Attention to space and time: Independent or interactive systems? A narrative review

While there is ample evidence for the ability to selectively attend to where in space and when in time a relevant event might occur, it remains poorly understood whether spatial and temporal attention operate independently or interactively to optimize behavior. To elucidate this important issue, we provide a narrative review of the literature investigating the relationship between the two. The studies were organized based on the attentional manipulation employed (endogenous vs. exogenous) and the type of task (detection vs. discrimination). Although the reviewed findings depict a complex scenario, three aspects appear particularly important in promoting independent or interactive effects of spatial and temporal attention: task demands, attentional manipulation, and their combination. Overall, the present review provides key insights into the relationship between spatial and temporal attention and identifies some critical gaps that need to be addressed by future research.

Outcomes of Forest Landscape Restoration Shaped by Endogenous or Exogenous Actors and Institutions? A Systematic Review on Sub-Saharan Africa

Although ambitious, forest landscape restoration (FLR) is still very high on global climate change mitigation and adaptation research and policy agendas. The scientific literature highlights the importance of institutions and actors' collaboration for achieving the intended outcomes. Despite these diffuse indications, a comprehensive understanding of the role played by different types of actors and institutions in shaping FLR outcomes is missing. This hinders the definition of an actor-cum-institutions research agenda for FLR, especially in sub-Saharan Africa (SSA). Yet, in this region, different actors with diverse interests shape FLR practices. Likewise, formal and informal institutions are known to collide frequently. Hence, this paper addresses the lacunae by systematically reviewing FLR actors' interests and power manifestations and the typologies of institutions linked to FLR outcomes in SSA. The review further defines future research agendas on actors and institutions in SSA. The following lessons can be drawn from the review of 75 peer-reviewed journal articles: First, while exogenous actors are interested more in the ecological benefits of FLR, endogenous actors are interested in economic ones. Second, exogenous actors mostly use (dis-)incentives and coercion to shape the behavior of endogenous actors in FLR. Finally, while the exogenous formal institutional typology produces positive and negative ecological, economic, political, and sociocultural FLR outcomes, the endogenous formal and informal institutions produce only positive outcomes. Future studies should identify actors' compliance levels of the exogenous and endogenous formal and informal typologies of institutions. Future studies should also analyze the effectiveness of FLR-linked institutions towards ensuring successful FLR.

A method for researching the eutrophication and N/P loads of plateau lakes: Lugu Lake as a case

Lugu Lake is one of the best plateau lakes in China in terms of water quality, but in recent years the eutrophication of Lugu Lake has accelerated due to high nitrogen and phosphorus loads. This study aimed to determine the eutrophication state of Lugu Lake. Specifically, the spatio-temporal variations of nitrogen and phosphorus pollution during the wet and dry seasons were investigated in Lianghai and Caohai, and the primary environmental effect factors were defined. Adopting the endogenous static release experiments and the exogenous improved export coefficient model, a novel approach (a combination of internal and external sources) was developed for the estimation of nitrogen and phosphorus pollution loads in Lugu Lake. It was indicated that the order of nitrogen and phosphorus pollution in Lugu Lake was Caohai > Lianghai and dry season > wet season. Dissolved oxygen (DO) and chemical oxygen demand (COD_Mn) were the main environmental factors causing nitrogen and phosphorus pollution. Endogenous nitrogen and phosphorus release rates in Lugu Lake were 668.7 and 42.0 t/a, respectively, and exogenous nitrogen and phosphorus input rates were 372.7 and 30.8 t/a, respectively. The contributions of pollution sources, in descending order, were sediment > land-use categories > residents and livestock breeding > plant decay, of which sediment nitrogen and phosphorus loads accounted for 64.3 % and 57.4 %, respectively. Regulating the endogenous release of sediment and obstructing the exogenous input from shrubland and woodland are emphasized for the management of nitrogen and phosphorus contamination in Lugu Lake. Thus, this study can serve as a theoretical foundation and technical guide for eutrophication control in plateau lakes.

