Lateralized difference in tympanic membrane temperature: emotion and hemispheric activity

We review literature examining relationships between tympanic membrane temperature (TMT), affective/motivational orientation, and hemispheric activity. Lateralized differences in TMT might enable real-time monitoring of hemispheric activity in real-world conditions, and could serve as a corroborating marker of mental illnesses associated with specific affective dysregulation. We support the proposal that TMT holds potential for broadly indexing lateralized brain physiology during tasks demanding the processing and representation of emotional and/or motivational states, and for predicting trait-related affective/motivational orientations. The precise nature of the relationship between TMT and brain physiology, however, remains elusive. Indeed the limited extant research has sampled different participant populations and employed largely different procedures and measures, making for seemingly discrepant findings and implications. We propose, however, that many of these discrepancies can be resolved by considering how emotional states map onto motivational systems and further examining how validated methods for inducing lateralized brain activity might affect TMT

Getting a Grip on Memory: Unilateral Hand Clenching Alters Episodic Recall

Unilateral hand clenching increases neuronal activity in the frontal lobe of the contralateral hemisphere. Such hand clenching is also associated with increased experiencing a given hemisphere’s “mode of processing.” Together, these findings suggest that unilateral hand clenching can be used to test hypotheses concerning the specializations of the cerebral hemispheres during memory encoding and retrieval. We investigated this possibility by testing the effects of a unilateral hand clenching on episodic memory. The hemispheric Encoding/Retrieval Asymmetry (HERA) model proposes left prefrontal regions are associated with encoding, and right prefrontal regions with retrieval, of episodic memories. It was hypothesized that right-hand clenching (left hemisphere activation) pre-encoding, and left-hand clenching (right hemisphere activation) pre-recall, would result in superior memory. Results supported the HERA model. Also supported was that simple unilateral hand clenching can be used as a means by which the functional specializations of the cerebral hemispheres can be investigated in intact humans

Hemispheric bases for emotion and memory

The goal of this Research Topic was to bring together diverse scientific perspectives on lateralized brain mechanisms underlying emotion, motivation, and memory. The Topic resulted in eight articles, three of which report original research and five of which review and synthesize past research with the aim of developing new hypotheses and theory. A range of international experts with diverse backgrounds, theoretical perspectives, and experimental methods contributed to the Topic. Contributions strongly reflect this diversity, ranging from examining pupil dilation in response to viewing Rembrandt portraits to understanding how caffeine supplementation influences levels of spatial processing. In all cases, the authors developed strong, empirically guided insights into the lateralized brain mechanisms underlying behavioral effects. Two primary themes emerge to guide and constrain continuing research

Hemispheric bases for emotion and memory

The goal of this Research Topic was to bring together diverse scientific perspectives on lateralized brain mechanisms underlying emotion, motivation, and memory. The Topic resulted in eight articles, three of which report original research and five of which review and synthesize past research with the aim of developing new hypotheses and theory. A range of international experts with diverse backgrounds, theoretical perspectives, and experimental methods contributed to the Topic. Contributions strongly reflect this diversity, ranging from examining pupil dilation in response to viewing Rembrandt portraits to understanding how caffeine supplementation influences levels of spatial processing. In all cases, the authors developed strong, empirically guided insights into the lateralized brain mechanisms underlying behavioral effects. Two primary themes emerge to guide and constrain continuing research

