Differential activation of pre-SMA and SMA proper during action observation: Effects of instructions

Many neurophysiological studies give evidence for a matching system between action observation and imitation. We used functional MRI to investigate the effects of different instructions for observing identical stimuli of whole-body gymnastics movements. The imitative-like observation mode asked normal human participants to observe the sequence containing repetitive parts and to subsequently imagine the observed movements in the first-person perspective. The evaluative observation mode asked the participants to carefully observe and judge movement accuracy and consistency in the repetitive sequence. We hypothesized that the supplementary motor area would be specifically involved in performing the observational tasks. Results indicate that the SMA proper is generally activated during observation of whole-body gymnastic movements and shows pronounced activation in imitative-like observation mode. Pre-SMA activity can be differentially modulated by instructions related to the observation task.

Personality and Emotion: Test of Gray's Personality Theory by Means of an fMRI Study

Although it is known that there are fundamental personality differences in the behavioral responses to emotional stimuli, traits have scarcely been investigated in this context by means of functional imaging studies. To maximize the variance with respect to personality, the authors tested 12 control subjects and 12 subjects who had sadomasochistic experiences with respect to the relationship between J. A. Gray's (1970) personality dimensions, the behavioral approach system (BAS) and the behavioral inhibition system (BIS), and brain activity in regions of interest. The BIS was associated with activity in numerous brain areas in response to fear, disgust, and erotic visual stimuli, whereas few associations could he detected between the BAS and brain activity in response to disgust and erotic stimuli.

Equid herpesvirus (EHV-1) live vaccine strain C147: efficacy against respiratory diseases following EHV types 1 and 4 challenges

The temperature sensitive and host range mutant clone 147 of equine herpesvirus 1 (EHV-1) was assessed for its ability to protect conventional, susceptible adult horses against respiratory infection by EHV-1 and equine herpesvirus 4 (EHV-4). Intranasal (IN) vaccination with 5.2 log(10) TCID(50) did not cause adverse clinical reactions although a limited virus shedding and viraemia (leukocytes) was observed in 11 of 15 and 10 of 15 vaccinated horses respectively. All 15 vaccinated horses showed a significant seroresponse to both EHV-1 and EHV-4 for virus neutralising (VN) antibody. None of 14 control horses shed virus or became viraemic or seroconverted prior to challenge. EHV-1 challenge (dose 6.0 log(10)) 6 weeks after vaccination resulted in pyrexia in all eight control horses while eight vaccinated horses remained unaffected. Six control horses developed nasal discharge, five of which were mucopurulent nasal discharge (mean duration 3.2 days) which also occurred in four vaccinated horses for 1 day. All eight control horses shed challenge EHV-1 at a significantly higher level (group mean titre 2.6+/-0.4 log(10) TCID(50) per sample) and for much longer (mean duration 4.8+/-1.5 days) than that (group mean titre 1.4+/-0.8 log(10) TCID(50) per sample and mean duration 1.5+/-0.5 days) in six vaccinated horses. Furthermore, all eight control horses became viraemic (mean duration 2.9 days) but viraemia did not occur in eight vaccinated horses. Following EHV-1 challenge, all eight control horses showed a significant VN antibody rise to both EHV-1 and EHV-4 but this occurred in only one vaccinated horse and to EHV-4 only. In EHV-4 challenge (dose of 4.2 log(10) TCID(50)) of a separate pair of seven vaccinated and six control horses, 6 weeks after EHV-1 vaccination resulted in pyrexia (mean duration 2.3 days) and nasal discharge (mean duration 1.8 days) in three and five control horses respectively but the only reaction observed in the vaccinated group was nasal discharge for 1 day in one animal. All six control animals shed virus (mean titre 2.5+/-0.6 log(10) TCID(50) per sample and mean duration 2+/-0.6 days) compared to one vaccinated animal. Although EHV-4 viraemia is rare, 3 of 6 control horses became viraemic after EHV-4 challenge but this was not observed in vaccinated horses. After EHV-4 challenge 3 and 5 of 6 control horses seroconverted for VN antibody to EHV-1 and EHV-4 respectively; a non-responsive control horse had high level of pre-existing VN antibody to EHV-4. However, only 1 of 7 vaccinated horses showed a significant antibody rise and only to EHV-4.