Spatial attention is not affected by alpha or beta transcranial alternating current stimulation: A registered report

Using Electroencephalography (EEG) an event-related change in alpha activity has been observed over primary sensory cortices during the allocation of spatial attention. This is most prominent during top-down, or endogenous, attention, and nearly absent in bottom-up, or exogenous orienting. These changes are highly lateralised, such that an increase in alpha power is seen ipsilateral to the attended region of space and a decrease is seen contralaterally. Whether these changes in alpha oscillatory activity are causally related to attentional resources, or to perceptual processes, or are simply epiphenomenal, is unknown. If alpha oscillations are indicative of a causal mechanism whereby attention is allocated to a region of space, it remains an open question as to whether this is driven by ipsilateral increases or contralateral decreases in alpha power. This preregistered report set out to test these questions. To do so, we used transcranial Alternating Current Stimulation (tACS) to modulate alpha activity in the somatosensory cortex whilst measuring performance on established tactile attention paradigms. All participants completed an endogenous and exogenous tactile attention task in three stimulation conditions; alpha, sham and beta. Sham and beta stimulation operated as controls so that any observed effects could be attributed to alpha stimulation specifically. We replicated previous behavioural findings in all stimulation conditions showing a facilitation of cued trials in the endogenous task, and inhibition of return in the exogenous task. However, these were not affected by stimulation manipulations. Using Bayes-factor analysis we show strong support for the null hypotheses - that the manipulation of Alpha by tACS does not cause changes in tactile spatial attention. This well-powered study, conducted over three separate days, is an important contribution to the current debate regarding the efficiency of brain stimulation.

Interference in ELISA

ELISA is a well-established technique used worldwide to quantify analytes present in a diverse milieu of biological samplings. It is especially important to clinicians who rely on the accuracy and precision of the test to administer patient care. Those results are to be held with great scrutiny since the assay is subject to error caused by interfering substances found in the sample matrix. In this chapter, we examine the nature of such interferences and discuss approaches to identify and offer remedies to remove the interference and validate the assay.

Deficits in visuospatial attentional cueing following mild traumatic brain injury

Visual attentional deficits are frequently reported in patients with mild traumatic brain injury (TBI). In the present study, the ability to orient visual attention (i.e., the use of endogenous and exogenous visual cues) was investigated using a modified Posner visual search task, in which the participant was required to search for a target shape (radial frequency patterns) amongst distractor shapes. Participants were required to determine whether a target radial frequency pattern was present or absent from an array of distractors. Attention to the target location was cued using central or peripheral cueing procedures to investigate endogenous or exogenous attention allocation. Predictability was not manipulated between central and peripheral cues. Search difficulty was varied by systematically changing the radial frequency difference between target and distractors (and thereby shape difference), and cues could be valid or invalid in that they correctly or incorrectly indicated the position of the target shape. Both target discriminability (i.e., identifying the presence or absence of the target) and reaction times were measured. Thirteen patients with chronic mild TBI and 21 age-, sex-, and IQ -matched healthy controls participated in the study. For control participants, both discrimination accuracy and reaction times improved with visual search efficiency, and they were sensitive to the type of cue, with performance worst for cue invalid conditions than valid conditions. However, the results for TBI patients were strikingly different; we find that discrimination accuracy slightly improved with visual search difficulty (compared to controls), but not reaction times, and TBI patients were largely insensitive to the type of visual cue, and did not show a selective deficit for central or peripheral cues, suggesting an impairment in both endogenous and exogenous visual attention. In conclusion, patients with mild TBI exhibit a poor ability to orient visual attention.

What role do endogenous retroviruses play in domestic cats infected with feline leukaemia virus?

AbstractFeline leukaemia virus (FeLV) is a retrovirus that infects domestic and wild cats around the world. FeLV infection is associated with the development of neoplasms, bone marrow disorders and immunosuppression. Viral subgroups arise from mutations in the FeLV genome or from recombination of FeLV with ancestral endogenous retroviruses in the cat genome. The retroviral endogenisation process has allowed generation of a diversity of endogenous viruses, both functional and defective. These elements may be part of the normal functioning of the feline genome and may also interact with FeLV to form recombinant FeLV subgroups, enhance pathogenicity of viral subgroups, or inhibit and/or regulate other retroviral infections. Recombination of the env gene occurs most frequently and appears to be the most significant in terms of both the quantity and diversification of pathogenic effects in the viral population, as well as affecting cell tropism and types of disease that occur in infected cats. This review focuses on available information regarding genetic diversity, pathogenesis and diagnosis of FeLV as a result of the interaction between endogenous and exogenous viruses.

