The Human Affectome

Over the last decades, theoretical perspectives in the interdisciplinary field of the affective sciences have proliferated rather than converged due to differing assumptions about what human affective phenomena are and how they work. These metaphysical and mechanistic assumptions, shaped by academic context and values, have dictated affective constructs and operationalizations. However, an assumption about the purpose of affective phenomena can guide us to a common set of metaphysical and mechanistic assumptions. In this capstone paper, we home in on a nested teleological principle for human affective phenomena in order to synthesize metaphysical and mechanistic assumptions. Under this framework, human affective phenomena can collectively be considered algorithms that either adjust based on the human comfort zone (affective concerns) or monitor those adaptive processes (affective features). This teleologically-grounded framework offers a principled agenda and launchpad for both organizing existing perspectives and generating new ones. Ultimately, we hope the Human Affectome brings us a step closer to not only an integrated understanding of human affective phenomena, but an integrated field for affective research.

The need for maternal critical care education, point-of-care ultrasound and critical care echocardiography in obstetric anesthesiologists training

Globally, the increase in medically complex obstetric patients is challenging the educational approach and clinical management of critically ill obstetric patients. This increase in medical complexity calls into question the educational paradigm in which future physicians are trained. Obstetric anesthesiologists, physician experts in the perio-perative planning and management of complex obstetric patients, represent an essential workforce in the strategies to address maternal mortality. Unfortunately, the development of peri-operative medicine and maternal critical care curricula has only received minor attention in most countries. Proposed guidelines and models highlight the existing need for tiered maternity care services in which critical care infrastructure plays a central role in the delivery of high-risk peripartum care. Therefore, the development of maternal critical care models designed to prepare obstetric anesthesiologists for the clinical challenges of a medically complex patient are warranted. Key critical care topics such as advanced ultrasonography, with the inclusion of quantitative echocardiographic assessments into obstetric anesthesiology educational curricula, will serve to better prepare physicians for the realities of an increasingly complex pregnant patient population, and further reinforce the critical care infrastructure detailed in the Levels of Maternal Care consensus. Despite an increasingly complex obstetric patient population, heterogeneity of maternal critical care practices exists across the globe, warranting standardization and further development of proposed curricula.

A sensorimotor control framework for understanding emotional communication and regulation

Our research team was asked to consider the relationship of the neuroscience of sensorimotor control to the language of emotions and feelings. Actions are the principal means for the communication of emotions and feelings in both humans and other animals, and the allostatic mechanisms controlling action also apply to the regulation of emotional states by the self and others. We consider how motor control of hierarchically organised, feedback-based, goal-directed action has evolved in humans, within a context of consciousness, appraisal and cultural learning, to serve emotions and feelings. In our linguistic analysis, we found that many emotion and feelings words could be assigned to stages in the sensorimotor learning process, but the assignment was often arbitrary. The embodied nature of emotional communication means that action words are frequently used, but that the meanings or senses of the word depend on its contextual use, just as the relationship of an action to an emotion is also contextually dependent.

Resource use and Costs for a Glaucoma Screening Program in Austria: An 8-Year Review.: A Cost-Consequence Analysis Based on the Salzburg-Moorfields Collaborative Glaucoma Study

Purpose

The aim of this study is to report costs, detection rates, and resources needed for detection of primary open angle glaucoma and related diseases in a glaucoma screening program in Salzburg, Austria, over a period of 8 years.

Methods

The Salzburg-Moorfields Collaborative Glaucoma Study performed a complete ophthalmologic examination on a total of 4864 subjects within a study period of approximately 8 years (98 months). The total numbers reported are total number of subjects screened at the initial examination and follow-up examinations; total working hours and estimated working hours per visit for one ophthalmologist and two medical assistants; direct costs per visit; detection rates for subjects; and corresponding costs per true positive case diagnosed with definite primary open angle glaucoma (POAG), early POAG, POAG suspect, ocular hypertension (OHT), and glaucoma artefact.

Results

Within the screening period of 98 months, a total of 9427 examinations and second verification checks were performed: 5466 at the initial examination, 404 at the 1-year follow-up, 815 at the 2-year follow-up, 339 at the 3-year follow-up, 225 at the 4-year follow-up, 1059 at the 5-year follow-up, 996 at the 6-year follow-up, 118 at the 7-year follow-up, and 5 at the 8-year follow-up. The total amount of time spent for screening was 23,814 working hours. We estimate the costs per visit at EUR 123 for each initial examination, EUR 28 for each second confirmation check, and EUR 95 per follow-up examination. The following detection rates were observed: definite POAG: 1.7% (95% CI: 1.3–2.2%), early POAG: 2.9% (95% CI: 2.3–3.5%), POAG suspect: 8.5% (95% CI: 7.6–9.4%), OHT: 2.2% (95% CI: 1.7–2.7%), glaucoma artefact or other causes: 5.8% (95% CI: 5.1–6.6%), normal cases: 79% (95% CI: 78–80%).

Conclusions

Direct costs per visit were considerably higher than those reported in the Netherlands or the United Kingdom. If a health care provider decides to perform a glaucoma screening within this setting, the costs for the detection of a new case are EUR 7250 for definite POAG, EUR 4250 for early POAG, EUR 1450 for POAG suspect, EUR 5600 for OHT, EUR 2100 for glaucoma artefact case, and EUR 156 for a normal case.

