Psychiatric manifestations of multiple sclerosis and acute disseminated encephalomyelitis

It is unusual for acute disseminated encephalomyelitis and multiple sclerosis to present as purely psychiatric disorders. We report five patients with such demyelinating diseases and symptoms of psychosis, depression or anxiety. The importance of excluding demyelination as the basis for these psychiatric disturbances is emphasized, especially in the presence of unexplained neurologic findings. The possible relationship between psychiatric symptoms and demyelinating disorders is explored

Rozsiane zapalenie mózgu i rdzenia kręgowego oraz stwardnienie rozsiane; dwie różne choroby - spojrzenie krytyczne

Podjęcie leczenia immunomodulacyjnego bezpośrednio po wystąpieniu pierwszego izolowanego zespołu objawów (CIS, clinically isolated syndrome), sugerującego stwardnienie rozsiane (SM, sclerosis multiplex), powinno być poprzedzone diagnostyką różnicową z wykluczeniem rozsianego zapalenia mózgu i rdzenia kręgowego (DEM, disseminated encephalomyelitis). Przebieg kliniczny, właściwości genetyczne, obraz histopatologiczny oraz wyniki badań obrazowych wskazują, że DEM i SM są odrębnymi jednostkami chorobowymi. Ostre i nawracające DEM częściej dotyczy dzieci, ale może również wystąpić u osób dorosłych. Przebieg DEM jest wieloobjawowy. W porównaniu z SM częściej występują gorączka, zaburzenia świadomości, zaburzenia poznawcze, afazja i objawy oponowe. Rzadko stwierdza się obecność prążków oligoklonalnych w płynie mózgowo-rdzeniowym. Rezonans magnetyczny (MRI, magnetic resonance imaging) jest najlepszą metodą obrazowania ośrodkowego układu nerwowego wykorzystywaną w diagnostyce różnicowej DEM i SM. W przypadku DEM występuje wiele ognisk demielinizacji w istocie białej. Zmiany umiejscawiają się także we wzgórzu i jądrach podstawy. W początkowej fazie choroby są zwykle bardziej rozległe niż w przypadku SM i wzmacniają się po podaniu gadoliny. W obrazie MRI stwierdza się występowanie ognisk demielinizacyjnych obejmujących co najmniej trzy segmenty rdzenia kręgowego oraz zapalenie nerwów wzrokowych (NMO, neuromyelitis optica). Niekiedy NMO towarzyszy obecność przeciwciał przeciw akwaporynie 4, ale bywają także stwierdzane w SM oraz DEM. W większości przypadków NMO jest składową DEM, a nie SM i przypomina „orientalną” lub „wzrokowo-rdzeniową” postać SM

The endosomal transcriptional regulator RNF11 integrates degradation and transport of EGFR

Stimulation of cells with epidermal growth factor (EGF) induces internalization and partial degradation of the EGF receptor (EGFR) by the endo-lysosomal pathway. For continuous cell functioning, EGFR plasma membrane levels are maintained by transporting newly synthesized EGFRs to the cell surface. The regulation of this process is largely unknown. In this study, we find that EGF stimulation specifically increases the transport efficiency of newly synthesized EGFRs from the endoplasmic reticulum to the plasma membrane. This coincides with an up-regulation of the inner coat protein complex II (COPII) components SEC23B, SEC24B, and SEC24D, which we show to be specifically required for EGFR transport. Up-regulation of these COPII components requires the transcriptional regulator RNF11, which localizes to early endosomes and appears additionally in the cell nucleus upon continuous EGF stimulation. Collectively, our work identifies a new regulatory mechanism that integrates the degradation and transport of EGFR in order to maintain its physiological levels at the plasma membrane

A digital shadow cloud-based application to enhance quality control in manufacturing

In Industry 4.0 era, rapid changes to the global landscape of manufacturing are transforming industrial plants in increasingly more complex digital systems. One of the most impactful innovations generated in this context is the "Digital Twin", a digital copy of a physical asset, which is used to perform simulations, health predictions and life cycle management through the use of a synchronized data flow in the manufacturing plant. In this paper, an innovative approach is proposed in order to contribute to the current collection of applications of Digital Twin in manufacturing: a Digital Shadow cloud-based application to enhance quality control in the manufacturing process. In particular, the proposal comprises a Digital Shadow updated on high performance computing cloud infrastructure in order to recompute the performance prediction adopting a variation of the computer-aided engineering model shaped like the actual manufactured part. Thus, this methodology could make possible the qualification of even not compliant parts, and so shift the focus from the compliance to tolerance requirements to the compliance to usage requirements. The process is demonstrated adopting two examples: the structural assessment of the geometry of a shaft and the one of a simplified turbine blade. Moreover, the paper presents a discussion about the implications of the use of such a technology in the manufacturing context in terms of real-time implementation in a manufacturing line and lifecycle management. Copyright (C) 2020 The Authors

