Modular Optoelectronic System for Wireless, Programmable Neuromodulation During Free Behavior

This work presents a modular, light-weight head-borne neuromodulation platform that achieves low-power wireless neuromodulation and allows real-time programmability of the stimulation parameters such as the frequency, duty cycle, and intensity. This platform is comprised of two parts: the main device and the optional intensity module. The main device is functional independently, however, the intensity control module can be introduced on demand. The stimulation is achieved through the use of energy-efficient µLEDs directly integrated in the custom-drawn fiber-based probes. Our platform can control up to 4 devices simultaneously and each device can control multiple LEDs in a given subject. Our hardware uses off-the-shelf components and has a plug and play structure, which allows for fast turn-over time and eliminates the need for complex surgeries. The rechargeable, battery-powered wireless platform uses Bluetooth Low Energy (BLE) and is capable of providing stable power and communication regardless of orientation. This presents a potential advantage over the battery-free, fully implantable systems that rely on wireless power transfer, which is typically direction-dependent, requires sophisticated implantation surgeries, and demands complex custom-built experimental apparatuses. Although the battery life is limited to several hours, this is sufficient to complete the majority of behavioral neuroscience experiments. Our platform consumes an average power of 0.5 mW, has a battery life of 12 hours.

Molecular Genetic and Immune Functional Responses Distinguish Bone Marrow Mesenchymal Stromal Cells from Hepatic Stellate Cells

Defining the immune physiology of culture-adapted mesenchymal stromal cells (MSCs) derived from distinct tissue compartments informs their potential utility as pharmaceuticals. Here, we have investigated the comparative immune plasticity of MSCs and hepatic stellate cells (HeSCs) isolated from human and murine bone marrow (BM) and liver, respectively. Although both BM-MSCs and HeSCs share mesenchymal phenotype and overall molecular genetic responses to inflammatory cues, HeSCs differ from BM-MSCs in a meaningful manner. We show that culture-adapted HeSCs express substantially higher levels of hepatocyte growth factor (HGF), matrix metalloproteinase-1, and chemokine (CC motif) ligand 2 (CCL2) than BM-MSCs. Both human BM-MSCs and HeSCs inhibit T-cell proliferation by a shared indoleamine 2,3-dioxygenase (IDO)-dependent mechanism. However, HeSCs are distinct from BM-MSCs by their significant differential expression of HGF, CCL2, IL-8, CCL11, and GMCSF when cocultured with and/or without activated peripheral blood mononuclear cells. We have investigated MSCs and HeSCs derived from murine systems to describe interspecies comparability. Murine BM-MSCs inhibit T-cell proliferation through inducible nitric oxide synthase (iNOS) but not IDO. However, murine HeSCs inhibit T-cell proliferation through a mechanism distinct from either IDO or iNOS. Altogether, these results suggest that although culture-adapted BM-MSCs and HeSCs display a similar phenotype, their secretome and immune plasticity are in part distinct likely mirroring their tissular origins. In addition, the discordance in immune biology between mouse and human sourced HeSC and BM-MSCs speaks to the importance of comparative biology when interrogating rodent systems for human translational insights. Stem Cells 2019;37:1075-1082.

Physical and biochemical characteristics of the human dysraphic spinal cord

The spinal cords were removed from 29 infants between 17 and 46 weeks gestation, all with various forms of spinal dysraphia. The spinal cords were assessed for weight, length, thickness, size and number of cells, and myelination, and then were compared with 86 control spinal cords. The strongest characteristic of the dysraphic cords was a reduced degree of myelination. Cell size and number generally were appropriate for the weight of the cords. There was a tendency for cord weight, length and thickness to be reduced, though in part this was a reflection of poor over-all bodily growth. In a small group of infants these measurements were increased in comparison with the controls.

