The Role of the Atrial Neural Network In Atrial Fibrillation: The Metastatic Progression Hypothesis

With the advent of catheter ablation of atrial fibrillation (AF) there has been acceleration in our understanding of the mechanisms underlying the etiology of this common clinical arrhythmia. In this regard, the role of the intrinsic cardiac autonomic nervous system in the initiation and maintenance of AF began to receive attention in numerous experimental and clinical investigations. Up to now, the focus has been on the large ganglionated plexi (GP) which are located in the posterior left atrium mainly at the pulmonary vein-atrial junctions. As long term outcomes have been reported and single procedures have indicated diminished success rates particularly for persistent/long standing persistent AF, emphasis has begun to shift away from the pulmonary vein isolation (PVI) alone as well as GP ablation with or without PVI. An understanding of the atrial substrate represented by the extensions of the intrinsic cardiac autonomic system constituting the atrial neural network is beginning to evolve. In this review, the contribution of the intrinsic cardiac autonomic nervous system to the etiology of AF is addressed, particularly in regard to the greater prevalence of AF in the elderly. In addition, we emphasize the involvement of the atrial neural network in the "metastatic" progression of paroxysmal to persistent and long standing persistent forms of AF.

H19 DMR methylation correlates to the progression of esophageal squamous cell carcinoma through IGF2 imprinting pathway

BACKGROUND

H19 gene has been proved to be essential for human tumor growth which contains CpG rich regions. Imprinted gene expression in many cancers is usually associated with the function of methylation. We performed this study to better understand wether H19 DMR methylation correlates to the progression of esophageal squamous cell carcinoma through IGF2 imprinting pathway.

METHODS

LOI of IGF2 was detected in 276 samples, which were determined as heterozygote with ApaI polymorphism in exon 9 of IGF2 by PCR-RFLP and RT-PCR-RFLP. Methylation status of H19 DMR in informative samples was analyzed by bisulfite sequencing PCR. IGF2 expression was examined by real-time PCR and IHC.

RESULTS

208 ESCC patients were informative for ApaI polymorphism. 92 tumor and 30 normal tissues showed IGF2 LOI. Methylation status of H19 CBS6 was higher in patients with IGF2 LOI compared to patients with IGF2 MOI (p < 0.05). IGF2 expression in patients with IGF2 LOI was higher than patients with IGF2 MOI (p < 0.05) which was correlated with lymph node involvement, neoplastic grade and metastasis (p < 0.05).

CONCLUSIONS

Our results suggested that H19 CBS6 hypermethylation is related to the LOI of IGF2 which usually leads to an overexpression of IGF2, playing important roles in the occurrence, development as well as metastasis of ESCC. Therefore, H19 CBS6 methylation potentially represents a novel clinically relevant epigenetic marker to identify individuals at increased risk for the occurrence, progression and prognosis of ESCC.

Arsenic trioxide induced apoptosis in retinoblastoma cells by abnormal expression of microRNA-376a

Arsenic trioxide (ATO) has been demonstrated to induce apoptosis in retinoblastoma cells, however, mechanisms responsible for this phenomenon are not fully understood. In the present study, we determined whether ATO induced apoptosis by abnormal expression of microRNA. In an apoptosis model of retinoblastoma cells subjected to 4 μM ATO for 72 hours, we found 14 miRNAs changed more than 2-fold by using miRNA microarray analysis. Most of these aberrantly expressed miRNAs were confirmed by quantitative RT-PCR. MiR-376a, a significantly down-regulated miRNA, was selected for further study. The overexpression of miR-376a resulting from miR-376a mimic transfection significantly inhibited ATO-induced apoptosis. By contrast, miR-376a deficiency resulting from miR-376a inhibitor transfection aggravated ATO-induced apoptosis. Using bioinformatic algorithms, caspase-3, a key apoptosis executioner, was predicted as a putative target of miR-376a. The quantitative RT-PCR showed no effects of miR-376a mimic or inhibitor on caspase-3 mRNA level. However, the amount of caspase-3 proteins was reduced by miR-376a mimic, whereas increased by miR-376a inhibitor. Furthermore, the luciferase reporter assay confirmed caspase-3 to be a target of miR-376a, and the apoptosis caused by miR-376a inhibitor were abolished by a caspase-3 inhibitor. These results suggest that ATO -induced apoptosis in retinoblastoma cells is part mediated by decreasing expression of miR-376a, which subsequently increased caspase-3 expression.

Laparoscopic kidney orthotopic transplant: preclinical study in the pig model

BACKGROUND

Laparoscopic surgery has rapidly expanded in clinical practice replacing conventional open surgery over the last three decades. Laparoscopic donor nephrectomy has been favored due to its multiple benefits. The aim of this study was to explore the safety and feasibility of kidney transplantation by a laparoscopic technique in a pig model.

MATERIALS AND METHODS

The study was approved by the university animal ethics committee. Eight female pigs (Sus Scrofra, weighing 45-50 kg) were divided into 2 groups: group I included 4 animals that underwent laparoscopic kidney orthotopic transplantation on the left side. The right kidney was remained functional in situ. The pigs recovered and were observed for 1 week. In the 4 hosts group II pigs underwent a laparoscopic kidney transplantation on the left side. With simultaneous clipping of the right ureter. After recovery, the pigs were observed for 4 weeks. A laparotomy for examination was performed prior to euthanasia.

