Physical activity and exercise alter cognitive abilities, and brain structure and activity in obese children

The prevalence of childhood obesity is increasing to such an extent that it has become a major global public health problem in the 21st century. Obesity alters children’s brain structure and activity and impairs their cognitive abilities. On the basis of these findings, it is necessary for educational and healthcare institutions to combat childhood obesity through preventive and therapeutic strategies. In general, exercise and physical activity are considered common but effective methods for improving physical, psychological, and brain health across the life span. Therefore, this review article mainly focuses on existing neuroimaging studies that have used magnetic resonance imaging (MRI), and functional magnetic resonance imaging (fMRI)to assess children’s brain anatomy and neural activity. We intended to explore the roles of physical activity and exercise in modulating the associations among childhood obesity, cognitive abilities, and the structure and activity of the brain.

Lifespan developmental changes in neural substrates and functional connectivity for visual semantic processing

Human learning and cognitive functions change with age and experience, with late-developed complex cognitive functions, particularly those served by the prefrontal cortex, showing more age-dependent variance. Reading as a complex process of constructing meaning from print uses the left prefrontal cortex and may show a similar aging pattern. In this study, we delineated the lifespan developmental changes in the neural substrates and functional connectivity for visual semantic processing from childhood (age 6) to late adulthood (age 74). Different from previous studies that reported aging as a form of activation or neuronal changes, we examined additionally how the functional connectivity networks changed with age. A cohort of 122 Chinese participants performed semantic and font-size judgment tasks during functional magnetic resonance imaging. Although a common left-lateralized neural system including the left mid-inferior prefrontal cortex was recruited across all participants, the effect of age, or reading experience, is evident as 2 contrastive developmental patterns: a declining trend in activation strength and extent and an increasing trend in functional connections of the network. This study suggests that visual semantic processing is not prone to cognitive decline, and that continuous reading until old age helps strengthen the functional connections of reading-related brain regions.

Myeloarchitectonic plasticity in elite golf players' brains

Human neuroimaging studies have demonstrated that exercise influences the cortical structural plasticity as indexed by gray or white matter volume. It remains elusive, however, whether exercise affects cortical changes at the finer‐grained myelination structure level. To answer this question, we scanned 28 elite golf players in comparison with control participants, using a novel neuroimaging technique—quantitative magnetic resonance imaging (qMRI). The data showed myeloarchitectonic plasticity in the left temporal pole of the golf players: the microstructure of this brain region of the golf players was better proliferated than that of control participants. In addition, this myeloarchitectonic plasticity was positively related to golfing proficiency. Our study has manifested that myeloarchitectonic plasticity could be induced by exercise, and thus, shed light on the potential benefits of exercise on brain health and cognitive enhancement.

Is phonological deficit a necessary or sufficient condition for Chinese reading disability?

While phonological skills have been found to be correlated with reading across different writing systems, recent findings have shown that developmental dyslexia in Chinese individuals has multiple deficits, and no single factor has ever been identified as crucial for learning this writing system. To examine whether a deficit in the phonological or another cognitive domain is a necessary or sufficient condition for Chinese reading disability, this study examined the cognitive profiles of 521 good readers and 502 dyslexic readers in Chinese primary schools using a battery of behavioral measures covering phonological, visual, orthographic, visual-motor coordination and working memory skills. The results showed that among all cognitive measures, phonological skills correlated more strongly with character reading performance but that poor phonological skills did not necessarily or sufficiently lead to poor reading performance in Chinese.

Myeloarchitectonic Asymmetries of Language Regions in the Human Brain

One prominent theory in neuroscience and psychology assumes that cortical regions for language are left hemisphere lateralized in the human brain. In the current study, we used a novel technique, quantitative magnetic resonance imaging (qMRI), to examine interhemispheric asymmetries in language regions in terms of macromolecular tissue volume (MTV) and quantitative longitudinal relaxation time (T1) maps in the living human brain. These two measures are known to reflect cortical myeloarchitecture from the microstructural perspective. One hundred and fifteen adults (55 male, 60 female) were examined for their myeloarchitectonic asymmetries of language regions. We found that the cortical myeloarchitecture of inferior frontal areas including the pars opercularis, pars triangularis, and pars orbitalis is left lateralized, while that of the middle temporal gyrus, Heschl’s gyrus, and planum temporale is right lateralized. Moreover, the leftward lateralization of myelination structure is significantly correlated with language skills measured by phonemic and speech tone awareness. This study reveals for the first time a mixed pattern of myeloarchitectonic asymmetries, which calls for a general theory to accommodate the full complexity of principles underlying human hemispheric specialization.

