Multiple consecutive-biphasic pulse stimulation improves spatially localized firing of retinal ganglion cells in the degenerate retina

Retinal prostheses have shown some clinical success in restoring vision in patients with retinitis pigmentosa. However, the post-implantation visual acuity does not exceed that of legal blindness. The reason for the poor visual acuity might be that (1) degenerate retinal ganglion cells (RGCs) are less responsive to electrical stimulation than normal RGCs, and (2) electrically-evoked RGC spikes show a more widespread not focal response. The single-biphasic pulse electrical stimulation, commonly used in artificial vision, has limitations in addressing these issues. In this study, we propose the benefit of multiple consecutive-biphasic pulse stimulation. We used C57BL/6J mice and C3H/HeJ (rd1) mice for the normal retina and retinal degeneration model. An 8 × 8 multi-electrode array was used to record electrically-evoked RGC spikes. We compared RGC responses when increasing the amplitude of a single biphasic pulse versus increasing the number of consecutive biphasic pulses at the same stimulus charge. Increasing the amplitude of a single biphasic pulse induced more RGC spike firing while the spatial resolution of RGC populations decreased. For multiple consecutive-biphasic pulse stimulation, RGC firing increased as the number of pulses increased, and the spatial resolution of RGC populations was well preserved even up to 5 pulses. Multiple consecutive-biphasic pulse stimulation using two or three pulses in degenerate retinas induced as much RGC spike firing as in normal retinas. These findings suggest that the newly proposed multiple consecutive-biphasic pulse stimulation can improve the visual acuity in prosthesis-implanted patients.

An Automated Brain Metastasis Detection and Segmentation System from MRI with a Large Multi-Institutional Dataset

PURPOSE/OBJECTIVE(S)

Developments of automated systems for brain metastasis (BM) detection and segmentation from MRI for assisting early detection and stereotactic radiosurgery (SRS) have been reported but most based upon relatively small datasets from single institutes. This work aims to develop and evaluate a system using a large multi-institutional dataset, and to improve both identification of small/subtle BMs and segmentation accuracy of large BMs.

MATERIALS/METHODS

A 3D U-Net system was trained and evaluated to detect and segment intraparenchymal BMs with a size > 2mm using 1856 MRI volumes from 1791 patients treated with SRS from seven institutions (1539 volumes for training, 183 for validation, and 134 for testing). All patients had 3D post-Gd T1w MRI scans pre-SRS. Gross tumor volumes (GTVs) of BMs for SRS were curated by each institute first. Then, additional efforts were spent to create GTVs for the untreated and/or uncontoured BMs, including central reviews by two radiologists, to improve accuracy of ground truth. The training dataset was augmented with synthetic BMs of 3773 MRIs using a 3D generative pipeline. Our system consists of two U-Nets with one using small 3D patches dedicated for detecting small BMs and another using large 3D patches for segmenting large BMs, and a random-forest based fusion module for combining the two network outputs. The first U-Net was trained with 3D patches containing at least one BM < 0.1 cm3. For detection performance, we measured BM-level sensitivity and case-level false-positive (FP) rate. For segmentation performance, we measured BM-level Dice similarity coefficient (DSC) and 95-percentile Hausdorff distance (HD95). We also stratified performances based upon BM sizes.

RESULTS

For 739 BMs in the 134 testing cases, the overall lesion-level sensitivity was 0.870 with an average case-level FP of 1.34±1.92 (95% CI: 1.02-1.67). The sensitivity was >0.969 for the BMs >0.1 cm3, but dropped to 0.755 for the BMs < 0.1 cm3 (Table 1). The average DSC and HD95 for all detected BMs were 0.786 and 1.35mm. The worse performance for BMs > 20 cm3 was caused by a case with 83 cm3 GTV and artifacts in the MRI volume.

CONCLUSION

We achieved excellent detection sensitivity and segmentation accuracy for BMs > 0.1 cm3, and promising performance for small BMs (<0.1cm3) with a controlled FP rate using a large multi-institutional dataset. Clinical utility for assisting early detection and SRS planning will be investigated. Table 1: Per-lesion detection and segmentation performance stratified by individual BM size. N is the number of BMs in each category.

The Variation of Electrical Pulse Duration Elicits Reliable Network-Mediated Responses of Retinal Ganglion Cells in Normal, Not in Degenerate Primate Retinas

This study aims to investigate the efficacy of electrical stimulation by comparing network-mediated RGC responses in normal and degenerate retinas using a N-methyl-N-nitrosourea (MNU)-induced non-human primate (NHPs) retinitis pigmentosa (RP) model. Adult cynomolgus monkeys were used for normal and outer retinal degeneration (RD) induced by MNU. The network-mediated RGC responses were recorded from the peripheral retina mounted on an 8 × 8 multielectrode array (MEA). The amplitude and duration of biphasic current pulses were modulated from 1 to 50 μA and 500 to 4000 μs, respectively. The threshold charge density for eliciting a network-mediated RGC response was higher in the RD monkeys than in the normal monkeys (1.47 ± 0.13 mC/cm2 vs. 1.06 ± 0.09 mC/cm2, p < 0.05) at a 500 μs pulse duration. The monkeys required a higher charge density than rodents among the RD models (monkeys; 1.47 ± 0.13 mC/cm2, mouse; 1.04 ± 0.09 mC/cm2, and rat; 1.16 ± 0.16 mC/cm2, p < 0.01). Increasing the pulse amplitude and pulse duration elicited more RGC spikes in the normal primate retinas. However, only pulse amplitude variation elicited more RGC spikes in degenerate primate retinas. Therefore, the pulse strategy for primate RD retinas should be optimized, eventually contributing to retinal prosthetics. Given that RD NHP RGCs are not sensitive to pulse duration, using shorter pulses may potentially be a more charge-effective approach for retinal prosthetics.

