Mental health promotion and the positive concept of health: Navigating dilemmas

A prevailing view holds that the main goal of mental health promotion is to maintain and improve positive mental health, which is not merely defined by the absence of mental disorders, but by the presence of certain abilities. There are, however, challenges associated with this view that this paper aims to identify and explore. We start by highlighting three requirements for an ethically and politically justified mental health promotion scheme: (i) using a positive concept of mental health that (ii) respects the neutrality principle while (iii) not being overly permissive. Then, we argue that the WHO's positive concept of health violates (ii), and continue by exploring three philosophical accounts (i.e., Nordenfelt, 1995, 2017; Graham 2010; Wren-Lewis & Alexandrova, 2021) that could potentially provide a solution. We show that these face a dilemma of their own: they either violate (ii) or (iii), and they can rectify one issue only by violating the other. Considering the problems linked to the positive notion of health, the final section explores the alternate route of rejecting proposition (i) and instead embracing a negative concept of health. We argue that this option does not present a more advantageous solution. We conclude by highlighting the necessity for additional research to tackle the challenges we identified.

Breathing in waves: Understanding respiratory-brain coupling as a gradient of predictive oscillations

Breathing plays a crucial role in shaping perceptual and cognitive processes by regulating the strength and synchronisation of neural oscillations. Numerous studies have demonstrated that respiratory rhythms govern a wide range of behavioural effects across cognitive, affective, and perceptual domains. Additionally, respiratory-modulated brain oscillations have been observed in various mammalian models and across diverse frequency spectra. However, a comprehensive framework to elucidate these disparate phenomena remains elusive. In this review, we synthesise existing findings to propose a neural gradient of respiratory-modulated brain oscillations and examine recent computational models of neural oscillations to map this gradient onto a hierarchical cascade of precision-weighted prediction errors. By deciphering the computational mechanisms underlying respiratory control of these processes, we can potentially uncover new pathways for understanding the link between respiratory-brain coupling and psychiatric disorders.

"The great mixing machine": multisensory integration and brain-breath coupling in the cerebral cortex

It is common to distinguish between "holist" and "reductionist" views of brain function, where the former envisions the brain as functioning as an indivisible unit and the latter as a collection of distinct units that serve different functions. Opposing reductionism, a number of researchers have pointed out that cortical network architecture does not respect functional boundaries, and the neuroanatomist V. Braitenberg proposed to understand the cerebral cortex as a "great mixing machine" of neuronal activity from sensory inputs, motor commands, and intrinsically generated processes. In this paper, we offer a contextualization of Braitenberg's point, and we review evidence for the interactions of neuronal activity from multiple sensory inputs and intrinsic neuronal processes in the cerebral cortex. We focus on new insights from studies on audiovisual interactions and on the influence of respiration on brain functions, which do not seem to align well with "reductionist" views of areal functional boundaries. Instead, they indicate that functional boundaries are fuzzy and context dependent. In addition, we discuss the relevance of the influence of sensory, proprioceptive, and interoceptive signals on cortical activity for understanding brain-body interactions, highlight some of the consequences of these new insights for debates on embodied cognition, and offer some suggestions for future studies.

The criticism of medicine at the end of its "golden age"

Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of medicine. Further work making medicine's internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino's account of the aim of medicine as well as the Hastings Center's consensus report.

On the definition of stigma

BACKGROUND

There are thousands of papers about stigma, for instance about stigma's impact on wellbeing, mental or physical health. But the definition of stigma has received only modest attention. In "Conceptualizing stigma" from 2001, Link and Phelan offer a thorough and detailed definition of stigma. They suggest that there are six necessary conditions for stigma, namely labelled differences, stereotypes, separation, status loss and discrimination, power, and emotional reaction. This definition is widely applied in the literature but is left mainly uncriticized.

METHOD

We submit the Link and Phelan definition of stigma to a systematic conceptual analysis. We first interpret, analyze and reconsider each of the six components in Link and Phelan's definition of stigma, and on the basis of these analyses, we secondly suggest a revised definition of stigma.

RESULT

The Link and Phelan definition is thorough and detailed, but includes redundant components. These are status loss and discrimination, and emotional reaction.