Acupoint-brain (acubrain) mapping: Common and distinct cortical language regions activated by focused ultrasound stimulation on two language-relevant acupoints

Acupuncture, taking the advantage of modality-specific neural pathways, has shown promising results in the treatment of brain disorders that affect different modalities such as pain and vision. However, the precise underlying mechanisms of within-modality neuromodulation of acupoints on human high-order cognition remain largely unknown. In the present study, we used a non-invasive and easy-operating method, focused ultrasound, to stimulate two language-relevant acupoints, namely GB39 (Xuanzhong) and SJ8 (Sanyangluo), of thirty healthy adults. The effect of focused ultrasound stimulation (FUS) on brain activation was examined by functional magnetic resonance imaging (fMRI). We found that stimulating GB39 and SJ8 by FUS evoked overlapping but distinct brain activation patterns. Our findings provide a major step toward within-modality (in this case, language) acupoint-brain (acubrain) mapping and shed light on to the potential use of FUS as a personalized treatment option for brain disorders that affect high-level cognitive functions.

Effect of Gender on Development of Hippocampal Subregions From Childhood to Adulthood

The hippocampus is known to be comprised of several subfields, but the developmental trajectories of these subfields are under debate. In this study, we analyzed magnetic resonance imaging (MRI) data from a cross-sectional sample (198 healthy Chinese) using an automated segmentation tool to delineate the development of the hippocampal subregions from 6 to 26 years of age. We also examined whether gender and hemispheric differences influence the development of these subregions. For the whole hippocampus, the trajectory of development was observed to be an inverse-u. A significant increase in volume with age was found for most of the subregions, except for the L/R-parasubiculum, L/R-fimbria, and L-HATA. Gender-related differences were also found in the development of most subregions, especially for the hippocampal tail, CA1, molecular layer HP, GC-DG, CA3, and CA4, which showed a consistent increase in females and an early increase followed by a decrease in males. A comparison of the average volumes showed that the right whole hippocampus was significantly larger, along with the R-presubiculum, R-hippocampal-fissure, L/R-CA1, and L/R-molecular layer HP in males in comparison to females. Additionally, the average volume of the right hemisphere was shown to be significantly larger for the hippocampal tail, CA1, molecular layer HP, GC-DG, CA3, and CA4. However, for the presubiculum, parasubiculum, and fimbria, the left side was shown to be larger. In conclusion, the hippocampal subregions appear to develop in various ways from childhood to adulthood, with both gender and hemispheric differences affecting their development.

The Cortical Maps of Hierarchical Linguistic Structures during Speech Perception

The hierarchical nature of language requires human brain to internally parse connected-speech and incrementally construct abstract linguistic structures. Recent research revealed multiple neural processing timescales underlying grammar-based configuration of linguistic hierarchies. However, little is known about where in the whole cerebral cortex such temporally scaled neural processes occur. This study used novel magnetoencephalography source imaging techniques combined with a unique language stimulation paradigm to segregate cortical maps synchronized to 3 levels of linguistic units (i.e., words, phrases, and sentences). Notably, distinct ensembles of cortical loci were identified to feature structures at different levels. The superior temporal gyrus was found to be involved in processing all 3 linguistic levels while distinct ensembles of other brain regions were recruited to encode each linguistic level. Neural activities in the right motor cortex only followed the rhythm of monosyllabic words which have clear acoustic boundaries, whereas the left anterior temporal lobe and the left inferior frontal gyrus were selectively recruited in processing phrases or sentences. Our results ground a multi-timescale hierarchical neural processing of speech in neuroanatomical reality with specific sets of cortices responsible for different levels of linguistic units.

A Lifespan fMRI Study of Neurodevelopment Associated with Reading Chinese

We used functional magnetic resonance imaging (fMRI) to map the neural systems involved in reading Chinese in 125 participants 6-74 years old to examine two theoretical issues: how brain structure and function are related in the context of the lifetime neural development of human cognition and whether the neural network for reading is universal or different across languages. Our findings showed that a common network of left frontal and occipital regions typically involved in reading Chinese was recruited across all participants. Crucially, activation in left mid-inferior frontal regions, fusiform and striate-extrastriate sites, premotor cortex, right inferior frontal gyrus, bilateral insula, and supplementary motor area all showed linearly decreasing changes with age. These findings differ from previous findings on alphabetic reading development and suggest that early readers at age 6-7 are already using the same cortical network to process printed words as adults, though the connections among these regions are modulated by reading proficiency, and cortical regions for reading are tuned by experience toward reduced and more focused activation. This fMRI study has demonstrated, for the first time, the neurodevelopment of reading across the lifespan and suggests that learning experience, instead of pre-existing brain structures, determines reading acquisition.

Children's neurodevelopment of reading is affected by China's language input system in the information era

Communications through electronic devices require knowledge in typewriting, typically with the pinyin input method in China. Yet, the over utilization of the pronunciation-based pinyin input method may violate the traditional learning processes of written Chinese, which involves abundant visual orthographic analysis of characters and repeated writing. We used functional magnetic resonance imaging to examine the influence of pinyin typing on reading neurodevelopment of intermediate Chinese readers (age 9-11). We found that, relative to less frequent pinyin users, more frequent pinyin users showed an overall weaker pattern of cortical activations in the left middle frontal gyrus, left inferior frontal gyrus, and right fusiform gyrus in performing reading tasks. In addition, more frequent pinyin typists had relatively less gray matter volume in the left middle frontal region, a site known to be crucial for Chinese reading. This study demonstrates that Chinese children's brain development in the information era is affected by the frequent use of the pinyin input method.