Perceptions, expectations, apprehensions and realities of graduating South African optometry students (PEAR study, 2006)

The objective of this study was to establish the perceptions, expectations, apprehensions and realities of South Africa optometry students completing their undergraduate studies in 2006. Copies of a questionnaire containing relevant information were distributed to all graduating students at the four Universities offering Optometry. The responses were coded and analyzed. The respondents (N=143), representing 77% of the graduating students included 27.3% males and 72.7% females, aged 20 to 37 years (mean = 23.34 ± 2.75). About a third (32.9%) of the respondents considered opening their own practice as the best way of entering into practice. Also, this mode of practice was considered as providing the greatest fulfilment for their personal (60.8%) and professional (53.8%) goals as well as offering long  term financial security (43.7%). Many (56.6%) have secured employment before graduation. Upon graduation, 43.4% would like to join a franchise.  Many (79.7%) felt that Government was not offering sufficient opportunities for optometrists. The majority, (70.6%) felt that the South African optometry profession is fastly becoming saturated and this was of great concern to many (31.5%). About half, (50.3%) have plans to go overseas to practice and the most common destinations were the UK (36.1%) and Australia (15%).  The mean minimum monthly salary expected as new graduates was between R9 500 and R11 500 in the public and private sectors respectively. On a response scale, the future of optometry in South Africa was scored as 6.59 ± 1.92. Findings in this study may be useful to all stake holders in optometric education in South Africa, as they may reflect the future of the optometry profession in the country

Re-examination of siRNA specificity questions role of PICH and Tao1 in the spindle checkpoint and identifies Mad2 as a sensitive target for small RNAs

The DNA-dependent adenosine triphosphatase (ATPase) Plk1-interacting checkpoint helicase (PICH) has recently been implicated in spindle checkpoint (SAC) signaling (Baumann et al., Cell 128(1):101–114, 2007). Depletion of PICH by siRNA abolished the SAC and resulted in an apparently selective loss of Mad2 from kinetochores, suggesting a role for PICH in the regulation of the Mad1–Mad2 interaction. An apparent rescue of SAC functionality by overexpression of PICH in PICH-depleted cells initially seemed to confirm a role for PICH in the SAC. However, we have subsequently discovered that all PICH-directed siRNA oligonucleotides that abolish the SAC also reduce Mad2 mRNA and protein expression. This reduction is functionally significant, as PICH siRNA does not abolish SAC activity in a cell line that harbors a bacterial artificial chromosome driving the expression of murine Mad2. Moreover, we identified several siRNA duplexes that effectively deplete PICH but do not significantly affect SAC functionality or Mad2 abundance or localization. Finally, we discovered that the ability of overexpressed PICH to restore SAC activity in PICH-depleted cells depends on sequestration of the mitotic kinase Plk1 rather than ATPase activity of PICH, pointing to an underlying mechanism of “bypass suppression.” In support of this view, depletion or inhibition of Plk1 also rescued SAC activity in cells harboring low levels of Mad2. This observation suggests that a reduction of Plk1 activity partially compensates for reduced Mad2 levels and argues that Plk1 normally reduces the strength of SAC signaling. Collectively, our results question the role of PICH in the SAC and instead identify Mad2 as a sensitive off target for small RNA duplexes. In support of the latter conclusion, our evidence suggests that an off-target effect on Mad2 may also contribute to explain the apparent role of the Tao1 kinase in SAC signaling (Draviam et al., Nat Cell Biol 9(5):556–564, 2007)

Small heat-shock protein HSPB3 promotes myogenesis by regulating the lamin B receptor

One of the critical events that regulates muscle cell differentiation is the replacement of the lamin B receptor (LBR)-tether with the lamin A/C (LMNA)-tether to remodel transcription and induce differentiation-specific genes. Here, we report that localization and activity of the LBR-tether are crucially dependent on the muscle-specific chaperone HSPB3 and that depletion of HSPB3 prevents muscle cell differentiation. We further show that HSPB3 binds to LBR in the nucleoplasm and maintains it in a dynamic state, thus promoting the transcription of myogenic genes, including the genes to remodel the extracellular matrix. Remarkably, HSPB3 overexpression alone is sufficient to induce the differentiation of two human muscle cell lines, LHCNM2 cells, and rhabdomyosarcoma cells. We also show that mutant R116P-HSPB3 from a myopathy patient with chromatin alterations and muscle fiber disorganization, forms nuclear aggregates that immobilize LBR. We find that R116P-HSPB3 is unable to induce myoblast differentiation and instead activates the unfolded protein response. We propose that HSPB3 is a specialized chaperone engaged in muscle cell differentiation and that dysfunctional HSPB3 causes neuromuscular disease by deregulating LBR

Assessment of atmospheric correction algorithms for the Sentinel-2A MultiSpectral Imager over coastal and inland waters

