The phenomenology of pareidolia in healthy subjects and patients with left- or right-hemispheric stroke

Pareidolia are perceptions of recognizable images or meaningful patterns where none exist. In recent years, this phenomenon has been increasingly studied in healthy subjects and patients with neurological or psychiatric diseases. The current study examined pareidolia production in a group of 53 stroke patients and 82 neurologically healthy controls who performed a natural images task. We found a significant reduction of absolute pareidolia production in left- and right-hemispheric stroke patients, with right-hemispheric patients producing overall fewest pareidolic output. Responses were categorized into 28 distinct categories, with 'Animal', 'Human', 'Face', and 'Body parts' being the most common, accounting for 72% of all pareidolia. Regarding the percentages of the different categories of pareidolia, we found a significant reduction for the percentage of "Body parts" pareidolia in the left-hemispheric patient group as compared to the control group, while the percentage of this pareidolia type was not significantly reduced in right-hemispheric patients compared to healthy controls. These results support the hypothesis that pareidolia production may be influenced by local-global visual processing with the left hemisphere being involved in local and detailed analytical visual processing to a greater extent. As such, a lesion to the right hemisphere, that is believed to be critical for global visual processing, might explain the overall fewest pareidolic output produced by the right-hemispheric patients.

The neuropsychology and neuroanatomy of reduplicative paramnesia

Reduplicative paramnesia refers to the delusional belief that there are identical places in different locations. In this case-control study we investigated the clinical, phenomenological, neuropsychological and neuroanatomical data of eleven patients with reduplicative paramnesia and compared them against a control group of eleven patients with severe spatial disorientation without signs of reduplicative paramnesia. We show that most patients with reduplicative paramnesia report that a current place is reduplicated and/or relocated to an other familiar place. Patients with reduplicative paramnesia show a higher prevalence of deficits in the executive functions compared to the control patients, while mnestic and visuo-spatial deficits were both frequent in patients with reduplicative paramnesia and the control group. Patients with reduplicative paramnesia mostly suffer from right hemispheric lesions with a maximal overlap in the dorsolateral prefrontal cortex. Using lesion network mapping we show that lesions causing reduplicative paramnesia are connected to bilateral anterior insula and the right cingulate cortex. We argue that patients with reduplicative paramnesia fail to integrate the actual context with visuo-spatial memories and personal relevant emotional information due to a disruption of the neural network within the anterior temporal lobe, the cingulate cortex and the anterior insula. Also patients with reduplicative paramnesia are not able to resolve this conflict due to the lesion of the dorsolateral prefrontal cortex and executive dysfunction.

Influence of yeasts of the genus Saccharomyces and not Saccharomyces in elaboration of white wines

Traditionally the Serra Gaúcha region, in the state of Rio Grande do Sul, is known as a barn productor of excellent quality wines. The aromatic complexity of wine in general, and white wine in particular, is what is essential to satisfy an increasingly demanding consumer. Among the most used techniques to achieve this purpose is the addition of yeasts of different genres, thus providing a range of aromatic characteristics that are accentuated in it. In this sense, the objective of this work was to evaluate the use of different strains of yeasts in white wines of Riesling Italic variety, made from grapes grown in the Serra Gaúcha region, in the state of Rio Grande do Sul. Based on the results, it was possible to observe that there were no significant differences between the treatments in relation to the variables pH, total acidity and alcoholic degree. However, with respect to the fermentation yield, T3 was the treatment that obtained the best performance, reaching the ideal density (below 1000 g.cm3) in the course of 6 to 7 days, followed by treatments T1 (Saccharomyces cerevisae) and T5 (Levulia pulcherrima) (7 to 8 days), with treatments T2 (Saccharomyces cerevisaecerevisae) and T4 (Torulaspora delbrueckii), which had the lowest performance (9 to 10 days). The T4 treatment was also the one that presented a higher amount of residual sugars, which proves the less activity of this yeast in more alcoholic means. All the yeasts used have a low production of volatile acidity, but the lowest concentration was Saccharomyces cerevisae cerevisae, used in treatment T2 (0.1 gL−1), and the other treatments presented higher concentrations (0, 4 to 0.5 gL−1), although it is still within the parameters considered ideal for obtaining quality white wines. T2 was also the treatment with lower concentrations of glycerol (5.1 g.L−1). This compound is mainly formed by glyceropyruvic fermentation through the metabolism of yeasts at the beginning of alcoholic fermentation, usually being produced by the first 50 grams of fermented sugars, which may indicate a greater activity of this yeast in this fermentation period. In general, we can say that all the yeasts used have the potential to produce quality white wines, since they had good fermentation yields, satisfactory production of alcohol and glycerol, and low production of volatile acidity.