Whole-Brain Functional Networks for Phonological and Orthographic Processing in Chinese Good and Poor Readers

The neural basis of dyslexia in different languages remains unresolved, and it is unclear whether the phonological deficit as the core deficit of dyslexia is language-specific or universal. The current functional magnetic resonance imaging (fMRI) study using whole-brain data-driven network analyses investigated the neural mechanisms for phonological and orthographic processing in Chinese children with good and poor reading ability. Sixteen good readers and 16 poor readers were requested to make homophone judgments (phonological processing) and component judgments (visual-orthographic processing) of presented Chinese characters. Poor readers displayed worse performance than the good readers in phonological processing, but not in orthographic processing. Whole-brain activation analyses showed compensatory activations in the poor readers during phonological processing and automatic phonological production activation in the good readers during orthographic processing. Significant group differences in the topological properties of their brain networks were found only in orthographic processing. Analyses of nodal degree centrality and betweenness centrality revealed significant group differences in both phonological and orthographic processing. The present study supports the phonological core deficit hypothesis of reading difficulty in Chinese. It also suggests that Chinese good and poor readers might recruit different strategies and neural mechanisms for orthographic processing.

Sex Differences in Functional Brain Networks for Language

Men and women process language differently, but how the brain functions to support this difference is poorly understood. A few studies reported sex influences on brain activation for language, whereas others failed to detect the difference at the functional level. Recent advances of brain network analysis have shown great promise in picking up brain connectivity differences between sexes, leading us to hypothesize that the functional connections among distinct brain regions for language may differ in males and females. To test this hypothesis, we scanned 58 participants’ brain activities (28 males and 30 females) in a semantic decision task using functional magnetic resonance imaging. We found marked sex differences in dynamic interactions among language regions, as well as in functional segregation and integration of brain networks during language processing. The brain network differences were further supported by a machine learning analysis that accurately discriminated males from females using the multivariate patterns of functional connectivity. The sex-specific functional brain connectivity may constitute an essential neural basis for the long-held notion that men and women process language in different ways. Our finding also provides important implications for sex differences in the prevalence of language disorders, such as dyslexia and stuttering.

Microstructural plasticity in the bilingual brain

The human brain has been uniquely equipped with the remarkable ability to acquire more than one language, as in bilingual individuals. Previous neuroimaging studies have indicated that learning a second language (L2) induced neuroplasticity at the macrostructural level. In this study, using the quantitative MRI (qMRI) combined with functional MRI (fMRI) techniques, we quantified the microstructural properties and tested whether second language learning modulates the microstructure in the bilingual brain. We found significant microstructural variations related to age of acquisition of second language in the left inferior frontal region and the left fusiform gyrus that are crucial for resolving lexical competition of bilinguals' two languages. Early second language acquisition contributes to enhance cortical development at the microstructural level.

Neural correlates and functional connectivity of lexical tone processing in reading

Lexical tone processing in speech is mediated by bilateral superior temporal and inferior prefrontal regions, but little is known concerning the neural circuitries of lexical tone phonology in reading. Using fMRI, we examined the neural systems for lexical tone in visual Chinese word recognition. We found that the extraction of lexical tone phonology in print was subserved by bilateral fronto-parietal regions. Seed-to-voxel analyses showed that functionally connected cortical regions involved right inferior frontal gyrus and SMA, right middle frontal gyrus and right inferior parietal lobule, and SMA and bilateral cingulate gyri. Our results indicate that in Chinese tone reading, a bilateral network of frontal, parietal, motor, and cingulate regions is engaged, without involvement of temporal regions crucial for tone identification in auditory domain. Although neural couplings for lexical tone processing are different in speech and reading to some degree, the motor cortex seems to be a key component independent of modality.

Anaesthesia for Implantation of the Jarvik 2000 Flowmaker® LVAD

The Jarvik 2000 Flowmaker® is an intraventricular continuous axial flow left ventricular assist device. We describe the anaesthetic management and considerations for five patients with end-stage heart failure who underwent implantation of the Jarvik 2000 Flowmaker® as a bridge to transplantation or as destination therapy.

Abnormal neural response to phonological working memory demands in persistent developmental stuttering

Persistent developmental stuttering is a neurological disorder that commonly manifests as a motor problem. Cognitive theories, however, hold that poorly developed cognitive skills are the origins of stuttering. Working memory (WM), a multicomponent cognitive system that mediates information maintenance and manipulation, is known to play an important role in speech production, leading us to postulate that the neurophysiological mechanisms underlying stuttering may be associated with a WM deficit. Using functional magnetic resonance imaging, we aimed to elucidate brain mechanisms in a phonological WM task in adults who stutter and controls. A right-lateralized compensatory mechanism for a deficit in the rehearsal process and neural disconnections associated with the central executive dysfunction were found. Furthermore, the neural abnormalities underlying the phonological WM were independent of memory load. This study demonstrates for the first time the atypical neural responses to phonological WM in PWS, shedding new light on the underlying cause of stuttering.