Public service markets: their economics, institutional oversight and regulation

Public services in the UK have been transformed over the past 25 years with the introduction of market oriented solutions into their provision. This has been characterised by a shift away from state provision to independent providers, and by the introduction of competition and choice. This shift was partly ideologically motivated and partly driven by budget cutting considerations following the financial crisis. As such it has been lacking a comprehensive economic justification or method of analysis. It is now commonly accepted that the language of economic markets is essential to frame arguments about how effectively public services are achieving their intended outcomes. Using market language and concepts may not always be comfortable for those from a traditional policy-making background. It can nevertheless be very useful when designing investigations into the effectiveness and value for money in the mechanisms of delivery of such services, whenever these services entail a degree of user choice as is currently the case in large parts of health, social care and education (referred to as competition in the market). Our paper wants to provide a conceptual basis on the way of thinking in these terms. We provide a description of the current state and then comment on the desirability of this quasi market approach. Uniquely in the literature, we analyse the expected and desired developments by distinguishing between choice and compulsory merit goods. In choice merit goods markets many users are unable to choose effectively because of the existence of a number of demand side or supply side market failures. Moreover, conflicts may exist between how service users actually make choices, and policy objectives such as universality or equity which may not be achieved simply by ‘leaving it to the market’. The users of compulsory merit goods are typically a minority and unable to internalise the full social benefits of their actions; hence it may be welfare-enhancing for society to coerce them ‘consume’ these services. As choice cannot be an objective, the commissioning (competition for the market) or direct provision by the state of such goods may meet public policy objectives more effectively than the market mechanism alone. Building on these foundations the paper discusses when public service markets are likely to be an effective method of achieving public policy objectives, and when they may not be. Our paper analyses the implications for the institutional and legal framework, funding oversight and regulation of public service markets as a result of their transformation into quasi-markets. The paper concludes with some suggestions for those charged with overseeing public service markets in practice based on this analysis

Strength, But Not Direction, of Handedness Is Related to Height

Left-handers are reputed to be shorter than right-handers. However, previous research has confounded handedness direction (left- versus right-handedness) with handedness strength (consistency with which one hand is chosen across a variety of tasks; consistent- versus inconsistent-handedness). Here, we support a relationship between handedness strength, but not direction, and stature, with increasing inconsistent-handedness associated with increasing self-reported height

Phase II study of TP300 in patients with advanced gastric or gastro-oesophageal junction adenocarcinoma

Background: TP300, a recently developed synthetic camptothecin analogue, is a highly selective topoisomerase I inhibitor. A phase I study showed good safety and tolerability. As camptothecins have proven active in oesophago-gastric adenocarcinomas, in this phase II study we assessed the efficacy and safety of TP300 in patients with gastric or gastro-oesophageal junction (GOJ) adenocarcinomas. Methods: Eligible patients had metastatic or locally advanced gastric or Siewert Types II or III GOJ inoperable adenocarcinoma. Patients were chemotherapy naïve unless this had been administered in the perioperative setting. TP300 was administered as a 1-h intravenous infusion every 3 weeks (a cycle) for up to 6 cycles at a starting dose of 8 mg/m2 with intra-patient escalation to 10 mg/m2 from cycle 2 in the absence of dose-limiting toxicity. Tumour responses (RECIST 1.1) were assessed every 6 weeks. Toxicity was recorded by NCI-CTCAE version 3.0. Using a modified two-stage Simon design (Stage I and II), a total of 43 patients were to be included providing there were 3 of 18 patients with objective response in Stage I of the study. Results: In Stage I of the study 20 patients (14 males, 6 females), median age 67 years (range 40 − 82), performance status ECOG 0/1, with GC [14] or GOJ carcinoma [6] were enrolled. Of the 16 evaluable patients, 11 received the planned dose increase to 10 mg/m2 at cycle 2, 2 decreased to 6 mg/m2, and 3 continued on 8 mg/m2. There were no objective responses after 2 cycles of treatment. Twelve patients had stable disease for 1 − 5 months and 4 had progressive disease. Median progression free survival (PFS) was 4.1 months (CI [1.6 − 4.9]), median time to progression (TTP) was 2.9 months (CI [1.4 − 4.2]). Grade 3/4 toxicities (worst grade all cycles) included 7 patients (35 %) with neutropenia, 4 patients (20 %) with anaemia, 2 patients (10 %) with thrombocytopenia, and 3 patients (15 %) with fatigue. This study was terminated at the end of Stage I due to a lack of the required (3/18) responders. Conclusions: This study of TP300 showed good drug tolerability but it failed to demonstrate sufficient efficacy as measured by radiological response

Bilateral vestibular hypofunction in a tertiary dizziness center: occurrence and etiology

