Dataset of EEG power integral, spontaneous recurrent seizure and behavioral responses following combination drug therapy in soman-exposed rats.

This article investigated the efficacy of the combination of antiepileptic drug therapy in protecting against soman-induced seizure severity, epileptogenesis and performance deficits. Adult male rats with implanted telemetry transmitters for continuous recording of electroencephalographic (EEG) activity were exposed to soman and treated with atropine sulfate and the oxime HI-6 one minute after soman exposure and with midazolam, ketamine and/or valproic acid 40 min after seizure onset. Rats exposed to soman and treated with medical countermeasures were evaluated for survival, seizure severity, the development of spontaneous recurrent seizure and performance deficits; combination anti-epileptic drug therapy was compared with midazolam monotherapy. Telemetry transmitters were used to record EEG activity, and a customized MATLAB algorithm was used to analyze the telemetry data. Survival data, EEG power integral data, spontaneous recurrent seizure data and behavioral data are illustrated in figures and included as raw data. In addition, edf files of one month telemetry recordings from soman-exposed rats treated with delayed midazolam are provided as supplementary materials. Data presented in this article are related to research articles "Rational Polytherapy in the Treatment of Cholinergic Seizures" [1] and "Early polytherapy for benzodiazepine-refractory status epilepticus [4]

A POLARIZED PROTON TARGET

We have successfully conducted a series of experiments involving scattering of high energy pions and protons from a target containing polarized protons. Results of some of these experiments were reported at this conference, and in the literature. Proton polarizations as high as 65% have been measured; the average polarization during sustained data-taking has been typically 45%

Microtome-integrated microscope system for high sensitivity tracking of in-resin fluorescence in blocks and ultrathin sections for correlative microscopy

Many areas of biological research demand the combined use of different imaging modalities to cover a wide range of magnifications and measurements or to place fluorescent patterns into an ultrastructural context. A technically difficult problem is the efficient specimen transfer between different imaging modalities without losing the coordinates of the regions-of-interest (ROI). Here, we report a new and highly sensitive integrated system that combines a custom designed microscope with an ultramicrotome for in-resin-fluorescence detection in blocks, ribbons and sections on EM-grids. Although operating with long-distance lenses, this system achieves a very high light sensitivity. Our instrumental set-up and operating workflow are designed to investigate rare events in large tissue volumes. Applications range from studies of individual immune, stem and cancer cells to the investigation of non-uniform subcellular processes. As a use case, we present the ultrastructure of a single membrane repair patch on a muscle fiber in intact muscle in a whole animal context

Early polytherapy for benzodiazepine-refractory status epilepticus.

The transition from single seizures to status epilepticus (SE) is associated with malaptive trafficking of synaptic gamma-aminobutyric acid (GABAA) and glutamate receptors. The receptor trafficking hypothesis proposes that these changes are key events in the development of pharmacoresistance to antiepileptic drugs (AEDs) during SE, and that blocking their expression will help control drug-refractory SE (RSE). We tested this hypothesis in a model of SE induced by very high-dose lithium and pilocarpine (RSE), and in a model of SE induced by sc soman. Both models are refractory to benzodiazepines when treated 40 min after seizure onset. Our treatments aimed to correct the loss of inhibition because of SE-associated internalization of synaptic GABAA receptors (GABAAR), using an allosteric GABAAR modulator, sometimes supplemented by an AED acting at a nonbenzodiazepine site. At the same time, we reduced excitation because of increased synaptic localization of NMDA and AMPA (?-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and N-methyl-D-aspartate) receptors (NMDAR, AMPAR (?-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor, N-methyl-D-aspartate receptors)) with an NMDAR channel blocker, since AMPAR changes are NMDAR-dependent. Treatment of RSE with combinations of the GABAAR allosteric modulators midazolam or diazepam and the NMDAR antagonists dizocilpine or ketamine terminated RSE unresponsive to high-dose monotherapy. It also reduced RSE-associated neuronal injury, spatial memory deficits, and the occurrence of spontaneous recurrent seizures (SRS), tested several weeks after SE. Treatment of soman-induced SE also reduced seizures, behavioral deficits, and epileptogenesis. Addition of an AED further improved seizure outcome in both models. Three-dimensional isobolograms demonstrated positive cooperativity between midazolam, ketamine, and valproate, without any interaction between the toxicity of these drugs, so that the therapeutic index was increased by combination therapy. The midazolam-ketamine-valproate combination based on the receptor trafficking hypothesis was far more effective in stopping RSE than the midazolam-fosphenytoin-valproate combination inspired from clinical guidelines for the treatment of SE. Furthermore, sequential administration of midazolam, ketamine, and valproate was far less effective than simultaneous treatment with the same drugs at the same dose. These data suggest that treatment of RSE should be based at least in part on its pathophysiology. The search for a better treatment should focus on the cause of pharmacoresistance, which is loss of synaptic GABAAR and gain of synaptic glutamate receptors. Both need to be treated. Monotherapy addresses only half the problem. Improved pharmacokinetics will not help pharmacoresistance because of loss of receptors. Waiting for one drug to fail before giving the second drugs gives pharmacoresistance time to develop. Future clinical trials should consider treating both the failure of inhibition and the runaway excitation which characterize RSE, and should include an early polytherapy arm. This article is part of the Special Issue "Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures"

Rational polytherapy in the treatment of cholinergic seizures.