Local treatments for cutaneous warts

BACKGROUND

Viral warts caused by the human papilloma virus represent one of the most common diseases of the skin. Any area of skin can be affected although the hands and feet are by far the commonest sites. A very wide range of local treatments are available.

OBJECTIVES

To assess the effects of different local treatments for cutaneous, non-genital warts in healthy people.

SEARCH STRATEGY

We searched the Cochrane Controlled Trials Register (January 2003), the Skin Group trials register (January 2003), MEDLINE (1966 to January 2003), EMBASE (1980 to January 2003) and a number of other key biomedical and health economics databases. In addition the cited references of all trials identified and key review articles were searched. Pharmaceutical companies involved in local treatments for warts and experts in the field were contacted. The most recent searches were carried

SELECTION CRITERIA

Randomised controlled trials of local treatments for cutaneous non-genital viral warts in immunocompetent human hosts were included.

DATA COLLECTION AND ANALYSIS

Study selection and assessment of methodological quality were carried out by two independent reviewers.

MAIN RESULTS

Fifty two trials were identified which fulfilled the criteria for inclusion in the review. The evidence provided by these studies was generally weak because of poor methodology and reporting. In 17 trials with placebo groups that used participants as the unit of analysis the average cure rate of placebo preparations was 30% (range 0 to 73%) after an average period of 10 weeks (range 4 to 24 weeks). The best available evidence was for simple topical treatments containing salicylic acid, which are clearly better than placebo. Data pooled from six placebo-controlled trials show a cure rate of 144/191 (75%) compared with 89/185 (48%) in controls, odds ratio 3.91 (95% confidence interval 2.40 to 6.36), random effects model. Most of the bigger trials of cryotherapy studied different regimens rather than comparing cryotherapy with other treatments or placebo. Pooled data from two small trials that included cryotherapy and placebo or no treatment, showed no significant difference in cure rates. In two trials comparing cryotherapy with salicylic acid and one comparing duct tape with cryotherapy no significant difference in efficacy was demonstrated. There was no consistent evidence for the effectiveness of intralesional bleomycin. Four studies, using warts rather than individuals as the unit of analysis, had widely varying results which could not be meaningfully pooled. There was some evidence for the efficacy of dinitrochlorobenzene, a potent contact sensitizer. Pooled data from two small studies comparing dinitrochlorobenzene with placebo showed cure rates of 32/40 (80%) and 15/40 (38%) respectively, odds ratio 6.67 (95% confidence interval 2.44 to 18.23), random effects model. Only limited evidence was found for the efficacy of topical 5-fluorouracil, intralesional interferons and photodynamic therapy.Bleomycin, dinitrochlorobenzene, 5-fluorouracil, interferons and photodynamic therapy are potentially hazardous or toxic treatments.

REVIEWER'S CONCLUSIONS

There is a considerable lack of evidence on which to base the rational use of the local treatments for common warts. The reviewed trials are highly variable in method and quality. Cure rates with placebo preparations are variable but nevertheless considerable. There is certainly evidence that simple topical treatments containing salicylic acid have a therapeutic effect. There is less evidence for the efficacy of cryotherapy and some evidence that it is only of equivalent efficacy to simpler, safer treatments. Dinitrochlorobenzene appears to be effective but there were no statistically significant differences when compared with the safer, simpler and cheaper topical treatments containing salicylic acid. The benefits and risks of 5-fluorouracil, bleomycin, interferons and photodynamic therapy remain to be determined.

