EFNS guidelines on the diagnosis and management of orthostatic hypotension

Orthostatic (postural) hypotension (OH) is a common, yet under diagnosed disorder. It may contribute to disability and even death. It can be the initial sign, and lead to incapacitating symptoms in primary and secondary autonomic disorders. These range from visual disturbances and dizziness to loss of consciousness (syncope) after postural change. Evidence based guidelines for the diagnostic workup and the therapeutic management (non-pharmacological and pharmacological) are provided based on the EFNS guidance regulations. The final literature research was performed in March 2005. For diagnosis of OH, a structured history taking and measurement of blood pressure (BP) and heart rate in supine and upright position are necessary. OH is defined as fall in systolic BP below 20 mmHg and diastolic BP below 10 mmHg of baseline within 3 min in upright position. Passive head-up tilt testing is recommended if the active standing test is negative, especially if the history is suggestive of OH, or in patients with motor impairment. The management initially consists of education, advice and training on various factors that influence blood pressure. Increased water and salt ingestion effectively improves OH. Physical measures include leg crossing, squatting, elastic abdominal binders and stockings, and careful exercise. Fludrocortisone is a valuable starter drug. Second line drugs include sympathomimetics, such as midodrine, ephedrine, or dihydroxyphenylserine. Supine hypertension has to be considered.

Glucocorticoids promote development of the osteoblast phenotype by selectively modulating expression of cell growth and differentiation associated genes

To understand the mechanisms by which glucocorticoids promote differentiation of fetal rat calvaria derived osteoblasts to produce bone-like mineralized nodules in vitro, a panel of osteoblast growth and differentiation related genes that characterize development of the osteoblast phenotype has been quantitated in glucocorticoid-treated cultures. We compared the mRNA levels of osteoblast expressed genes in control cultures of subcultivated cells where nodule formation is diminished, to cells continuously (35 days) exposed to 10(-7) M dexamethasone, a synthetic glucocorticoid, which promotes nodule formation to levels usually the extent observed in primary cultures. Tritiated thymidine labelling revealed a selective inhibition of internodule cell proliferation and promotion of proliferation and differentiation of cells forming bone nodules. Fibronectin, osteopontin, and c-fos expression were increased in the nodule forming period. Alkaline phosphatase and type I collagen expression were initially inhibited in proliferating cells, then increased after nodule formation to support further growth and mineralization of the nodule. Expression of osteocalcin was 1,000-fold elevated in glucocorticoid-differentiated cultures in relation to nodule formation. Collagenase gene expression was also greater than controls (fivefold) with the highest levels observed in mature cultures (day 35). At this time, a rise in collagen and TGF beta was also observed suggesting turnover of the matrix. Short term (48 h) effects of glucocorticoid on histone H4 (reflecting cell proliferation), alkaline phosphatase, osteopontin, and osteocalcin mRNA levels reveal both up or down regulation as a function of the developmental stage of the osteoblast phenotype. A comparison of transcriptional levels of these genes by nuclear run-on assays to mRNA levels indicates that glucocorticoids exert both transcriptional and post-transcriptional effects. Further, the presence of glucocorticoids enhances the vitamin D3 effect on gene expression. Those genes which are upregulated by 1,25(OH)2D3 are transcribed at an increased rate by dexamethasone, while those genes which are inhibited by vitamin D3 remain inhibited in the presence of dexamethasone and D3. We propose that the glucocorticoids promote changes in gene expression involved in cell-cell and cell-extracellular matrix signaling mechanisms that support the growth and differentiation of cells capable of osteoblast phenotype development and bone tissue-like organization, while inhibiting the growth of cells that cannot progress to the mature osteoblast phenotype in fetal rat calvarial cultures.

Resorption of implanted bone prepared from normal and warfarin-treated rats

Bone that was virtually depleted of the vitamin K-dependent protein, osteocalcin, and 93% reduced in the concentration of its characteristic amino acid, gamma-carboxyglutamic acid, was obtained from rats treated with warfarin for 6 wk. Osteocalcin-deficient bone particles were resistant to resorption when implanted subcutaneously in normal rats. The relative resorption was 60% of control bone, as measured by histomorphometry as percent of bone particles in the field. Additionally, the number of multinucleated cells around the bone particles was reduced by 54%. These data suggest that osteocalcin is an essential component for bone matrix to elicit progenitor-cell recruitment and differentiation necessary for bone resorption.