Distinct distributed patterns of neural activity are associated with two languages in the bilingual brain

A large body of previous neuroimaging studies suggests that multiple languages are processed and organized in a single neuroanatomical system in the bilingual brain, although differential activation may be seen in some studies because of different proficiency levels and/or age of acquisition of the two languages. However, one important possibility is that the two languages may involve interleaved but functionally independent neural populations within a given cortical region, and thus, distinct patterns of neural computations may be pivotal for the processing of the two languages. Using functional magnetic resonance imaging (fMRI) and multivariate pattern analyses, we tested this possibility in Chinese-English bilinguals when they performed an implicit reading task. We found a broad network of regions wherein the two languages evoked different patterns of activity, with only partially overlapping patterns of voxels in a given region. These regions, including the middle occipital cortices, fusiform gyri, and lateral temporal, temporoparietal, and prefrontal cortices, are associated with multiple aspects of language processing. The results suggest the functional independence of neural computations underlying the representations of different languages in bilinguals.

Taeniasis and neurocysticercosis among Malaysians

Taeniasis, endemic in Southeast Asia, is caused by Taenia saginata (for beef) or Taenia solium and Taenia asiatica (for pork). T. solium also causes cysticercosis which can affect various organs. Taeniasis and cysticercosis cases are rarely reported in Malaysia. We report here two separate cases of beef taeniasis, and an interesting case of neurocysticercosis in a Malay Muslim. The taeniasis cases involved a Malaysian Chinese and a native Sabahan. Proglottids were recovered from them, and identification of the tapeworm done either from the microscopic examination of the egg or using PCR-based molecular diagnosis. Upon confirmation of taeniasis, both cases were given praziquantel and had been asymptomatic since. The neurocysticercosis case involving a Muslim who presented with seizure, was confirmed by histopathological examination of tissue sections taken from craniotomy excision of the brain lesion. He was given one month course of albendazole 400 mg bid and dexamethasone, and had been well and seizure free since. The two cases of taeniasis documented here had acquired the disease through eating raw or undercooked contaminated beef. For the neurocyticercosis case, it is suspected that he might have acquired the infection in one of his travels through human to human transmission via contaminated food or water consumption, given that Malaysia is not T. solium endemic area. Lastly praziquantel is an effective drug for beef taeniasis, while a combination of albendazole and dexamethasone work well for neurocysticercosis.

Effect of electroacupuncture on the cervicospinal P2X7 receptor/fractalkine/CX3CR1 signaling pathway in a rat neck-incision pain model

Increasing evidence supports that acupuncture intervention is an effective approach for intraoperative and postoperative pain. Neuron-microglia crosstalk, mediated by the purinergic P2X7 receptor (R)/fractalkine/CX3CR1 cascade in the spinal cord dorsal horn, plays a pivotal role in pain processing. However, its involvement in the analgesic effect of electroacupuncture (EA) remains unclear. In this study, a rat neck-incision pain model was established by making a longitudinal incision along the midline of the neck and subsequent repeated mechanical stimulation. EA stimulation was applied to bilateral LI18, LI4-PC6, or ST36-GB34. The thermal pain threshold, cervicospinal ATP concentration, expression levels of purinergic P2XR and P2YR subunits mRNAs, and fractalkine, CX3CR1 and p38 MAPK proteins, were detected separately. The neck incision induced strong thermal hyperalgesia and upregulation of spinal ATP within 48 h. No significant change was found in thermal hyperalgesia after a single session of EA intervention. However, a single session of EA dramatically enhanced the neck incision-induced upregulation of ATP and upregulated the expression of P2X7R, which was reversed by two sessions of EA. Two sessions of EA at bilateral LI18 or LI4-PC6 attenuated hyperalgesia significantly, accompanied with downregulation of P2X7R/fractalkine/ CX3CR1 signaling after three sessions of EA. EA stimulation of LI18 or LI4-PC6 alleviates thermal hyperalgesia in neck-incision pain rats, which may be associated with its effects in regulating the neck incision-induced increase of ATP and P2X7R and subsequently suppressing fractalkine/CX3CR1 signaling in the cervical spinal cord.

Altered functional connectivity in persistent developmental stuttering

Persistent developmental stuttering (PDS) is a speech disorder that impairs communication skills. Despite extensive research, the core causes of PDS are elusive. Converging evidence from task-induced neuroimaging methods has demonstrated the contributions of the basal ganglia and the cerebellum to PDS, but such task-state neuroimaging findings are often confounded by behavioral performance differences between subjects who stutter and normal controls. Here, using resting-state functional magnetic resonance imaging, we investigated functional connectivity within cerebellar-cortical and basal ganglia-thalamocortical networks in 16 adults who stutter and 18 age-matched fluent speakers. Seed-to-voxel analysis demonstrated that, compared to controls, adults who stutter showed alternations in functional connectivity of cerebellum to motor cortex as well as connectivity among different locals within cerebellum. Additionally, we found that functional connectivity within cerebellar circuits was significantly correlated with severity of stuttering. The alternations of functional connectivity within basal ganglia-thalamocortical networks were identified as the reduced connectivity of the putamen to the superior temporal gyrus and inferior parietal lobules in adults who stutter. The abnormalities of resting state functional connectivity are assumed to affect language planning and motor execution critical for speaking fluently. Our findings may yield neurobiological cues to the biomarkers of PDS.