The initiation and maintenance phases of cholinergic status epilepticus (SE) are associated with maladaptive trafficking of synaptic GABAA and glutamate receptors. The resulting pharmacoresistance reflects a decrease in synaptic GABAA receptors and increase in NMDA and AMPA receptors, which tilt the balance between inhibition and excitation in favor of the latter. If these changes are important to the pathophysiology of SE, both should be treated, and blocking their consequences should have therapeutic potential. We used a model of benzodiazepine-refractory SE (RSE) (Tetz et al., 2006) and a model of soman-induced SE to test this hypothesis. Treatment of RSE with combinations of the GABAAR agonists midazolam or diazepam and the NMDAR antagonists MK-801 or ketamine terminated RSE unresponsive to high-dose monotherapy with benzodiazepines, ketamine or other antiepileptic drugs (AEDs). It also reduced RSE-associated neuronal injury, spatial memory deficits and the occurrence of spontaneous recurrent seizures (SRS), tested several weeks after SE. Treatment of sc soman-induced SE similarly showed much greater reduction of EEG power by a combination of midazolam with ketamine, compared to midazolam monotherapy. When treating late (40 min after seizure onset), there may not be enough synaptic GABAAR left to be able to restore inhibition with maximal GABAAR stimulation, and further benefit is derived from the addition of an AED which increases inhibition or reduces excitation by a non-GABAergic mechanism. The midazolam-ketamine-valproate combination is effective in terminating RSE. 3-D isobolograms demonstrate positive cooperativity between midazolam, ketamine and valproate, without any interaction between the toxicity of these drugs, so that the therapeutic index is increased by combination therapy between GABAAR agonist, NMDAR antagonist and selective AEDs. We compared this drug combination based on the receptor trafficking hypothesis to treatments based on clinical practice. The midazolam-ketamine-valproate combination is far more effective in stopping RSE than the midazolam-fosphenytoin-valproate combination inspired from clinical guidelines. Furthermore, sequential administration of midazolam, ketamine and valproate is far less effective than simultaneous treatment with the same drugs at the same dose. These data suggest that we should re-evaluate our traditional treatment of RSE, and that treatment should be based on pathophysiology. The search for a better drug has to deal with the fact that most monotherapy leaves half the problem untreated. The search for a better benzodiazepine should acknowledge the main cause of pharmacoresistance, which is loss of synaptic GABAAR. Future clinical trials should consider treating both the failure of inhibition and the runaway excitation which characterize RSE, and should include an early polytherapy arm

Ursinus College Alumni Journal, August 1967

Exposure \u2767 Ursinus • Viewpoint at commencement time: Means to an end; Toward freedom; Liberal morality; Open-minded attitude; Quality vs. quantity • From the President • What makes Suzy a language dud? • The paradox of urbia: an interview • Negro voices of the city • Springtime was alumni time • Dr. Myers wins alumni award • Dr. Wessel speaks on urbia • Alumni giving climbs in 1967 • Campus clippings: Collegeville area grows; Staigers tour world; Color film; Miss congeniality; New Board members; Placement service; Schultze promoted; Humble gift; Include Ursinus in your will • Sporting scene: Tennis; Baseball; Track • Anatomy of medical school life • Class notebook • Faculty members speak at spring regional meetings • Weddings • Births • In memoriam • Physicians Club meets •https://digitalcommons.ursinus.edu/alumnijournal/1089/thumbnail.jp

Reversal of Long-Term Trends in Ethane Identified from the Global Atmosphere Watch Reactive Gases Measurement Network

Reactive gases play an important role in climate and air pollution issues. They control the self-cleansing capability of the troposphere, contribute to air pollution and acid deposition, regulate the lifetimes and provide tracers for deciphering sources and sinks for greenhouse gases. Within GAW, the focus is placed on long-term, high-quality observations of ozone (O3), carbon monoxide (CO), volatile organic compounds (VOC), nitrogen oxides (NOx), and sulfur dioxide (SO2). More than 100 stations worldwide carry out reactive gases measurements with data reported to two World Data Centers. The reactive gases program in GAW cooperates The WMO GAW Reactive Gases Program with regional networks and other global monitoring initiatives in order to attain a complete picture of the tropospheric chemical composition. Observations are being made by in-situ monitoring, measurements from commercial routine air-crafts (e.g. IAGOS), column observations, and from flask sampling networks. Quality control and coordination of measurements between participating stations are a primary emphasis. GAW reactive gases data in rapid delivery mode are used to evaluate operational atmospheric composition forecasts in the EU Copernicus Atmospheric Monitoring Service. Oversight of the program is provided by GAW-WMO coordinated Reactive Gases Scientific Advisory Committee (RG-SAG)

Abbreviated Antiplatelet Therapy After Coronary Stenting in Patients With Myocardial Infarction at High Bleeding Risk.