High amplitude pulses on the same charge condition efficiently elicit bipolar cell-mediated retinal ganglion cell responses in the degenerate retina

Retinal pigmentosa (RP) patients lose vision due to the loss of photoreceptors. Retinal prostheses bypass the dead photoreceptors by electrically stimulating surviving retinal neurons, such as bipolar cells or retinal ganglion cells (RGCs). In previous studies, stimulus charge has been mainly optimized to maximize the RGC response to electrical stimulation. This study aimed to investigate the effect of amplitude and duration even under the same charge condition on eliciting RGC spikes in the wild-type and degenerate retinas. Wild-type (WT) Sprague-Dawley rats were used as the normal retinal model, and Pde6b knockout rats were used as a retinal degeneration (RD) model. Electrically-evoked RGC spikes were recorded from isolated rat retinas using an 8 × 8 multielectrode array. The same charge was maintained (10 or 20 nC), and electrical stimulation was applied to WT and RD retinas, adjusting the amplitude and duration of the 1st phase of biphasic pulses. In the pulse modulation of the 1st phase, high amplitude (short duration) pulses induced more RGC spikes than low amplitude (long duration) pulses. Both WT and RD retinas showed a significant reduction in the number of RGC spikes upon stimulation with lower amplitude (longer duration) pulses. In clinical trials where stimulus charges are delivered to the degenerate retina of blind patients, high amplitude (short duration) pulses would help elicit more RGC spikes.

Stage-Dependent Changes of Visual Function and Electrical Response of the Retina in the rd10 Mouse Model

One of the critical prerequisites for the successful development of retinal prostheses is understanding the physiological features of retinal ganglion cells (RGCs) in the different stages of retinal degeneration (RD). This study used our custom-made rd10 mice, C57BL/6-Pde6bem1(R560C)Dkl/Korl mutated on the Pde6b gene in C57BL/6J mouse with the CRISPR/Cas9-based gene-editing method. We selected the postnatal day (P) 45, P70, P140, and P238 as representative ages for RD stages. The optomotor response measured the visual acuity across degeneration stages. At P45, the rd10 mice exhibited lower visual acuity than wild-type (WT) mice. At P140 and older, no optomotor response was observed. We classified RGC responses to the flashed light into ON, OFF, and ON/OFF RGCs via in vitro multichannel recording. With degeneration, the number of RGCs responding to the light stimulation decreased in all three types of RGCs. The OFF response disappeared faster than the ON response with older postnatal ages. We elicited RGC spikes with electrical stimulation and analyzed the network-mediated RGC response in the rd10 mice. Across all postnatal ages, the spikes of rd10 RGCs were less elicited by pulse amplitude modulation than in WT RGCs. The ratio of RGCs showing multiple peaks of spike burst increased in older ages. The electrically evoked RGC spikes by the pulse amplitude modulation differ across postnatal ages. Therefore, degeneration stage-dependent stimulation strategies should be considered for developing retinal prosthesis and successful vision restoration.

Correlated Activity in the Degenerate Retina Inhibits Focal Response to Electrical Stimulation

Retinal prostheses have shown some clinical success in patients with retinitis pigmentosa and age-related macular degeneration. However, even after the implantation of a retinal prosthesis, the patient’s visual acuity is at best less than 20/420. Reduced visual acuity may be explained by a decrease in the signal-to-noise ratio due to the spontaneous hyperactivity of retinal ganglion cells (RGCs) found in degenerate retinas. Unfortunately, abnormal retinal rewiring, commonly observed in degenerate retinas, has rarely been considered for the development of retinal prostheses. The purpose of this study was to investigate the aberrant retinal network response to electrical stimulation in terms of the spatial distribution of the electrically evoked RGC population. An 8 × 8 multielectrode array was used to measure the spiking activity of the RGC population. RGC spikes were recorded in wild-type [C57BL/6J; P56 (postnatal day 56)], rd1 (P56), rd10 (P14 and P56) mice, and macaque [wild-type and drug-induced retinal degeneration (RD) model] retinas. First, we performed a spike correlation analysis between RGCs to determine RGC connectivity. No correlation was observed between RGCs in the control group, including wild-type mice, rd10 P14 mice, and wild-type macaque retinas. In contrast, for the RD group, including rd1, rd10 P56, and RD macaque retinas, RGCs, up to approximately 400–600 μm apart, were significantly correlated. Moreover, to investigate the RGC population response to electrical stimulation, the number of electrically evoked RGC spikes was measured as a function of the distance between the stimulation and recording electrodes. With an increase in the interelectrode distance, the number of electrically evoked RGC spikes decreased exponentially in the control group. In contrast, electrically evoked RGC spikes were observed throughout the retina in the RD group, regardless of the inter-electrode distance. Taken together, in the degenerate retina, a more strongly coupled retinal network resulted in the widespread distribution of electrically evoked RGC spikes. This finding could explain the low-resolution vision in prosthesis-implanted patients.

The role of intraoperative frozen section analysis in joint arthroplasty with CD66b immunohistochemical staining

The preoperative diagnosis of infection during joint arthroplasty is important for clinical management. However, the evaluation of polymorphonuclear leukocytes (PMNs) during frozen section analysis is sometimes difficult due to frozen artifacts. In the present study, we sought to investigate the utility of intraoperative fresh frozen section (FFS) examination for diagnosis of infection and to evaluate whether the neutrophil-specific surface marker CD66b helps to improve the diagnostic accuracy of infection. A consecutive series of 65 original frozen sections at the time of resection arthroplasty was retrospectively reviewed compared with corresponding permanent sections. The presence of PMNs was determined using intraoperative FFS and permanent sections. Furthermore, CD66b staining was performed to identify PMNs clearly. The ratio of male to female patients was 21:42. The mean age was 70 years. Postoperatively, 25 of 65 cases were histologically diagnosed with infection (25/65; 39%). The sensitivity and specificity of intraoperative FFS relative to permanent section histology were 100% (25/25) and 95% (38/40), respectively. Among 40 patients without infection, two showed false-positive results during intraoperative FFS diagnosis (2/40, 5%). In addition, on CD66b staining, six cases (9%) experienced changes in results, which altered the sensitivity and specificity of intraoperative FFS compared with permanent histology only to 87% and 87%, respectively. In conclusion, the diagnostic performance of intraoperative FFS is high and comparable to yields of permanent section histology. Therefore, intraoperative FFS is highly suitable diagnostic method for detection of infection during joint arthroplasty. And CD66b immunostaining facilitates delicate identification of PMNs, especially in equivocal cases.

