Lymphogranuloma venereum detected from the pharynx in four London men who have sex with men

Summary

Lymphogranuloma venereum (LGV) is an established cause of proctitis in men who have sex with men (MSM). Currently in the UK, testing for pharyngeal Chlamydia trachomatis (CT) is not routine, and LGV typing is usually only performed in patients with anorectal symptoms. We report four cases where LGV-associated CT DNA was detected from the pharynx in MSM, demonstrating that nucleic acid amplification testing (NAAT) can be used for detecting and typing pharyngeal CT infection. These cases also highlight other possible routes of infection for LGV, and add to the broad spectrum of clinical presentations associated with this infection.

Hippocampal "time cells": time versus path integration

Recent studies have reported the existence of hippocampal "time cells," neurons that fire at particular moments during periods when behavior and location are relatively constant. However, an alternative explanation of apparent time coding is that hippocampal neurons "path integrate" to encode the distance an animal has traveled. Here, we examined hippocampal neuronal firing patterns as rats ran in place on a treadmill, thus "clamping" behavior and location, while we varied the treadmill speed to distinguish time elapsed from distance traveled. Hippocampal neurons were strongly influenced by time and distance, and less so by minor variations in location. Furthermore, the activity of different neurons reflected integration over time and distance to varying extents, with most neurons strongly influenced by both factors and some significantly influenced by only time or distance. Thus, hippocampal neuronal networks captured both the organization of time and distance in a situation where these dimensions dominated an ongoing experience.

Place cell activation predicts subsequent memory

A major quandary in memory research is how hippocampal place cells, widely recognized as elements of a spatial map, contribute to episodic memory, our capacity to remember unique experiences that depends on hippocampal function. Here we recorded from hippocampal neurons as rats performed a T-maze alternation task in which they were required to remember a preceding experience over a delay in order to make a subsequent spatial choice. As it has been reported previously in other variations of this task, we observed differential firing that predicted correct subsequent choices, even as the animal traversed identical locations prior to the choice. Here we also observed that most place cells also fired differently on correct as compared to error trials. Among these cells, a large majority fired strongly before the delay or during the retrieval phase but were less active or failed to activate when the animal subsequently made an error. These findings join the place cell phenomenon with episodic memory performance dependent on the hippocampus, revealing that memory accuracy can be predicted by the activation of single place cells in the hippocampus.

Performance of the GeneXpert CT/NG assay compared to that of the Aptima AC2 assay for detection of rectal Chlamydia trachomatis and Neisseria gonorrhoeae by use of residual Aptima Samples

There are currently no commercially available molecular assays for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in rectal swabs with regulatory approval. We compared the Cepheid GeneXpert CT/NG assay with the GenProbe Aptima Combo2 assay, using 409 rectal swabs. Using Aptima as the gold standard, the sensitivity, specificity, and positive and negative predictive values of GeneXpert for the detection of C. trachomatis and N. gonorrhoeae were 86%, 99.2%, 92.5%, and 98.4% and 91.1%, 100%, 100%, and 98.6%, respectively. Despite significant dilution of samples prior to GeneXpert testing, the assay performed well with excellent specificity.

Simulation analysis of contact angles and retention forces of liquid drops on inclined surfaces

A simulation study of liquid drops on inclined surfaces is performed in order to understand the evolution of drop shapes, contact angles, and retention forces with the tilt angle. The simulations are made by means of a method recently developed for dealing with contact angle hysteresis in the public-domain Surface Evolver software. The results of our simulations are highly dependent on the initial contact angle of the drop. For a drop with an initial contact angle equal to the advancing angle, we obtain results similar to those of experiments in which a drop is placed on a horizontal surface that is slowly tilted. For drops with an initial contact angle equal to the mean between the advancing and the receding contact angles, we recover previous results of finite element studies of drops on inclined surfaces. Comparison with experimental results for molten Sn-Ag-Cu on a tilted Cu substrate shows excellent agreement.

Short conduction delays cause inhibition rather than excitation to favor synchrony in hybrid neuronal networks of the entorhinal cortex

How stable synchrony in neuronal networks is sustained in the presence of conduction delays is an open question. The Dynamic Clamp was used to measure phase resetting curves (PRCs) for entorhinal cortical cells, and then to construct networks of two such neurons. PRCs were in general Type I (all advances or all delays) or weakly type II with a small region at early phases with the opposite type of resetting. We used previously developed theoretical methods based on PRCs under the assumption of pulsatile coupling to predict the delays that synchronize these hybrid circuits. For excitatory coupling, synchrony was predicted and observed only with no delay and for delays greater than half a network period that cause each neuron to receive an input late in its firing cycle and almost immediately fire an action potential. Synchronization for these long delays was surprisingly tight and robust to the noise and heterogeneity inherent in a biological system. In contrast to excitatory coupling, inhibitory coupling led to antiphase for no delay, very short delays and delays close to a network period, but to near-synchrony for a wide range of relatively short delays. PRC-based methods show that conduction delays can stabilize synchrony in several ways, including neutralizing a discontinuity introduced by strong inhibition, favoring synchrony in the case of noisy bistability, and avoiding an initial destabilizing region of a weakly type II PRC. PRCs can identify optimal conduction delays favoring synchronization at a given frequency, and also predict robustness to noise and heterogeneity.