Thinking about attention: Successive approximations to a productive taxonomy

Attention, the recruitment of processing resources, is viewed as pivotal for understanding normal behaviour and thought as well as the disorganizations associated with brain damage and disease. A brief history foreshadows aspects of a proposed taxonomy of attention that builds upon Posner's tripartite taxonomy. Posner's influential taxonomy views attention as a set of isolable neural systems (alerting, orienting and executive control), often working together to organize behaviour. For measuring the efficacy of these three networks, Posner and colleagues created the Attention Network Test (ANT). The impact of the taxonomy and this model task for exploring it is illustrated by the facts that they have spawned numerous variants designed for different purposes and that one or another variant has been used in almost a thousand publications. We have previously built upon this conceptual framework by considering: two modes of control over resource allocation which we labelled exogenous and endogenous and three domains over which these modes of control are presumed to operate (space, time and task or activity). The Combined Attention Systems Test (or CAST) was developed to measure the efficacy of the six kinds of attention implied by revised taxonomy. Lastly, this taxonomic effort is further developed by incorporating the distinction between overt, observable behaviour in the "real" world and covert "behaviour" in the realm of thought and imagination.

Plant miR167e-5p promotes 3T3-L1 adipocyte adipogenesis by targeting β-catenin

Adipogenesis is important in the development of fat deposition. Evidence showed that plant microRNAs (miRNAs) could be absorbed by the digestive tract and exert regulatory effects on animals' physiological processes. However, the regulation of plant miRNA on host lipogenesis remains unknown. This study explored the potential function of plant miRNA, miR167e-5p, in adipogenesis in vitro. The presentation of plant miR167e-5p improved lipid accumulation in 3T3-L1 cells. Bioinformatics prediction and luciferase reporter assay indicated that miR167e-5p targeted β-catenin. MiR167e-5p could not only negatively affect the expression of β-catenin but also showed a positive effect on several fat synthesis-related genes, peroxisome proliferator-activated receptor gamma (Pparγ), CCAAT/enhancer-binding protein α (Cebpα), fatty acid-binding protein 4 (Ap2), lipolysis genes, adipose triglyceride lipase (Atgl), and hormone-sensitive lipase (Hsl) messenger RNA levels. Meanwhile, lipid accumulation and the expression of the β-catenin and other five fat synthesis-related genes were recovered to their original pattern by adding the miR167e-5p inhibitor in 3T3-L1 cells. The immunoblot confirmed the same expression pattern in protein levels in β-catenin, PPAR-γ, FAS, and HSL. This research demonstrates that plant miR167e-5p can potentially affect adipogenesis through the regulation of β-catenin, suggesting that plant miRNAs could be a new class of bioactive ingredients in adipogenesis.

Metacognitive blindness in temporal selection during the deployment of spatial attention

How does orienting attention in space affect the quality of our confidence judgments? Orienting attention to a particular location is known to boost visual performance, but the deployment of attention is far from being instantaneous. Whether observers are able to monitor the time needed for attention to deploy remains largely unknown. To address this question, we adapted a "Wundt clocks" paradigm, asking observers (N=140) to reproduce the phase of a rotating clock at the time of an attentional cue, and to evaluate their confidence in their responses. Attention affected the latency between objective and perceived events: the average reported phase was delayed in accordance with the known latencies of voluntary and involuntary attention. Yet, we found that confidence remains oblivious to these attention-induced perceptual delays, like a 'metacognitive blind spot'. In addition, we observed weaker metacognition specifically during the deployment of voluntary attention, suggesting a tight relationship between the attentional and metacognitive systems. While previous work has considered how visual confidence adjusts to fully attended versus unattended locations, our study demonstrates that the very process of orienting attention in space can alter metacognition.

Specifying exogeneity and bilinear effects in data-driven model searches

Data-driven model searches provide the opportunity to quantify person-specific processes using ambulatory assessment data. Here, the search space typically includes all potential relations among variables, meaning that all variables can potentially explain variability in all other variables. Oftentimes, this is unrealistic. For example, weather is unlikely to be predicted by someone's emotional state, whereas the reverse might be true. Allowing for specification of exogenous variables, or variables that are not predicted within the system, permits more realistic models and allows the researcher to model contextual change processes via the use of moderation variables. We use two sets of daily diary data to demonstrate the capabilities of allowing for the specification of exogenous variables in GIMME (Group Iterative Multiple Model Estimation), a model search algorithm that allows for models with idiographic, individual-level as well as subgroup- and group-level processes with intensive longitudinal data. First, using data collected from individuals diagnosed with personality disorders, we show results where weather-related and temporal basis variables are specified as exogenous, and reports on affect and behavior are endogenous. Next, we demonstrate the modeling of treatment effects in an intervention study, looking at data from a 6-week meditation workshop in midlife adults. Finally, we use the meditation intervention data to demonstrate modeling moderation effects, where relationships between two endogenous variables are dependent on the current stage of the study for a given participant (i.e., currently attending meditation classes or not). We end by presenting adaptive LASSO as a method for probing results obtained from GIMME.