Foldable Perovskite Solar Cells Using Carbon Nanotube-Embedded Ultrathin Polyimide Conductor

Recently, foldable electronics technology has become the focus of both academic and industrial research. The foldable device technology is distinct from flexible technology, as foldable devices have to withstand severe mechanical stresses such as those caused by an extremely small bending radius of 0.5 mm. To realize foldable devices, transparent conductors must exhibit outstanding mechanical resilience, for which they must be micrometer-thin, and the conducting material must be embedded into a substrate. Here, single-walled carbon nanotubes (CNTs)-polyimide (PI) composite film with a thickness of 7 µm is synthesized and used as a foldable transparent conductor in perovskite solar cells (PSCs). During the high-temperature curing of the CNTs-embedded PI conductor, the CNTs are stably and strongly p-doped using MoO x , resulting in enhanced conductivity and hole transportability. The ultrathin foldable transparent conductor exhibits a sheet resistance of 82 Ω sq.-1 and transmittance of 80% at 700 nm, with a maximum-power-point-tracking-output of 15.2% when made into a foldable solar cell. The foldable solar cells can withstand more than 10 000 folding cycles with a folding radius of 0.5 mm. Such mechanically resilient PSCs are unprecedented; further, they exhibit the best performance among the carbon-nanotube-transparent-electrode-based flexible solar cells.

Spike-triggered Clustering for Retinal Ganglion Cell Classification

Retinal ganglion cells (RGCs), the retina's output neurons, encode visual information through spiking. The RGC receptive field (RF) represents the basic unit of visual information processing in the retina. RFs are commonly estimated using the spike-triggered average (STA), which is the average of the stimulus patterns to which a given RGC is sensitive. Whereas STA, based on the concept of the average, is simple and intuitive, it leaves more complex structures in the RFs undetected. Alternatively, spike-triggered covariance (STC) analysis provides information on second-order RF statistics. However, STC is computationally cumbersome and difficult to interpret. Thus, the objective of this study was to propose and validate a new computational method, called spike-triggered clustering (STCL), specific for multimodal RFs. Specifically, RFs were fit with a Gaussian mixture model, which provides the means and covariances of multiple RF clusters. The proposed method recovered bipolar stimulus patterns in the RFs of ON-OFF cells, while the STA identified only ON and OFF RGCs, and the remaining RGCs were labeled as unknown types. In contrast, our new STCL analysis distinguished ON-OFF RGCs from the ON, OFF, and unknown RGC types classified by STA. Thus, the proposed method enables us to include ON-OFF RGCs prior to retinal information analysis.

Toward a Unified Framework for Cognitive Maps

In this study, we integrated neural encoding and decoding into a unified framework for spatial information processing in the brain. Specifically, the neural representations of self-location in the hippocampus (HPC) and entorhinal cortex (EC) play crucial roles in spatial navigation. Intriguingly, these neural representations in these neighboring brain areas show stark differences. Whereas the place cells in the HPC fire as a unimodal function of spatial location, the grid cells in the EC show periodic tuning curves with different periods for different subpopulations (called modules). By combining an encoding model for this modular neural representation and a realistic decoding model based on belief propagation, we investigated the manner in which self-location is encoded by neurons in the EC and then decoded by downstream neurons in the HPC. Through the results of numerical simulations, we first show the positive synergy effects of the modular structure in the EC. The modular structure introduces more coupling between heterogeneous modules with different periodicities, which provides increased error-correcting capabilities. This is also demonstrated through a comparison of the beliefs produced for decoding two- and four-module codes. Whereas the former resulted in a complete decoding failure, the latter correctly recovered the self-location even from the same inputs. Further analysis of belief propagation during decoding revealed complex dynamics in information updates due to interactions among multiple modules having diverse scales. Therefore, the proposed unified framework allows one to investigate the overall flow of spatial information, closing the loop of encoding and decoding self-location in the brain.

Synchrony of Spontaneous Burst Firing between Retinal Ganglion Cells Across Species

Neurons communicate with other neurons in response to environmental changes. Their goal is to transmit information to their targets reliably. A burst, which consists of multiple spikes within a short time interval, plays an essential role in enhancing the reliability of information transmission through synapses. In the visual system, retinal ganglion cells (RGCs), the output neurons of the retina, show bursting activity and transmit retinal information to the lateral geniculate neuron of the thalamus. In this study, to extend our interest to the population level, the burstings of multiple RGCs were simultaneously recorded using a multi-channel recording system. As the first step in network analysis, we focused on investigating the pairwise burst correlation between two RGCs. Furthermore, to assess if the population bursting is preserved across species, we compared the synchronized bursting of RGCs between marmoset monkey (callithrix jacchus), one species of the new world monkeys and mouse (C57BL/6J strain). First, monkey RGCs showed a larger number of spikes within a burst, while the inter-spike interval, burst duration, and inter-burst interval were smaller compared with mouse RGCs. Monkey RGCs showed a strong burst synchronization between RGCs, whereas mouse RGCs showed no correlated burst firing. Monkey RGC pairs showed significantly higher burst synchrony and mutual information than mouse RGC pairs did. Comprehensively, through this study, we emphasize that two species have a different bursting activity of RGCs and different burst synchronization suggesting two species have distinctive retinal processing.