CONCLUSION

We suggest that groups, not individuals, are the target of stigma, though it is individuals who may be the victims of it. We suggest a revised definition of stigma that is more simple, precise, and consistent with the empirical literature on stigma; there is stigma if and only if there is labelling, negative stereotyping, linguistic separation, and power asymmetry.

Respiratory rhythms of the predictive mind

Respiratory rhythms sustain biological life, governing the homeostatic exchange of oxygen and carbon dioxide. Until recently, however, the influence of breathing on the brain has largely been overlooked. Yet new evidence demonstrates that the act of breathing exerts a substantive, rhythmic influence on perception, emotion, and cognition, largely through the direct modulation of neural oscillations. Here, we synthesize these findings to motivate a new predictive coding model of respiratory brain coupling, in which breathing rhythmically modulates both local and global neural gain, to optimize cognitive and affective processing. Our model further explains how respiratory rhythms interact with the topology of the functional connectome, and we highlight key implications for the computational psychiatry of disordered respiratory and interoceptive inference. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Naturalism, Disease, and Levels of Functional Description

The paper engages Christopher Boorse’s Bio-Statistical Theory (BST). In its current form, BST runs into a significant challenge. For BST to account for its central tenet—that lower-level part-dysfunction is sufficient for higher-level pathology—it must provide criteria for how to decide which lower-level parts are the ones to be analyzed for health or pathology. As BST is a naturalistic theory, such choices must be based solely on naturalistic considerations. An argument is provided to show that, if BST is to be preserved, such parthood choices are based on non-naturalistic considerations. We demonstrate that even when parthood choices are based on the best way to preserve BST, there are counterintuitive results which bring the central tenet of BST into question.

Female advantage in gynodioecious plants: A meta-analysis focused on seed quality

In gynodioecious systems, female plants must counteract the selective disadvantage of not passing genes via pollen production, as hermaphrodites can. Theory predicts that females must produce more or better-quality seeds than hermaphrodites in order to be maintained within the same population. This female advantage has been widely measured and reported for seed number, but whether female advantage is gained through the production of better seeds remains relatively under-studied. Here, a meta-analysis approach was used to investigate whether females in gynodioecious species produce seeds of better quality than hermaphrodites (measured as seed mass, seed nutrient content, seed germinability and seedling survival and performance) in addition to achieving a larger seed production. In total, 50 studies were included, reporting traits for 34 gynodioecious species in 17 different families. Female advantage was significant for seed number and seed germination, but was not detected for seed mass, seed nutrient content or seedling performance. A female advantage in seed number was corroborated in this meta-analysis, which together with better seed germination, may explain maintenance of female plants within gynodioecious populations.

Practice-guided public health philosophy

Although highly relevant, philosophical theory and philosophical competences are rarely integrated in empirical public health research. We suggest a variant of applied philosophy that is valuable for the development and improvement of public health research. We call it practice-guided public health philosophy because: (i) research questions derive from public health challenges, i.e. real-life concerns that relate to the prevention of disease or the promotion of health and well-being, (ii) the ultimate test of success lies within an empirical framework aiming to improve public health practices and (iii) philosophers collaborate very closely with different kinds of empirical researchers in the different stages of the research process. Using examples from current public health projects at the National Institute of Public Health at the University of Southern Denmark, we outline three paradigmatic cases of practice-guided public health philosophy: (i) by using philosophy as an idea generator of empirical research, (ii) by using philosophy as a frame of reference for interpreting ethnographic data and (iii) by using philosophy as an explanatory resource for discussing survey and register data.