BACKGROUND: The primary goal of this study was to determine the occurrence of bilateral vestibular hypofunction in a specialized dizziness clinic and to assess the etiology in patients diagnosed with bilateral vestibular hypofunction. Secondary goal was to find out if the diagnosis was already made before the patient was seen at our clinic. METHODS: A retrospective cohort study, including patients who visited our specialized dizziness center between January 1, 2008, and December 31, 2018, fulfilling the criteria for bilateral vestibular hypofunction according to the Classification Committee of the Barany Society (2017). Data were collected regarding symptoms, causes, and vestibular function. RESULTS: In total, 126 patients met our initial inclusion criteria, of which 103 patients met the Classification Committee of the Barany Society criteria for bilateral vestibular hypofunction, so patients with bilateral vestibular hypofunction comprised 0.9% of the total population seen at our clinic. Mean age was 65.2 years and 49.5% were female. In only 29.1% of patients, the diagnosis was already made elsewhere. A definite cause was identified in 39.8%, the most common cause being ototoxicity. CONCLUSION: About 1% of the patients visiting our dizziness clinic has bilateral vestibular hypofunction. In our patient population, ototoxicity was the most common cause of bilateral vestibular hypofunction, and in more than 40%, the cause remains unknown. In the majority of the cases, the diagnosis of bilateral vestibular hypofunction was first made at our clinic and not by the referring general practitioner or specialist. When using the Classification Committee of the Barany Society criteria for bilateral vestibular hypofunction and presbyvestibulopathy, some patients with bilateral vestibular weakness and complaints cannot be categorized in either group.Disorders of the head and nec

Phase II study of TP300 in patients with advanced gastric or gastro-oesophageal junction adenocarcinoma

Background TP300, a recently developed synthetic camptothecin analogue, is a highly selective topoisomerase I inhibitor. A phase I study showed good safety and tolerability. As camptothecins have proven active in oesophago-gastric adenocarcinomas, in this phase II study we assessed the efficacy and safety of TP300 in patients with gastric or gastro-oesophageal junction (GOJ) adenocarcinomas. Methods Eligible patients had metastatic or locally advanced gastric or Siewert Types II or III GOJ inoperable adenocarcinoma. Patients were chemotherapy naïve unless this had been administered in the perioperative setting. TP300 was administered as a 1-h intravenous infusion every 3 weeks (a cycle) for up to 6 cycles at a starting dose of 8 mg/m2 with intra-patient escalation to 10 mg/m2 from cycle 2 in the absence of dose-limiting toxicity. Tumour responses (RECIST 1.1) were assessed every 6 weeks. Toxicity was recorded by NCI-CTCAE version 3.0. Using a modified two-stage Simon design (Stage I and II), a total of 43 patients were to be included providing there were 3 of 18 patients with objective response in Stage I of the study. Results In Stage I of the study 20 patients (14 males, 6 females), median age 67 years (range 40 − 82), performance status ECOG 0/1, with GC [14] or GOJ carcinoma [6] were enrolled. Of the 16 evaluable patients, 11 received the planned dose increase to 10 mg/m2 at cycle 2, 2 decreased to 6 mg/m2, and 3 continued on 8 mg/m2. There were no objective responses after 2 cycles of treatment. Twelve patients had stable disease for 1 − 5 months and 4 had progressive disease. Median progression free survival (PFS) was 4.1 months (CI [1.6 − 4.9]), median time to progression (TTP) was 2.9 months (CI [1.4 − 4.2]). Grade 3/4 toxicities (worst grade all cycles) included 7 patients (35 %) with neutropenia, 4 patients (20 %) with anaemia, 2 patients (10 %) with thrombocytopenia, and 3 patients (15 %) with fatigue. This study was terminated at the end of Stage I due to a lack of the required (3/18) responders. Conclusions This study of TP300 showed good drug tolerability but it failed to demonstrate sufficient efficacy as measured by radiological response. Trial registration EU-CTR 2009-012097-12 2009-09-0