. B. Unsupervised hierarchical cluster analysis of the normalized array data similarly shows complete separation of winter samples from the warmer seasons.</p

Hierarchical cluster of probes mapping to the KEGG pathway “Metabolism of xenobiotics by cytochrome p450”.

<p>Heat map color is relative to the median intensity for each probe: red is increased, blue is decreased, log₂ scale.</p

Two-dimensional hierarchical cluster analysis of 391 probes differentially expressed in 29 samples collected from spring and summer 2010 (pre- and post-oiling) (p<0.01, fold change ≥1.5).

<p>Spring Chandeleur Sound (boxed) animals cluster with the summer expression profiles. Heat map color is relative to the median intensity for each probe: red is increased, blue is decreased, log₂ scale.</p

Samples included in microarray analysis.

<p>*pre oil-exposure</p><p>** possible exposure; all others post-exposure</p><p>Samples included in microarray analysis.</p

Location of biopsy samples collected from Barataria Bay (BB), Chandeleur Sound (CS), and Mississippi Sound (MS), in the northern Gulf of Mexico.

<p>Location of biopsy samples collected from Barataria Bay (BB), Chandeleur Sound (CS), and Mississippi Sound (MS), in the northern Gulf of Mexico.</p