Effects of selenium source and level of supplementation on the performance and meat quality of lambs

Objective of this study was to evaluate the performance, the quality and oxidative stability of meat, the total Se and specific selenoamino-acids content of muscle of lambs that were fed diets supplemented from different Se sources and at different levels. Forty-eight Apennine lambs 30day old (12.78±0.94kg) received, during a 63day period, a total mixed ration (TMR) which was either Se unsupplemented (Control group - background only- 0.13mg/kg Se) or supplemented with Na selenite (0.30mg/kg Se as sodium selenite) or selenium enriched yeast (0.30mg/kg and 0.45mg/kg Se as Se-yeast). Growth performance, feed to gain ratio, carcass and meat quality (pH, drip and cooking losses, colour, GSH-Px activity and chemical analysis) did not show any difference between the treatments. Meat colour and oxidative stability during 9 days of refrigerated storage were unaffected by dietary supplementation, suggesting that, at the levels of Se used in this experiment, dietary Se, even from an organic source, had limited potential for reducing lipid oxidation. Selenium supplementation raised the Se content in muscle (P<0.001) with the greatest increase when Se-yeast was fed. Although selenite increased total Se, it did not influence total or specific selenoamino-acids in this tissue. On the contrary, Se-yeast supplementation led to an increase in muscle Se-methionine content. We conclude that Se supplementation can increase significantly muscle Se levels and produce, particularly when Se-yeast is fed, a source of Se enriched meat as Se-methionine.

Accretion rates of meteorites and cosmic dust in the Early Ordovician

Abundant fossil meteorites in marine, condensed Lower Ordovician limestones from Kinnekulle, Sweden, indicate that accretion rates of meteorites were one to two orders of magnitude higher during an interval of the Early Ordovician than at present. Osmium isotope and iridium analyses of whole-rock limestone indicate a coeval enhancement of one order of magnitude in the influx rate of cosmic dust. Enhanced accretion of cosmic matter may be related to the disruption of the L chondrite parent body around 500 million years ago.

2,3,7,8-Tetrachlorodibenzo-p-dioxin inhibits differentiation of normal diploid rat osteoblasts in vitro

The influence of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a potent halogenated aromatic hydrocarbon, on the development of bone tissue-like organization in primary cultures of normal diploid calvarial-derived rat osteoblasts was examined. Initially, when placed in culture, these cells actively proliferate while expressing genes associated with biosynthesis of the bone extracellular matrix. Then, post-proliferatively, genes are expressed that render the osteoblast competent for extracellular matrix mineralization and maintenance of structural as well as functional properties of the mature bone-cell phenotype. Our results indicate that, in the presence of TCDD, proliferation of osteoblasts was not inhibited but post-confluent formation of multicellular nodules that develop bone tissue-like organization was dramatically suppressed. Consistent with TCDD-mediated abrogation of bone nodule formation, expression of alkaline phosphatase and osteocalcin was not upregulated post-proliferatively. These findings are discussed within the context of TCDD effects on estrogens and vitamin D-responsive developmental gene expression during osteoblast differentiation and, from a broader biological perspective, on steroid hormone control of differentiation.

Hepatocellular carcinoma. Prognostic factors and survival analysis in 135 Italian patients

This is a retrospective study to evaluate the history of hepatocellular carcinoma and find the relationship between clinical, biochemical and ultrasonographic features and survival in Italian patients. In 135 consecutive patients median follow-up was 16 months (range 1-66 months) and median survival from the time of diagnosis was 12 months. Univariate analysis showed that individual variables associated with significantly decreased survival included: absence of therapy, Okuda's Stage III, Child-Pugh's Class C, alpha-fetoprotein greater than 400 ng/ml, presence of symptoms, moderate or severe ascites, tumor involving both lobes, mixed internal echo pattern, and multinodular or massive type. Multiple regression analysis (Cox model) revealed that the mixed internal echo pattern of hepatocellular carcinoma, the presence of moderate or severe ascites and Okuda's Stage III were independent predictors of high risk of death. These data can help in selecting patients whose probability of survival is considered high enough to undergo treatment and may be useful for stratifying patients in randomized controlled trials.

A new type of solar-system material recovered from Ordovician marine limestone

From mid-Ordovician ∼470 Myr-old limestone >100 fossil L-chondritic meteorites have been recovered, representing the markedly enhanced flux of meteorites to Earth following the breakup of the L-chondrite parent body. Recently one anomalous meteorite, Österplana 065 (Öst 65), was found in the same beds that yield L chondrites. The cosmic-ray exposure age of Öst 65 shows that it may be a fragment of the impactor that broke up the L-chondrite parent body. Here we show that in a chromium versus oxygen-isotope plot Öst 65 falls outside all fields encompassing the known meteorite types. This may be the first documented example of an 'extinct' meteorite, that is, a meteorite type that does not fall on Earth today because its parent body has been consumed by collisions. The meteorites found on Earth today apparently do not give a full representation of the kind of bodies in the asteroid belt ∼500 Myr ago.