Short cut of protein purification by integration of cell-disrupture and affinity extraction

Screening strategies based on functional genomics require the isolation of gene products of several hundred cDNA clones in a fast and versatile manner. Conventional purification strategies will fail to accomplish this goal within a reasonable time frame. In order to short-cut these procedures, we have developed a combination of cell disintegration and affinity technique for rapid isolation and purification. For our purpose, tagged proteins have been produced in yeast by fusing the FLAG-sequence adjacent to the 5' end of cDNAs coding for the respective protein. The example of an over-expressed FLAG-tagged fusion protein, human serum albumin (HSA), was released into the cytoplasm. Detection and purification of the FLAG-fusion protein were carried out by using a mouse monoclonal antibody directed against the FLAG-peptide. For purification purposes, the antibody was immobilized on PROSEP magnetic glass beads. These magnetic glass beads with 500 microns diameter have been investigated for disintegration of yeast and simultaneous capturing of the target protein. After 60 s, 90% of the maximal disintegration level was achieved when a ratio of 20 microliters yeast cell suspension and 100 microliters glass are vortexed. After a wash step, the FLAG-fusion proteins have been eluted with chelating agents such as EDTA. The short-cut procedure has been compared to a conventional purification strategy using an affinity chromatography process. Due to the highly favorable binding characteristics of the applied immunoaffinity sorbent the yield observed in batch operation was 90% and purity in the range of 70-80%.

Protein expression in yeast; comparison of two expression strategies regarding protein maturation

The driving force for the modification of existing, or the development of new, protein expression systems lies in the identification of a tremendous number of potential novel drug targets through recent genomics approaches. Saccharomyces cerevisiae as a host for recombinant protein expression, offers many advantages, as its biosynthetic pathways resemble higher eukaryotic cells in many aspects. Two yeast vectors were compared to evaluate the versatility of this organism for expression of recombinant proteins. One expression vector enables the secretion of the recombinant protein into the culture medium through fusion with the leader sequence of the mating-type pheromone alpha; the other directs the expression product into the cytoplasm of the yeast cell through fusion with ubiquitin. To facilitate immunological detection and purification, proteins were expressed as fusions to an octapeptide, the so-called Flag-tag, which is recognised by a monoclonal antibody in the presence of Ca2+. We chose 20 functionally different cDNAs to compare the efficiency of both expression systems. All cDNAs could be expressed at the correct size but at varying yields and purity. Both expression systems differed greatly in the degree of glycosylation and other, not further analysed, post-translational modifications. Secretion of all model proteins into the cell culture supernatant could be accomplished if membrane domains or signal sequences were absent, but many proteins were heavily glycosylated as demonstrated by lectin mapping or enzymatical deglycosylation. Some proteins, however, were expressed as homogenous products, and could be easily purified for further functional studies. Further investigations on the expression biology of yeast are required, in order to optimise the conditions of fermentation which may finally lead to more homogeneous expression products.

Protein expression strategies for identification of novel target proteins

Identification of new target proteins is a novel paradigm in drug discovery. A major bottleneck of this strategy is the rapid and simultaneous expression of proteins from differential gene expression to identify eligible candidates. By searching for a generic system enabling high throughput expression analysis and purification of unknown cDNAs, we evaluated the YEpFLAG-1 yeast expression system. We have selected cDNAs encoding model proteins (eukaryotic initiation factor-5A [eIF-5A] and Homo sapiens differentiation-dependent protein-A4) and cDNA encoding an unknown protein (UP-1) for overexpression in Saccharomyces cerevisiae using fusions with a peptide that changes its conformation in the presence of Ca2+ ions, the FLAG tag (Eastman Kodak, Rochester, NY). The cDNAs encoding unknown proteins originating from a directionally cloned cDNA library were expressed in all three possible reading frames. The expressed proteins were detected by an antibody directed against the FLAG tag and/or by antibodies against the model proteins. The alpha-leader sequence, encoding a yeast mating pheromone, upstream of the gene fusion site facilitates secretion into the culture supernatant. EIF-5A could be highly overexpressed and was secreted into the culture supernatant. In contrast, the Homo sapiens differentiation-dependent protein-A4 as well as the protein UP-1, whose cDNA did not match to any known gene, could not be detected in the culture supernatant. The expression product of the correct frame remained in the cells, whereas the FLAG-tagged proteins secreted into the supernatant were short, out-of-frame products. The presence of transmembrane domains or patches of hydrophobic amino acids may preclude secretion of these proteins into the culture supernatant. Subsequently, isolation and purification of the various proteins was accomplished by affinity chromatography or affinity extraction using magnetizable beads coated with the anti-FLAG monoclonal antibody. The purity of isolated proteins was in the range of 90%. In the case of unknown cDNAs, the expression product with the highest molecular mass was assumed to represent the correct reading frame. In summary, we consider the YEpFLAG-1 system to be a very efficient tool to overexpress and isolate recombinant proteins in yeast. The expression system enables high throughput production and purification of proteins under physiological conditions, and allows miniaturization into microtiter formats.