Giant Chondrosarcoma of Proximal Humerus in an Adult Female Patient: A Case Report

Chondrosarcoma is the third most common primary tumour of the bone, after myeloma and osteosarcoma. Most of the chondrosarcoma grow slowly and rarely metastasize, and they have an excellent prognosis after adequate surgery. However most of them are chemo or radio-resistant. We report a case of primary chondrosarcoma of proximal humerus in a 36-year-old female who presented with a six years history of left shoulder swelling and restricted range of motion. Trucut biopsy showed a well-differentiated chondrosarcoma. The patient underwent forequarter amputation of left upper limb and was started on chemotherapy following operation.

Effective connectivity of brain regions related to visual word recognition: An fMRI study of Chinese reading

Past neuroimaging studies have focused on identifying specialized functional brain systems for processing different components of reading, such as orthography, phonology, and semantics. More recently, a few experiments have been performed to look into the integration and interaction of distributed neural systems for visual word recognition, suggesting that lexical processing in alphabetic languages involves both ventral and dorsal neural pathways originating from the visual cortex. In the present functional magnetic resonance imaging study, we tested the multiple pathways model with Chinese character stimuli and examined how the neural systems interacted in reading Chinese. Using dynamic causal modeling, we demonstrated that visual word recognition in Chinese engages the ventral pathway from the visual cortex to the left ventral occipitotemporal cortex, but not the dorsal pathway from the visual cortex to the left parietal region. The ventral pathway, however, is linked to the superior parietal lobule and the left middle frontal gyrus (MFG) so that a dynamic neural network is formed, with information flowing from the visual cortex to the left ventral occipitotemporal cortex to the parietal lobule and then to the left MFG. The findings suggest that cortical dynamics is constrained by the differences in how visual orthographic symbols in writing systems are linked to spoken language.

Association study of stuttering candidate genes GNPTAB, GNPTG and NAGPA with dyslexia in Chinese population

Background

Dyslexia is a polygenic speech and language disorder characterized by an unexpected difficulty in reading in children and adults despite normal intelligence and schooling. Increasing evidence reveals that different speech and language disorders could share common genetic factors. As previous study reported association of GNPTAB, GNPTG and NAGPA with stuttering, we investigated these genes with dyslexia through association analysis.

Results

The study was carried out in an unrelated Chinese cohort with 502 dyslexic individuals and 522 healthy controls. In all, 21 Tag SNPs covering GNPTAB, GNPTG and NAGPA were subjected to genotyping. Association analysis was performed on all SNPs. Significant association of rs17031962 in GNPTAB and rs882294 in NAGPA with developmental dyslexia was identified after FDR correction for multiple comparisons.

Conclusion

Our results revealed that the stuttering risk genes GNPTAB and NAGPA might also associate with developmental dyslexia in the Chinese population.

Electronic supplementary material

The online version of this article (doi:10.1186/s12863-015-0172-5) contains supplementary material, which is available to authorized users.

Association study of developmental dyslexia candidate genes DCDC2 and KIAA0319 in Chinese population

Developmental dyslexia (DD) is characterized by difficulties in reading and spelling independent of intelligence, educational backgrounds and neurological injuries. Increasing evidences supported DD as a complex genetic disorder and identified four DD candidate genes namely DYX1C1, DCDC2, KIAA0319 and ROBO1. As such, DCDC2 and KIAA0319 are located in DYX2, one of the most studied DD susceptibility loci. However, association of these two genes with DD was inconclusive across different populations. Given the linguistic and genetic differences between Chinese and other populations, it is worthwhile to investigate association of DCDC2 and KIAA0319 with Chinese dyslexic children. Here, we selected 60 tag SNPs covering DCDC2 and KIAA0319 followed by high density genotyping in a large unrelated Chinese cohort with 502 dyslexic cases and 522 healthy controls. Several SNPs (Pmin = 0.0192) of DCDC2 and KIAA0319 as well as a four-maker haplotype (Padjusted = 0.0289, Odds Ratio (OR) = 1.3400) of KIAA0319 showed nominal association with DD. However, none of these results survived Bonferroni correction for multiple comparisons. Thus, the association of DCDC2 and KIAA0319 with DD in Chinese population should be further validated and their contribution to DD etiology and pathology should be interpreted with caution.

Is moral beauty different from facial beauty? Evidence from an fMRI study

Is moral beauty different from facial beauty? Two functional magnetic resonance imaging experiments were performed to answer this question. Experiment 1 investigated the network of moral aesthetic judgments and facial aesthetic judgments. Participants performed aesthetic judgments and gender judgments on both faces and scenes containing moral acts. The conjunction analysis of the contrasts 'facial aesthetic judgment > facial gender judgment' and 'scene moral aesthetic judgment > scene gender judgment' identified the common involvement of the orbitofrontal cortex (OFC), inferior temporal gyrus and medial superior frontal gyrus, suggesting that both types of aesthetic judgments are based on the orchestration of perceptual, emotional and cognitive components. Experiment 2 examined the network of facial beauty and moral beauty during implicit perception. Participants performed a non-aesthetic judgment task on both faces (beautiful vs common) and scenes (containing morally beautiful vs neutral information). We observed that facial beauty (beautiful faces > common faces) involved both the cortical reward region OFC and the subcortical reward region putamen, whereas moral beauty (moral beauty scenes > moral neutral scenes) only involved the OFC. Moreover, compared with facial beauty, moral beauty spanned a larger-scale cortical network, indicating more advanced and complex cerebral representations characterizing moral beauty.