Impact of slow versus rapid digesting carbohydrates on substrate oxidation in pre-pubertal children: A randomized crossover trial

BACKGROUND & AIMS

Consumption of rapid digesting sugars by children are under increased scrutiny because of their contribution to unhealthy weight gain. Previous studies in adults and children have suggested that altering the blend of carbohydrates (CHOs) consumed may cause shifts in substrate utilization. The purpose of this study was to examine the effects of consuming a slow digesting carbohydrate (SDC) and rapid digesting carbohydrate (RDC) on CHO and fat oxidation, glucose, and insulin responses at rest, during exercise, and post-exercise rest in pre-pubescent children.

METHODS

A randomized, double-blind, crossover design was used. Nineteen pre-pubescent children (n = 10 boys, n = 9 girls, mean ± standard error, age = 9.84 ± 0.37-yrs) participated. Visits to the laboratory began with a 30-min measurement of resting metabolism followed by consumption of either an RDC or SDC drink. Postprandial resting metabolism was recorded for 60-min, immediately followed by 60-min of submaximal cycling exercise while metabolism was recorded, which was immediately followed by another 60-min recording of post-exercise metabolism. Total CHO and fat oxidation, endogenous and exogenous CHO oxidation, blood glucose, and insulin were assessed.

RESULTS

Total CHO oxidation rate (g∙min^-1) was greater after the RDC drink at 60 min (p = 0.032). Endogenous CHO oxidation rate (g∙min^-1) was greater after the SDC drink at 15 min (p ≤ 0.010). Cumulative endogenous CHO oxidation (g) was greater after the SDC drink at 45 min (p = 0.009). Endogenous CHO oxidation accounted for a greater proportion of substrate oxidation after the first 60-min rest period (p = 0.028), while exogenous CHO oxidation accounted for a greater proportion of substrate oxidation for the RDC at all time points (p ≤ 0.019).

CONCLUSIONS

The present study provides novel data suggesting that an SDC promotes greater endogenous substrate utilization in pre-pubertal children, which may have beneficial health impacts on energy intake and carbohydrate regulation/metabolism during growth and development.

CLINICAL TRIALS REGISTRY NUMBER

NCT03185884, clinicaltrials.gov.

On the origins and evolution of the Attention Network Tests

Attention is a pivotal cognitive function and efforts to understand its properties and operations are fundamental. Building upon the best known taxonomy of attention put forward by Posner and colleagues, the Attention Network Test (ANT) was designed to efficiently provide scores that reflect the efficacy of alerting, orienting and executive control. The ANT has not only been very widely adopted by scholars around the world, it has inspired a wide range of variants, the ANTs, - each with its own purpose. This review will describe the origin of the ANT in the taxonomic contributions of Posner and the evolution of the ANTs with some discussion of the nature and rationale for each major variant described here. We briefly allude to minor modifications of the ANT and present some suggestions related to data reporting and data analysis. We end with some projections about the future use of the original ANT and its notable variants.

The endogenous and exogenous brain-derived neurotrophic factor plays pivotal roles in the pathogenesis of stroke onset in high salt-loaded hypertensive rats