Individual oscillators, such as pendulum-based clocks and fireflies, can spontaneously organize into a coherent, synchronized entity with a common frequency. Neurons can oscillate under some circumstances, and can synchronize their firing both within and across brain regions. Synchronized assemblies of neurons are thought to underlie cognitive functions such as recognition, recall, perception and attention. Pathological synchrony can lead to epilepsy, tremor and other dynamical diseases, and synchronization is altered in most mental disorders. Biological neurons synchronize despite conduction delays, heterogeneous circuit composition, and noise. In biological experiments, we built simple networks in which two living neurons could interact via a computer in real time. The computer precisely controlled the nature of the connectivity and the length of the communication delays. We characterized the synchronization tendencies of individual, isolated oscillators by measuring how much a single input delivered by the computer transiently shortened or lengthened the cycle period of the oscillation. We then used this information to correctly predict the strong dependence of the coordination pattern of the firing of the component neurons on the length of the communication delays. Upon this foundation, we can begin to build a theory of the basic principles of synchronization in more complex brain circuits.

Theory and simulation of angular hysteresis on planar surfaces

A simple model is proposed to simulate contact angle hysteresis in drops on a planar surface. The model is based on assuming a friction force acting on the triple contact line in such a way that the contact line keeps fixed for contact angles comprised between the advancing angle and the receding one and is allowed to move in order to avoid angles outside this interval. The model is straightforwardly applied to axisymmetric drops for which a simple solution of the Young-Laplace equation can be obtained. A variation of the method has also been implemented for nonaxisymmetric drops by resorting to the public-domain "Surface Evolver" software. Comparison with experiments shows the excellent performance of the model.

Entropic selectivity of binary mixtures in cylindrical pores

We show that a simple model consisting of a binary hard-sphere mixture in a narrow cylindrical pore can lead to strong size selectivity by considering a situation where each species of the mixture sees a different radius of the cylinder. Two mechanisms are proposed to explain the observed results depending on the radius of the cylinder: for large radii the selectivity is driven by an enhancement of the depletion forces at the cylinder walls whereas for the narrowest cylinders excluded-volume effects lead to a shift of the effective chemical potential of the particles in the pore.

Seven days of doxycycline is an effective treatment for asymptomatic rectal Chlamydia trachomatis infection

There are no evidence-based guidelines for the specific management of rectal Chlamydia trachomatis (CT) infection. All men who have sex with men (MSM) diagnosed with asymptomatic rectal CT by nucleic acid amplification test (NAAT) at a large London genitourinary (GU) medicine clinic between September 2006 and September 2009 were offered oral doxycycline 100 mg twice daily for seven days and invited for a test of cure (TOC) by CT NAAT four weeks after treatment. A total of 487 asymptomatic rectal CT infections were diagnosed and analysis was restricted to 165 TOCs from men whose only treatment had been doxycycline for seven days. The median time post-treatment for TOC was 45 days (interquartile range [IQR], 34–88). Only two patients tested CT-positive at follow-up. One had taken doxycycline only for three days; the other attended for TOC 240 days after the completion of doxycycline treatment and at this time presented with new symptoms in the context of ongoing high sexual risk. Our findings show that doxycycline 100 mg twice daily for seven days is highly effective treatment for asymptomatic rectal CT infection, achieving clearance of CT in 98.8% (163/165; 95% CI 95.4–99.9%) of cases. We advocate doxycycline for seven days as first-line therapy for asymptomatic rectal CT.

GenNet: A Platform for Hybrid Network Experiments

We describe General Network (GenNet), a software plugin for the real time experimental interface (RTXI) dynamic clamp system that allows for straightforward and flexible implementation of hybrid network experiments. This extension to RTXI allows for hybrid networks that contain an arbitrary number of simulated and real neurons, significantly improving upon previous solutions that were limited, particularly by the number of cells supported. The benefits of this system include the ability to rapidly and easily set up and perform scalable experiments with hybrid networks and the ability to scan through ranges of parameters. We present instructions for installing, running and using GenNet for hybrid network experiments and provide several example uses of the system.