RESULTS

All 4 group I pigs survived for 1 week. The laparotomy showed normal graft perfusion with wall patent renal artery and vein as well as satisfactory urine output upon transection of ureter in 3 hosts. Renal artery stenosis occurred in one pig. In The Immediate kidney graft function was achieved in 3 group II pigs. The fourth died following extubation due to laryngospasm despite a functional graft. The average creatinine levels were 195.5 μmol/L on day 3; 224.5 μmol/L at week 1; 127 μmol/L at week 2; 182.7 umol/L at week 3; and 154.7 umol/L at week 4.

CONCLUSION

Laparoscopic kidney transplantation was feasible and safe in a pig model with immediate graft function. This study will provide further evidence to support application of laparoscopic technique to human kidney transplant.

Meticulous use of techniques for reconstruction of multiple renal arteries in live donor kidney transplantation

BACKGROUND

The aims of this study were to provide an overview of techniques for renal artery reconstruction and to introduce a novel technique using the gonadal vein as a "Carrel patch."

MATERIALS AND METHODS

From January 2005 to December 2011, we performed 128 live donor kidney transplantations. All donor nephrectomies used laparoscopic surgery, yielding 23 grafts with 2 and 3 with 3 renal arteries. The reconstruction technique was based on the length and caliber of the arteries. For 3 renal arteries, we used the gonadal vein as a "Carrel patch". The gonadal vein was harvested with the ureter as a bundle during nephrectomy. The recipients were 1.5 to 71 years old (average, 43.9).

RESULTS

All laparoscopic donor nephrectomies were performed successfully with preservation of the multiple arteries. The reconstructions were satisfactory; all grafts functioned immediately. There was no arterial infarction on postoperative Doppler ultrasound and renal nuclear scan. Renal artery stenosis occurred in 2 cases, in which the interventional balloon dilatation was first used; 1 case required subsequent stent insertion.

CONCLUSION

In cases of multiple renal arteries, the live donor kidney can be recovered safely by laparoscopic surgery. Our technique to reconstruct multiple renal arteries uses the gonadal vein as a "Carrel patch." The gonadal vein is readily available during laparoscopic donor nephrectomy.

Double prospectively ECG-triggered high-pitch spiral acquisition for CT coronary angiography: initial experience

AIM

To evaluate the feasibility of double prospectively electrocardiogram (ECG)-triggered high-pitch spiral acquisition mode (double high-pitch mode) for coronary computed tomography angiography (CTCA).

MATERIALS AND METHODS

One hundred and forty-nine consecutive patients [40 women, 109 men; mean age 58.2 ± 9.2 years; sinus rhythm ≤70 beats/min (bpm) after pre-medication, body weight ≤100 kg] were enrolled for CTCA examinations using a dual-source CT system with 2 × 128 × 0.6 mm collimation, 0.28 s rotation time, and a pitch of 3.4. Double high-pitch mode was prospectively triggered first at 60% and later at 30% of the R-R interval within two cardiac cycles. Image quality was evaluated using a four-point scale (1 = excellent, 4 = non-assessable).

RESULTS

From 2085 coronary artery segments, 86.4% (1802/2085) were rated as having a score of 1, 12.3% (257/2085) as score of 2, 1.2% (26/2085) as score of 3, and none were rated as "non-assessable". The average image quality score was 1.15 ± 0.26 on a per-segment basis. The effective dose was calculated by multiplying the coefficient factor of 0.028 by the dose-length product (DLP); the mean effective dose was 3.5 ± 0.8 mSv (range 1.7-7.6 mSv). The total dosage of contrast medium was 78.7 ± 2.9 ml.

CONCLUSION

Double prospectively ECG-triggered high-pitch spiral acquisition mode provides good image quality with an average effective dose of less than 5 mSv in patients with a heart rate ≤70 bpm.

Microstructural analysis of collagen and elastin fibres in the kangaroo articular cartilage reveals a structural divergence depending on its local mechanical environment

OBJECTIVE

To assess the microstructure of the collagen and elastin fibres in articular cartilage under different natural mechanical loading conditions and determine the relationship between the microstructure of collagen and its mechanical environment.

METHOD

Articular cartilage specimens were collected from the load bearing regions of the medial femoral condyle and the medial distal humerus of adult kangaroos. The microstructure of collagen and elastin fibres of these specimens was studied using laser scanning confocal microscopy (LSCM) and the orientation and texture features of the collagen were analysed using ImageJ.

RESULTS

A zonal arrangement of collagen was found in kangaroo articular cartilage: the collagen fibres aligned parallel to the surface in the superficial zone and ran perpendicular in the deep zone. Compared with the distal humerus, the collagen in the femoral condyle was less isotropic and more clearly oriented, especially in the superficial and deep zones. The collagen in the femoral condyle was highly heterogeneous, less linear and more complex. Elastin fibres were found mainly in the superficial zone of the articular cartilage of both femoral condyle and distal humerus.

CONCLUSIONS

The present study demonstrates that the collagen structure and texture of kangaroo articular cartilage is joint-dependent. This finding emphasizes the effects of loading on collagen development and suggests that articular cartilage with high biochemical and biomechanical qualities could be achieved by optimizing joint loading, which may benefit cartilage tissue engineering and prevention of joint injury. The existence of elastin fibres in articular cartilage could have important functional implications.