Brain-derived neurotrophic factor (BDNF) is known to have neuroprotective effects on multiple neurovascular diseases especially poststroke recovery. On the other hand, BDNF reported to increase blood pressure (BP) which is one of the major risk factors for stroke onset. To clarify the conflicting effects on stroke onset, we examined the expression of endogenous BDNF in relation to stroke onset. In addition, we explored the effect of exogenous central BDNF against stroke onset and all-cause mortality as the primary endpoint and BP as the secondary object in hypertensive rats with high-salt diet. In experiment 1, male spontaneously hypertensive stroke-prone rats (SHRSP) were fed a 0.3% (n = 8) or an 8% (n = 22) sodium diet (Na) through 28 days. The SHRSP with 8% Na showed significant increase of stroke onset, all-cause mortality, upregulation of reactive astrocytes, and disruption of blood-brain barrier. BDNF in the rats with 8% Na was significantly upregulated and mainly expressed in reactive astrocytes, whereas phosphorylated tropomyosin-related kinase B did not change by the rich BDNF. In experiment 2, male SHRSP were treated with continuous intracerebroventricular injection of 2.1 μg/day BDNF (n = 10) or the vehicle (Phosphate buffer saline; n = 10) and fed an 8% Na through 24 days. Exogenous central BDNF induced significant increase of BP and heart rate, and exhibited higher stroke onset and all-cause mortality compared with vehicle group. The present study demonstrated that endogenous BDNF were significantly produced in reactive astrocytes in relation to stroke onset regardless of neuroprotection. In addition, exogenous central BDNF increased BP which might be associated with sympathetic nerve activity and provided unfavorable effects on the prognosis of hypertensive rats. As BDNF is still potentially a good candidate for the treatment of neurovascular diseases, we suggest that hypertensive patients need care for the elevation of BP in the clinical trials of BDNF.

Differentiation of endogenous erythropoietin and exogenous ESAs by Western blotting

Doping tests for the illegal use of erythropoiesis-stimulating agents (ESAs) have been developed. We developed a new Western blotting method to detect and distinguish endogenous erythropoietin (Epo, 35-38 kDa) and exogenous ESAs (epoetin α and β, 38-42 kDa; darbepoetin α, 47-50 kDa; epoetin β pegol, 93-110 kDa). Epo and ESAs are glycoproteins and deglycosylation using peptide-N-glycosidase F shifted all Epo and ESA bands except epoetin β pegol to 22 kDa. We cut the bands of Epo and ESAs from SDS-PAGE gels and analyzed them by Liquid Chromatography/Mass Spectrometry (LC/MS). LC/MS detected all endogenous Epo and exogenous ESAs as deglycosylated 22 kDa Epo, indicating that LC/MS analysis could confirm the presence of Epo or ESA, but could not distinguish between endogenous Epo and exogenous ESAs. We propose the following Epo doping tests: 1) detect Epo or ESAs by Western blotting of the glycosylated form; 2) increase the reliability by the band shift following deglycosylation; and 3) complete confirmation of Epo or ESA by LC/MS analysis using cut gels. One of the advantages of our method is that pre-purification of samples for Epo is not required in our Western blotting.

Predictivity and Manifestation Factors in Aging Effects on the Orienting of Spatial Attention

OBJECTIVE

Prior attention research has asserted that endogenous orienting of spatial attention by willful focusing may be differently influenced by aging than exogenous orienting, the capture of attention by external cues. However, most such studies confound factors of manifestation (locational vs symbolic cues) and the predictivity of cues. We therefore investigated whether age effects on orienting are mediated by those factors.

METHOD

We measured accuracy and response times of groups of younger and older adults in a discrimination task with flanker distracters, under three spatial cueing conditions: nonpredictive locational cues, predictive symbolic cues, and a hybrid predictive locational condition.

RESULTS

Age differences were found to be related to the factor of cue predictivity, but not to the factor of spatial manifestation. These differences were not modulated by flanker congruency.

DISCUSSION

The results indicate that the orienting of spatial attention in healthy aging may be adversely affected by less effective perception or utilization of the predictive value of cues, but not by the requirement to voluntarily execute a shift of attention.

The role of exogenous Fibrinogen in cardiac surgery: stop bleeding or induce cardiovascular disease

The surgical treatment contributes to broad variety of cardiovascular diseases (CVD). Due to many involved factors in preoperative bleeding, it is almost difficult to perform better Haemostatic approach. Fibrinogen is a major blood glycoprotein and a coagulation factor which decreases postoperative bleeding. It has a potential role in platelet activation and bleeding inhibition; it may reflect the inflammatory responses and be related to the endothelial dysfunction. Fibrinogen can act as a pro-inflammatory element via increasing some inflammatory markers including IL-6, tumor necrosis factor-α (TNF-α), monocyte chemo attractant protein (MCP-1), macrophage inflammatory protein-1 (MIP-1a and b), matrix metalloproteinase (MMP-1 and MMP-9) and Toll-like Receptors (TLRs); through activation of these factors, fibrinogen may induce some inflammatory mechanisms such as focal adhesion kinase (FAK), mitogen-activated protein kinases (MAPK) and nuclear factor κB (NF-κB) pathways. It may cause endothelial dysfunction by increasing P and E-selection, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) levels which activate MAPK and NF-κB pathways. This factor is also associated with increased exocytosed von Willebrand factor (vWF) as well as activation of Rho-GTPase mechanism. All of these data demonstrate the dual role of fibrinogen in cardiac surgeries, bleeding inhibition and CVD. Therefore, identifying the CVD factors is helpful for designing preventive strategies and alternative drugs.