The insula is not specifically involved in disgust processing: an fMRI study

fMRI studies have shown that the perception of facial disgust expressions specifically activates the insula. The present fMRI study investigated whether this structure is also involved in the processing of visual stimuli depicting non-mimic disgust elicitors compared to fear-inducing and neutral scenes. Twelve female subjects were scanned while viewing alternating blocks of 40 disgust-inducing, 40 fear-inducing and 40 affectively neutral pictures, shown for 1.5 s each. Afterwards, affective ratings were assessed. The disgust pictures, rated as highly repulsive, induced activation in the insula, the amygdala, the orbitofrontal and occipito-temporal cortex. Since during the fear condition the insula was also involved, our findings do not fit the idea of the insula as a specific disgust processor.

Latent inhibition and schizophrenia: Pavlovian conditioning of autonomic responses

Latent inhibition (LI) is an important model for understanding cognitive deficits in schizophrenia. Disruption of LI is thought to result from an inability to ignore irrelevant stimuli. The study investigated LI in schizophrenic patients by using Pavlovian conditioning of electrodermal responses in a complete within-subject design. Thirty-two schizophrenic patients (16 acute, unmedicated and 16 medicated patients) and 16 healthy control subjects (matched with respect to age and gender) participated in the study. The experiment consisted of two stages: preexposure and conditioning. During preexposure two visual stimuli were presented. one of which served as the to-be-conditioned stimulus (CSp + ) and the other one was the not-to-be-conditioned stimulus (CSp - ) during the following conditioning ( = acquisition). During acquisition, two novel visual stimuli(CSn + and CSn - ) were introduced. A reaction time task was used as the unconditioned stimulus (US). LI was defined as the difference in response differentiation observed between preexposed and non-preexposed sets of CS + and CS - . During preexposure, the schizophrenic patients did not differ in electrodermal responding from the control subjects, neither concerning the extent of orienting nor the course of habituation. The exposure to novel stimuli at the beginning of the acquisition elicited reduced orienting responses in unmedicated patients compared to medicated patients and control subjects. LI was observed in medicated schizophrenic patients and healthy controls, but not in acute unmedicated patients. Furthermore LI was found to be correlated with the duration of illness: it was attenuated in patients who had suffered their first psychotic episode.

Perception of posture and cerebral blood flow

The perception of posture in man is made possible by the information of the vestibular organs, the visual system, the proprioception and the blood volume distribution. The present study examined the cerebral blood flow velocity (CBFV) and the fluid volume of the thoracic cavity under different pressure conditions and their effects on the perception of posture. Changes in blood flow velocity were measured by transcranial Doppler sonography (TCD), and changes in the blood volume distribution of the upper torso were registered by impedance plethysmography. The results indicated that the cerebral blood flow volume and the thoracic blood volume changed in the same manner. Lower Body Positive Pressure (+30 mmHg) led to an increase in central volume and CBFV. During the Lower Body Negative Pressure Treatment (-30 mmHg), the central blood volume and the cerebral blood flow velocity decreased while venous pooling occurred. Additionally, the changes in both parameters were associated with an altered posture perception. The correlations between the SHP and the two physiological parameters cerebral blood flow velocity and fluid shift in the upper thorax indicate that the fluid shift in the thoracic cavity was more closely related to the SHP than to the changes in cerebral blood volume.

Efficacy, safety and tolerability of oral eletriptan in the acute treatment of migraine: results of a phase III, multicentre, placebo-controlled study across three attacks

The efficacy, safety and tolerability of the 5-HT1B/D receptor agonist eletriptan (40 mg and 80 mg) in acute treatment of migraine was evaluated in a multinational, randomized, double-blind, parallel-group, placebo-controlled, three-attack study treating 1153 patients. In the initial attack, significantly more eletriptan patients reported headache relief and complete pain relief at 2 h vs. placebo (40 mg 62% and 32%, 80 mg 65% and 34%, placebo 19% and 3%; P < 0.0001). Headache relief occurred faster after eletriptan, with more patients at both doses reporting relief 30 min (P < 0.01) and 1 h (P < 0.0001) after treatment than after placebo. There was a significantly lower recurrence rate with eletriptan 80 mg compared with placebo (P < 0.01). Adverse events for all treatments were generally mild or moderate and self-limiting. Eletriptan 40 mg and eletriptan 80 mg both appear to be effective and well-tolerated acute migraine treatments.