Bifidobacterium infantis-mediated HSV-TK/GCV suicide gene therapy induces both extrinsic and intrinsic apoptosis in a rat model of bladder cancer

Bladder cancer is the most common cancer in the urological tract. Here, we investigated the molecular pathways involved in the apoptosis of rodent bladder cancer, which was treated with Bifidobacterium infantis (BI)-mediated herpes simplex virus thymidine kinase (HSV-TK)/ganciclovir (GCV) suicide gene therapy. We engineered the BI-TK system, which consists of BI with the recombinant plasmid PGEX-1λT carrying HSV-TK (that is, TK) gene. Tumor-bearing rats were randomly divided into three groups and tail vein injected with normal saline (group A), BI/PGEX-1λT (group B) or BI-TK (group C), followed by intraperitoneal injection of GCV. The BI-TK/GCV system (group C) was shown to inhibit tumor growth and caused the apoptosis of tumor cells as assessed by in situ terminal transferase dUTP nick-end labeling assay. While varied extents of apoptosis were detected in tumor cells from all groups, tumor cells treated with BI-TK/GCV system (group C) exhibited the highest level of apoptosis (P < 0.05), consistent with our previous studies. Furthermore, we found that the expression levels of Fas, FasL, Cyt-C and caspase-9 in tumor tissues derived from group C were significantly higher than the other two groups (P < 0.001). Therefore, our results have demonstrated that the BI-TK/GCV therapy system exhibits a sustainable antitumor growth activity in the rodent model of bladder cancer. Mechanistically, both extrinsic and intrinsic apoptosis pathways are involved in the BI-TK/GCV antitumor functionality.

Plate fixation of paediatric fractures of the distal tibia and fibula

The role of surgery in the management of paediatric long-bone shaft fractures remains a matter of debate. We present a series of paediatric patients with unstable fractures of the distal tibia and fibula, treated with titanium plate fixation. Excellent results were obtained after plate fixation.

A novel technique for reconstruction of multiple renal arteries in live donor kidney transplantation: a case report and literature review

BACKGROUND

Reconstruction for three renal arteries from a living donor becomes a real challenge as the limited material can be used when compared with deceased donors. Therefore, in this report we introduce a novel technique by using the gonadal vein as a Carrel patch for reconstruction with three renal arteries. The other techniques will also be reviewed in this report.

METHODS

The living donor is a 51-year-old woman with three renal arteries on the left side and one renal artery on the right side, but with early branching 15 mm from the origin. The recipient is her husband, a 56-year-old with end-stage kidney disease secondary to type II diabetes. A left laparoscopic donor nephrectomy was performed successfully. The three renal arteries were anastomosed to the gonadal vein patch in a parallel fashion. Thereafter, the gonadal vein patch was anastomosed to the side of external iliac artery. The renal vein was anastomosed to the side of external iliac vein.

RESULTS

The kidney was reperfused rapidly and uniformly. The kidney functioned immediately. Doppler ultrasound and renal nuclear scans revealed that the perfusion of the kidney was normal. The creatinine level was 158 umol/L at day 7 and stable at 140 umol/L during the 2-month follow-up examination.

CONCLUSIONS

The gonadal vein can be used as a Carrel patch for multiple renal artery reconstruction, in particular, for more than two renal arteries. This technique provides a new approach for the reconstruction of multiple renal arteries in living donor kidney transplantations.

Laparoscopic donor nephrectomy for ectopic kidney

Laparoscopic donor nephrectomy has been widely accepted in living donor kidney transplantation. Ectopic kidneys are sometimes encountered during the living donor workup. Ectopic kidneys have been utilized successfully for kidney transplant. However, all these donor nephrectomies were performed by open surgery. We report a successful case of laparoscopic donor nephrectomy for ectopic kidney. The literature was reviewed and the technique points were emphasized.

Comparison of the antiviral effects of entecavir and adefovir dipivoxil in chronic HBV infection: a randomized control trial

AIMS

The purpose of this study is to compare the antiviral efficacy of entecavir (ETV) and adefovir dipivoxil (ADV) at various time points during the treatment.

METHODS

A randomized, controlled, open-label study was designed to analyze the kinetics of HBeAg seroconversion, HBV DNA level, and liver and renal functions in 72 ETV-treated chronic hepatitis B (CHB) patients and 66 ADV-treated CHB patients. The data was collected every 12 weeks up to 96 weeks after drug administration.

RESULTS

The negative rate of HBeAg seroconversion was significantly increased at 24 weeks in ETV-treated patients, whereas in ADV-treated patients, these changes were not significant. The serum HBV DNA levels were significantly decreased from 24 weeks in both ETV- and ADV-treated patients. Other than ETV showing significantly decreased levels of HBV DNA at 24 weeks when compared with ADV, there was no difference in virological response between two treatments at any other time points. The serum alanine aminotransferase (ALT) and total bilirubin (TBIL) levels were significantly decreased 12 weeks after either ETV- or ADV-treated patients without differences between two treatments. The urea nitrogen levels were in normal range and there was no difference between two groups.