Neural signatures of lexical tone reading

Research on how lexical tone is neuroanatomically represented in the human brain is central to our understanding of cortical regions subserving language. Past studies have exclusively focused on tone perception of the spoken language, and little is known as to the lexical tone processing in reading visual words and its associated brain mechanisms. In this study, we performed two experiments to identify neural substrates in Chinese tone reading. First, we used a tone judgment paradigm to investigate tone processing of visually presented Chinese characters. We found that, relative to baseline, tone perception of printed Chinese characters were mediated by strong brain activation in bilateral frontal regions, left inferior parietal lobule, left posterior middle/medial temporal gyrus, left inferior temporal region, bilateral visual systems, and cerebellum. Surprisingly, no activation was found in superior temporal regions, brain sites well known for speech tone processing. In activation likelihood estimation (ALE) meta-analysis to combine results of relevant published studies, we attempted to elucidate whether the left temporal cortex activities identified in Experiment one is consistent with those found in previous studies of auditory lexical tone perception. ALE results showed that only the left superior temporal gyrus and putamen were critical in auditory lexical tone processing. These findings suggest that activation in the superior temporal cortex associated with lexical tone perception is modality-dependent.

Comparison and critical appraisal of dengue clinical guidelines and their use in Asia and Latin America

The World Health Organization (WHO) dengue classification scheme for dengue fever (DF) and dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS) has been adopted as the standard for diagnosis, clinical management and reporting. In recent years, difficulties in applying the WHO case classification have been reported in several countries. A multicenter study was carried out in Asia and Latin America to analyze the variation and utility of dengue clinical guidelines (DCGs) taking as reference the WHO/PAHO guidelines (1994) and the WHO/SEARO guidelines (1998). A document analysis of 13 dengue guidelines was followed by a questionnaire and Focus Group discussions (FGDs) with 858 health care providers in seven countries. Differences in DCGs of the 13 countries were identified including the concept of warning signs, case classification, use of treatment algorithms and grading into levels of severity. The questionnaires and FGDs revealed (1) inaccessibility of DCGs, (2) lack of training, (3) insufficient number of staff to correctly apply the DCGs at the frontline and (4) the unavailability of diagnostic tests. The differences of the DCGs and the inconsistency in their application suggest a need to re-evaluate and standardise DCGs. This applies especially to case classification and case management.

High energy and average power femtosecond laser for driving mid-infrared optical parametric amplifiers

We have developed the first (to our knowledge) femtosecond Tm-fiber-laser-pumped Ho:YAG room-temperature chirped pulse amplifier system delivering scalable multimillijoule, multikilohertz pulses with a bandwidth exceeding 12 nm and average power of 15 W. The recompressed 530 fs pulses are suitable for broadband white light generation in transparent solids, which makes the developed source ideal for both pumping and seeding optical parametric amplifiers operating in the mid-IR spectral range.

Coherent polarization locking: an approach to mitigating optical damage in a pulsed Ho:YAG laser

Intracavity optical damage is mitigated in a pulsed Ho:YAG laser cavity using the coherent polarization locking (CPL) technique. By splitting the available pump power into two individual Ho:YAG laser rods, we passively coherently locked two orthogonal polarization lasers with 9.13 mJ output pulse energies and 14 ns pulsewidths, and operating at 800 Hz repetition rate. A conventional Ho:YAG laser cavity with the same pump and cavity configuration results in severe optical damage when operating at <2 kHz repetition rate, thus limiting the output pulse energies to <5 mJ. We also demonstrated, to the best of our knowledge, the first pulsed operation within the entire CPL Ho:YAG laser cavity by Q-switching in one of the polarization arms, producing nanosecond pulses with no sign of pulse instability.

Preserving a diffraction-limited beam in Ho:YAG laser using coherent polarization locking

We overcome several thermal issues present in Ho:YAG lasers by distributing the gain over a larger volume and achieve a diffraction-limited beam using coherent polarization locking. Increased single-pass absorption, suppression of output power saturation, and improvement in beam quality were shown using the coherent polarization locking technique as compared to a conventional Ho:YAG laser cavity with the same pump and cavity configuration. Ten watts of CW Ho:YAG laser power was generated with >96% coherent combining efficiency.

Unusual manifestation of cutaneous toxoplasmosis in a HIV-positive patient

We report a case of unusual cutaneous toxoplasmosis manifestation in a HIV-positive patient. He presented with hard and painful nodular lesions on the arms, hands and chest. Serology tests for anti-Toxoplasma antibody were negative. However, histopathologic examination of the lesion revealed foci of macrophages containing crescent-shaped organisms resembling the zoites of the protozoan parasite Toxoplasma gondii. Ultrastructure examination under electron microscopy and PCR confirmed the organism as T. gondii.