Koala retrovirus diversity, transmissibility, and disease associations

Background

Koalas are infected with the koala retrovirus (KoRV) that exists as exogenous or endogenous viruses. KoRV is genetically diverse with co-infection with up to ten envelope subtypes (A-J) possible; KoRV-A is the prototype endogenous form. KoRV-B, first found in a small number of koalas with an increased leukemia prevalence at one US zoo, has been associated with other cancers and increased chlamydial disease. To better understand the molecular epidemiology of KoRV variants and the effect of increased viral loads (VLs) on transmissibility and pathogenicity we developed subtype-specific quantitative PCR (qPCR) assays and tested blood and tissue samples from koalas at US zoos (n = 78), two Australian zoos (n = 27) and wild-caught (n = 21) in Australia. We analyzed PCR results with available clinical, demographic, and pedigree data.

Results

All koalas were KoRV-A-infected. A small number of koalas (10.3%) at one US zoo were also infected with non-A subtypes, while a higher non-A subtype prevalence (59.3%) was found in koalas at Australian zoos. Wild koalas from one location were only infected with KoRV-A. We observed a significant association of infection and plasma VLs of non-A subtypes in koalas that died of leukemia/lymphoma and other neoplasias and report cancer diagnoses in KoRV-A-positive animals. Infection and VLs of non-A subtypes was not associated with age or sex. Transmission of non-A subtypes occurred from dam-to-offspring and likely following adult-to-adult contact, but associations with contact type were not evaluated. Brief antiretroviral treatment of one leukemic koala infected with high plasma levels of KoRV-A, -B, and -F did not affect VL or disease progression.

Conclusions

Our results show a significant association of non-A KoRV infection and plasma VLs with leukemia and other cancers. Although we confirm dam-to-offspring transmission of these variants, we also show other routes are possible. Our validated qPCR assays will be useful to further understand KoRV epidemiology and its zoonotic transmission potential for humans exposed to koalas because KoRV can infect human cells.

Associations between brain activity and endogenous and exogenous cortisol - A systematic review

To arrive at a coherent understanding of the relation between glucocorticoids and the human brain, we systematically reviewed the literature for studies examining the associations between endogenous or exogenous cortisol and human brain function. Higher levels of endogenous cortisol during psychological stress were related to increased activity in the middle temporal gyrus and perigenual anterior cingulate cortex (ACC), decreased activity in the ventromedial prefrontal cortex, and altered function (i.e., mixed findings, increased or decreased) in the amygdala, hippocampus and inferior frontal gyrus. Moreover, endogenous cortisol response to psychological stress was related to increased activity in the inferior temporal gyrus and altered function in the amygdala during emotional tasks that followed psychological stress. Exogenous cortisol administration was related to increased activity in the postcentral gyrus, superior frontal gyrus and ACC, and altered function in the amygdala and hippocampus during conditioning, emotional and reward-processing tasks after cortisol administration. These findings were in line with those from animal studies on amygdala activity during and after stress.

Infectious endophthalmitis at a Philippine tertiary hospital: a ten-year retrospective study

Background

Endophthalmitis is a sight-threatening disease characterized by marked progressive inflammation of the vitreous and/or aqueous humors. Limited information is currently available regarding endophthalmitis in the Philippines. This study aimed to provide long-term summary data on endophthalmitis cases seen at the largest tertiary referral hospital in the Philippines.

Methods

All endophthalmitis cases diagnosed at the Philippine General Hospital from January 1, 2007 to December 31, 2016 were retrieved and classified by etiology. Data pertaining to history, associated risk factors, isolated microorganisms, management, and final visual outcomes for each patient were reviewed.