Dexamethasone ester treatment alters insulin-like growth factor-I, its binding proteins and thyroid status in finishing calves

To improve carcass quality in finishing calves, some breeders use preparations containing corticoids alone or in association with other growth promoters. We have investigated the effects of dexamethasone treatment on insulin-like growth factor-I (IGF-I), IGF-binding proteins (IGFBP-2 and 3) and thyroid hormones (T3, T4, free T4). Limousine male calves were allocated to a control group (C) (n = 18) and a group (n = 18) that received dexamethasone esters (DEX). Blood and hepatic tissue samples were collected at slaughtering. Thyroid hormones and IGF-I plasma levels were measured by RIA and IGFBPs were evaluated by immunoblotting. Hepatic type I 5′deiodinase (5′D-I) activity was determined by enzyme assay and hepatic expression of mRNA for GH receptor, IGF-I, IGFBP-2, IGFBP-3 and type I deiodinase (D-I) was evaluated by dot blot analysis. Plasma IGF-I and IGFBP-3 levels were reduced by the DEX treatment (P < 0.001 and P < 0.01, respectively) while IGFBP-2 was unaffected. Significant plasma changes for IGF-I and IGFBP-3 were not corroborated by hepatic mRNA levels, for which only a slight non-significant decrease was noted. Growth hormone receptor mRNA expression was increased after treatment (P < 0.01). T3 plasma level was higher in DEX animals (P < 0.05) than in C calves. Finally, treatment increased 5′D-I activity in the hepatic tissue (P < 0.001) and seemed to also affect D-I mRNA expression (P = 0.1). In conclusion, dexamethasone ester injection in calves altered some of their endocrinological parameters; this could explain the catabolic action of corticoids in the bovine species. Key words: Calves, corticoids, IGF-I, IGFBPs, thyroid axis

Innovation in the solid waste management industry: Integrating neoclassical and complexity theory perspectives

Often considered a traditional labour intensive activity, in recent years, the solid waste management (SWM) industry has been largely interested in innovation. Nonetheless, the analysis of innovations in the SW industry is frequently confined to process innovation in the disposal segment, neglecting other kinds of innovation - such as product innovation and organizational innovation - in other segments. While several economic theoretical frameworks have been developed for interpreting eco-innovation in general, a specific analysis of innovation in each segment of SWM is still missing, despite the specificities of this sector. To fill this gap, this paper shows how complexity theory can be profitably used to integrate the more traditional neoclassical approach, offering a comprehensive theoretical framework to analyse innovation in the SWM industry from both a market and firm perspective (the neoclassical approach) and from a social perspective (the complexity theory framework). Four main typologies of the SW market system, exhibiting different kinds of innovation, are outlined: (i) a "traditional" landfill-oriented system; (ii) a modern "waste-to-energy" incinerator-oriented system; (iii) a "light recycling" system with integrated solutions and a selection performance that is lower than 50%; and (iv) a "hard recycling" system.

Investigating the Influence of Intergroup Contact in Virtual Reality on Empathy: An Exploratory Study Using AltspaceVR

Virtual Reality (VR) has often been referred to as an "empathy machine." This is mostly because it can induce empathy through embodiment experiences in outgroup membership. However, the potential of intergroup contact with an outgroup avatar in VR to increase empathy is less studied. Even though intergroup contact literature suggests that less threatening and more prosocial emotions are the key to understanding why intergroup contact is a powerful mean to decrease prejudice, few studies have investigated the effect of intergroup contact on empathy in VR. In this study, we developed a between-participants design to investigate how VR can be used to create a positive intergroup contact with a member of a stigmatized outgroup (ethnic minority) and present the results of the effect of intergroup contact in VR on empathy. Sixty four participants experienced either positive contact (i.e., equal intergroup status, collaborative) with a black (experimenter-controlled) avatar (experimental condition) or no intergroup contact (i.e., ingroup contact with a white avatar; control condition), with situational empathy (personal distress and empathic interest) being measured through a self-report questionnaire up to a week before and right after the VR contact experience. The experiment showed that satisfying degrees of body ownership of participants' own avatar and co-presence with the contacted avatar can be achieved in simple and universally accessible virtual environments such as AltspaceVR. The results indicated that while VR intergroup contact had no significant direct effect on empathy, exploratory analyses indicated that post-intervention empathic interest increased with stronger feelings of co-presence in the intergroup contact condition.

