Cortical activity evoked by inoculation needle prick in infants up to one-year old

Inoculation is one of the first and most common experiences of procedural pain in infancy. However, little is known about how needle puncture pain is processed by the central nervous system in children. In this study, we describe for the first time the event-related activity in the infant brain during routine inoculation using electroencephalography. Fifteen healthy term-born infants aged 1 to 2 months (n = 12) or 12 months (n = 5) were studied in an outpatient clinic. Pain behavior was scored using the Modified Behavioral Pain Scale. A distinct inoculation event-related vertex potential, consisting of 2 late negative-positive complexes, was observable in single trials after needle contact with the skin. The amplitude of both negative-positive components was significantly greater in the 12-month group. Both inoculation event-related potential amplitude and behavioral pain scores increased with age but the 2 measures were not correlated with each other. These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old. They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group

Medicinal plant analysis: A historical and regional discussion of Chinese publication trends and emergent complex techniques

The analysis of medicinal plants has had a long history, and especially with regard to assessing a plant’s quality. The first techniques were organoleptic using the physical senses of taste, smell, and appearance. Then gradually these led on to more advanced instrumental techniques. Though different countries have their own traditional medicines China currently leads the way in terms of the number of publications focused on medicinal plant analysis and number of inclusions in their Pharmacopoeia. The monographs contained within these publications give directions on the type of analysis that should be performed, and for manufacturers, this typically means that they need access to more and more advanced instrumentation. We have seen developments in many areas of analytical analysis and particularly the development of chromatographic and spectroscopic methods and the hyphenation of these techniques. The ability to process data using multivariate analysis software has opened the door to metabolomics giving us greater capacity to understand the many variations of chemical compounds occurring within medicinal plants, allowing us to have greater certainty of not only the quality of the plants and medicines but also of their suitability for clinical research. Refinements in technology have resulted in the ability to analyze and categorize plants effectively and be able to detect contaminants and adulterants occurring at very low levels. However, advances in technology cannot provide us with all the answers we need in order to deliver high-quality herbal medicines and the more traditional techniques of assessing quality remain as important today

Does Antiretroviral Treatment Reduce Case Fatality Among HIV-Positive Patients with Tuberculosis in Malawi?

SETTING: Thyolo district, Malawi. OBJECTIVES: To report on 1) case fatality among human immunodeficiency virus (HIV) positive tuberculosis (TB) patients while on anti-tuberculosis treatment and 2) whether antiretroviral treatment (ART) initiated during the continuation phase of TB treatment reduces case fatality. DESIGN: Retrospective cohort analysis. METHODS: Comparative analysis of treatment outcomes for TB patients registered between January and December 2004. RESULTS: Of 983 newly registered TB patients receiving diagnostic HIV testing, 658 (67%) were HIV-positive. A total of 132 (20%) patients died during the 8-month course of anti-tuberculosis treatment, of whom 82 (62%) died within the first 2 months of treatment when ART was not provided (cumulative incidence 3.0, 95%CI 2.5-3.6 per 100 person-years). A total of 576 TB patients started the continuation phase of anti-tuberculosis treatment, 180 (31%) of whom were started on ART. The case-fatality rate per 100 person-years was not significantly different for patients on ART (1.0, 95%CI 0.6-1.7) and those without ART (1.2, 95%CI 0.9-1.7, adjusted hazard ratio 0.86, 95%CI 0.4-1.6, P = 0.6) CONCLUSIONS: ART provided in the continuation phase of TB treatment does not have a significant impact on reducing case fatality. Reasons for this and possible measures to reduce high case fatality in the initial phase of TB treatment are discussed

Cortical pain responses in human infants

Despite the recent increase in our understanding of the development of pain processing, it is still not known whether premature infants are capable of processing pain at a cortical level. In this study, changes in cerebral oxygenation over the somatosensory cortex were measured in response to noxious stimulation using real-time near-infrared spectroscopy in 18 infants aged between 25 and 45 weeks postmenstrual age. The noxious stimuli were heel lances performed for routine blood sampling; no blood tests were performed solely for the purpose of the study. Noxious stimulation produced a clear cortical response, measured as an increase in total hemoglobin concentration [HbT] in the contralateral somatosensory cortex, from 25 weeks (mean Delta[HbT] = 7.74 mu mol/L; SE, 1.10). Cortical responses were significantly greater in awake compared with sleeping infants, with a mean difference of 6.63 mu mol/L [95% confidence interval (CI) limits: 2.35, 10.91 mu mol/L; mean age, 35.2 weeks]. In awake infants, the response in the contralateral somatosensory cortex increased with age ( regression coefficient, 0.698 mu mol/L/week; 95% CI limits: 0.132, 1.265 mu mol/L/week) and the latency decreased with age (regression coefficient, -0.9861 mu mol/L/week; 95% CI limits: -1.5361, -0.4361 mu mol/L/week; age range, 25-38 weeks). The response was modality specific because no response was detected after non-noxious stimulation of the heel, even when accompanied by reflex withdrawal of the foot. We conclude that noxious information is transmitted to the preterm infant cortex from 25 weeks, highlighting the potential for both higher-level pain processing and pain-induced plasticity in the human brain from a very early age

Medicinal Plant Analysis: A Historical and Regional Discussion of Emergent Complex Techniques

The analysis of medicinal plants has had a long history, and especially with regard to assessing a plant’s quality. The first techniques were organoleptic using the physical senses of taste, smell, and appearance. Then gradually these led on to more advanced instrumental techniques. Though different countries have their own traditional medicines China currently leads the way in terms of the number of publications focused on medicinal plant analysis and number of inclusions in their Pharmacopoeia. The monographs contained within these publications give directions on the type of analysis that should be performed, and for manufacturers, this typically means that they need access to more and more advanced instrumentation. We have seen developments in many areas of analytical analysis and particularly the development of chromatographic and spectroscopic methods and the hyphenation of these techniques. The ability to process data using multivariate analysis software has opened the door to metabolomics giving us greater capacity to understand the many variations of chemical compounds occurring within medicinal plants, allowing us to have greater certainty of not only the quality of the plants and medicines but also of their suitability for clinical research. Refinements in technology have resulted in the ability to analyze and categorize plants effectively and be able to detect contaminants and adulterants occurring at very low levels. However, advances in technology cannot provide us with all the answers we need in order to deliver high-quality herbal medicines and the more traditional techniques of assessing quality remain as important today

Theory and Simulation of the diffusion of kinks on dislocations in bcc metals

Isolated kinks on thermally fluctuating (1/2) screw, edge and (1/2) edge dislocations in bcc iron are simulated under zero stress conditions using molecular dynamics (MD). Kinks are seen to perform stochastic motion in a potential landscape that depends on the dislocation character and geometry, and their motion provides fresh insight into the coupling of dislocations to a heat bath. The kink formation energy, migration barrier and friction parameter are deduced from the simulations. A discrete Frenkel-Kontorova-Langevin (FKL) model is able to reproduce the coarse grained data from MD at a fraction of the computational cost, without assuming an a priori temperature dependence beyond the fluctuation-dissipation theorem. Analytic results reveal that discreteness effects play an essential r\^ole in thermally activated dislocation glide, revealing the existence of a crucial intermediate length scale between molecular and dislocation dynamics. The model is used to investigate dislocation motion under the vanishingly small stress levels found in the evolution of dislocation microstructures in irradiated materials