Atmospheric electromagnetism: attempted replication of the correlation between natural sferics and ESP

In a previous study a negative correlation was found between the natural sferics activity and scores on an ESP task. We attempted a replication in three studies with 37, 100, and 68 participants. In these studies ESP scores and the level of sferics activity were not significantly correlated. The result for all combined data is significant but with a quite low effect size. Other trends in the data could not be confirmed.

Headache and sferics

Many patients with migraine believe weather is a trigger for their headaches. The objective of this study was to determine if very low frequency sferics, pulse-shaped electromagnetic fields originating from atmospheric discharges (lightning), are precipitating factors. The occurrence of sferics impulses is characterized by a daily, as well as an annual, periodicity and is thought to be associated with various pathological processes. The diaries of 37 women suffering from migraine and tension-type headaches were analyzed over a period of 6 months and correlated with daily sferics activity and other weather phenomena in the area of Giessen, Germany. From October through December (autumn), sferics activity was correlated with the occurrence of migraine (r = 0.33, P<.01); however, there was no correlation in July and August (summer), when the thunderstorm activity had been very intense. In summer, tension-type headaches were associated with other weather parameters such as temperature (r = 0.36, P<.01) and vapor pressure (r = 0.27, P<.05).

Natural very-low-frequency sferics and headache

Very-low-frequency (VLF) atmospherics or sferics are pulse-shaped alternating electric and magnetic fields which originate from atmospheric discharges (lightning). The objective of the study was threefold: (i) to analyse numerous parameters characterizing the sferics activity with regard to their suitability for field studies, (ii) to identify meteorological processes related to the sferics activity and (iii) to investigate the possible association of sferics with pain processes in patients suffering from migraine- and tension-type headaches. Over a period of 6 months (July through December) the sferics activity in the area of Giessen (Germany) was recorded. Three sferics parameters were chosen. The number of sferics impulses per day, the variability of the impulse rate during a day and the variability in comparison to the preceding day were correlated with weather processes (thunderstorm, temperature, vapour pressure, barometric pressure, humidity, wind velocity, warm sector). Significant correlations were obtained during the summer months (July, August) but not during the autumn months (October, November, December). During autumn, however, the sferics activity was correlated with the occurrence of migraine-type headaches (r=0.33, P<0.01) recorded by 37 women who had filled out a headache diary over a period of 6 months (July-December). While the thunderstorm activity was very intense during July and August, no relationship between sferics and migraine was found. In summer, tension-type headaches were associated with meteorological parameters such as temperature (r=0.42, P<0.01) and vapour pressure (r=0.28, P<0.05). Although the sferics activity can explain a small percentage of the variation in migraine occurrence, a direct influence was more likely exerted by visible or otherwise perceptible weather conditions (thunderstorms, humidity, vapour pressure, warm sector, etc.) than by the sferics activity itself.

Perceptibility of simulated VLF-sferics

Sferics are weak, naturally occurring electromagnetic fields related to specific weather conditions. There are some hints that these signals might be responsible for certain complaints that are often described as "weather sensitivity syndrome." The study's purpose was to find out whether humans, when exposed to simulated sferics, can consciously perceive any kind of psychophysiological changes. 63 subjects were trained within a simple learning paradigm to discriminate between phases where simulated sferics were present or absent. They were reinforced for each correct decision out of 80 judgements by means of acoustic signals. A reward of 100 German marks was pledged to the participant who would achieve the best result of the total sample. The total number of correct judgements did not differ from a random run and no learning occurred. Subjects who reported fewer bodily complaints in their recent past had higher scores in the discrimination task.