New Features of Receptive Fields in Mouse Retina through Spike-triggered Covariance

Retinal ganglion cells (RGCs) encode various spatiotemporal features of visual information into spiking patterns. The receptive field (RF) of each RGC is usually calculated by spike-triggered average (STA), which is fast and easy to understand, but limited to simple and unimodal RFs. As an alternative, spike-triggered covariance (STC) has been proposed to characterize more complex patterns in RFs. This study compares STA and STC for the characterization of RFs and demonstrates that STC has an advantage over STA for identifying novel spatiotemporal features of RFs in mouse RGCs. We first classified mouse RGCs into ON, OFF, and ON/OFF cells according to their response to full-field light stimulus, and then investigated the spatiotemporal patterns of RFs with random checkerboard stimulation, using both STA and STC analysis. We propose five sub-types (T1–T5) in the STC of mouse RGCs together with their physiological implications. In particular, the relatively slow biphasic pattern (T1) could be related to excitatory inputs from bipolar cells. The transient biphasic pattern (T2) allows one to characterize complex patterns in RFs of ON/OFF cells. The other patterns (T3–T5), which are contrasting, alternating, and monophasic patterns, could be related to inhibitory inputs from amacrine cells. Thus, combining STA and STC and considering the proposed sub-types unveil novel characteristics of RFs in the mouse retina and offer a more holistic understanding of the neural coding mechanisms of mouse RGCs.

Whole-exome sequencing and immune profiling of early-stage lung adenocarcinoma with fully annotated clinical follow-up

Background

Lung adenocarcinomas (LUADs) lead to the majority of deaths attributable to lung cancer. We performed whole-exome sequencing (WES) and immune profiling analyses of a unique set of clinically annotated early-stage LUADs to better understand the pathogenesis of this disease and identify clinically relevant molecular markers.

Methods

We performed WES of 108 paired stage I-III LUADs and normal lung tissues using the Illumina HiSeq 2000 platform. Ten immune markers (PD-L1, PD-1, CD3, CD4, CD8, CD45ro, CD57, CD68, FOXP3 and Granzyme B) were profiled by imaging-based immunohistochemistry (IHC) in a subset of LUADs (n = 92). Associations among mutations, immune markers and clinicopathological variables were analyzed using ANOVA and Fisher's exact test. Cox proportional hazards regression models were used for multivariate analysis of clinical outcome.

Results

LUADs in this cohort exhibited an average of 243 coding mutations. We identified 28 genes with significant enrichment for mutation. SETD2-mutated LUADs exhibited relatively poor recurrence- free survival (RFS) and mutations in STK11 and ATM were associated with poor RFS among KRAS-mutant tumors. EGFR, KEAP1 and PIK3CA mutations were predictive of poor response to adjuvant therapy. Immune marker analysis revealed that LUADs in smokers and with relatively high mutation burdens exhibited increased levels of immune markers. Analysis of immunophenotypes revealed that LUADs with STK11 mutations exhibited relatively low levels of infiltrating CD4+/CD8+ T-cells indicative of a muted immune response. Tumoral PD-L1 was significantly elevated in TP53 mutant LUADs whereas PIK3CA mutant LUADs exhibited markedly down-regulated PD-L1 expression. LUADs with TP53 or KEAP1 mutations displayed relatively increased CD57 and Granzyme B levels indicative of augmented natural killer (NK) cell infiltration.

Conclusion(s)

Our study highlights molecular and immune phenotypes that warrant further analysis for their roles in clinical outcomes and personalized immune-based therapy of LUAD.

On predicting epileptic seizures from intracranial electroencephalography

This study investigates the sensitivity and specificity of predicting epileptic seizures from intracranial electroencephalography (iEEG). A monitoring system is studied to generate an alarm upon detecting a precursor of an epileptic seizure. The iEEG traces of ten patients suffering from medically intractable epilepsy were used to build a prediction model. From the iEEG recording of each patient, power spectral densities were calculated and classified using support vector machines. The prediction results varied across patients. For seven patients, seizures were predicted with 100% sensitivity without any false alarms. One patient showed good sensitivity but lower specificity, and the other two patients showed lower sensitivity and specificity. Predictive analytics based on the spectral feature of iEEG performs well for some patients but not all. This result highlights the need for patient-specific prediction models and algorithms.

On Decoding Grid Cell Population Codes Using Approximate Belief Propagation

Neural systems are inherently noisy. One well-studied example of a noise reduction mechanism in the brain is the population code, where representing a variable with multiple neurons allows the encoded variable to be recovered with fewer errors. Studies have assumed ideal observer models for decoding population codes, and the manner in which information in the neural population can be retrieved remains elusive. This letter addresses a mechanism by which realistic neural circuits can recover encoded variables. Specifically, the decoding problem of recovering a spatial location from populations of grid cells is studied using belief propagation. We extend the belief propagation decoding algorithm in two aspects. First, beliefs are approximated rather than being calculated exactly. Second, decoding noises are introduced into the decoding circuits. Numerical simulations demonstrate that beliefs can be effectively approximated by combining polynomial nonlinearities with divisive normalization. This approximate belief propagation algorithm is tolerant to decoding noises. Thus, this letter presents a realistic model for decoding neural population codes and investigates fault-tolerant information retrieval mechanisms in the brain.

SATB2-associated syndrome presenting with Rett-like phenotypes

The SATB2-associated syndrome (SAS) was proposed recently, after the SATB2 gene was initially discovered to be associated with isolated cleft palate. This syndrome is characterized by intellectual disability with delayed speech development, facial dysmorphism, cleft or high-arched palate, and dentition problems. Here, we describe two novel SATB2 sequence variants in two unrelated patients presenting with Rett-like phenotypes. We performed trio-based whole-exome sequencing in a 17-month-old girl presenting with severe retardation and Rett-like phenotypes, which revealed a de novo missense variant in SATB2 (p.Glu396Gln). Moreover, targeted sequencing of the SATB2 gene was performed in a 2-year-old girl with severe psychomotor retardation, facial hypotonia, and cleft palate who also exhibited some features of Rett syndrome. A nonsense variant in SATB2 was identified in this patient (p.Arg459*). This study expanded the clinical and genetic spectrum of SAS. SATB2 variants should be considered in cases with psychomotor retardation alone or in any cases with Rett-like phenotypes, regardless of the typical features of SAS such as cleft palate.