The use of F-specific coliphages to assess effluent treatment and reuse schemes

This study reports on the use of naturally occurring F-specific coliphages, as well as spiked MS-2 phage, to evaluate a land-based effluent treatment/reuse system and an effluent irrigation scheme. Both the natural phages and the spiked MS-2 phage indicated that the effluent treatment/reuse system (FILTER - Filtration and Irrigated cropping for Land Treatment and Effluent Reuse) achieved a reduction in phage levels over the treatment system by one to two log10. FILTER reduced natural F-specific phage numbers from around 10(3) to below 10(2) 100-ml(-1) and the spiked phage from 10(5) to around 10(4) 100-ml(-1) (incoming compared with outgoing water). In the effluent irrigation scheme, phage spiked into the holding ponds dropped from 10(6) to 10(2) 100-ml(-1) after 168 h (with no detectable levels of natural F-specific phage being found prior to spiking). Only low levels of the spiked phage (10(2) gm(-1)) could be recovered from soil irrigated with phage-spiked effluent (at 10(6) phage 100 ml(-1)) or from fruits (around 10(2) phage per fruit) that had direct contact with soil which had been freshly irrigated with the same phage-spiked effluent.

Reducing environmental pollution using animal feed enzymes

The global livestock population is estimated to be close to 4 billion animals, and to produce around 500 million tons of manure annually (Baidoo, 2003). This is expected to increase in the future with the projected greater demand for meat for human consumption. The problem of manure disposal is exacerbated by the concentration of animal production in increasingly large units, to obtain economies of scale and keep up with the demand for cheap food. The primary environmentalfactors are manure volume, manure nitrogen and phosphorus contents, methane production and odour (Jongbloed and Lenis, 1998). Legislation in many regions now restricts the amount of manure that can be applied per hectare, to prevent environmental pollution (Centner, 2001; Pellini and Morris, 2001). There are a number of strategies the animal production industry can take to reduce environmental impact. These include taking steps to improve the efficiency of conversion of feed into edible products, reduce feed wastage and formulate diets that more closely satisfy animal requirements for specific nutrients. At present 50-80% of the nitrogen and phosphorus fed to animals are not utilized but are excreted via manure and urine to the environment (Baidoo, 2003). Biotechnology could play a very important role in reducing the environmental impact of animal production. Examples include the development of animals more efficient at converting nutrients into edible products, and of higher quality, more digestible feedstuffs. Biotechnology can also be used to produce a range of feed additives that can improve the efficiency of animal production, including for example recombinant somatrophin, amino acids and enzymes. This paper summarizes a series of four experiments looking at the effects of microbial xylanase or phytase supplementation on excretion in swine and poultry. This summary indicates that the inclusion of these enzymes in animal feeds can reduce manure volume by up to 14%, and nitrogen and phosphorus outputs by up to 13% and 70%, respectively.

Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality?

When a fetal abnormality has been diagnosed, a woman may be offered termination of pregnancy. It is important that delays in the assessment process are avoided, as after 21 weeks' gestation fetocide must be performed as part of the termination, with only a few rare exceptions. To determine whether preventable delays in the assessment of suspected fetal abnormalities are occurring, a retrospective review of all stillbirths resulting from termination of pregnancy in 1998 and 1999 in the North Western Region of England was conducted. There were 47 terminations of pregnancy after 24 weeks gestation. Of these, 43 cases had intracardiac potassium chloride fetocide before induction of labour. One of the 47 women was not referred to the tertiary referral centre; 39 women were referred within 1 week of the diagnosis of an abnormality, but in seven cases referral was delayed for more than 2 weeks. Inappropriate and preventable delays are occurring. In some cases this may mean that a woman has to undergo fetocide, which could have been avoided had she been referred to a tertiary centre more promptly.

The human obesity gene map: the 2000 update

This report constitutes the seventh update of the human obesity gene map incorporating published results up to the end of October 2000. Evidence from the rodent and human obesity cases caused by single-gene mutations, Mendelian disorders exhibiting obesity as a clinical feature, quantitative trait loci uncovered in human genome-wide scans and in cross-breeding experiments in various animal models, and association and linkage studies with candidate genes and other markers are reviewed. Forty-seven human cases of obesity caused by single-gene mutations in six different genes have been reported in the literature to date. Twenty-four Mendelian disorders exhibiting obesity as one of their clinical manifestations have now been mapped. The number of different quantitative trait loci reported from animal models currently reaches 115. Attempts to relate DNA sequence variation in specific genes to obesity phenotypes continue to grow, with 130 studies reporting positive associations with 48 candidate genes. Finally, 59 loci have been linked to obesity indicators in genomic scans and other linkage study designs. The obesity gene map reveals that putative loci affecting obesity-related phenotypes can be found on all chromosomes except chromosome Y. A total of 54 new loci have been added to the map in the past 12 months and the number of genes, markers, and chromosomal regions that have been associated or linked with human obesity phenotypes is now above 250. Likewise, the number of negative studies, which are only partially reviewed here, is also on the rise.