The use of virtual reality in studying prejudice and its reduction: A systematic review

This systematic review provides an up-to-date analysis of existing literature about Virtual Reality (VR) and prejudice. How has VR been used in studying intergroup attitudes, bias and prejudice, are VR interventions effective at reducing prejudice, and what methodological advantages and limitations does VR provide compared to traditional methods are the questions we aim to answer. The included studies had to use VR to create an interaction with one or more avatars belonging to an outgroup, and/or embodiment in an outgroup member; furthermore, they had to be quantitative and peer-reviewed. The review of the 64 included studies shows the potential of VR contact to improve intergroup relations. Nevertheless, the results suggest that under certain circumstances VR contact can increase prejudice as well. We discuss these results in relation to the intergroup perspective (i.e., minority or majority) and target minority groups used in the studies. An analysis of potential mediators and moderators is also carried out. We then identify and address the most pressing theoretical and methodological issues concerning VR as a method to reduce prejudice.

[Hemimandibular reconstruction via an autologous transplant of vascularized fibula. A report of a clinical case]

The authors illustrate the advantage of vascularised as opposed to conventional edges in the reconstruction of the jaw, focusing in particular on the use of a fibular autologous transplant. After a rapid description of the surgical technique used to remove the graft, they report a case of mandibular reconstruction in a young patient who had been involved in a shooting accident which had led to the loss of the left of this jaw.

[Madrepore as a bone filler]

The authors studied the behaviour of the porite type coral which has been previously implanted in man in order to get a reparation of osseous and parodontal defects. The histomorfological exam (at the optical microscope, SEM and X-Ray microscope) of a non decalcified bioptic piece, which had been obtained with an appropriate instrument, shows a deposition of neoformed bone around the coral. Six months after the implantation the tissue was stable without any osteoclasts in activity; even the implanted coral grains had not been attached by them. The Authors agree with most of the statements made by Souyris et Al., but they do not believe in the total substitution of the coral with the bone, at least not in short terms: therefore further scientific works will be necessary to clear this point.

Supportive but biased: Perceptual neural intergroup bias is sensitive to minor reservations about supporting outgroup immigration

While decreasing negative attitudes against outgroups are often reported by individuals themselves, biased behaviour prevails. This gap between words and actions may stem from unobtrusive mental processes that could be uncovered by using neuroimaging in addition to self-reports. In this study we investigated whether adding neuroimaging to a traditional intergroup bias measure could detect intersubject differences in intergroup bias processes in a societal context where opposing discrimination is normative. In a sample of 43 Finnish students, implicit behavioural measures failed to indicate intergroup bias against Middle Eastern and Muslim immigrants, and explicit measures reported rather positive attitudes and sentiments towards that targeted group. Yet, while implementing a repeatedly validated method for detecting intergroup bias, an implicit association paradigm presenting stereotypical ingroup and outgroup face stimuli while undergoing magnetoencephalography, we detected a clear neural difference between two experimental conditions. The neural effect is thought to reflect intergroup bias in the valence of the associations that faces evoke. The activity cluster of the neural bias peaked in BA37 and included significant activity in the fusiform gyrus, which has been repeatedly found to be active during face perception bias. Importantly, this neural pattern was driven by participants who were explicitly favourable of immigration - but to a lesser extent than others. These findings suggest that such variations in explicit support of immigration are associated with the differential neural sensitivity to the congruency of associations between intergroup faces and valence. This research showcases the potential of neuroimaging to unravel covert perceptual bias against outgroup members and its sensitivity to small variations in explicit attitudes.

Fingerprint patterns of human brain activity reveal a dynamic mix of emotional responses during virtual intergroup encounters

The Stereotype Content Model (SCM) states that different social groups elicit different emotions according to their perceived level of competence and warmth. Because of this relationship between stereotypes and emotional states and because emotions are highly predictive of intergroup behaviors, emotional evaluation is crucial for research on intergroup relations. However, emotional assessment heavily relies on self-reports, which are often compromised by social desirability and challenges in reporting immediate emotional appraisals. In this study, we used machine learning to identify emotional brain patterns using functional magnetic resonance imaging. Subsequently, those patterns were used to monitor emotional reactions during virtual intergroup encounters. Specifically, we showed Finnish majority group members 360-videos depicting members of their ethnic ingroup and immigrant outgroups approaching and entering participants' personal space. All the groups showed different levels of perceived competence and warmth. In alignment with the SCM, our results showed that the groups perceived as low in competence and warmth evoked contempt and discomfort. Moreover, the ambivalent low-competent/high-warm group elicited both happiness and discomfort. Additionally, upon the protagonists' approach into personal space, emotional reactions were modulated differently for each group. Taken together, our findings suggest that our method could be used to explore the temporal dynamics of emotional responses during intergroup encounters.