Alternative amendment for vineyards from by-products of pyro-bituminous shale: Effect on wine amino acids and biogenic amines

With the aim of looking for a model of agroecological production, the use of by-products from pyro-bituminous shale as amendment, and its effect on wine amino acids and biogenic amines has been evaluated. Field trials aimed to compare the effect of different doses of conventional and limestone shale from by-products of pyro-bituminous. Four replicates for six different fertilization treatments were arranged in a split plot design during 2009/2010 and 2010/2011 vintage. A chromatographic analysis was carried out to evaluate the impact of fertilization treatments on the amino acid and biogenic amine content of wines produced. Results showed few significant differences among fertilization treatments tested according to the amino acids composition of wines, although it seemed that a combination of conventional and pyro-bituminous shale could be the best option. By-products of pyro-bituminous shale seem to be a good partial substitutive amendment for Brazilian vineyards. This research seems to be a new approach for sustainable revalorization of domestic fertilizers to enable minor environmental impacts and lower production costs without detriment to quality.

Screening for Language Disorders in Stroke: German Validation of the Language Screening Test (LAST)

Background

Screening of aphasia in acute stroke is crucial for directing patients to early language therapy. The Language Screening Test (LAST), originally developed in French, is a validated language screening test that allows detection of a language deficit within a few minutes. The aim of the present study was to develop and validate two parallel German versions of the LAST.

Methods

The LAST includes subtests for naming, repetition, automatic speech, and comprehension. For the translation into German, task constructs and psycholinguistic criteria for item selection were identical to the French LAST. A cohort of 101 stroke patients were tested, all of whom were native German speakers. Validation of the LAST was based on (1) analysis of equivalence of the German versions, which was established by administering both versions successively in a subset of patients, (2) internal validity by means of internal consistency analysis, and (3) external validity by comparison with the short version of the Token Test in another subset of patients.

Results

The two German versions were equivalent as demonstrated by a high intraclass correlation coefficient of 0.91. Furthermore, an acceptable internal structure of the LAST was found (Cronbach's α = 0.74). A highly significant correlation (r = 0.74, p < 0.0001) between the LAST and the short version of the Token Test indicated good external validity of the scale.

Conclusion

The German version of the LAST, available in two parallel versions, is a new and valid language screening test in stroke.

Titanium template for scaphoid reconstruction

Reconstruction of a non-united scaphoid with a humpback deformity involves resection of the non-union followed by bone grafting and fixation of the fragments. Intraoperative control of the reconstruction is difficult owing to the complex three-dimensional shape of the scaphoid and the other carpal bones overlying the scaphoid on lateral radiographs. We developed a titanium template that fits exactly to the surfaces of the proximal and distal scaphoid poles to define their position relative to each other after resection of the non-union. The templates were designed on three-dimensional computed tomography reconstructions and manufactured using selective laser melting technology. Ten conserved human wrists were used to simulate the reconstruction. The achieved precision measured as the deviation of the surface of the reconstructed scaphoid from its virtual counterpart was good in five cases (maximal difference 1.5 mm), moderate in one case (maximal difference 3 mm) and inadequate in four cases (difference more than 3 mm). The main problems were attributed to the template design and can be avoided by improved pre-operative planning, as shown in a clinical case.

An ESR Investigation of the Vanadium Pentoxide-Water System Illuminated in the Solar Spectrum Range

Photoreduction of vanadium (V) ions in aqueous solution is followed by ESR observation of the VO2+ aq ions formed. In addition shortlived surface centers are detected at room temperature in illuminated V2O5-samples being suspended in water. These centers are tentatively related to the active species in the photoassisted electrolysis of water

Studies by the Electron Cyclotron Resonance(ECR)-Technique IX: Interactions of Low-Energy Electrons with the Molecules CH2Cl2 and CHCl3 in the Gas Phase

The capture of thermal electrons by the molecules CH2Cl2 and CHCl3 is reinvestigated and discussed. An attempt is presented to describe the reaction path in terms of potential energy diagrams.

