Early intravenous magnesium sulfate and its impact on cerebral vasospasm as well as delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a retrospective matched case-control analysis

Introduction Magnesium sulfate (MgSO4) is a potential neuroprotective agent for patients with aneurysmal subarachnoid hemorrhage (aSAH). We analysed the effect of early application of intraoperative intravenous magnesium sulfate (MgSO4) and compared the rate of cerebral vasospasm (CV), delayed cerebral ischemia (DCI) and neurological outcome in two patient cohorts. Material and methods A retrospective matched-pair analysis from patients of a single center in Germany was performed without (group A) and with (group B) MgSO4 application <24 hrs after diagnosis. Pairs were matched according to the known risk factors for DCI and CV (age, Fisher grade, smoking, severity of SAH). Incidence of CV, DCI, and neurological outcome using the modified Rankin Scale (mRS) 3 and 12 months after SAH were recorded. Results 196 patients fulfilled the inclusion criteria. After risk stratification, 48 patients were included in the final analysis (mean±SD age 54.2±8.1yrs, 30 f, 18 m) and were assigned to group A (n=24) or group B (n=24). CV occurred less frequently in group B (33%) than in A (46%). Likewise, DCI was present in 13% (group B) as compared to 42% (group A). After 12 months, 22 patients of group B had a favorable functional outcome (mRS 0 to 3) compared to 15 of group A. Conclusions In this study, the incidence of CV and DCI was lower in patients receiving intravenous MgSO4 within 24 hrs after aneurysmal SAH onset. Favorable functional outcome was more likely in the magnesium group after 12 months of follow-up

Neurofascin-155 IgM autoantibodies in patients with inflammatory neuropathies

Objectives Recently, IgG autoantibodies against different paranodal proteins have been detected and this has led to important advances in the management of inflammatory neuropathies. In contrast, not much is known on IgM autoantibodies against paranodal proteins. Methods In the present study, we screened a large cohort of patients (n=140) with inflammatory neuropathies for IgM autoantibodies against neurofascin-155, neurofascin-186 or contactin-1. Results IgM autoantibodies against neurofascin-155 were detected by ELISA in five patients, four with inflammatory demyelinating polyradiculoneuropathy (CIDP) and one with Guillain-Barre syndrome (GBS), and were confirmed by ELISA-based preabsorption experiments and Western blot. Titres ranged from 1:100 to 1:400. We did not detect IgM anti-neurofascin-186 or anti-contactin-1 antibodies in this cohort. All patients presented with distally accentuated tetraparesis and hypesthesia. Remarkably, tremor was present in three of the patients with CIDP and occurred in the patients with GBS after the acute phase of disease. Nerve conduction studies revealed prolonged distal motor latencies and F wave latencies. Nerve biopsies showed signs of secondary axonal damage in three of the patients, demyelinating features in one patient. Teased fibre preparations did not demonstrate paranodal damage. Conclusion In summary, IgM neurofascin-155 autoantibodies may be worth testing in patients with inflammatory neuropathies. Their pathogenic role needs to be determined in future experiments

Multi-Technology Cooperative Driving: An Analysis Based on PLEXE

Cooperative Driving requires ultra-reliable communications, and it is now clear that no single technology will ever be able to satisfy such stringent requirements, if only because active jamming can kill (almost) any wireless technology. Cooperative driving with multiple communication technologies which complement each other opens new spaces for research and development, but also poses several challenges. The work we present tackles the fallback and recovery mechanisms that the longitudinal controlling system of a platoon of vehicles can implement as a distributed system with multiple communication interfaces. We present a protocol and procedure to correctly compute the safe transition between different controlling algorithms, down to autonomous (or manual) driving when no communication is possible. To empower the study, we also develop a new version of PLEXE, which is an integral part of this contribution as the only Open Source, free simulation tool that enables the study of such systems with a modular approach, and that we deem offers the community the possibility of boosting research in this field. The results we present demonstrate the feasibility of safe fallback, but also highlight that such complex systems require careful design choices, as naive approaches can lead to instabilities or even collisions, and that such design can only be done with appropriate in-silico experiments

A randomised pilot trial of virtual reality-based relaxation for enhancement of perioperative well-being, mood and quality of life