CONCLUSIONS

Our study suggested that both ETV and ADV could be used as monotherapy for nucleotide-naive patients, but ETV has displayed potential efficacy in HBeAg seroconversion.

Diagnostic Potential of Polyclonal Antibodies Against Bacterially Expressed Recombinant Coat Protein of Alfalfa mosaic virus

Alfalfa mosaic virus (AMV), a pathogen of a wide range of plant species, including Glycine max (soybean), is poorly immunogenic. Polyclonal antibodies were generated against bacterially expressed recombinant coat proteins (rCPs) of two biologically distinct AMV strains in rabbits and compared with those raised against native and glutaraldehyde-treated virions of the same strains. Analyses showed that sera against rCPs had comparable antibody titers in indirect enzyme-linked immunosorbent assay with those raised against virions when soybean sap containing homologous viruses served as antigens. Polyclonal antibodies against rCPs were specific, sensitive, and detected all AMV isolates that originated from soybean fields from geographically different regions of the United States. Comparison of CP genes of these isolates showed 96 to 99 and 96 to 100% nucleotide and amino acid sequence identities, respectively, suggesting that they are all closely related. This was further confirmed by phylogenetic analysis where they were all clustered together along with representative AMV strains belonging to group I. Collectively, our data demonstrate that, despite poor immunogenicity of AMV, polyclonal antibodies against rCP are effective probes for detection and diagnosis of the virus.

Study of the functional hyperconnectivity between couples of pilots during flight simulation: an EEG hyperscanning study

Brain Hyperscanning, i.e. the simultaneous recording of the cerebral activity of different human subjects involved in interaction tasks, is a very recent field of Neuroscience aiming at understanding the cerebral processes generating and generated by social interactions. This approach allows the observation and modeling of the neural signature specifically dependent on the interaction between subjects, and, even more interestingly, of the functional links existing between the activities in the brains of the subjects interacting together. In this EEG hyperscanning study we explored the functional hyperconnectivity between the activity in different scalp sites of couples of Civil Aviation Pilots during different phases of a flight reproduced in a flight simulator. Results shown a dense network of connections between the two brains in the takeoff and landing phases, when the cooperation between them is maximal, in contrast with phases during which the activity of the two pilots was independent, when no or quite few links were shown. These results confirms that the study of the brain connectivity between the activity simultaneously acquired in human brains during interaction tasks can provide important information about the neural basis of the "spirit of the group".

Association of angiotensin I converting enzyme, angiotensin II type 1 receptor and angiotensin I converting enzyme 2 gene polymorphisms with the dyslipidemia in type 2 diabetic patients of Chinese Han origin

OBJECTIVE

To investigate whether the genetic polymorphisms in the angiotensin I converting enzyme (ACE) (insertion/ deletion, or I/D), angiotensin II type 1 receptor (AT1R) (rs5186), and ACE2 (rs2285666) could be associated with dyslipidemia in Type 2 diabetic (T2D) patients of Chinese Han origin.

DESIGN AND METHODS

The above 3 polymorphisms were genotyped in a total of 282 patients with T2D and dyslipidemia (Group A), 182 patients with T2D but without dyslipidemia (Group B), and 324 healthy controls. The association between a certain polymorphism and each group was assessed by an odds ratio (OR).

RESULTS

The D allele of the ACE (I/D) was significantly associated with the risk of T2D accompanying dyslipidemia between group A and controls [OR=1.37, 95% confidence interval (CI)=1.08-1.74; p=0.010], and significant association of the D allele with dyslipidemia was also observed in diabetic patients (OR=1.88, 95% CI=1.40-2.54; p<0.001). Furthermore, the ID genotype had a decreased risk of developing T2D without dyslipidemia as compared with controls (OR=0.52, 95% CI=0.32-0.82; p=0.0060). The distributions of the AT1R (rs5186) and ACE2 (rs2285666) genotypes and alleles did not differ between T2D patients with or without dyslipidemia and the controls.

CONCLUSIONS

This study demonstrates that the ACE (I/D) polymorphism is associated with T2D, regardless of the absence or presence of dyslipidemia. The polymorphisms in the AT1R (rs5186) and ACE2 (rs2285666) seem to play lesser roles in the development of T2D.

Cortical activity and functional hyperconnectivity by simultaneous EEG recordings from interacting couples of professional pilots

Controlling an aircraft during a flight is a compelling condition, which requires a strict and well coded interaction between the crew. The interaction level between the Captain and the First Officer changes during the flight, ranging from a maximum (during takeoff and landing, as well as in case of a failure of the instrumentation or other emergency situations) to a minimum during quiet mid-flight. In this study, our aim is to investigate the neural correlates of different kinds and levels of interaction between couples of professional crew members by means of the innovative technique called brain hyperscanning, i.e. the simultaneous recording of the hemodynamic or neuroelectrical activity of different human subjects involved in interaction tasks. This approach allows the observation and modeling of the neural signature specifically dependent on the interaction between subjects, and, even more interestingly, of the functional links existing between the brain activities of the subjects interacting together. In this EEG hyperscanning study, different phases of a flight were reproduced in a professional flight simulator, which allowed, on one side, to reproduce the ecological setting of a real flight, and, on the other, to keep under control the different levels of interaction induced in the crew by means of systematic and simulated failures of the aircraft instrumentation. Results of the procedure of linear inverse estimation, together with functional hyperconnectivity estimated by means of Partial Directed Coherence, showed a dense network of connections between the activity in the two brains in the takeoff and landing phases, when the cooperation between the crew is maximal, while conversely no significant links were shown during the phases in which the activity of the two pilots was independent.