The filter system for tertiary treatment of sewage effluent by land application--its performance in a subtropical environment

FILTER is an innovative, CSIRO developed system for treating effluent using high rate land application and subsequent effluent recapture via a closely spaced, subsurface drainage network. We report on the summer performance of a FILTER system established in a subtropical environment on a relatively impermeable swelling clay soil underlain by a deep regional water table. Using secondary treated sewage effluent, the FILTER system produced effluent of tertiary nutrient standards (< or = 5 mg/L TN; < or = 1 mg/L TP), with salinity levels suitable for subsequent irrigation reuse (EC < or = 2.5 dS/m). Removal of faecal coliforms was considerably less effective. The hydraulic loading rate achieved was about two and a half times large than conventional irrigation demand, but this was associated with high deep percolation losses (c 3 mm/day). Comparisons are made with the original FILTER system developed and tested by Jayawardane et al. in temperate Australia. Suggestions are made for modifications to, and further testing of FILTER in a subtropical environment.

A prospective longitudinal 10-year study of schizophrenia's three major factors and depression

This study investigated the nature, independence, and stability of schizophrenia's syndrome factors and depression at 2, 4.5, 7.5 and 10 years post-index hospitalization. At the four follow-ups, 71 patients (48 with schizophrenia and 23 with schizoaffective disorder) were assessed for symptoms hypothesized to constitute the reality distortion, disorganized, and negative factors of schizophrenia. At the last three follow-ups, the patients were also assessed for symptoms of depression. Factor analyses of schizophrenia symptoms revealed more than three syndrome factors at each follow-up. Longitudinally, reality distortion was a stable and relatively independent factor. The negative syndrome was independent but was bifurcated into two dimensions, interpreted as social/emotional withdrawal and diminished movement/expressiveness. Although signs of disorganization were not unified or independent early in schizophrenia's course, speech/thought disorder, disorganized affect, and poverty of speech content coalesced to form a disorganization factor by the 7.5-year follow-up. When depressive symptoms were added to the analyses, depression constituted an independent and stable dimension of schizophrenia over time. Each schizophrenia factor demonstrated a unique longitudinal course. Courses included stable symptom consistency (reality distortion), evolving symptom convergence (disorganization), and recurrent bifurcation and symptom instability (the negative syndrome).

An ovine model of acute myocardial infarction and chronic left ventricular dysfunction

In order to develop and validate an ovine model of myocardial infarction with subsequent impairement of left ventricular function, 15 instrumented sheep underwent selective microembolization of the left coronary arteries with 0.5 mL 90 microns polystyrene beads. Hemodynamics and plasma hormones were measured preembolization (baseline) and then at hours 2, 4, 6, and 12 and days 1, 2, 3, 5 and 7 postembolization. Of the 15 sheep studied, 2 (13%) died on the day of embolization from arrhythmias. In the remaining sheep, left ventricular systolic pressure and stroke work (both P < 0.001) were reduced promptly and remained below basal levels. Mean arterial pressure (P < 0.001) increased initially, then decreased to below basal levels by hour 6. Heart rate (P < 0.001) and left atrial pressure (P < 0.05) were increased while cardiac output was decreased (P < 0.05). Left ventricular ejection fraction at day 7 was reduced (38.8 +/- 3.5 vs 46.0 +/- 3.9% preembolization; P < 0.05). The cardiac enzymes creatine kinase (P < 0.001) and troponin-T (P < 0.001) were increased following microembolization and returned to basal levels by days 2 and 5 respectively. Plasma atrial and brain natriuretic peptides (both P < 0.001) and plasma renin activity (P < 0.005) were all increased following embolization. This ovine model mimics the hemodynamic and neurohumoral features of acute myocardial infarction, resulting in left ventricular dysfunction, and should prove suitable for the study of interventions in a number of these conditions.