Role of second-look ultrasound examinations for MR-detected lesions in patients with breast cancer

PURPOSE

To assess the clinical value of second-look ultrasound (US) examination for the evaluation of additional enhancing lesions detected on magnetic resonance (MR) imaging.

MATERIALS AND METHODS

Between May 2008 and February 2011, 794 consecutive patients with histologically confirmed breast cancer underwent breast MR imaging. We included 101 patients with 132 additional enhancing breast lesions detected on MR imaging who underwent second-look US.  The imaging features and lesion category according to the Breast Imaging and Reporting and Data System (BI-RADS) were assessed with MR and US imaging, respectively.

RESULTS

According to the BI-RADS system, 67 lesions (50.8 %) were classified as category 0, 33 lesions (25.0 %) as category 3, and 32 lesions (24.2 %) as category 4. Of the 67 indeterminate lesions on MR imaging, 34 (50.7 %) were demonstrated on second-look US. 11 of these 34 lesions showed suspicious sonographic features, including 1 lesion that showed malignancy (9.1 %, 1/11). Most of the suspicious lesions on MR imaging (26 of 32 BI-RADS category 4 lesions, 81.3 %) were demonstrated on second-look US, and 17 were malignant (65.4 %, 17/26). Of the 6 BI-RADS category 4 lesions without sonographic correlation, 1 was malignant (16.7 %, 1/6).

CONCLUSION

Second-look US examination was useful for evaluating MR-detected lesions in patients with breast cancer.

On resolving simultaneous congruences using belief propagation

Graphical models and related algorithmic tools such as belief propagation have proven to be useful tools in (approximately) solving combinatorial optimization problems across many application domains. A particularly combinatorially challenging problem is that of determining solutions to a set of simultaneous congruences. Specifically, a continuous source is encoded into multiple residues with respect to distinct moduli, and the goal is to recover the source efficiently from noisy measurements of these residues. This problem is of interest in multiple disciplines, including neural codes, decentralized compression in sensor networks, and distributed consensus in information and social networks. This letter reformulates the recovery problem as an optimization over binary latent variables. Then we present a belief propagation algorithm, a layered variant of affinity propagation, to solve the problem. The underlying encoding structure of multiple congruences naturally results in a layered graphical model for the problem, over which the algorithms are deployed, resulting in a layered affinity propagation (LAP) solution. First, the convergence of LAP to an approximation of the maximum likelihood (ML) estimate is shown. Second, numerical simulations show that LAP converges within a few iterations and that the mean square error of LAP approaches that of the ML estimation at high signal-to-noise ratios.

The analgesic effect of remifentanil on prevention of withdrawal response associated with the injection of rocuronium in children: no evidence for a peripheral action

Remifentanil pre-treatment has been reported to decrease the incidence of rocuronium injection-associated withdrawal movement. This study was designed to explore the site of action of remifentanil for reducing withdrawal response during rocuronium injection in children. Ninety-six paediatric patients were randomly assigned to three groups. After induction of anaesthesia with 5 mg/kg 2.5% thiopental sodium, 2 ml saline (placebo group) or 0.5 microg/kg remifentanil (group R), was injected intravenously 1 min before 0.6 mg/kg rocuronium. In a third group (group R'), the venous retention of 0.5 microg/kg remifentanil was maintained for 30 s followed by tourniquet release and injection of 0.6 mg/kg rocuronium. Withdrawal response was graded using a four-point scale. The incidence of withdrawal movement after rocuronium administration was 94%, 22% and 81% in the placebo, R, and R' groups, respectively. This study demonstrated that the pre-treatment effect of remifentanil for reducing rocuronium-associated withdrawal response occurs mainly through a central action.

Tyrosine phosphorylation of cofilin at Y68 by v-Src leads to its degradation through ubiquitin-proteasome pathway

Cofilin is a major regulator of actin dynamics involved in the regulation of cell spreading and migration through its actin depolymerizing and severing activities. V-Src is an activated Src tyrosine kinase and a potent oncogene known to phosphorylate a variety of cellular proteins in cell transformation process including altered cell adhesion, spreading and migration. Recently, it has been suggested that cofilin is a potential substrate of v-Src (Rush et al., 2005). Here, we show direct tyrosine phosphorylation of cofilin by v-Src and identify Y68 as the major phosphorylation site. Cofilin phosphorylation at Y68 did not change its activity per se, but induced increased ubiquitination of cofilin and its degradation through the proteosome pathway. Furthermore, the negative effect of cofilin on cellular F-actin contents was inhibited by co-expression of v-Src, whereas that of cofilin mutant Y68F (Y68 mutated to F) was not affected, suggesting that v-Src-mediated cofilin phosphorylation at Y68 is required for degradation of cofilin in vivo. Lastly, inhibition of cell spreading by v-Src was rescued partially by co-expression of cofilin, and to a greater extent by the Y68F mutant which is not subjected to v-Src induced degradation through phosphorylation, suggesting that v-Src mediated changes in cell spreading is, at least in part, through inhibiting the function of cofilin via phosphorylating it at Y68. Together, these results suggest a novel mechanism by which cofilin is regulated by v-Src through tyrosine phosphorylation at Y68 that triggers degradation of cofilin via ubiquitination-proteosome pathway and consequently inhibits cofilin activity in reducing cellular F-actin contents and cell spreading.

Relationships of methacholine and AMP responsiveness with peak expiratory flow variability in children with asthma

BACKGROUND

Both bronchial responsiveness (BR) and peak expiratory flow (PEF) variability are increased in asthma. PEF variability is presumed to reflect the degree of BR in asthma. BR is commonly assessed by bronchial challenges using direct or indirect stimuli.

OBJECTIVE

The aim of this study was to compare methacholine and adenosine 5'-monophosphate (AMP) responsiveness with regard to their relationships with PEF variability in children with asthma.