Surface nanostructuring of boron-doped diamond films and their electrochemical performance

Uniform and vertically aligned nanocone and nanopillar arrays were successfully constructed on heavily boron-doped nanocrysatlline diamond films by carrying out bias-assisted reactive ion etching in hydrogen/argon plasmas. The electrochemical properties of the nanostructured boron-doped diamond films were investigated by cyclic voltammetry using 1 mM [Fe(CN)6](3-/4-) as redox couple. Compared to the planar boron-doped nanocrystalline diamond film electrode, the surface nanostructuring of boron-doped diamond film electrodes demonstrate enhanced sensitivity due to their enlarged electro-active surface areas. The results indicated that boron-doped diamond nanocones and nanopillars are promising electrode materials which benefit to improve the efficiency, sensitivity and reproducibility of biomedical and chemical sensors.

EQPlanar: a maximum-likelihood method for accurate organ activity estimation from whole body planar projections

Optimizing targeted radionuclide therapy requires patient-specific estimation of organ doses. The organ doses are estimated from quantitative nuclear medicine imaging studies, many of which involve planar whole body scans. We have previously developed the quantitative planar (QPlanar) processing method and demonstrated its ability to provide more accurate activity estimates than conventional geometric-mean-based planar (CPlanar) processing methods using physical phantom and simulation studies. The QPlanar method uses the maximum likelihood-expectation maximization algorithm, 3D organ volume of interests (VOIs), and rigorous models of physical image degrading factors to estimate organ activities. However, the QPlanar method requires alignment between the 3D organ VOIs and the 2D planar projections and assumes uniform activity distribution in each VOI. This makes application to patients challenging. As a result, in this paper we propose an extended QPlanar (EQPlanar) method that provides independent-organ rigid registration and includes multiple background regions. We have validated this method using both Monte Carlo simulation and patient data. In the simulation study, we evaluated the precision and accuracy of the method in comparison to the original QPlanar method. For the patient studies, we compared organ activity estimates at 24 h after injection with those from conventional geometric mean-based planar quantification using a 24 h post-injection quantitative SPECT reconstruction as the gold standard. We also compared the goodness of fit of the measured and estimated projections obtained from the EQPlanar method to those from the original method at four other time points where gold standard data were not available. In the simulation study, more accurate activity estimates were provided by the EQPlanar method for all the organs at all the time points compared with the QPlanar method. Based on the patient data, we concluded that the EQPlanar method provided a substantial increase in accuracy of organ activity estimates from 24 h planar images compared to the CPlanar using 24 h SPECT as the golden standard. For other time points, where no golden standard is available, better agreement between estimated and measured projections was observed by using the EQPlanar method compared to the QPlanar method. This phenomenon is consistent with the improvement in goodness of fit seen in both simulation data and 24 h patient data. Therefore, this indicates the improved reliability of organ activity estimates obtained though the EQPlanar method.

Inclusion of the female condom in a male condom-only intervention in the sex industry in China: a cross-sectional analysis of pre- and post-intervention surveys in three study sites

OBJECTIVES

To describe female condom (FC) use, male condom (MC) use and overall levels of protected sex before, during and after FC education and promotion (using the original prototype FC) combined with MC promotion among female sex workers in three rural or small urban settings in southern China.

STUDY DESIGN

The 1-year FC intervention was conducted by local health workers through outreach to establishments where sex work is conducted. Three serial cross-sectional surveys were conducted in each study town before, during and after the intervention along with process documentation throughout the intervention period.

METHODS

Cross-sectional data from pre-intervention (baseline) and 6-month and 12-month post-intervention surveys from three study sites are used in a descriptive comparison of the context of the sex industry, outreach in two phases of intervention, and FC adoption after the intensive intervention phase in each site.

RESULTS

Approximately 75-80% of eligible women working in sex establishments, varying from 74 to 155 participants for each survey, were recruited from three study sites. After introduction and promotion of the FC along with the MC during the community public health intervention, between one-fifth and one-half of the study participants had tried the FC in the three study sites by the time of the 6-month and 12-month cross-sectional surveys. Among them, 10-30% had used the FC more than once. FC awareness increased following the intervention with much less variation across the three study sites. At baseline, 31-54% of participants across the three sites reported 100% protected sex in the last 30 days with all types of partners. At one of the sites with relatively low MC use before the intervention, the proportion of women reporting 100% protected sex in the last 30 days increased by 15%, and the proportion reporting nil protected sex in the last 30 days decreased by 13% between baseline and 12-month post-intervention surveys. More complex profiles of FC and MC use and protected sex were shown at the other two study sites, where a higher level of protection had been reached before the project started.

CONCLUSIONS

Different levels of FC adoption were identified after the 1-year FC promotion intervention through outreach to sex establishments. The input, output and outcomes of the intervention may be associated with women's demographic and risk characteristics, the local capacities of intervention staff, and other contextual factors. Further analysis of these factors will help establish the role of the FC in increasing protected sex, and provide insight into how to achieve greater FC use.