Increasing numbers of AV fistulas for hemodialysis access

As part of our CQI program, we initiated an effort to see if we could successfully increase the total number of native arterio-venous (AV) fistulas relative to synthetic PTFE grafts in our dialysis population. This was a combined effort of the nephrology and surgery departments. The program emphasized placement of brachial fistulas in elderly patients and diabetics. Permcaths were placed in the internal jugular position to allow adequate time for maturation of fistulas. The percentage of AV fistulas in our total dialysis population increased from 28% (93 of 328) in the base period 1990 through 1992 to 44% (170 of 386) in the period from 1993 through 1995 (p < 0.0001). Initial AV fistula insertions increased from 38% (52 of 137) in 1990-1992 to 71.8% (102 of 142) in the years 1993 through 1995 (p < 0.0001). 86.5% (45 of 52) of initial fistulas placed in 1990-1992 were useable compared to 63.7% (65 of 102) in 1993-1995 (p < 0.01). Patient demographics were unchanged throughout the study. In conclusion, the number and percentage of AV fistulas in our dialysis population was significantly increased through a coordinated CQI initiative. We expect that this will have a positive impact on decreasing future thrombosis rates and decreasing the cost of access management.

Detection of transmissible gastroenteritis virus by RT-PCR and differentiation from porcine respiratory coronavirus

An RT-PCR method was developed that amplified genetic material from the 5' end of the S protein gene of both transmissible gastroenteritis virus (TGEV) and porcine respiratory coronavirus (PRCV), but discriminated between the two by the size of the product generated. A number of restriction endonuclease enzymes were assessed for recognition of the amplicons so produced. The assay was shown to detect viral RNA from all of the 26 different TGEV and PRCV isolates examined, covering a period from 1946 to 1996. Detection of TGEV in clinical specimens was possible using a spin column method to extract RNA and sensitivity was compared to virus isolation and antigen detection ELISA. The method could provide a means of confirming positive results from immunological screening tests such as FAT and ELISA, reducing the need for virus isolation and convalescent serology.

Establishment of serial persistent infections with bovine viral diarrhoea virus in cattle and sheep and changes in epitope expression related to host species

A pestivirus was transmitted by contact from a persistently infected (P.I.) bullock to pregnant sheep. This resulted in the birth of P.I. lambs, one of which in turn was able to transmit virus by contact to pregnant cattle. Two of these animals gave birth to P.I. calves, from one of which the virus was again transmitted by contact with pregnant sheep, leading to another generation of P.I. lambs. The expression of one or more epitopes on the E2 glycoprotein of the viruses isolated from this series of alternate cattle-sheep transmissions appeared to depend on the host species. Thus, several monoclonal antibodies which bound strongly to, and neutralised, viruses isolated from the bovine hosts, failed to bind or neutralise in the case of sheep isolates. The viral consensus sequences of the E2 gene as well as parts of the 5' untranslated region and of the Npro and capsid genes were compared between the different isolates. This revealed a high degree of genetic stability. However, a single codon change at amino acid position 9 of the E2 gene correlated with and was able to cause the loss of particular epitopes.

Hemodialysis access flow measurement. Comparison of ultrasound dilution and duplex ultrasonography

Decreased hemodialysis access flow is associated with an increased risk of access thrombosis. Duplex ultrasonography can measure access flow and select a subset of patients at increased risk for access failure. With in-line techniques (ultrasound dilution), access flow can be measured during hemodialysis. This study attempted to determine if access flow measured by ultrasound dilution (QA-T) was comparable to that measured by duplex ultrasonography (QA-S). The authors performed 66 simultaneous measurements of hemodialysis access flow in 19 patients by ultrasound dilution and duplex ultrasound with time-domain correlation during 19 hemodialysis treatments. The mean access flow was 1,086 +/- 505 ml/min by ultrasound dilution and 1,026 +/- 513 ml/min with duplex ultrasonography (NS). Regression analysis revealed a linear relationship between the two techniques described by the equation QAT = 246.14 + 0.8104(QAS) (correlation coefficient of 0.83; p < 0.0001). Measurement of hemodialysis access flow by ultrasound dilution was essentially equivalent to that obtained by duplex ultrasound. Additional studies are needed to determine if regular in-line flow measurements can predict and prevent future access thrombosis and decreased the cost of access management.

