Low Intensity Focused Ultrasound Stimulation of the Vagus Nerve for Modulation of the Inflammatory Reflex Assessed in Rats

Major depressive disorder (MDD) affects approximately 300 million people globally, with over 15% having treatment-resistant depression (TRD). People with depression have elevated levels of pro-inflammatory cytokines, especially tumor necrosis factor alpha (TNF-α). Electrical vagus nerve stimulation (eVNS) is an alternative treatment option that works by reducing cytokine production, but requires surgery and isn’t always effective. As an alternative, I propose the use of focused ultrasound stimulation of the vagus nerve (fVNS), which can be applied non-invasively. Low intensity focused ultrasound stimulation has previously been used to stimulate structures in the brain and peripheral nerves such as the sciatic and abducens. However, it has not been used to excite the vagus nerve. In this study, my colleagues and I used an LPS challenge in rats to induce an inflammatory response. I applied one or three 5-minute pulsed focused ultrasound stimulations to the vagus nerve (250 kHz, ISPPA= 3 W/cm2) and collected blood to analyze the effects of fVNS therapy on cytokine concentrations. Animals that received a single ultrasound application saw an average decrease in TNF-α levels by 19%, similar to electrically stimulated animals, which decreased on average by 16% compared to the control. With multiple applications, fVNS therapy statistically reduced serum TNF-α levels (73% reduction) compared to control animals without any observed damage to the nerve. When I cauterized the vagus nerve, the stimulation no longer had a reduction effect on TNF-α. These findings indicate that focused ultrasound stimulation can excite the vagus nerve and has the potential for use as a non-invasive, lower risk therapy for TRD

The Clinic as a Site of Grounded Pedagogy

Legal education tends to focus on teaching students federal law from hefty casebooks, inculcating the ability to think like lawyers. In a sea of Socratic lectures and hypotheticals, students often take refuge in clinics as an island of practical skills-building, client centeredness, and individual fulfillment. Yet even clinics sometimes fail to highlight for students how the place where they practice, with its particular political context and history, shapes their clients\u27 lives and legal problems. This Article describes the law school clinic as a site of grounded pedagogy: a teaching method that centers the con­nection between local history and the present to help students under­stand their individual clients\u27 situations and the wider struggle for justice. Grounded pedagogy locates learning in the clinic\u27s built environ­ment, links past and present, and is supported with data. Among other benefits, grounded pedagogy guides students to understand the social context of their clients\u27 communities, reduces ideological barri­ers to analyses of structural injustice, and deconstructs substantive si­los in legal education. This Article demonstrates the utility of grounded pedagogy through the example of its implementation in a Juvenile Defense Clinic in Baton Rouge, Louisiana. Envisioning clinics as a site of grounded pedagogy situates wider struggles in local context and models for non-clinical legal education a method to lo­calize law school curricula

Immunocompromised travellers

Given a better quality of life and extended life expectancy in patients with immune suppression, the number of immunocompromised travellers is constantly growing. The aim of the article is to discuss travel-related health problems in immunocompromised patients, their most common destinations and reasons to travel, as well as complications associated with travel to regions with harsh environmental conditions. The article focuses on selected groups of immunocompromised travellers (ICTs), i.e., cancer patients, transplant patients receiving immunosuppressant agents, splenectomised patients and HIV-infected individuals. The most common infections and complications, including traveller’s diarrhoea, vector-borne diseases (yellow fever, malaria, leishmaniasis, dengue, chikungunya), respiratory infections (including tuberculosis), and dermatoses were taken into account. Preventive measures dedicated to ICTs (pre-travel consultation, vaccinations, malaria chemoprophylaxis, prevention during travelling) have been also characterised

It is not OK but it works – unproductive entrepreneurship, the case of Poland

The concept of unproductive entrepreneurs was introduced to science by Baumol, who pointed out the differences in business output between countries. Unproductive behaviour of entrepreneurs is often a consequence of ineffective institutions used by entrepreneurs for rent seeking. The aim of this article is to examine subjective norms (S.N.) and attitudes regarding specified types of unproductive entrepreneurship, which in many cases takes the form of unethical or even unlawful behaviour among entrepreneurs in Poland. Examples of such behaviour are: bribery and tax evasion, burdensome lawsuits, often unfounded or lobbying. The structure of the research was based on Baumol’s work while the research model was based on Ajzen’s theory of planned behaviour (T.P.B.). In this article we argue that unproductive entrepreneurship in transforming economies is often forced by inefficient institutions and the desire to avoid bankruptcy. The results of the survey carried out among 270 Polish entrepreneurs indicated a permissive and subjective standard regarding tax evasion when the existence of their business is endangered, and more negative behavioural beliefs (B.B.) regarding the effectiveness of tax evasion than regarding the effectiveness of paying bribes (P.B.)

Pathway by which Vagus Nerve Stimulation of B Fibers Affects Heart Rate

Heart failure (HF) affects over 5 million adults in the United States. Many HF patients have a high resting heart rate, which is correlated with a high mortality rate. In recent years, vagus nerve stimulation (VNS) has become an increasingly researched therapy to reduce the resting heart rate of HF patients. However, current dosage given during VNS is increased incrementally at the doctor’s office until side effects present themselves in a patient. In addition, the means by which the therapy works is not completely understood. To better understand the therapy’s mechanisms, the right cervical vagus nerve of several Long Evans rats was exposed and cuffed. Autonomous Nerve Control (ANC) was utilized to activate various percentages of B Fibers, which have been found to be the most influential fiber on heart rate. After the first round of stimulation, a vagotomy was performed superior to the stimulation cuff on the nerve, and the stimulation was repeated. Initial experimentation was performed to confirm the electronics set-up and the surgical approach as well as ensure that a decrease in heart rate could be achieved with stimulation. Further experimentation is still needed to fully characterize the relationship between VNS and heart rate both before and after vagotomy. Knowing the pathway by which VNS affects heart rate can give further insight into how VNS treatment works. Additionally, further research needs to be performed to characterize the interaction between VNS therapy and drugs routinely prescribed to HF patients