Environmental stressors affect sex ratios in sexually dimorphic plant sexual systems

Revealing the environmental pressures determining the frequency of females amongst populations of sexually dimorphic plants is a key research question. Analyses of sex ratio variation have been mainly done in dioecious plants, which misses key plant sexual systems that might represent intermediate stages in the evolution of dioecy from hermaphroditism. We investigated female frequency across populations of sexually dimorphic plant species in relation to environmental stressors (temperature, precipitation), totaling 342 species, 2011 populations, representing 40 orders and three different sexual systems (dioecy, gynodioecy and subdioecy). We also included the biome where the population was located to test how female frequency may vary more broadly with climate conditions. After correcting for phylogeny, our results for gynodioecious systems showed a positive relationship between female frequency and increased environmental stress, with the main effects being temperature-related. Subdioecious systems also showed strong positive relationships with temperature, and positive and negative relationships related to precipitation, while no significant effects on sex ratio in dioecious plants were detected. Combined, we show that female frequencies in an intermediate sexual system on the pathway from hermaphroditism to dioecy respond strongly to environmental stressors and have different selective agents driving female frequency.

Meshed Architecture of Performance as a Model of Situated Cognition

In this paper, we engage in a reciprocal analysis of situated cognition and the notion of "meshed architecture" as found in performance studies (Christensen et al., 2016). We start with an account of various conceptions of situated cognition using the distinction between functional integration, which characterizes how an agent dynamically organizes to couple with its environment, and task dependency, which specifies various constraints and structures imposed by the environment (see Slors, 2019). We then exploit the concept of a meshed architecture as a model that provides a more focused analysis of situated cognition and performance. Through this analysis, we show how the model of meshed architecture can be enhanced through (1) the involvement of a more complex set of cognitive processes, (2) a form of intrinsic control, (3) the influence of affective factors, and (4) the role of factors external to the performer. The aim of this paper, then, is twofold: first to work out an enhanced conception of the model of meshed architecture by taking into consideration a number of factors that clarify its situated nature, and second, to use this model to provide a richer and more definitive understanding of the meaning of situated cognition. Thus, we argue that this reciprocal analysis gives us a very productive way to think about how various elements come together in skilled action and performance but also a detailed way to characterize situated cognition.

Embodied Concepts and Mental Health

Often drawing on the phenomenological tradition, a number of philosophers and cognitive scientists working in the field of "embodied cognition" subscribe to the general view that cognition is grounded in aspects of its sensorimotor embodiment and should be comprehended as the result of a dynamic interaction of nonneural and neural processes. After a brief introduction, the paper critically engages Lakoff and Johnson's "conceptual metaphor theory" (CMT), and provides a review of recent empirical evidence that appears to support it. Subsequently, the paper underscores some of the limitations of CMT, points to some philosophical problems that require further attention, and explores possible implications for understanding and treating of mental disorders.

Arbuscular mycorrhizal fungi change host plant DNA methylation systemically

DNA methylation is an important epigenetic mechanism regulating gene expression in plants. DNA methylation has been shown to vary among species and also among plant tissues. However, no study has evaluated whether arbuscular mycorrhizal (AM) fungi affect DNA methylation levels in a tissue-specific manner. We investigated whether symbiosis with AM fungi affects DNA methylation in the host, focusing on different plant tissues (roots versus leaves) and across time. We carried out a 6-month pot experiment using Geranium robertianum in symbiosis with the AM fungus Funneliformis mosseae. Our results show that the pattern of total DNA methylation differed between leaves and roots and was related to when plants were harvested, confirming that DNA methylation is a process that occurs dynamically throughout an organism's lifetime. More importantly, the presence of AM fungus in roots of our experimental plants had a positive effect on total DNA methylation in both tissues. This study shows that colonisation by AM fungi can affect DNA methylation levels in their hosts and that plant DNA methylation varies in an age- and tissue-specific manner.

"Relaxed" natural kinds and psychiatric classification

This paper starts out highlighting a particular criticism that psychiatry faces and continues by investigating approaches to classification in psychiatry that operate with a "relaxed" (non-essentialist) notion of natural kind. Two accounts are examined, one by Rachel Cooper (2005; 2013) and one based on the work of Richard Boyd (1991; 1999; 2003; 2010). While these accounts do not directly pursue such a goal, the main aim is to probe whether deploying a "relaxed" notion of natural kind would be able to neutralize the criticism. While the conclusion is in the negative, the analysis raises doubts that it is possible to completely neutralize this criticism without assuming an overly simplistic view of the causal structure of the world.