BACKGROUND The optimal duration of antiplatelet therapy (APT) after coronary stenting in patients at high bleeding risk (HBR) presenting with an acute coronary syndrome remains unclear. OBJECTIVES The objective of this study was to investigate the safety and efficacy of an abbreviated APT regimen after coronary stenting in an HBR population presenting with acute or recent myocardial infarction. METHODS In the MASTER DAPT trial, 4,579 patients at HBR were randomized after 1 month of dual APT (DAPT) to abbreviated (DAPT stopped and 11 months single APT or 5 months in patients with oral anticoagulants) or nonabbreviated APT (DAPT for minimum 3 months) strategies. Randomization was stratified by acute or recent myocardial infarction at index procedure. Coprimary outcomes at 335 days after randomization were net adverse clinical outcomes events (NACE); major adverse cardiac and cerebral events (MACCE); and type 2, 3, or 5 Bleeding Academic Research Consortium bleeding. RESULTS NACE and MACCE did not differ with abbreviated vs nonabbreviated APT regimens in patients with an acute or recent myocardial infarction (n = 1,780; HR: 0.83; 95% CI: 0.61-1.12 and HR: 0.86; 95% CI: 0.62-1.19, respectively) or without an acute or recent myocardial infarction (n = 2,799; HR: 1.03; 95% CI: 0.77-1.38 and HR: 1.13; 95% CI: 0.80-1.59; Pinteraction = 0.31 and 0.25, respectively). Bleeding Academic Research Consortium 2, 3, or 5 bleeding was significantly reduced in patients with or without an acute or recent myocardial infarction (HR: 0.65; 95% CI: 0.46-0.91 and HR: 0.71; 95% CI: 0.54-0.92; Pinteraction = 0.72) with abbreviated APT. CONCLUSIONS A 1-month DAPT strategy in patients with HBR presenting with an acute or recent myocardial infarction results in similar NACE and MACCE rates and reduces bleedings compared with a nonabbreviated DAPT strategy. (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Prolonged DAPT Regimen [MASTER DAPT]; NCT03023020)

A multi-model analysis of vertical ozone profiles

A multi-model study of the long-range transport of ozone and its precursors from major anthropogenic source regions was coordinated by the Task Force on Hemispheric Transport of Air Pollution (TF HTAP) under the Convention on Long-range Transboundary Air Pollution (LRTAP). Vertical profiles of ozone at 12-h intervals from 2001 are available from twelve of the models contributing to this study and are compared here with observed profiles from ozonesondes. The contributions from each major source region are analysed for selected sondes, and this analysis is supplemented by retroplume calculations using the FLEXPART Lagrangian particle dispersion model to provide insight into the origin of ozone transport events and the cause of differences between the models and observations. In the boundary layer ozone levels are in general strongly affected by regional sources and sinks. With a considerably longer lifetime in the free troposphere, ozone here is to a much larger extent affected by processes on a larger scale such as intercontinental transport and exchange with the stratosphere. Such individual events are difficult to trace over several days or weeks of transport. This may explain why statistical relationships between models and ozonesonde measurements are far less satisfactory than shown in previous studies for surface measurements at all seasons. The lowest bias between model-calculated ozone profiles and the ozonesonde measurements is seen in the winter and autumn months. Following the increase in photochemical activity in the spring and summer months, the spread in model results increases, and the agreement between ozonesonde measurements and the individual models deteriorates further. At selected sites calculated contributions to ozone levels in the free troposphere from intercontinental transport are shown. Intercontinental transport is identified based on differences in model calculations with unperturbed emissions and emissions reduced by 20% by region. Intercontinental transport of ozone is finally determined based on differences in model ensemble calculations. With emissions perturbed by 20% per region, calculated intercontinental contributions to ozone in the free troposphere range from less than 1 ppb to 3 ppb, with small contributions in winter. The results are corroborated by the retroplume calculations. At several locations the seasonal contributions to ozone in the free troposphere from intercontinental transport differ from what was shown earlier at the surface using the same dataset. The large spread in model results points to a need of further evaluation of the chemical and physical processes in order to improve the credibility of global model results