Imaging the social brain: multi-subjects EEG recordings during the "Chicken's game"

In this study we measured simultaneously by EEG hyperscannings the neuroelectric activity in 6 couples of subjects during the performance of the "Chicken's game", derived from game theory. The simultaneous recording of the EEG in couples of interacting subjects allows to observe and model directly the neural signature of human interactions in order to understand the cerebral processes generating and generated by social cooperation or competition. Results suggested that the one of the most consistently activated structure in this particular social interaction paradigm is the left orbitofrontal cortex. Connectivity results also showed a significant involvement of the orbitofrontal regions of both hemispheres across the observed population. Taken together, results confirms that the study of the brain activities in humans during social interactions can take benefit from the simultaneous acquisition of brain activity during such interaction.

Simultaneous estimation of cortical activity during social interactions by using EEG hyperscannings

In this paper we show how the possibility of recording simultaneously the cerebral neuroelectric activity in different subjects (EEG hyperscanning) during the execution of different tasks could return useful information about the "internal" cerebral state of the subjects. We present the results obtained by EEG hyperscannings during ecological task (such as the execution of a card game) as well as that obtained in a series of couples of subjects during the performance of the Prisoner's Dilemma Game. The simultaneous recordings of couples of interacting subjects allows to observe and to model directly the neural signature of human interactions in order to understand the cerebral processes generating and generated by social cooperation or competition. Results obtained in a study of different groups recorded during the card game revealed a larger activity in prefrontal and anterior cingulated cortex in different frequency bands for the player that leads the game when compared to other players. Results collected in a population of 10 subjects during the performance of the Prisoner's Dilemma suggested that the most consistently activated structure is the orbitofrontal region (roughly described by the Brodmann area 10) during the condition of competition in both the tasks. It could be speculated whether the pattern of cortical connectivity between different cortical areas in different subjects could be employed as a tool for assessing the outcome of the task in advance.

Group IVB Oxides as High Permittivity Gate Insulators

Increasing MOSFET performance requires scaling, the systematic reduction in device dimensions. Tunneling leakage, however, provides an absolute scaling limit for SiO2of about 1.5 nm. Power limitations and device reliability are likely to pose softer limits slightly above 2 nm. We have investigated the use of high permittivity materials such as TiO2, ZrO2, and their silicates as potential replacements for SiO2. We have synthesized titanium nitrate (Ti(NO3)4or TN), zirconium nitrate (Zr(NO3)4or ZrN), and hafnium nitrate (Hf(NO3)4or HfN) as hydrogen and carbon free deposition precursors. Several problems arise in the use of these films including the formation of an amorphous low permittivity interfacial layer. For TiO2this layer is formed by silicon up diffusion. Surface nitridation retards the formation of the interfacial layer. We discuss the effects of both thermal and remote plasma surface nitridation treatments on the properties of the film stack. ZrO2and HfO2appear to form a thermal layer of silicon oxide between the high permittivity film and the silicon and have excess oxygen in the bulk of the film.

Therapeutic effect of statin on aortic stenosis: a review with meta-analysis

BACKGROUND

Aortic stenosis (AS) is a common progressive disease. Statins have been hypothesized to delay its progression via pleiotropic mechanisms. However, results of clinical trials focusing on statin therapy in AS patients have been controversial.

OBJECTIVE

To analyse and summarize the findings in recent statin trials and to discuss the rationale of statin usage in AS populations.

METHODS

A comprehensive database search was conducted by two independent reviewers. Controlled trials that compared progression of AS between statin and non-statin therapy published before 31 December 2008 were included. Data were extracted for meta-analysis, to estimate overall effects, if available. Factors that contributed to heterogeneities among the trials were analysed.

RESULTS

The meta-analysis included nine trials with a total of 2947 patients. Statin therapy displayed an overall statistically significant effect on delaying AS progression. The weighted mean difference (statin vs. control) of annual increase of peak aortic-jet velocity was -0·12 m/s (95% confidence interval -0·22 to -0·03); the increase of mean transaortic pressure gradient was -1·64 mmHg per year (-3·27 to -0·01); Heterogeneity-analysis suggested that the baseline risk factors and characteristics of the patients, the use of different statins, and the time point to initiate statin therapy, may be important considerations when interpreting the result of individual studies.

CONCLUSION

Although the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial reported negative results in delaying AS progression in low-risk patients, the potential benefits of statins in those with multiple risk factors and their value in preventing future coronary events call for further investigation of different categories of AS patients.