Influence of Spironolactone and other Steroids on the Enzymatic Decay and Anticoagulant Activity of Bishydroxycoumarin

In rats, pretreatment with spironolactone, norbolethone or ethylestrenol enhances the disappearance of bishydroxycoumarin from blood and restores prothrombin time to almost normal whereas triamcinolone or progesterone fail to do so.

In itself SKF 525-A does not influence prothrombin time, but it markedly increases the blood concentration and the anticoagulant activity of bishydroxycoumarin. Furthermore, this microsomal enzyme-inhibitor suppresses the decrease of blood bishydroxycoumarin concentration elicited by ethylestrenol.

Pretreatment with spironolactone or ethylestrenol (but not with progesterone) enhances the NADPH-dependent enzymatic decay of bishydroxycoumarin in liver microsomal + supernatant fraction.

The elimination of bishydroxycoumarin from blood is reduced if its administration is followed by subsequent treatment with norbolethone, progesterone, ethylestrenol or triamcinolone.

These findings suggest that great care should be exercised in patients on anticoagulant therapy and treated previously or conjointly with various steroids ; in dubious cases not only prothrombin time but also the blood concentration of the anticoagulant should be checked.

Rhythms of the body, rhythms of the brain: Respiration, neural oscillations, and embodied cognition

In spite of its importance as a life-defining rhythmic movement and its constant rhythmic contraction and relaxation of the body, respiration has not received attention in Embodied Cognition (EC) literature. Our paper aims to show that (1) respiration exerts significant and unexpected influence on cognitive processes, and (2) it does so by modulating neural synchronization that underlies specific cognitive processes. Then, (3) we suggest that the particular example of respiration may function as a model for a general mechanism through which the body influences cognitive functioning. Finally, (4) we work out the implications for EC, draw a parallel to the role of gesture, and argue that respiration sometimes plays a double, pragmatic and epistemic, role, which reduces the cognitive load. In such cases, consistent with EC, the overall cognitive activity includes a loop-like interaction between neural and non-neural elements.

Sexes in gynodioecious Geranium sylvaticum do not differ in their isotopic signature or photosynthetic capacity

In gynodioecious plants, females are expected to produce more or better seeds than hermaphrodites in order to be maintained within the same population. Even though rarely measured, higher seed production can be achieved through differences in physiology. In this work, we measured sexual dimorphism in several physiological traits in the gynodioecious plant Geranium sylvaticum. Photosynthetic rate, stomatal conductance, transpiration rate, WUE and isotopic signatures were measured in plants growing in two habitats differing in light availability. Females have been reported to produce more seeds than hermaphrodites. However, we did not observe any significant difference in seed output between the sexes in these experimental populations. Similarly, the sexes did not differ in any physiological trait measured. Seed production was strongly limited by light availability. Likewise, differences between plants growing in full light versus low light were detected in most physiological parameters measured. Our results show that the sexes in G. sylvaticum do not show any evidence of sexual dimorphism in physiology, which concurred with a lack of sexual differences in seed output.

Orientational ordering of confined hard rods: the effect of shape anisotropy on surface ordering and capillary nematization

We examine the ordering properties of rectangular hard rods with length L and diameter D at a single planar wall and between two parallel hard walls using the second virial density-functional theory. The theory is implemented in the three-state Zwanzig approximation, where only three mutually perpendicular directions are allowed for the orientations of hard rods. The effect of varying shape anisotropy is examined at L/D=10,15,and20. In contact with a single hard wall, the density profiles show planar ordering, damped oscillatory behavior, and a wall-induced surface ordering transition below the coexisting isotropic density of a bulk isotropic-nematic (I-N) phase transition. Upon approaching the coexisting isotropic density, the thickness of the nematic film diverges logarithmically, i.e., the nematic wetting is complete for any shape anisotropy. In the case of confinement between two parallel hard walls, it is found that the continuous surface ordering transition depends strongly on the distance between confining walls H for H<L, while it depends weakly on H for H>L. The minimal density at which a surface ordering transition can be realized is located at around H∼2D for all studied shape anisotropies due to the strong interference effect between the two hard walls. The first-order I-N phase transition of the bulk system becomes a surface ordered isotropic I_{B} to capillary nematic N_{B} phase transition in the slit pore. This first-order I_{B}-N_{B} transition weakens with decreasing pore width and terminates in a critical point for all studied shape anisotropies.