Bestimmung von Streuquerschnitten für thermische Elektronen aus der Linienform von ECR-Signalen / Determination of the Scattering Cross Section for Thermal Electrons from the Line Shape of ECR-Signals

Changes of line width and line shape of electron cyclotron resonance (ecr) signals are measured as function of the pressure of neutral gases. The results are discussed in terms of an analysis for the absorption of microwave power by electrons given by Fehsenfeld et al. Good agreement is found for σ-values as obtained in ecr and drift tube measurements.

The prevalence of and attitudes toward neonatal functional echocardiography use and training in the United States: a survey of neonatal intensive care unit medical directors

BACKGROUND

Internationally, neonatologists are increasingly performing functional echocardiography to evaluate the hemodynamic status and cardiac function in neonates. The purpose of this study was to describe the current prevalence of and attitudes toward the use and training of neonatologists in functional echocardiography in the United States.

METHODS

An anonymous survey was sent to United States neonatal intensive care unit medical directors. Neonatologists scored availability of echocardiography and attitudes toward the use and training of neonatologists in functional echocardiography.

RESULTS

Response rate was 43.7% (247 of 565 surveys sent) and captured 95% of the neonatal-perinatal training programs. Nine percent of units had a functional echocardiography trained neonatologist; eight percent of the neonatal-perinatal training programs offered functional echocardiography training. There was no difference in the timely ability to obtain hemodynamic status with echocardiography in units compared by the presence of functional echocardiography trained neonatologists (mean = 3.13 vs. 2.67, p = 0.08) and fellowships (mean = 2.69 vs. 2.72, p = 0.85). Overall positive attitudes (mean = 14.6 ± 3.46) towards the training of neonatologists in functional echocardiography did not correlate with the perceived timely availability of echocardiography support (mean = 2.72 ± 1.43, r = -0.11, p = 0.1).

CONCLUSION

Functional echocardiography use and training is not prevalent in the United States. There are positive attitudes toward the training of neonatologists in functional echocardiography that are independent of the presence of fellowships, neonatologists with echocardiography training, and the perceived availability of echocardiography support.

Hydrometrocolpos: the Fjord sign

We want to stress a diagnostic sign in the diagnosis of pelvic cysts in newborns. In these cases the detection of an attached uterus is proof of a hydrocolpos or in cases with a dilated uterine cavity of a hydrometrocolpos.

Colchicine for acute gout

BACKGROUND

Gout is one of the most common rheumatic diseases worldwide. Colchicine is regarded as beneficial in the treatment of acute gout, but has a high frequency of gastrointestinal adverse events.

OBJECTIVES

To evaluate the efficacy and safety of colchicine for relief of the signs and symptoms of acute gouty arthritis, compared to placebo and other treatment interventions.

SEARCH STRATEGY

We searched the following electronic databases to March 2006: Cochrane Central Register of Controlled Trials (CENTRAL, Issue 1, 2006), MEDLINE (from 1966), EMBASE (from 1980), CINAHL (from 1982), AMED (from 1985), Web of Science (from 1945) and Current Controlled Trials.

SELECTION CRITERIA

Published randomised controlled trials (RCTs) and controlled clinical trials evaluating symptom relief and adverse outcomes of colchicine therapy in acute gout were considered for this review.

DATA COLLECTION AND ANALYSIS

Two reviewers independently screened search results for inclusion, collected the data in a standardized form and assessed the methodological quality of the trial using validated criteria. Results for continuous outcome measures were expressed as weighted mean differences. Dichotomous outcome measures were pooled using relative risk. The number needed to treat was calculated for significant outcomes.

MAIN RESULTS

One RCT (N=43) comparing colchicine to placebo for the treatment of acute gout was included in this review. The results favour the use of colchicine over placebo with an absolute reduction of 34% for pain and a 30% reduction in clinical symptoms such as tenderness on palpation, swelling, redness, and pain. The number needed to treat (NNT) with colchicine versus placebo to reduce pain was 3 and the NNT to reduce clinical symptoms was 2. All participants treated with colchicine experienced gastrointestinal side effects (diarrhea and/or vomiting) and the number needed to harm (NNH) with colchicine versus placebo was 1. No studies comparing colchicine to NSAIDs or other treatments such as corticosteroids or ACTH were identified.