Language regions of brain are operative in color perception

The effect of language on the categorical perception of color is stronger for stimuli in the right visual field (RVF) than in the left visual field, but the neural correlates of the behavioral RVF advantage are unknown. Here we present brain activation maps revealing how language is differentially engaged in the discrimination of colored stimuli presented in either visual hemifield. In a rapid, event-related functional MRI study, we measured subjects' brain activity while they performed a visual search task. Compared with colors from the same lexical category, discrimination of colors from different linguistic categories provoked stronger and faster responses in the left hemisphere language regions, particularly when the colors were presented in the RVF. In addition, activation of visual areas 2/3, responsible for color perception, was much stronger for RVF stimuli from different linguistic categories than for stimuli from the same linguistic category. Notably, the enhanced activity of visual areas 2/3 coincided with the enhanced activity of the left posterior temporoparietal language region, suggesting that this language region may serve as a top-down control source that modulates the activation of the visual cortex. These findings shed light on the brain mechanisms that underlie the hemifield- dependent effect of language on visual perception.

Effect of open-chest surgery in the lateral position on blood propofol concentration during target-controlled infusion of propofol

Our research hypothesis was that single lung ventilation during thoracic surgery in the lateral position increases the blood concentration of propofol during target-controlled infusion. Thirty adult patients in two tertiary referral hospitals undergoing open-chest surgery were studied. Anaesthesia was induced and maintained with propofol using a Diprifusor (Graseby 3500) computer-controlled pump set to deliver a blood concentration of 4 tg.ml(-1). Blood samples were taken with the patient positioned in (1) the supine position 20 minutes after induction (supine); (2) the lateral position just prior to one-lung ventilation (lateral); (3) the lateral position five minutes after commencing one-lung ventilation (OLV5) and (4) the lateral position 20 minutes after commencing one-lung ventilation (OLV20). Propofol concentrations were determined by high performance liquid chromatography. The target-controlled infusion target level was maintained at 4 microg.ml(-1) during the study period for all cases. The mean (SD) propofol blood concentration (microg.ml(-1)) at each stage was 5.5 (1.5) supine, 5.3 (1.1) lateral, 5.3 (1.2) OLV5 and 5.1 (1.2) OLV20. Repeated measures ANOVA showed an F value 1.9, lambda 5.5 and P value 0.15. Post hoc analysis did not identify a significant difference between the sample times. During target-controlled infusion of propofol, mean blood propofol concentrations did not change significantly from those obtained with the patient supine after up to 50 minutes in the lateral position during thoracic surgery, or 20 minutes after commencing one-lung ventilation.

Immunological profiles of immune restoration disease presenting as mycobacterial lymphadenitis and cryptococcal meningitis

OBJECTIVES

A proportion of HIV patients beginning antiretroviral therapy (ART) develop immune restoration disease (IRD). Immunological characteristics of IRD were investigated in a cohort of HIV patients beginning therapy in Kuala Lumpur, Malaysia.

METHODS

Peripheral blood mononuclear cells were collected at weeks 0, 6, 12, 24 and 48 of ART from five patients experiencing IRD [two with cryptococcal and three with Mycobacterium tuberculosis (Mtb) disease], eight non-IRD controls who had begun ART with CD4 T-cell counts of <100 cells/microL and 17 healthy controls. Leukocytes producing interferon-gamma (IFNgamma) were quantified by enzyme-linked immunospot assay after stimulation with purified protein derivative (PPD), early secretory antigenic target-6 (ESAT-6), Cryptococcus neoformans or Cytomegalovirus antigens. Plasma immunoglobulin (IgG) antibodies reactive with these antigens were assessed by enzyme-linked immunosorbent assay. Proportions of activated (HLA-DR(hi)) and regulatory (CD25 CD127(lo) and CTLA-4(+)) CD4 T-cells were quantified by flow cytometry.

RESULTS

Plasma HIV RNA declined and CD4 T-cell counts rose within 8-27 weeks on ART. Mtb IRD patients displayed elevated IFNgamma responses and/or plasma IgG to PPD, but none responded to ESAT-6. Cryptococcal IRD occurred in patients with low baseline CD4 T-cell counts and involved clear IFNgamma and antibody responses to cryptococcal antigen. Proportions of activated and regulatory CD4 T-cells declined on ART, but remained higher in patients than in healthy controls. At the time of IRD, proportions of activated CD4 T-cells and regulatory CD4 T-cells were generally elevated relative to other patients.

CONCLUSIONS

Cryptococcal and Mtb IRD generally coincide with peaks in the proportion of activated T-cells, pathogen-specific IFNgamma responses and reactive plasma IgG. IRD does not reflect a paucity of regulatory CD4 T-cells.

Effect of oil loading on microspheres produced by spray drying

Oil-loaded microspheres were produced by spray drying emulsions consisting of fish oil and modified starch suspensions with different oil loadings. The emulsion stability was assessed by oil droplet size analysis. Microspheres were characterized in terms of size, morphology, yield and microencapsulation efficiency. It was found that an increase in oil loading resulted in emulsions containing larger oil droplets. This corresponded with larger mean microsphere diameters and rounder microspheres. However, high oil loadings produced lower yields and affected microencapsulation efficiencies.