Social cognition and psychopathology: a critical overview

The philosophical and interdisciplinary debate about the nature of social cognition, and the processes involved, has important implications for psychiatry. On one account, mindreading depends on making theoretical inferences about another person's mental states based on knowledge of folk psychology, the so-called "theory theory" (TT). On a different account, "simulation theory" (ST), mindreading depends on simulating the other's mental states within one's own mental or motor system. A third approach, "interaction theory" (IT), looks to embodied processes (involving movement, gesture, facial expression, vocal intonation, etc.) and the dynamics of intersubjective interactions (joint attention, joint action, and processes not confined to an individual system) in highly contextualized situations to explain social cognition, and disruptions of these processes in some psychopathological conditions. In this paper, we present a brief summary of these three theoretical frameworks (TT, ST, IT). We then focus on impaired social abilities in autism and schizophrenia from the perspective of the three approaches. We discuss the limitations of such approaches in the scientific studies of these and other pathologies, and we close with a short reflection on the future of the field. In this regard we argue that, to the extent that TT, ST and IT offer explanations that capture different (limited) aspects of social cognition, a pluralist approach might be best.

Variable mycorrhizal benefits on the reproductive output of Geranium sylvaticum, with special emphasis on the intermediate phenotype

In several gynodioecious species, intermediate sex between female and hermaphrodite has been reported, but few studies have investigated fitness parameters of this intermediate phenotype. Here, we examined the interactions between plant sex and arbuscular mycorrhizal (AM) fungal species affecting the reproductive output of Geranium sylvaticum, a sexually polymorphic plant species with frequent intermediate sexes between females and hermaphrodites, using a common garden experiment. Flowering phenology, AM colonisation levels and several plant vegetative and reproductive parameters, including seed and pollen production, were measured. Differences among sexes were detected in flowering, fruit set, pollen production and floral size. The two AM species used in the present work had different effects on plant fitness parameters. One AM species increased female fitness through increasing seed number and seed mass, while the other species reduced seed mass in all sexes investigated. AM fungi did not affect intermediate and hermaphrodite pollen content in anthers. The three sexes in G. sylvaticum did not differ in their reproductive output in terms of total seed production, but hermaphrodites had potentially larger fathering ability than intermediates due to higher anther number. The ultimate female function--seed production--did not differ among the sexes, but one of the AM fungi used potentially decreased host plant fitness. In addition, in the intermediate sex, mycorrhizal symbiosis functioned similarly in females as in hermaphrodites.

Sex-specific interaction between arbuscular mycorrhizal and dark septate fungi in the dioecious plant Antennaria dioica (Asteraceae)

Male and female plants of dioecious species often differ in their resource demands and this has been linked to secondary sexual dimorphism, including sex-specific interactions with other organisms such as herbivores and pollinators. However, little is known about the interaction between dioecious plants and fungal root endophytes. Plants may be simultaneously colonised by arbuscular mycorrhizal (AM) and dark septate (DS) fungi. While it is well established that AM mutualism involves reciprocal transfer of photosynthates and mineral nutrients between roots of host plants and these fungi, the role of DS fungi remains controversial. Here, we report the temporal and spatial variation in AM and DS fungi in female, male and non-reproductive Antennaria dioica plants in three natural populations in Finland during flowering and after seed production. Females had higher colonisation by AM fungi, but lower colonisation by DS fungi than male and non-reproductive plants. The higher AM colonisation was observed during flowering, and this difference varied among populations. Our results suggest that females and males of A. dioica interact with AM and DS fungi differently and that this relationship is dependent on soil fertility.

Evolutionary psychiatry and depression: testing two hypotheses

In the last few decades, there has been a genuine 'adaptive turn' in psychiatry, resulting in evolutionary accounts for an increasing number of psychopathologies. In this paper, I explore the advantages and problems with the two main evolutionary approaches to depression, namely the mismatch and persistence accounts. I will argue that while both evolutionary theories of depression might provide some helpful perspectives, the accounts also harbor significant flaws that might question their authority and usefulness as explanations.