A cancer diagnosis and subsequent treatment can trigger distress, negatively impact coping resources, and affect well-being as well as quality of life. The aim of this pilot study was to investigate feasibility and clinical effects of a VR intervention on quality of life, well-being and mood in cancer patients undergoing surgery compared to a non-VR intervention and a control group. 54 patients with colorectal cancer or liver metastases from colorectal cancer undergoing elective curatively intended surgery were recruited and randomised to one of two intervention groups or a control group receiving standard treatment. Participants assigned to one of the intervention groups either received a VR-based intervention twice daily or listened to music twice daily. Adherence to the intervention was 64.6% in the music group and 81.6% in the VR group. The VR intervention significantly reduced heart rate (− 1.2 bpm; 95% CI − 2.24 to − 0.22; p = 0.02) and respiratory rate (− 0.7 brpm; 95% CI − 1.08 to − 0.25; p = 0.01). Self-reported overall mood improved in both groups (VR: + 0.79 pts; 95% CI 0.37–1.21; p = 0.001; music: + 0.59 pts; 95% CI 0.22–0.97; p = 0.004). There was no difference in quality of life between the three groups. Both interventions groups reported changes in feelings. Adherence rates favoured the VR intervention over the music group. Observed clinical outcomes showed stronger intragroup effects on mood, feelings, and vital signs in the VR group. The study demonstrated feasibility of a VR intervention in cancer patients undergoing surgery and should encourage further research investigating the potential of VR interventions to positively influence well-being and mood in cancer patients

An mRNA Blueprint for C-4 Photosynthesis Derived from Comparative Transcriptomics of Closely Related C-3 and C-4 Species

Bräutigam A, Kajala K, Wullenweber J, et al. An mRNA Blueprint for C-4 Photosynthesis Derived from Comparative Transcriptomics of Closely Related C-3 and C-4 Species. Plant Physiology. 2011;155(1):142-156.C-4 photosynthesis involves alterations to the biochemistry, cell biology, and development of leaves. Together, these modifications increase the efficiency of photosynthesis, and despite the apparent complexity of the pathway, it has evolved at least 45 times independently within the angiosperms. To provide insight into the extent to which gene expression is altered between C-3 and C-4 leaves, and to identify candidates associated with the C-4 pathway, we used massively parallel mRNA sequencing of closely related C-3 (Cleome spinosa) and C-4 (Cleome gynandra) species. Gene annotation was facilitated by the phylogenetic proximity of Cleome and Arabidopsis (Arabidopsis thaliana). Up to 603 transcripts differ in abundance between these C-3 and C-4 leaves. These include 17 transcription factors, putative transport proteins, as well as genes that in Arabidopsis are implicated in chloroplast movement and expansion, plasmodesmatal connectivity, and cell wall modification. These are all characteristics known to alter in a C-4 leaf but that previously had remained undefined at the molecular level. We also document large shifts in overall transcription profiles for selected functional classes. Our approach defines the extent to which transcript abundance in these C-3 and C-4 leaves differs, provides a blueprint for the NAD-malic enzyme C-4 pathway operating in a dicotyledon, and furthermore identifies potential regulators. We anticipate that comparative transcriptomics of closely related species will provide deep insight into the evolution of other complex traits

Evidence for a modulating effect of transcutaneous auricular vagus nerve stimulation (taVNS) on salivary alpha-amylase as indirect noradrenergic marker: A pooled mega-analysis.

BACKGROUND Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has received tremendous attention as a potential neuromodulator of cognitive and affective functions, which likely exerts its effects via activation of the locus coeruleus-noradrenaline (LC-NA) system. Reliable effects of taVNS on markers of LC-NA system activity, however, have not been demonstrated yet. METHODS The aim of the present study was to overcome previous limitations by pooling raw data from a large sample of ten taVNS studies (371 healthy participants) that collected salivary alpha-amylase (sAA) as a potential marker of central NA release. RESULTS While a meta-analytic approach using summary statistics did not yield any significant effects, linear mixed model analyses showed that afferent stimulation of the vagus nerve via taVNS increased sAA levels compared to sham stimulation (b = 0.16, SE = 0.05, p = 0.001). When considering potential confounders of sAA, we further replicated previous findings on the diurnal trajectory of sAA activity. CONCLUSION(S) Vagal activation via taVNS increases sAA release compared to sham stimulation, which likely substantiates the assumption that taVNS triggers NA release. Moreover, our results highlight the benefits of data pooling and data sharing in order to allow stronger conclusions in research