The mechanism of abrupt transition between theta and hyper-excitable spiking activity in medial entorhinal cortex layer II stellate cells

Recent studies have shown that stellate cells (SCs) of the medial entorhinal cortex become hyper-excitable in animal models of temporal lobe epilepsy. These studies have also demonstrated the existence of recurrent connections among SCs, reduced levels of recurrent inhibition in epileptic networks as compared to control ones, and comparable levels of recurrent excitation among SCs in both network types. In this work, we investigate the biophysical and dynamic mechanism of generation of the fast time scale corresponding to hyper-excitable firing and the transition between theta and fast firing frequency activity in SCs. We show that recurrently connected minimal networks of SCs exhibit abrupt, threshold-like transition between theta and hyper-excitable firing frequencies as the result of small changes in the maximal synaptic (AMPAergic) conductance. The threshold required for this transition is modulated by synaptic inhibition. Similar abrupt transition between firing frequency regimes can be observed in single, self-coupled SCs, which represent a network of recurrently coupled neurons synchronized in phase, but not in synaptically isolated SCs as the result of changes in the levels of the tonic drive. Using dynamical systems tools (phase-space analysis), we explain the dynamic mechanism underlying the genesis of the fast time scale and the abrupt transition between firing frequency regimes, their dependence on the intrinsic SC's currents and synaptic excitation. This abrupt transition is mechanistically different from others observed in similar networks with different cell types. Most notably, there is no bistability involved. 'In vitro' experiments using single SCs self-coupled with dynamic clamp show the abrupt transition between firing frequency regimes, and demonstrate that our theoretical predictions are not an artifact of the model. In addition, these experiments show that high-frequency firing is burst-like with a duration modulated by an M-current.

Phase-response curves and synchronized neural networks

We review the principal assumptions underlying the application of phase-response curves (PRCs) to synchronization in neuronal networks. The PRC measures how much a given synaptic input perturbs spike timing in a neural oscillator. Among other applications, PRCs make explicit predictions about whether a given network of interconnected neurons will synchronize, as is often observed in cortical structures. Regarding the assumptions of the PRC theory, we conclude: (i) The assumption of noise-tolerant cellular oscillations at or near the network frequency holds in some but not all cases. (ii) Reduced models for PRC-based analysis can be formally related to more realistic models. (iii) Spike-rate adaptation limits PRC-based analysis but does not invalidate it. (iv) The dependence of PRCs on synaptic location emphasizes the importance of improving methods of synaptic stimulation. (v) New methods can distinguish between oscillations that derive from mutual connections and those arising from common drive. (vi) It is helpful to assume linear summation of effects of synaptic inputs; experiments with trains of inputs call this assumption into question. (vii) Relatively subtle changes in network structure can invalidate PRC-based predictions. (viii) Heterogeneity in the preferred frequencies of component neurons does not invalidate PRC analysis, but can annihilate synchronous activity.

Endosymbiont costs and benefits in a parasitoid infected with both Wolbachia and Cardinium

Theory suggests that maternally inherited endosymbionts can promote their spread and persistence in host populations by enhancing the production of daughters by infected hosts, either by improving overall host fitness, or through reproductive manipulation. In the doubly infected parasitoid wasp Encarsia inaron, Wolbachia manipulates host reproduction through cytoplasmic incompatibility (CI), but Cardinium does not. We investigated the fitness costs and/or benefits of infection by each bacterium in differentially cured E. inaron as a potential explanation for persistence of Cardinium in this population. We introgressed lines infected with Wolbachia, Cardinium or both with the cured line to create a similar genetic background, and evaluated several parasitoid fitness parameters. We found that symbiont infection resulted in both fitness costs and benefits for E. inaron. The cost was lower initial egg load for all infected wasps. The benefit was increased survivorship, which in turn increased male production for wasps infected with only Cardinium. Female production was unaffected by symbiont infection; we therefore have not yet identified a causal fitness effect that can explain the persistence of Cardinium in the population. Interestingly, the Cardinium survivorship benefit was not evident when Wolbachia was also present in the host, and the reproduction of doubly infected individuals did not differ significantly from uninfected wasps. Therefore, the results of our study show that even when multiple infections seem to have no effect on a host, there may be a complex interaction of costs and benefits among symbionts.

Mechanisms of coherent activity in hippocampus and entorhinal cortex

We consider the mechanisms by which coherent activity arises in the hippocampus and entorhinal cortex, two brain areas that are associated with episodic memory in humans and similar forms of memory in animal models. Our approach relies upon techniques from the theory of coupled oscillators. We show that such techniques can yield accurate predictions of the behavior of synaptically coupled neurons. Future work will expand upon these techniques to include real-world complications that better mimic the in vivo state.