The relatively high spatial resolution, short revisit time and red-edge spectral band (705 nm) of the ESA Sentinel-2 Multi Spectral Imager makes this sensor attractive for monitoring water quality of coastal and inland waters. Reliable atmospheric correction is essential to support routine retrieval of optically active substance concentration from water-leaving reflectance. In this study, six publicly available atmospheric correction algorithms (Acolite, C2RCC, iCOR, l2gen, Polymer and Sen2Cor) are evaluated against above-water optical in situ measurements, within a robust methodology, in two optically diverse coastal regions (Baltic Sea, Western Channel) and from 13 inland waterbodies from 5 European countries with a range of optical properties. The total number of match-ups identified for each algorithm ranged from 1059 to 1668 with 521 match-ups common to all algorithms. These in situ and MSI match-ups were used to generate statistics describing the performance of each algorithm for each respective region and a combined dataset. All ACs tested showed high uncertainties, in many cases >100% in the red and >1000% in the near-infra red bands. Polymer and C2RCC achieved the lowest root mean square differences (~0.0016 sr−1) and mean absolute differences (~40–60% in blue/green bands) across the different datasets. Retrieval of blue-green and NIR-red band ratios indicate that further work on AC algorithms is required to reproduce the spectral shape in the red and NIR bands needed to accurately retrieve the chlorophyll-a concentration in turbid waters

Multi-centre parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based cognitive behavioural approach to managing fatigue in people with multiple sclerosis

Abstract (provisional) Background Fatigue is one of the most commonly reported and debilitating symptoms of multiple sclerosis (MS); approximately two-thirds of people with MS consider it to be one of their three most troubling symptoms. It may limit or prevent participation in everyday activities, work, leisure, and social pursuits, reduce psychological well-being and is one of the key precipitants of early retirement. Energy effectiveness approaches have been shown to be effective in reducing MS-fatigue, increasing self-efficacy and improving quality of life. Cognitive behavioural approaches have been found to be effective for managing fatigue in other conditions, such as chronic fatigue syndrome, and more recently, in MS. The aim of this pragmatic trial is to evaluate the clinical and cost-effectiveness of a recently developed group-based fatigue management intervention (that blends cognitive behavioural and energy effectiveness approaches) compared with current local practice. Methods This is a multi-centre parallel arm block-randomised controlled trial (RCT) of a six session group-based fatigue management intervention, delivered by health professionals, compared with current local practice. 180 consenting adults with a confirmed diagnosis of MS and significant fatigue levels, recruited via secondary/primary care or newsletters/websites, will be randomised to receive the fatigue management intervention or current local practice. An economic evaluation will be undertaken alongside the trial. Primary outcomes are fatigue severity, self-efficacy and disease-specific quality of life. Secondary outcomes include fatigue impact, general quality of life, mood, activity patterns, and cost-effectiveness. Outcomes in those receiving the fatigue management intervention will be measured 1 week prior to, and 1, 4, and 12 months after the intervention (and at equivalent times in those receiving current local practice). A qualitative component will examine what aspects of the fatigue management intervention participants found helpful/unhelpful and barriers to change. Discussion This trial is the fourth stage of a research programme that has followed the Medical Research Council guidance for developing and evaluating complex interventions. What makes the intervention unique is that it blends cognitive behavioural and energy effectiveness approaches. A potential strength of the intervention is that it could be integrated into existing service delivery models as it has been designed to be delivered by staff already working with people with MS. Service users will be involved throughout this research. Trial registration: Current Controlled Trials ISRCTN7651747

Efficacy of repeated intrathecal triamcinolone acetonide application in progressive multiple sclerosis patients with spinal symptoms

BACKGROUND: There are controversial results on the efficacy of the abandoned, intrathecal predominant methylprednisolone application in multiple sclerosis (MS) in contrast to the proven effectiveness in intractable postherpetic neuralgia. METHODS: We performed an analysis of the efficacy of the application of 40 mg of the sustained release steroid triamcinolone acetonide (TCA). We intrathecally injected in sterile saline dissolved TCA six times within three weeks on a regular basis every third day in 161 hospitalized primary and predominant secondary progressive MS patients with spinal symptoms. The MS patients did not experience an acute onset of exacerbation or recent distinct increased progression of symptoms. We simultaneously scored the MS patients with the EDSS and the Barthel index, estimated the walking distance and measured somatosensory evoked potentials. Additionally the MS patients received a standardized rehabilitation treatment. RESULTS: EDSS score and Barthel index improved, walking distance increased, latencies of somatosensory evoked potentials of the median and tibial nerves shortened in all MS patients with serial evaluation (p < 0.0001 for all variables). Side effects were rare, five patients stopped TCA application due to onset of a post lumbar puncture syndrome. CONCLUSIONS: Repeated intrathecal TCA application improves spinal symptoms, walking distance and SSEP latencies in progressive MS patients in this uncontrolled study. Future trials should evaluate the long-term benefit of this invasive treatment