METHODS

Methacholine and AMP challenge tests were performed in 79 children with mild to moderate asthma, and a provocative concentration causing a 20% decline in forced expiratory volume in 1 s (PC(20)) was calculated for each challenge. Subjects recorded PEF each morning and each evening for 14 consecutive days. PEF variability was expressed as amplitude percentage mean (amp%mean; high PEF minus low PEF on each day, expressed as a percentage of their mean, averaged over 14 days), and as the lowest percentage highest (low%high; the lowest PEF expressed as a percentage of the highest PEF recorded over the period).

RESULTS

Methacholine PC(20) correlated significantly but weakly with both indices of PEF variability (amp%mean: r=-0.285, P=0.011; low%high: r=0.238, P=0.034). However, there was a significant and strong correlation between AMP PC(20) and both amp%mean (r=-0.583, P=0.000) and low%high (r=0.496, P=0.000). For AMP PC(20), the correlations were stronger than for methacholine PC(20) (comparison of correlation coefficients with amp%mean: P=0.021; with low%high: P=0.063).

CONCLUSION

Both methacholine PC(20) and AMP PC(20) correlated significantly with PEF variability. However, the stronger correlations for AMP PC(20) than for methacholine PC(20) suggest that PEF variability may be better reflected by BR assessed by AMP than by methacholine.

Bronchial responsiveness to methacholine and adenosine 5'-monophosphate in young children with asthma: their relationship with blood eosinophils and serum eosinophil cationic protein

BACKGROUND

Bronchial hyperresponsiveness is a characteristic feature of asthma, and is usually measured by bronchial challenges using direct or indirect stimuli. Blood eosinophil numbers and serum levels of eosinophil cationic protein (ECP) are considered as indirect measures of airway inflammation in asthma. The aim of this study was to investigate whether bronchial responsiveness to adenosine 5'-monophosphate (AMP) is more closely associated with blood eosinophil markers, compared with that to methacholine, in young children with asthma.

METHODS

Methacholine and AMP bronchial challenges were performed in 4- to 6-year-old children with asthma (n = 77) and in healthy controls (n = 32), using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. The peripheral blood eosinophil counts and serum ECP concentrations were determined in each subject.

RESULTS

A positive response to methacholine (end-point concentration < or =8mg/ml) and to AMP (end-point concentration < or =200 mg/ml) was observed in 74 (96.1%) and 66 asthmatic children (85.7%), respectively. A majority of controls was unresponsive to both challenges. In the asthma group, there was no significant correlation between methacholine end-point concentration and the eosinophil counts (r = -0.111, P = 0.337) or serum ECP levels (r = -0.126, P = 0.274). In contrast, AMP end-point concentration correlated significantly with the eosinophil counts (r = -0.372, P = 0.001) and with serum ECP levels (r = -0.371, P = 0.001).

CONCLUSIONS

Our results suggest that bronchial responsiveness to AMP is more closely related to airway inflammation, compared with that to methacholine, and support the potential usefulness of AMP challenges in detecting inflammatory changes in young children with asthma.

Bronchial responsiveness to methacholine and adenosine 5'-monophosphate in atopic and non-atopic preschool children with recurrent wheezing

BACKGROUND

It is well known that atopy is a major determinant of bronchial hyper-responsiveness (BHR) in both asymptomatic and asthmatic children. However, the relationship between atopy and BHR has not been well studied in preschool children with wheezing. BHR is usually measured by bronchial challenges using direct and indirect stimuli.

OBJECTIVE

The aim of this study was to investigate whether atopic and non-atopic preschool wheezers display similar or different BHR profiles for direct and indirect stimuli.

METHODS

Methacholine and adenosine 5'-monophosphate (AMP) bronchial challenges were performed in 4 to 6-year-old children with recurrent wheezing, using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Atopy was determined to be present when a child had at least one positive reaction to a panel of 13 common airborne allergens in the presence of positive and negative controls.

RESULTS

A positive response to methacholine (an end-point concentration < or =8 mg/mL) was observed in 89.3% (50/56) of atopic wheezers and in 83.8% (31/37) of non-atopic wheezers (P=0.44) for the difference. By contrast, the frequency of a positive response to AMP (an end-point concentration < or =200 mg/mL) was significantly higher in the atopic group (47/56, 83.9%) compared with the non-atopic group (12/37, 32.4%; P<0.01).

CONCLUSION

While a majority of both atopic and non-atopic preschool wheezers were hyper-responsive to methacholine, atopic subjects were more hyper-responsive to AMP than non-atopic subjects. These findings suggest that atopic and non-atopic wheeze in preschool children are related to distinctive pathophysiologic pathways.

Bronchial hyperresponsiveness in young children with allergic rhinitis and its risk factors

BACKGROUND

Subjects with allergic rhinitis but no clinical evidence of asthma have greater bronchial hyperresponsiveness (BHR), and several factors have been implicated as its determinants. However, studies in young children are lacking. The aims of this study were to evaluate the prevalence of BHR in young children with allergic rhinitis and to investigate its risk factors.

METHODS

Methacholine bronchial challenges were performed in 4- to 6-year-old nonasthmatic children with allergic rhinitis (n = 83) and in healthy nonatopic controls (n = 32), using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Subjects were considered to have BHR when they had end-point concentrations of methacholine <or=8 mg/mL. Clinical and laboratory data in allergic rhinitis patients and a history of allergic diseases in their parents were collected.

RESULTS

BHR was observed in 27 subjects with allergic rhinitis (32.5%) and three controls (9.4%). Among subjects with allergic rhinitis, serum total IgE, the number and pattern of skin-prick test responses, blood eosinophil markers, and parental history of allergic rhinitis and atopic dermatitis were not different between the BHR(+) and BHR(-) groups, whereas the persistent type of rhinitis and parental history of asthma were more frequent in the BHR(+) group than in the BHR(-) group. These associations remained significant in a multivariable logistic regression.

CONCLUSIONS

Young children with allergic rhinitis alone showed an increased prevalence of BHR. Both persistent type of rhinitis and parental history of asthma were significant and independent risk factors for BHR in these children.