Access flow measured during hemodialysis

Hemodialysis accesses must supply adequate blood flow to perform hemodialysis and maintain access patency. Access flow (QA) is not measured routinely during hemodialysis. The purpose of this study was to evaluate whether access flow changes during hemodialysis and to determine which factors correlate with QA. The authors measured hemodialysis access flow by ultrasound dilution (QA-T) (Transonic HD01 hemodialysis monitor; Transonic Systems, Inc., Ithaca, NY) and duplex ultrasound, with time-domain correlation (QA-S) (Philips CVI Phillips Medical Systems, Santa Ana, CA) hourly, in 19 patients during hemodialysis. Mean arterial pressure (MAP) (Fresenius automated blood pressure cuff) and cardiac output (CO) (Transonic hemodialysis monitor; Transonic Systems, Inc.) also were measured sequentially. Using duplex ultrasound, access flow was unchanged. However, it fell 132 +/- 137 ml/m (p < 0.05) by ultrasound dilution in hr 4. Cardiac output fell 586 +/- 840 ml/ m (p < 0.05), and MAP fell 11.9 +/- 13.0 mmHg (p < 0.01). There were small positive correlations between CO and QA (correlation coefficient (r) = 0.32, QA-T; r = 0.27, QA-S; p < 0.05), and between CO and MAP (r = 0.35; p < 0.01). In conclusion, access flow, CO, and MAP decreased modestly during hemodialysis. Further studies are necessary to see if access flow is similar off dialysis, and whether in-line access flow measurements can decrease access thrombosis.

Difference between delivered and prescribed blood flow in hemodialysis

The authors compared delivered and prescribed blood flow (QB) during 208 hemodialysis treatments using the Transonic hemodialysis monitor (Transonic Systems, Inc, Ithaca, New York). Delivered QB averaged 205.6, 300.6, 384.3 (p < .0001), and 467.7 cc/min (p < .0001) at pump settings of 200, 300, 400, and 500 cc/min. Permcaths had significantly lower delivered QB (188, 266, and 314 cc/min at 200, 300, and 400 pump settings) (p < .01). When catheters were excluded, delivered QB was at least 10% less than prescribed in 13.5%, 18.4%, and 20.8% of patients (300, 400, and 500 pump settings). Patients using 14 gauge arterial needles had higher delivered QB than patients using 15 gauge needles (418 vs 383 cc/min at 400 pump; p < .0001). Patients on Baxter 550 machines had lower delivered QB (294 and 376 ml/min) than those on fresenius 2008H machines (323 and 411 ml/min) at 300 and 400 pump settings, respectively (p < .0001). Excluding catheters, 17.4% and 23.4% of patients on Baxter machines had delivered QB of 10% less than prescribed, compared to 2.1% and 4.3% of patients on Fresenius machines at 300 and 400 pump settings. In conclusion, delivered QB during hemodialysis is often significantly less than prescribed QB. Further studies are necessary to determine the factors involved in these differences.

Case management: a formula for resource conservation

Case management as a concept of efficiency and effectiveness has demonstrated its applicability in acute care. This article addresses one model of case management that integrates the traditional structure of independently functioning, nonrevenue-producing activities of quality, risk, and utilization management under the comprehensive umbrella of quality resource management. The model transformed existing full-time equivalent services at an acute care hospital in Florida into value-added services on behalf of patients, physicians, the hospital, and payers and presented a practical approach to organizing a case management program. Issues in the transformation process also are addressed.

The effect of Doppler flow screening studies and elective revisions on dialysis access failure

A retrospective study was undertaken to see if screening ultrasounds and elective surgical revision could decrease access failure. Two hundred fifty-three accesses [177 gortex grafts, 76 arteriovenous (AV) fistulas] were studied with duplex imaging. Patients were subdivided by access type, flow, percent stenosis, and whether they were surgically revised. Data was examined to determine access failure within 6 months. Ten of 76 fistulas clotted (13.1%), while 53 of 177 grafts clotted (29.9%) (p = 0.005). In Gortex grafts, stenosis (p < 0.05) and decreased flow (p = 0.005) correlated with clotting. In unrevised grafts with flow < or = 801 ml/min, 13 of 14 (92.8%) clotted, whereas of those with flow > or = 1603 ml/min only, 10 of 38 (26.3%) clotted (chi-square = 24.74; p < 0.0001). Only 1 of 18 (5.6%) revised grafts with flow < or = 1300 ml/min clotted, while 29 of 69 (42%) unrevised grafts clotted (p = 0.004). We were unable to demonstrate decreased clotting in fistulae with revisions. In conclusion, screening duplex scanning was able to select groups with a higher risk of access failure over the subsequent 6 months. Elective revision with correction of areas of stenosis in grafts with flows < or = 1300 ml/min significantly decreased the incidence of clotting.