Sferics provoke changes in EEG power

The present study investigated electrocortical and psychological influences of Very Low Frequency (VLF) sferics. Eighty female subjects, who were divided into two groups participated in the study. After a 10-minute baseline period the experimental group (n=40) underwent a 10-minute exposure to a previously recorded 10 kHz-sferics impulse, which was presented with a pulse repetition frequency statistically varying between 1 and 3 Hz. After the sferics stimulation, an additional 20 minutes without treatment were recorded in order to examine possible prolonged sferics effects. The control group (n=40) received no treatment. As the physiological dependent measure, the background electroencephalogram (EEG) was registered throughout the course of the experiment. Absolute power values for different EEG frequency bands were determined by means of a Fast Fourier Transform (FFT) and compared between the two groups at four electrode sites (P3/P4; O1/O2). Also, the emotional and somatic state of the subjects and their ability consciously to perceive sferics were investigated. It could be shown that the two groups were characterized by different courses of EEG alpha and beta power. Whereas the sferics group displayed power increases in both frequency bands, which reached their maximum 20 minutes after the end of exposure, the control group showed a slight power reduction. Sferics had no effect on the subjective state and could not be perceived consciously.

[Recurrent mitigated erysipelas in severe combined immunodeficiency]

A patient with congenital severe combined swiss-type immune deficiency suffered from recurrent cellulitis and at least 26 documented cases of bacterial pneumonia. Parenteral immunoglobins prevented the recurrence of the bacterial pneumonias but not of the cellulitis. This was successfully halted by benzathine penicillin injections every four weeks.

Endothelial dysfunction in a murine model of mild hyperhomocyst(e)inemia

Homocysteine is a risk factor for the development of atherosclerosis and its thrombotic complications. We have employed an animal model to explore the hypothesis that an increase in reactive oxygen species and a subsequent loss of nitric oxide bioactivity contribute to endothelial dysfunction in mild hyperhomocysteinemia. We examined endothelial function and in vivo oxidant burden in mice heterozygous for a deletion in the cystathionine beta-synthase (CBS) gene, by studying isolated, precontracted aortic rings and mesenteric arterioles in situ. CBS(-/+) mice demonstrated impaired acetylcholine-induced aortic relaxation and a paradoxical vasoconstriction of mesenteric microvessels in response to superfusion of methacholine and bradykinin. Cyclic GMP accumulation following acetylcholine treatment was also impaired in isolated aortic segments from CBS(-/+) mice, but aortic relaxation and mesenteric arteriolar dilation in response to sodium nitroprusside were similar to wild-type. Plasma levels of 8-epi-PGF(2alpha) (8-IP) were somewhat increased in CBS(-/+) mice, but liver levels of 8-IP and phospholipid hydroperoxides, another marker of oxidative stress, were normal. Aortic tissue from CBS(-/+) mice also demonstrated greater superoxide production and greater immunostaining for 3-nitrotyrosine, particularly on the endothelial surface. Importantly, endothelial dysfunction appears early in CBS(-/+) mice in the absence of structural arterial abnormalities. Hence, mild hyperhomocysteinemia due to reduced CBS expression impairs endothelium-dependent vasodilation, likely due to impaired nitric oxide bioactivity, and increased oxidative stress apparently contributes to inactivating nitric oxide in chronic, mild hyperhomocysteinemia.

Effects of paced respiration on heart period and heart period variability

The present study investigated psychophysiological responses to paced respiration of different frequencies. Twenty men and 20 women (mean age: 24.3 years) underwent five breathing conditions (paced with 0.15 Hz, 0.20 Hz, 0.25 Hz, 0.30 Hz, and unpaced), each lasting 5 min. As dependent physiological measures heart period, and different heart period variability (HPV) parameters were assessed. Psychological variables consisted of mood estimates as well as rated accuracy and effort to follow the pacing rhythm. HPV decreased with higher breathing frequencies, under paced and unpaced conditions, whereas mood ratings did not change. Subjects indicated more effort and less accuracy in following the pacing signal, the more its frequency differed from their spontaneous breathing frequency. The comparison of a spontaneous breathing condition with a frequency-matched paced condition revealed that pacing per se provoked a reduction in heart period. Because this decrease was not accompanied by changes in any of the HPV frequency components, their validity as measures of autonomic control needs to be questioned.