Methacholine and adenosine 5'-monophosphate challenges in children with post-infectious bronchiolitis obliterans

Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, but is also frequently demonstrated by children and adults with chronic obstructive lung diseases. AHR is usually measured by bronchial challenges using direct or indirect stimuli. The aim of this study was to compare these two types of bronchial challenge in children with post-infectious bronchiolitis obliterans (BO). Methacholine and adenosine 5'-monophosphate (AMP) challenges were used as tools for the evaluation of AHR to direct and indirect stimuli, respectively, in children with post-infectious BO (n = 28). These results were compared with those of asthmatic (n = 30) and control children (n = 25). Altogether, twenty-two patients (78.6%) with post-infectious BO were hyperreactive to methacholine with a provocative concentration causing a 20% fall in forced expiratory volume in one second (PC20) of <16 mg x mL(-1), but only six (21.4%) were hyperreactive to AMP with a PC20 of <200 mg x mL(-1). All patients with asthma responded positively to methacholine, and most (28, 93.3%) also responded positively to AMP. The majority of controls were insensitive to both challenges. Airway hyperresponsiveness to methacholine is a frequent, but by no means universal, finding in children with post-infectious bronchiolitis obliterans, but is usually not accompanied by airway hyperresponsiveness to adenosine 5'-monophosphate. This finding suggests that airway hyperresponsiveness in patients with post-infectious bronchiolitis obliterans has characteristics that differ from those of asthmatic subjects.

Birth month and sensitization to house dust mites in asthmatic children

BACKGROUND

Early exposure to high quantities of allergen has an important role in the incidence of atopic sensitization. In fact, subjects sensitized to house dust mites (HDMs) have a significantly higher proportion of births in the season when HDMs are most abundant.

OBJECTIVE

The aim of this study was to investigate whether birth month patterns differ for asthmatic patients sensitized only to HDMs and for those sensitized to HDMs and other allergen(s).

METHODS

Among 2225 patients with asthma, aged 10-16 years, 1642 sensitized to HDMs were identified by skin prick testing. This group was composed of patients sensitized only to HDMs (n = 715) and patients sensitized to HDMs and other allergen(s) (n = 927). The birth month distributions of the group of HDM-sensitive asthmatics or its subgroups were compared with that of a reference population (total live births in the same years as the studied subjects). The risk ratio of a given birth month in relation to all the other months was calculated as an odds ratio (OR) with the corresponding 95% confidence interval (CI).

RESULTS

A significant difference in birth month distribution was observed for HDM-sensitive asthmatics (chi(2) = 23.6, P = 0.015), with higher rates of birth in August (OR: 1.23, 95% CI: 1.04-1.46) and September (1.24, 1.04-1.46). When the two subgroups were analyzed separately, significantly more births were noted in August (1.34, 1.06-1.71) and September (1.34, 1.05-1.70) for those sensitized only to HDMs, whereas no such birth month preference was observed for those sensitized to HDMs and other allergen(s).

CONCLUSIONS

The HDM-positive asthmatics showed a greater proportion of births in August and September, which correspond to high HDM exposure. However, this birth month pattern was evident in asthmatic-sensitive only to HDMs, but was not observed in those sensitive to HDMs and other allergen(s).

Coincidence of atopy profile in terms of monosensitization and polysensitization in children and their parents

BACKGROUND

Results from epidemiologic studies have shown that childhood atopy is probably a hereditary disorder, because the offspring of affected parents have a higher risk of developing atopy. Among the atopic population, some subjects are sensitized to only one class of allergens (monosensitized), while other subjects are sensitized to more than one class of allergens (polysensitized). The aim of this study was to investigate whether atopy profile (monosensitization/polysensitization) in children is linked to the same conditions in their parents.

METHODS

We evaluated sensitization to five classes of aeroallergens (house dust mites, animal danders, pollens, molds, and cockroach) by skin prick testing in a group of 494 children with suspicious allergic symptoms and in their parents.

RESULTS

The frequency of parental atopy was highest (51.6%) in polysensitized children (n = 189), intermediate (37.1%) in monosensitized children (n = 178), and was lowest (22.4%) in nonsensitized children (n = 127). The proportion of polysensitized subjects among atopic parents was significantly higher for polysensitized children (45.6%) than for monosensitized children (31.1%). Polysensitized children were found to more frequently have one or both parents polysensitized (32.3%, 7.4%) than monosensitized children (18.5%, 2.2%) with odds ratios of 2.09 (95% CI: 1.29-3.40) and 3.48 (1.12-10.78), respectively, whereas the likelihood of having one or two monosensitized parents was not increased for polysensitized children.

CONCLUSION

Our data suggest a familial coincidence of atopy profile in terms of monosensitization and polysensitization, although the relative importance of genetic or environmental influence should be studied further.

Sputum eosinophil counts and eosinophil cationic protein levels in cough-variant asthma and in classic asthma, and their relationships to airway hypersensitivity or maximal airway response to methacholine

BACKGROUND

The aims of this study were to compare the degree of airway inflammation in cough-variant asthma (CVA) with that in classic asthma (CA), and to examine the relationship between airway inflammation and airway hypersensitivity or maximal airway response to methacholine in both conditions.

METHODS

Sputum was induced in 41 CVA patients, in 41 methacholine PC(20)-matched CA patients, and in 20 healthy children. The sputum samples were analyzed for total and differential cell counts, and for eosinophilic cationic protein (ECP). A high-dose methacholine challenge test was performed in CVA and CA patients to determine PC(20) and maximal airway response.

RESULTS

Sputum eosinophil percentages and ECP levels were significantly elevated in CVA and CA vs the control, but no significant differences were found between the two asthma groups. In the two asthma groups, neither sputum parameters correlated significantly with methacholine PC(20). However, the absence of a maximal response plateau or its higher level, when present, was associated with increased eosinophil percentages and ECP levels in the CVA group.

CONCLUSIONS

The degree of eosinophilic inflammation may not be causally related to differences in presented asthma manifestations. The identification of a maximal response plateau and the level of this plateau in patients with CVA may provide information pertinent to airway eosinophilic inflammation.