European versus U.S. data on the course of schizophrenia

OBJECTIVE

The present research attempts to add to the existing body of data on the course of schizophrenia by comparing the findings of a prospective study of a group of U.S. schizophrenic patients with data from two European studies.

METHOD

Seventy-four U.S. patients given the diagnosis of schizophrenia according to Research Diagnostic Criteria were longitudinally assessed at hospitalization and at three intervals up to 10 years after illness onset. The longitudinal criteria for type of onset, course of illness, and outcome were derived from the European studies of Manfred Bleuler and Luc Ciompi. The type of onset, course of illness, and outcome of the U.S. patients were compared with those of the patients in the two European studies.

RESULTS

A lower rate of acute onset and of episodic illness was found in the U.S. patients, but the relative frequency of a number of major overall course patterns was similar across studies.

CONCLUSIONS

Despite many potential threats to comparability, the results of the European and U.S. longitudinal studies of the course of schizophrenia were fairly congruent in terms of the relative rate with which patients fell into the categories established by Bleuler and Ciompi. These results are encouraging in that they point to the possibility of estimating the rate of occurrence of particular expressions of the overall course of schizophrenia.

Corneal rupture from blunt trauma 22 months after radial keratotomy

This report describes a case of traumatic corneal rupture 22 months after radial keratotomy in a 39-year-old woman. The patient struck her face on the side of her car resulting in a limbus rupture in her cornea through the horizontal incisions of a four-incision radial keratotomy. An orbital blowout fracture was also present. A sclerotomy was performed to drain persistent choroidal detachment. After the hemorrhage in the anterior chamber resolved, the iris and lens were found to be absent. Visual acuity of 20/40 was achieved with aphakic correction.

A gene pair from the human major histocompatibility complex encodes large proline-rich proteins with multiple repeated motifs and a single ubiquitin-like domain

A large number of genes has been identified previously between the class I and class II gene families within the class III region of the human major histocompatibility complex. The complete sequences of two of these genes, BAT2 and BAT3 (where BAT is HLA-B-associated transcript), which are closely linked, were determined from cDNA clones. The putative BAT2 and BAT3 proteins are 228 and 110 kDa, respectively, and do not appear to be members of any known family of proteins. However, BAT3 contains an amino-terminal ubiquitin-like domain. Both BAT2 and BAT3 are very rich in proline and include short tracts of polyproline, polyglycine, and charged amino acids. In addition, these proteins contain several unrelated families of similar repeated segments. BAT2 and BAT3 are similar to other proteins with large proline-rich domains, such as some nuclear proteins, collagens, elastin, and synapsin. BAT2 also contains four Arg-Gly-Asp (RGD) motifs typical of the integrin receptor family.

A new cluster of genes within the human major histocompatibility complex

A 435-kilobase (kb) DNA segment, which is centromeric to HLA-B in the human major histocompatibility complex, was isolated by chromosome walking with overlapping cosmids. Within the cloned region, the genes for the tumor necrosis factors (TNFs) alpha and beta and HLA-B were 210 kb apart. The human homolog of a mouse gene, B144, was located next to TNF alpha. Moreover, the presence of additional genes was suggested by a large cluster of CpG islands. With cosmid probes, several distinct transcripts were detected in RNA samples from a variety of cell lines. Altogether, five novel genes were identified by isolation of corresponding complementary DNA clones. These "HLA-B-associated transcripts" (BATs) were mapped to different locations within a 160-kb region that includes the genes for TNF alpha and TNF beta. The presence of the genes for BAT1 and BAT5 in the vicinity of HLA-B again raises the question of which gene in this region determines susceptibility to ankylosing spondylitis.