The effect of volume-of-interest misregistration on quantitative planar activity and dose estimation

In targeted radionuclide therapy (TRT), dose estimation is essential for treatment planning and tumor dose response studies. Dose estimates are typically based on a time series of whole-body conjugate view planar or SPECT scans of the patient acquired after administration of a planning dose. Quantifying the activity in the organs from these studies is an essential part of dose estimation. The quantitative planar (QPlanar) processing method involves accurate compensation for image degrading factors and correction for organ and background overlap via the combination of computational models of the image formation process and 3D volumes of interest defining the organs to be quantified. When the organ VOIs are accurately defined, the method intrinsically compensates for attenuation, scatter and partial volume effects, as well as overlap with other organs and the background. However, alignment between the 3D organ volume of interest (VOIs) used in QPlanar processing and the true organ projections in the planar images is required. The aim of this research was to study the effects of VOI misregistration on the accuracy and precision of organ activity estimates obtained using the QPlanar method. In this work, we modeled the degree of residual misregistration that would be expected after an automated registration procedure by randomly misaligning 3D SPECT/CT images, from which the VOI information was derived, and planar images. Mutual information-based image registration was used to align the realistic simulated 3D SPECT images with the 2D planar images. The residual image misregistration was used to simulate realistic levels of misregistration and allow investigation of the effects of misregistration on the accuracy and precision of the QPlanar method. We observed that accurate registration is especially important for small organs or ones with low activity concentrations compared to neighboring organs. In addition, residual misregistration gave rise to a loss of precision in the activity estimates that was on the order of the loss of precision due to Poisson noise in the projection data. These results serve as a lower bound on the effects of misregistration on the accuracy and precision of QPlanar activity estimate and demonstrate that misregistration errors must be taken into account when assessing the overall precision of organ dose estimates.

EMX2 is epigenetically silenced and suppresses growth in human lung cancer

Lung cancer is a common cancer and the leading cause of cancer-related death worldwide. Aberrant activation of WNT signaling is implicated in lung carcinogenesis. EMX2, a human homologue of the Drosophila empty spiracles gene is a homeodomain-containing transcription factor. The function of EMX2 has been linked to the WNT signaling pathway during embryonic patterning in mice. However, little is known about the role of EMX2 in human tumorigenesis. In this study, we found that EMX2 was dramatically downregulated in lung cancer tissue samples and this downregulation was associated with methylation of the EMX2 promoter. Restoration of EMX2 expression in lung cancer cells lacking endogenous EMX2 expression suppressed cell proliferation and invasive phenotypes, inhibited canonical WNT signaling, and sensitized lung cancer cells to the treatment of the chemo cytotoxic drug cisplatin. On the other hand, knockdown of EMX2 expression in lung cancer cells expressing endogenous EMX2 promoted cell proliferation, invasive phenotypes and canonical WNT signaling. Taken together, our study suggests that EMX2 may have important roles as a novel suppressor in human lung cancer.

Estimation of the cortical activity from simultaneous multi-subject recordings during the prisoner's dilemma

One of the most challenging questions open in Neuroscience today is the characterization of the brain responses during social interaction. A major limitation of the approaches used in most of the studies performed so far is that only one of the participating brains is measured each time. The "interaction" between cooperating, competing or communicating brains is thus not measured directly, but inferred by independent observations aggregated by cognitive models and assumptions that link behavior and neural activation. In this paper, we present the results of the simultaneous neuroelectric recording of 5 couples of subjects engaged in cooperative games (EEG hyperscanning). The simultaneous recordings of couples of interacting subjects allows to observe and model directly the neural signature of human interactions in order to understand the cerebral processes generating and generated by social cooperation or competition. We used a paradigm called Prisoner's dilemma derived from the game theory. Results collected in a population of 10 subjects suggested that the most consistently activated structure in social interaction paradigms is the orbitofrontal region (roughly described by the Brodmann area 10) during the condition of competition.

Sulf-2, a heparan sulfate endosulfatase, promotes human lung carcinogenesis

Heparan sulfate (HS) proteoglycans (HSPGs) bind to multiple growth factors/morphogens and regulate their signaling. 6-O-sulfation (6S) of glucosamine within HS chains is critical for many of these ligand interactions. Sulf-1 and Sulf-2, which are extracellular neutral-pH sulfatases, provide a novel post-synthetic mechanism for regulation of HSPG function by removing 6S from intact HS chains. The Sulfs can thereby modulate several signaling pathways, including the promotion of Wnt signaling. We found induction of SULF2 transcripts and Sulf-2 protein in human lung adenocarcinoma and squamous cell carcinoma, the two major classes of non-small-cell lung carcinomas (NSCLCs). We confirmed widespread Sulf-2 protein expression in tumor cells of 10/10 surgical specimens of human lung squamous carcinomas. We studied five Sulf-2(+) NSCLC cell lines, including two, which were derived by cigarette-smoke transformation of bronchial epithelial cells. shRNA-mediated Sulf-2 knockdown in these lines caused an increase in 6S on their cell surface and in parallel reversed their transformed phenotype in vitro, eliminated autocrine Wnt signaling and strongly blunted xenograft tumor formation in nude mice. Conversely, forced Sulf-2 expression in non-malignant bronchial epithelial cells produced a partially transformed phenotype. Our findings support an essential role for Sulf-2 in lung cancer, the leading cancer killer.

Identification of epileptogenic foci from causal analysis of ECoG interictal spike activity

OBJECTIVE

In patients with intractable epilepsy, the use of interictal spikes as surrogate markers of the epileptogenic cortex has generated significant interest. Previous studies have suggested that the cortical generators of the interictal spikes are correlated with the epileptogenic cortex as identified from the ictal recordings. We hypothesize that causal analysis of the functional brain networks during interictal spikes are correlated with the clinically-defined epileptogenic zone.