Winkelstabile Plattenosteosynthese bei distalen periprothetischen Femurfrakturen : Klinisches Outcome und Mortalität

BACKGROUND The care of distal periprosthetic femoral fractures (PFF) is becoming a~major interdisciplinary challenge due to demographic developments. The operative treatment is often performed (depending on the type of fracture) by means of locking plate fixation (LPF), although little data on the clinical outcome exist by now. The aim of the study is to identify risk factors for a~poor outcome and increased mortality METHODS: In this retrospective study, 36 cases with distal PFF were examined. Exclusively treatment with LPF were included. Relevant previous illnesses (ASA score, Charlson index), fracture morphology and major complications were recorded as well as 1- and 3- year mortality. The clinical outcome was detected by using the Lysholm score. RESULTS The 1- and 3- year mortality were 9% and 26% - exclusively affecting ASA 3 and 4 patients. The Lysholm Score showed a high variability (65 ± 27~points) with higher values in the ASA 1-2 subgroup (82 vs. 63 points) but independent of fracture type. The preoperative ASA score, the Charlson comorbidity index, and the patient age were determined to be decisive for 3-year mortality. CONCLUSION This case series displayed a high absolute mortality even if the rate was slightly lower compared to previously published data. The rate of secondary dislocations, lack of fracture healing or follow-up operations were also low. The LPF therefore appears to be a suitable treatment for fractures with a stable prosthesis. However, there is a high variability in the clinical outcome regardless of the type of fracture and significantly increased mortality rates in previously ill patients

Mammalian deltavirus without hepadnavirus coinfection in the neotropical rodent Proechimys semispinosus.

Hepatitis delta virus (HDV) is a human hepatitis-causing RNA virus, unrelated to any other taxonomic group of RNA viruses. Its occurrence as a satellite virus of hepatitis B virus (HBV) is a singular case in animal virology for which no consensus evolutionary explanation exists. Here we present a mammalian deltavirus that does not occur in humans, identified in the neotropical rodent species Proechimys semispinosus The rodent deltavirus is highly distinct, showing a common ancestor with a recently described deltavirus in snakes. Reverse genetics based on a tandem minus-strand complementary DNA genome copy under the control of a cytomegalovirus (CMV) promoter confirms autonomous genome replication in transfected cells, with initiation of replication from the upstream genome copy. In contrast to HDV, a large delta antigen is not expressed and the farnesylation motif critical for HBV interaction is absent from a genome region that might correspond to a hypothetical rodent large delta antigen. Correspondingly, there is no evidence for coinfection with an HBV-related hepadnavirus based on virus detection and serology in any deltavirus-positive animal. No other coinfecting viruses were detected by RNA sequencing studies of 120 wild-caught animals that could serve as a potential helper virus. The presence of virus in blood and pronounced detection in reproductively active males suggest horizontal transmission linked to competitive behavior. Our study establishes a nonhuman, mammalian deltavirus that occurs as a horizontally transmitted infection, is potentially cleared by immune response, is not focused in the liver, and possibly does not require helper virus coinfection

El valor del lenguaje dramático en la escuela formal

En el siguiente trabajo, partiremos de tres ejes para desarrollar problemáticas que encontramos en el sistema educativo actual y que consideramos de especial importancia. Nuestra intención es no sólo crear conciencia sobre las mismas, sino también proponer diferentes alternativas que puedan servir de ayuda al docente ante situaciones de complejidad. (Párrafo extraído del texto a modo de resumen)Tema: Abordajes pedagógicosRed Nacional de Profesores de Teatro Dramatiz

El valor del lenguaje dramático en la escuela formal

En el siguiente trabajo, partiremos de tres ejes para desarrollar problemáticas que encontramos en el sistema educativo actual y que consideramos de especial importancia. Nuestra intención es no sólo crear conciencia sobre las mismas, sino también proponer diferentes alternativas que puedan servir de ayuda al docente ante situaciones de complejidad. (Párrafo extraído del texto a modo de resumen)Tema: Abordajes pedagógicosRed Nacional de Profesores de Teatro Dramatiz