Defining mental disorder. Exploring the 'natural function' approach

Due to several socio-political factors, to many psychiatrists only a strictly objective definition of mental disorder, free of value components, seems really acceptable. In this paper, I will explore a variant of such an objectivist approach to defining metal disorder, natural function objectivism. Proponents of this approach make recourse to the notion of natural function in order to reach a value-free definition of mental disorder. The exploration of Christopher Boorse's 'biostatistical' account of natural function (1) will be followed an investigation of the 'hybrid naturalism' approach to natural functions by Jerome Wakefield (2). In the third part, I will explore two proposals that call into question the whole attempt to define mental disorder (3). I will conclude that while 'natural function objectivism' accounts fail to provide the backdrop for a reliable definition of mental disorder, there is no compelling reason to conclude that a definition cannot be achieved.

Pretence, social cognition and self-knowledge in autism

This article suggests that an account of pretence based on the idea of shared intentionality can be of help in understanding autism. In autism, there seems to be a strong link between being able to engage in pretend play, understanding the minds of others and having adequate access to own mental states. Since one of the first behavioral manifestations of autism is the lack of pretend play, it therefore seems natural to investigate pretence in order to identify the nature of the central impairment in question. In mainstream theories, this has been identified as an impaired 'theory of mind module' or 'mentalizing' capacities. This paper points to some difficulties encountered by such accounts and - by drawing on research by Tomasello and Rakoczy - seeks to develop an alternative account of pretence and social cognition.

Competition between capillarity, layering and biaxiality in a confined liquid crystal

The effect of confinement on the phase behaviour and structure of fluids made of biaxial hard particles (cuboids) is examined theoretically by means of Onsager second-order virial theory in the limit where the long particle axes are frozen in a mutually parallel configuration. Confinement is induced by two parallel planar hard walls (slit-pore geometry), with particle long axes perpendicular to the walls (perfect homeotropic anchoring). In bulk, a continuous nematic-to-smectic transition takes place, while shape anisotropy in the (rectangular) particle cross-section induces biaxial ordering. As a consequence, four bulk phases, uniaxial and biaxial nematic and smectic phases, can be stabilised as the cross-sectional aspect ratio is varied. On confining the fluid, the nematic-to-smectic transition is suppressed, and either uniaxial or biaxial phases, separated by a continuous transition, can be present. Smectic ordering develops continuously from the walls for increasing particle concentration (in agreement with the supression of nematic-smectic second-order transition at confinement), but first-order layering transitions, involving structures with n and n + 1 layers, arise in the confined fluid at high concentration. Competition between layering and uniaxial-biaxial ordering leads to three different types of layering transitions, at which the two coexisting structures can be both uniaxial, one uniaxial and another biaxial, or both biaxial. Also, the interplay between molecular biaxiality and wall interactions is very subtle: while the hard wall disfavours the formation of the biaxial phase, biaxiality is against the layering transitions, as we have shown by comparing the confined phase behaviour of cylinders and cuboids. The predictive power of Onsager theory is checked and confirmed by performing some calculations based on fundamental-measure theory.

Early Microcirculatory Changes after Ischemic Preconditioning and Small Bowel Autotransplantation

BACKGROUND/AIMS

Ischemia-reperfusion injury contributes to the high complication rate of small bowel transplantation (SBTX). Ischemic preconditioning (IPC) protects against reperfusion injury in several organs, but the IPC-induced microcirculatory reaction in the intestine is unknown.

METHODS

We examined the effects of IPC on the macrohemodynamics and graft microcirculation in a canine model of SBTX during a 4-hour reperfusion period. In group 1 SBTX was performed, in group 2 IPC was induced before graft harvesting (ischemia 3 times for 5 min, followed by 10 min of reperfusion). Cardiac index and mesenteric blood flow were measured, and the mucosal microcirculation, villus epithelial thickness and functional capillary density were monitored by orthogonal polarization spectral imaging. Leukocyte-endothelial cell interactions were monitored in the postcapillary venules, with intravital fluorescence microscopy.