AUTHORS' CONCLUSIONS

Colchicine is an effective treatment for the reduction of pain and clinical symptoms in patients experiencing acute attacks of gout, although in the regimen studied its low benefit to toxicity ratio limits its usefulness. It should be used as a second line therapy when NSAIDs or corticosteroids are contraindicated or ineffective. More evidence is needed to compare the efficacy of colchicine to that of NSAIDs or corticosteroids, the current first line therapy for acute gout.

Computer aided designed neo-clavicle out of osteotomized free fibula: case report

Total clavicle reconstruction is a challenging task. We performed a reconstruction of the ventral shoulder girdle by calculating a 3D DICOM representation of the left clavicle to create a right neo-clavicle. Two cuts in correct position and angle leads to a natural 3D shape of the new clavicle. The data were used with a thermo-jet procedure to form model slices of thermoplastic wax. Subsequently, the double titanium osteotomy template with correct cut-angulation was constructed. A 40-year old patient presented with symptoms of progressive pain and instability in the shoulder girdle resulting from complete right clavicle resection due to desmoid tumour 23 years earlier. During the operative procedure, dissection, guided double osteotomy, microvascular anastomoses and acromioclavicular-sternoclavicular fixation were performed. The computer-assisted planning resulted in the exact calculation of the two osteotomy cuts, hence, the 3D appearance of the neo-clavicle. Two years postoperatively, patient showed slightly improved elevation and complete recovery from pain. Our operative procedure demonstrates that the computer-assisted planning with construction of a wax model and an osteotomy template is a useful approach to plan the two precise cuts leading to a predictable shape of the clavicle.

Encapsulation into sterically stabilised liposomes enhances the immunogenicity of melanoma-associated Melan-A/MART-1 epitopes

Tumour-associated antigens (TAA)-specific vaccination requires highly immunogenic reagents capable of inducing cytotoxic T cells (CTL). Soluble peptides are currently used in clinical applications despite an acknowledged poor immunogenicity. Encapsulation into liposomes has been suggested to improve the immunogenicity of discrete antigen formulations. We comparatively evaluated the capacity of HLA-A2.1 restricted Melan-A/MART-1 epitopes in soluble form (S) or following inclusion into sterically stabilised liposomes (SSL) to be recognised by specific CTL, to stimulate their proliferation and to induce them in healthy donors' peripheral blood mononuclear cells (PBMC), as well as in melanoma-derived tumour-infiltrating lymphocytes (TIL). HLA-A2.1⁺, Melan-A/MART-1-NA-8 melanoma cells served as targets of specific CTL in 51Cr release assays upon pulsing by untreated or human plasma-treated soluble or SSL-encapsulated Melan-A/MART-1 27–35 (M27–35) or 26–35 (M26–35) epitopes. These reagents were also used to stimulate CTL proliferation, measured as 3H-thymidine incorporation, in the presence of immature dendritic cells (iDC), as antigen-presenting cells (APC). Induction of specific CTL upon stimulation with soluble or SSL-encapsulated peptides was attempted in healthy donors' PBMC or melanoma-derived TIL, and monitored by 51Cr release assays and tetramer staining. Na-8 cells pulsing with SSL M27–35 resulted in a five-fold more effective killing by specific CTL as compared with equal amounts of S M27–35. Encapsulation into SSL also provided a partial (50%) protection of M27–35 from plasma hydrolysis. No specific advantages regarding M26–35 were detectable in these assays. However, at low epitope concentrations (⩽100 ng ml⁻¹), SSL M26–35 was significantly more effective in inducing CTL proliferation than S M26–35, in the presence of iDC, as APC. Preincubation with iDC for 6 h virtually abolished the capacity of S M26–35 to stimulate specific CTL proliferation, but only partially affected that of SSL M26–35. Most importantly, SSL M26–35 was able to enhance the induction of specific CTL in healthy donors PBMC and in melanoma-derived TIL as compared to S M26–35. Taken together, our data indicate that encapsulation of TAA epitopes into SSL results in effective immunogenic formulations suitable for clinical use in active specific tumour immunotherapy.