Sputum eosinophilia in cough-variant asthma as a predictor of the subsequent development of classic asthma

BACKGROUND

A significant proportion of patients diagnosed with cough-variant asthma eventually manifest classic asthma signs, such as wheezing and dyspnoea. The aim of this study was to investigate whether the percentage of eosinophils and/or concentration of eosinophilic cationic protein (ECP) in sputum induced from patients with cough-variant asthma can predict the development of classic asthma.

METHODS

Sixty-two children with cough-variant asthma were prospectively studied for 4 years. At the initiation of the study, sputum was induced with hypertonic saline, and the sputum samples were analysed for total and differential cell counts, and for ECP. Each subject was checked clinically at least every 3 months, and details of classic asthma signs experienced during the intervening periods were taken.

RESULTS

Twenty-four (47.1%) of the 51 subjects available for follow-up developed signs of classic asthma, while 27 did not. The only significant difference in the sputum parameters between these two groups was a higher percentage of sputum eosinophils in subjects who developed classic asthma. A significant association was found between sputum eosinophil percentage and classic asthma development, but not between the concentration of sputum ECP and classic asthma development.

CONCLUSION

Sputum eosinophilia in cough-variant asthma may be a correlate of the later development of classic asthma. This suggests that sputum differential cell counts may be useful in the clinical management of patients with cough-variant asthma, as they may enable the prediction of the subsequent classic asthma development.

Caenorhabditis elegans MES-3 is a target of GLD-1 and functions epigenetically in germline development

The maternal-effect sterile (MES) proteins are maternally supplied regulators of germline development in Caenorhabditis elegans. In the hermaphrodite progeny from mes mutant mothers, the germline dies during larval development. On the basis of the similarities of MES-2 and MES-6 to known transcriptional regulators and on the basis of the effects of mes mutations on transgene expression in the germline, the MES proteins are predicted to be transcriptional repressors. One of the MES proteins, MES-3, is a novel protein with no recognizable motifs. In this article we show that MES-3 is localized in the nuclei of embryos and germ cells, consistent with its predicted role in transcriptional regulation. Its distribution in the germline and in early embryos does not depend on the wild-type functions of the other MES proteins. However, its nuclear localization in midstage embryos and its persistence in the primordial germ cells depend on wild-type MES-2 and MES-6. These results are consistent with biochemical data showing that MES-2, MES-3, and MES-6 associate in a complex in embryos. The distribution of MES-3 in the adult germline is regulated by the translational repressor GLD-1: MES-3 is absent from the region of the germline where GLD-1 is known to be present, MES-3 is overexpressed in the germline of gld-1 mutants, and GLD-1 specifically binds the mes-3 3' untranslated region (3' UTR). Analysis of temperature-shifted mes-3(bn21ts) worms and embryos indicates that MES-3 function is required in the mother's germline and during embryogenesis to ensure subsequent normal germline development. We propose that MES-3 acts epigenetically to induce a germline state that is inherited through both meiosis and mitosis and that is essential for survival of the germline.

A fatality due to injection of tiletamine and zolazepam

A 22-year-old male with more than 28 needle marks on his right arm was found dead. First, he was suspected as a drug abuser. Blood, urine, spleen, and injection-site tissue was collected during autopsy. The blood and urine specimens were screened for drugs. Immunoassay studies did not show any illegal drugs. However, two unidentified peaks were isolated in both of these biological fluids by routine gas chromatography-flame-ionization detection (GC-FID) and thermionic specific detection. Additional gas chromatography-mass spectrometry analysis determined these two peaks to be tiletamine and zolazepam. These two agents are used in combination as veterinary anesthesia. The concentrations of these drugs in blood were quantitated by GC-FID and found to be 0.85 mg/L of tiletamine and 3.3 mg/L of zolazepam. In urine, tiletamine and its metabolite, 2-(ethylamino)-2-(2-thionyl) cyclohexanol, were identified to be present along with zolazepam. The concentrations of tiletamine and zolazepam in spleen were revealed to be 0.92 and 3.5 mg/kg, respectively. Injection-site tissue concentrations were determined to be 25.1 mg/kg tiletamine and 23.3 mg/kg for zolazepam. The cause of death in this case was determined to be due to the multiple drug intoxication of tiletamine and zolazepam.

Image subband coding using context-based classification and adaptive quantization

Adaptive compression methods have been a key component of many proposed subband (or wavelet) image coding techniques. This paper deals with a particular type of adaptive subband image coding where we focus on the image coder's ability to adjust itself "on the fly" to the spatially varying statistical nature of image contents. This backward adaptation is distinguished from more frequently used forward adaptation in that forward adaptation selects the best operating parameters from a predesigned set and thus uses considerable amount of side information in order for the encoder and the decoder to operate with the same parameters. Specifically, we present backward adaptive quantization using a new context-based classification technique which classifies each subband coefficient based on the surrounding quantized coefficients. We couple this classification with online parametric adaptation of the quantizer applied to each class. A simple uniform threshold quantizer is employed as the baseline quantizer for which adaptation is achieved. Our subband image coder based on the proposed adaptive classification quantization idea exhibits excellent rate-distortion performance, in particular at very low rates. For popular test images, it is comparable or superior to most of the state-of-the-art coders in the literature.

Identification of a blue photoluminescent composite material from a combinatorial library

A quaternary combinatorial masking strategy was used in conjunction with photolithography to generate compositionally diverse thin-film phosphor libraries containing 1024 different compositions on substrates 2.5 centimeters square. A parallel imaging system and scanning spectrophotometer were used to identify and characterize compositions in the library with interesting luminescent behavior. Optimal compositions were identified with the use of gradient libraries, in which the stoichiometry of a material was varied continuously. This process led to the identification of an efficient blue photoluminescent composite material, Gd3Ga5O12/SiO2. Experimental evidence suggests that luminescence in this material may arise from interfacial effects between SiO2 and Gd3Ga5O12.