Language affects patterns of brain activation associated with perceptual decision

Well over half a century ago, Benjamin Lee Whorf [Carroll JB (1956) Language, Thought, and Reality: Selected Writings of Benjamin Lee Whorf (MIT Press, Cambridge, MA)] proposed that language affects perception and thought and is used to segment nature, a hypothesis that has since been tested by linguistic and behavioral studies. Although clear Whorfian effects have been found, it has not yet been demonstrated that language influences brain activity associated with perception and/or immediate postperceptual processes (referred hereafter as "perceptual decision"). Here, by using functional magnetic resonance imaging, we show that brain regions mediating language processes participate in neural networks activated by perceptual decision. When subjects performed a perceptual discrimination task on easy-to-name and hard-to-name colored squares, largely overlapping cortical regions were identified, which included areas of the occipital cortex critical for color vision and regions in the bilateral frontal gyrus. Crucially, however, in comparison with hard-to-name colored squares, perceptual discrimination of easy-to-name colors evoked stronger activation in the left posterior superior temporal gyrus and inferior parietal lobule, two regions responsible for word-finding processes, as demonstrated by a localizer experiment that uses an explicit color patch naming task. This finding suggests that the language-processing areas of the brain are directly involved in visual perceptual decision, thus providing neuroimaging support for the Whorf hypothesis.

Effects of age of acquisition on brain activation during Chinese character recognition

The age of acquisition of a word (AoA) has a specific effect on brain activation during word identification in English and German. However, the neural locus of AoA effects differs across studies. According to Hernandez and Fiebach [Hernandez, A., & Fiebach, C. (2006). The brain bases of reading late-learned words: Evidence from functional MRI. Visual Cognition, 13(8), 1027-1043], the effects of AoA on brain activation depend on the predictability of the connections between input (orthography) and output (phonology) in a lexical network. We tested this hypothesis by examining AoA effects in a non-alphabetic script with relatively arbitrary mappings between orthography and phonology--Chinese. Our results showed that the effects of AoA in Chinese speakers are located in brain regions that are spatially distinctive including the bilateral middle temporal gyrus and the left inferior parietal cortex. An additional finding was that word frequency had an independent effect on brain activation in the right middle occipital gyrus only. We conclude that spatially distinctive effects of AoA on neural activity depend on the predictability of the mappings between orthography and phonology and reflect a division of labour towards greater lexical-semantic retrieval in non-alphabetic scripts.

Predictors of timed picture naming in Chinese

We report normative data collected from Mainland Chinese speakers for 232 objects taken from Snodgrass and Vanderwart (1980). These data include adult ratings of concept familiarity, age of acquisition (AoA), printed-word frequency, and word length (in syllables), as well as measures of rated visual complexity, image agreement, and name agreement. We then examined timed picture naming of these objects with native Chinese speakers in Beijing in two experiments using line drawings and colored pictures. In both experiments, the variables name agreement, rated concept familiarity, and AoA made significant independent contributions to naming latency in multiple regression analyses. We observed a correlation of r = .85 between naming latency with line drawings and colored pictures and a reduced effect of image agreement on naming when colored pictures were presented. We discuss the implications of our findings for the study of lexical processing in Chinese. Normative data for 232 Chinese nouns may be downloaded from www.psychonomic.org/archive.

Accidental blood exposure: risk and prevention in interventional radiology

There is a growing concern about the transmission of bloodborne pathogens during medical procedures among health care workers and patients. Over the last three decades, radiological services have undergone many changes with the introduction of new modalities. One of these new disciplines is interventional radiology (IR) which deals with procedures such as arteriography, image-guided biopsies, intravascular catheter insertions, angioplasty and stent placements. Despite these developments, the potential for accidental blood exposure and exposure to other infectious material continues to exist. Therefore, it is important for all radiologists who perform invasive procedures to observe specific recommendations for infection control. In this review, we look at the different policies for protection and universal standards on infection control.

Cognitive processing in Chinese literate and illiterate subjects: an fMRI study

Functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) were used to map brain activation during language tasks. While previous studies have compared performance between alphabetic literate and illiterate subjects, there have been no such data in Chinese-speaking individuals. In this study, we used fMRI to examine the effects of education on neural activation associated with silent word recognition and silent picture-naming tasks in 24 healthy right-handed Chinese subjects (12 illiterates and 12 literates). There were 30 single Chinese characters in the silent word recognition task and 30 meaningful road-signs in the silent picture-naming task. When we compared literate and illiterate subjects, we observed education-related differences in activation patterns in the left inferior/middle frontal gyrus and both sides of the superior temporal gyrus for the silent word recognition task and in the bilateral inferior/middle frontal gyrus and left limbic cingulated gyrus for the silent picture-naming task. These results indicate that the patterns of neural activation associated with language tasks are strongly influenced by education. Education appears to have enhanced cognitive processing efficiency in language tasks.