RESULTS

Reperfusion decreased cardiac index and mesenteric blood flow during reperfusion; IPC significantly improved these changes. Reperfusion was accompanied by decreased functional capillary density and epithelial thickness of the villi and increased leukocyte-endothelial cell interactions. IPC increased functional capillary density, prevented epithelial narrowing and reduced leukocyte rolling and adherence.

CONCLUSION

IPC improves the macrohemodynamics and the intestinal microcirculation and reduces leukocyte-mediated tissue injury during reperfusion. IPC can be an effective tool to limit reperfusion injury during SBTX.

Women with polycystic ovary syndrome are sensitive to the TNF-alpha-lowering effect of glucose-induced hyperinsulinaemia

BACKGROUND

Restoration of near-euglycaemia by intensive insulin therapy results in decreased serum levels of inflammatory mediators. The authors investigated whether the anti-inflammatory effect of insulin was independent of its glucose-lowering action and if this effect was intact in insulin-resistant women with the polycystic ovary syndrome (PCOS) characterized by low-grade chronic inflammation.

MATERIALS AND METHODS

Blood was drawn on the third and sixth days after progestin-induced withdrawal bleeding in 20 young non-diabetic women with PCOS and once between the third and sixth days of the menstrual cycle in 21 age-matched lean healthy control women during a 75-g oral glucose tolerance test (oGTT). Serum insulin, glucose and tumour necrosis factor alpha (TNF-alpha) concentrations were measured after 0, 30, 60, 90 and 120 min.

RESULTS

The increase in insulin and glucose concentrations during the oGTT was significantly more pronounced in patients with PCOS (one patient with impaired fasting glucose, one patient with impaired glucose tolerance, three patients with both) compared with healthy controls. The TNF-alpha serum concentrations decreased in patients with PCOS (mean of both days, P = 0.004). In patients and in controls, there was an inverse correlation between the serum concentrations of insulin and of TNF-alpha during oGTT (for patients, a mean of both days, P = 0.009; for controls, P = 0.047), but not between the serum concentrations of glucose and TNF-alpha.

CONCLUSIONS

The decrease in TNF-alpha concentrations during oGTT and the inverse correlation between endogenous hyperinsulinaemia and serum TNF-alpha concentrations suggested an anti-inflammatory effect of moderately-high insulin concentrations. This occurred despite the presence of moderate hyperglycaemia. These findings also demonstrated a preserved responsiveness of inflammatory mediators to insulin in PCOS.

Rare case of exomphalos complicated with umbilical cord teratoma in a fetus with trisomy 13

An exomphalos containing unusual solid and cystic mass was diagnosed during a routine ultrasound examination in the 17th week of gestation. Further investigations were planned but the pregnancy was terminated. The fetopathological examination revealed an umbilical cord teratoma. Although this entity is very rare it should be emphasized as a possible differential diagnosis when cystic lesion of the cord is detected. Large teratomas associated with abdominal wall defect may have poor fetal outcome and can be associated with structural and chromosomal abnormalities. In our case trisomy 13 was diagnosed.

Study of the inhibitory effect of the product dihydroxyacetone on Gluconobacter oxydans in a semi-continuous two-stage repeated-fed-batch process

The influence of the product inhibition by dihydroxyacetone (DHA) on Gluconobacter oxydans for a novel semi-continuous two-stage repeated-fed-batch process was examined quantitatively. It was shown that the culture was able to grow up to a DHA concentration of 80 kg m(-3) without any influence of product inhibition. The regeneration capability of the reversibly product inhibited culture from a laboratory-scale bioreactor system was observed up to a DHA concentration of about 160 kg m(-3). At higher DHA concentrations, the culture was irreversibly product inhibited. However, due to the robust membrane-bound glycerol dehydrogenase of G. oxydans, product formation was still active for a prolonged period of time. The reachable maximum final DHA concentration was as high as 220 kg m(-3). The lag phases for growth increased exponentially with increasing DHA threshold values of the first reactor stage. These results correlated well with fluorescence in situ hybridization (FISH) measurements confirming that the number of active cells decreased exponentially with increasing DHA concentrations.