METHODS

We employed a time-varying causality measure, the adaptive directed transfer function (ADTF), to identify the cortical sources of the interictal spike activity in eight patients with medically intractable neocortical-onset epilepsy. The results were then compared to the foci identified by the epileptologists.

RESULTS

In all eight patients, the majority of the ADTF-calculated source activity was observed within the clinically-defined SOZs. Furthermore, in three of the five patients with two separate epileptogenic foci, the calculated source activity was correlated with both cortical sites.

CONCLUSIONS

The ADTF method identified the cortical sources of the interictal spike activity as originating from the same cortical locations as the recorded ictal activity.

SIGNIFICANCE

Evaluation of the sources of the cortical networks obtained during interictal spikes may provide information as to the generators underlying the ictal activity.

The fabrication of cubic boron nitride nanocone and nanopillar arrays via reactive ion etching

High-density (2 x 10(9) cm(-2)) uniform arrays of cubic boron nitride (cBN) nanocones and nanopillars with a high aspect ratio were fabricated by employing sequential growth and bias-assisted reactive ion etching using gold nano-dots as an etching mask. The mechanism of formation of the nanopillar and nanocone morphologies was discussed in terms of the relative action of ion bombardment etching and chemical etching due to activated hydrogen plasma constituents. The presented method enabled nanostructuring of cBN surfaces over large areas with great uniformity and reproducibility with a controlled aspect ratio. The unique morphology of the nanostructures offers diverse application opportunities in microelectromechanical devices.

Estimation of effective and functional cortical connectivity from neuroelectric and hemodynamic recordings

In this paper, different linear and nonlinear methodologies for the estimation of cortical connectivity from neuroelectric and hemodynamic measurements are reviewed and applied on common data set in order to highlight similarities and differences in the results. Different effective and functional connectivity methods were applied to motor and cognitive data sets, including structural equation modeling (SEM), directed transfer function (DTF), partial directed coherence (PDC), and direct directed transfer function (dDTF). Comparisons were made between the results in order to understand if, for a same dataset, effective and functional connectivity estimators can return the same cortical connectivity patterns. An application of a nonlinear method [phase synchronization index (PSI)] to similar executed and imagined movements was also reviewed. Connectivity patterns estimated with the use of the neuroelectric information and of the information from the multimodal integration of neuroelectric and hemodynamic data were also compared. Results suggests that the estimation of the cortical connectivity patterns performed with the linear methods (SEM, DTF, PDC, dDTF) or with the nonlinear method (PSI) on movement related potentials returned similar cortical networks. Differences in cortical connectivity were noted between the patterns estimated with the use of multimodal integration and those estimated by using only the neuroelectric data.

Comparison of residence time estimation methods for radioimmunotherapy dosimetry and treatment planning--Monte Carlo simulation studies

Estimating the residence times in tumor and normal organs is an essential part of treatment planning for radioimmunotherapy (RIT). This estimation is usually done using a conjugate view whole body scan time series and planar processing. This method has logistical and cost advantages compared to 3-D imaging methods such as Single photon emission computed tomography (SPECT), but, because it does not provide information about the 3-D distribution of activity, it is difficult to fully compensate for effects such as attenuation and background and overlapping activity. Incomplete compensation for these effects reduces the accuracy of the residence time estimates. In this work we compare residence times estimates obtained using planar methods to those from methods based on quantitative SPECT (QSPECT) reconstructions. We have previously developed QSPECT methods that provide compensation for attenuation, scatter, collimator-detector response, and partial volume effects. In this study we compared the use of residence time estimation methods using QSPECT to planar methods. The evaluation was done using the realistic NCAT phantom with organ time activities that model (111)In ibritumomab tiuxetan. Projection data were obtained using Monte Carlo simulations (MCS) that realistically model the image formation process including penetration and scatter in the collimator-detector system. These projection data were used to evaluate the accuracy of residence time estimation using a time series of QSPECT studies, a single QSPECT study combined with planar scans and the planar scans alone. The errors in the residence time estimates were 3.8%, 15%, and 2%-107% for the QSPECT, hybrid planar/QSPECT, and planar methods, respectively. The quantitative accuracy was worst for pure planar processing and best for pure QSPECT processing. Hybrid planar/QSPECT methods, where a single QSPECT study was combined with a series of planar scans, provided a large and statistically significant improvement in quantitative accuracy for most organs compared to the planar scans alone, even without sophisticated attention to background subtraction or thickness corrections in planar processing. These results indicate that hybrid planar/QSPECT methods are generally superior to pure planar methods and may be an acceptable alternative to performing a time series of QSPECT studies.

A high resolution EEG study of dynamic brain activity during video game play

A high resolution EEG study was conducted on healthy human subjects during video game play. Throughout the game playing experiment short time segments of spontaneous activity were recorded. Spectral analysis was performed on these segments for the theta-wave (4-8 Hz) and alpha-wave (8-13 Hz) bands to investigate the modulatory effects of long-lasting game play and the dynamic changes of spectral contribution in range of alpha-and theta-wave. The present results revealed that a) the frontal midline theta-wave activity increased over time relative to the eye open resting condition and b) the parietal alpha-wave activity initially decreased relative to the resting condition, then followed by a slow increase. These experimental results indicate the high resolution EEG provides a useful quantitative analysis tool for studying dynamic brain activity.