Glycinergic inhibition in the hippocampus

Glycine and GABA are the two main inhibitory neurotransmitters in the central nervous system (CNS). While GABA receptors in the hippocampus have been studied in great detail, the role of glycine receptors (GlyRs) in the hippocampus is less understood. Here we examine recent evidence suggesting that GlyRs are present and active throughout the hippocampus. Extracellular glycine levels are controlled through a combination of release and transport mechanisms, both of which, along with the GlyRs themselves, can be modulated by a number of factors. We discuss the role of GlyRs in suppressing excitation by decreasing postsynaptic membrane resistance in the hippocampus, as well as the contribution of GlyRs to both short- and long-term plasticity.

Dynamical instability determines the effect of ongoing noise on neural firing

At low stimulation rates, electrically stimulated auditory nerve fibers typically fire regularly, in lock-step to the applied stimulus. At high stimulation rates, however, these same fibers fire irregularly. Firing irregularity has been attributed to the random opening and closing of voltage-gated sodium channels at the spike generation site. We demonstrate, however, that the nonlinear dynamics of neural excitation and refractoriness embodied in the FitzHugh-Nagumo (FN) model produce realistic firing irregularity at high stimulus rates, even in the complete absence of ongoing physiological noise. Indeed, we show that ongoing noise can actually regularize the response at low discharge rates. The degree of stimulus-dependent irregularity is determined not so much by the level of ongoing physiological noise as by the dynamical instability. Our work suggests that the dynamical instability, quantified by the Lyapunov exponent, controls neural sensitivity to input signals and to physiological noise, as well the amount of mutual desynchronization between similarly stimulated fibers. This instability, quantified by the value of the Lyapunov exponent, may play a critical role in determining modulation sensitivity and dynamic range in cochlear implants.

Preoperative embolization of cerebral arteriovenous malformations with onyx

BACKGROUND AND PURPOSE

Preoperative embolization facilitates the surgical management of complex cerebral arteriovenous malformations (cAVMs). This analysis aims to investigate the risks for preoperative cAVM embolization with Onyx.

MATERIALS AND METHODS

We retrospectively analyzed clinical data of all patients who underwent embolization with Onyx as a preoperative treatment of cAVMs at our institution since 2005 (US Food and Drug Administration [FDA] approval). Patients with arteriovenous fistulas were excluded. A total of 107 patients were treated for cAVMs during the study period. Of those patients, 41 underwent cAVM embolizations with Onyx in 82 procedures.

RESULTS

After the embolization, the cAVM diameter was reduced from 3.71 +/- 1.55 cm to 3.06 +/- 1.89 cm (P < .05). Median volume reduction was 75%. Complete occlusion with embolization alone was achieved in 4 (10%) cAVMs. The recurrence rate for completely occluded cAVMs was 50% (2 patients). A total of 71% of the 41 patients treated with Onyx underwent surgery, and 15% underwent radiosurgery. There were 9% who have not yet received definitive treatment of their residual cAVMs. A new permanent neurologic deficit occurred in 5 patients (6.1% per procedure or 12.2% per patient).

CONCLUSIONS

A considerable risk for a permanent neurologic deficit remains for cAVM embolization with Onyx. The risk has to be carefully weighted against the benefit of volume reduction in the treatment of cAVMs.

Cytoplasmic incompatibility in the parasitic wasp Encarsia inaron: disentangling the roles of Cardinium and Wolbachia symbionts

Many bacterial endosymbionts of insects are capable of manipulating their host's reproduction for their own benefit. The most common strategy of manipulation is cytoplasmic incompatibility (CI), in which embryonic mortality results from matings between uninfected females and infected males. In contrast, embryos develop normally in infected females, whether or not their mate is infected, and infected progeny are produced. In this way, the proportion of infected females increases in the insect population, thereby promoting the spread of the maternally inherited bacteria. However, what happens when multiple endosymbionts inhabit the same host? The parasitoid wasp Encarsia inaron is naturally infected with two unrelated endosymbionts, Cardinium and Wolbachia, both of which have been documented to cause CI in other insects. Doubly infected wasps show the CI phenotype. We differentially cured E. inaron of each endosymbiont, and crossed hosts of different infection status to determine whether either or both bacteria caused the observed CI phenotype in this parasitoid, and whether the two symbionts interacted within their common host. We found that Wolbachia caused CI in E. inaron, but Cardinium did not. We did not find evidence that Cardinium was able to modify or rescue Wolbachia-induced CI, nor did we find that Cardinium caused progeny sex ratio distortion, leaving the role of Cardinium in E. inaron a mystery.