Geophysical variables and behavior: LXXXVIII. Atmospheric electromagnetism: the possible disturbing influence of natural sferics on ESP

Sferics are electromagnetic impulses generated by electrical discharges during thunderstorms (lightning). One category is comprised of very low frequency electromagnetic waves, traveling over distances up to a thousand kilometers. Sferics have been shown to affect biological responses such as pain syndromes, reaction times, and power in the alpha band of the EEG. In the present study, in which 100 subjects took part, sferics have been studied in their relation to performance on a forced-choice extrasensory perception (ESP) task and to several secondary variables. The general finding is a negative correlation between ESP performance and sferics activity around the time of the session, most notably 24-48 hours prior to the session. Secondary variables appear to modulate this correlation, as has been found in previous research on sferics: the correlation tended to be stronger for persons who scored lower on Neuroticism and higher on the Openness scale of a Five-Factor Personality Questionnaire.

Optical characteristics of the phototroph Thiocapsa roseopersicina and implications for real-time monitoring of the bacteriochlorophyll concentration

Optical characteristics of a Thiocapsa roseopersicina culture and environmental samples containing T. roseopersicina were investigated in the spectral range of 400 to 1,100 nm (absorption coefficient, diffuse attenuation coefficient, and reflectance). Specific absorption coefficients of T. roseopersicina at wavelengths of 480, 520, 550, 580, 805, 860, and 880 nm were determined. It is suggested that the optical properties of T. roseopersicina in the near-infrared range of 800 to 930 nm, confirmed in this study, may be used for development of remote sensing techniques for real-time monitoring of T. roseopersicina and other bacteriochlorophyll a-containing microbes.

Nurse practitioners in developing countries: some ethical considerations

One of the principles of health care ethics is the principle of justice. An important expression of justice is equity. The provision of basic primary health care services to all people is the key to eliminating the gross inequities in health status existing in many countries. For many years nurses in developing countries have 'led the way' in bringing these essential services to poor rural communities, including the diagnosis and treatment of illnesses, and the prescribing and dispensing of medications. Nurses are the most appropriate health workers for this role, but most have not been prepared adequately for it. This is unsafe for patients and puts nurses at legal risk. Justice requires that patients should obtain access to safe health care and that nurses should receive appropriate education. Nurse practitioner programmes are being established to prepare nurses for this advanced practice role, but here again ethical considerations apply. Justice will be served only if nurse practitioner programmes are accessible to the nurses who are most likely to work in medically underserved communities where the need is greatest.

Electrocortical responses of headache patients to the simulation of 10 kHz sferics

Many headache patients believe that weather changes act as pain triggers. Therefore, the present study investigated the psychophysiological influence of an indicator of atmospheric instability, Very Low Frequency (VLF)-sferics, on 32 subjectively weather-sensitive women suffering from migraine attacks and/or tension-type headaches. It was analyzed if sferics exposure is able to induce electrocortical changes as well as headache symptoms. The subjects, who had been divided into two groups, participated in a sferics simulation study. The experimental group (n = 16) underwent a ten-minute exposure to 10kHz-sferics impulses followed by 20 minutes without treatment in order to examine possible prolonged sferics effects. The control group (n = 16) received no treatment. As dependent measures, EEG spectral power was compared between the two groups at six electrode sites (F3/F4; P3/P4; O1/O2). Sferics exposure provoked increases in absolute alpha and beta power during the treatment. The alpha power enhancement was still present at parietal sites at the end of registration (20 minutes after the end of exposure). The stimulation did not induce headache symptoms.