Results

A total of 202 cases diagnosed within the audit period were included in the study. These were classified as post-traumatic (55.94%), endogenous (14.36%), acute post-operative (10.40%), keratitis-induced (6.93%), chronic post-operative (5.44%), bleb-associated (3.96%), and suture-associated (2.97%) endophthalmitis. Males comprised 71.29% of the population, while the largest age group affected was 0–10 years (24.75%). The culture-positive rate was 57.89%. The predominant etiology was Gram-positive bacteria (38.18%), followed by Gram-negative bacteria and mixed pathogens (21.82% each), and fungi (18.18%). The most common organisms were Streptococcus, Staphylococcus, Pseudomonas, Aspergillus, and Candida, accounting for 56.45% of isolates. Pars plana vitrectomy was done for 62.87% of patients, intravitreal and other antibiotic therapy in 23.27%, and primary enucleation/evisceration in 10.89%. The final outcomes and best corrected visual acuities were: anophthalmia 11.86%, no light perception/no dazzle 27.84%, light perception 8.76%, hand motions 24.23%, counting fingers 5.15%, 3/200 to 20/50 12.89%, and 20/40 to 20/20 9.28%.

Conclusions

There was a higher proportion of post-traumatic endophthalmitis cases compared to traditional estimates but consistent with studies from China and Thailand. The majority of these cases involved younger children as well as young to middle-aged males engaged in carpentry and construction work, implying a need for increased public health awareness and strengthening of childcare and workplace safety policies. Our microbiologic profile showed a lower proportion of Gram-positive infections and a higher proportion of mixed pathogen infections compared to other studies. There was also a higher proportion of fungi associated with post-operative and keratitis-induced endophthalmitis. The best outcomes were seen in acute post-operative and bleb-associated endophthalmitis, and the worst outcomes in endogenous and keratitis-induced endophthalmitis. Visual outcomes were poorer compared to other Western and Asian countries, with only 21.7% of patients improving from presentation.

An endoplasmic reticulum-targeted two-photon fluorescent probe for bioimaging of HClO generated during sleep deprivation

With the development of social society, sleep deprivation has become a serious and common issue. Previous studies documented that there is a correlation between sleep deprivation and oxidative stress. However, the information of sleep deprivation related ROS has rarely been obtained. Also, it has been demonstrated that sleep deprivation can induce endoplasmic reticulum (ER) stress. As such, for a better understanding of sleep deprivation as well as its related diseases, it is important to develop probes with ER-targeting ability for detecting ROS generated in this process. Herein, a novel two-photon fluorescent molecular probe, JX-1, was designed for sensing HClO in live cells and zebrafish. The investigation data showed that in addition to real-time response (about 150 s), the probe also exhibited high sensitivity and selectivity. Moreover, the probe JX-1 demonstrated two-photon fluorescence, low cytotoxicity and ER targeting ability. These prominent properties enabled the utilization of the probe for monitoring exogenous and endogenous HClO in both live cells and zebrafish. Using this useful tool, it was found that sleep deprivation can induce the generation of HClO in zebrafish.

Multifactorial effects of aging on the orienting of visual attention

Differential sensitivity of brain areas to the effects of healthy aging may lead to multifactorial influences on the orienting of spatial attention. We examined how aging affects two key aspects of orienting: the benefits of orienting to valid spatial cues vs. the costs of re-orienting following invalid cues, and the impact on orienting of prior cue validity, in the context of different degrees of cue predictivity and types of cue manifestation. We analyzed accuracy and response time data from the performance of 103 older adults and 135 younger adults in three versions of the Attention Networks Test. Participants engaged in target discrimination following either locational cues that were generally non-predictive, locational cues that were generally predictive, or symbolic cues that were generally predictive. We found that healthy older adults did not exhibit greater re-orienting response time costs than younger adults across all cueing types, nor did they differ in the orienting benefits provided by predictive locational cues. However, older adults derived greater benefit from valid cues in a generally non-predictive cueing context, and lesser benefit from valid cues in a symbolic predictive cueing context. Additionally, aging had no impact on the effects of prior trial validity on subsequent trial validity benefits. A comprehensive appreciation of the effects of aging on attention may be informed by these distinctions.

Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management

Purpose

To present a case of fungal endophthalmitis with a novel organism and our management.

Observations

A 46 year old male presented with delayed-onset acute endophthalmitis 6 weeks after routine phacoemulsification and intraocular lens implantation. Initial treatment with intravitreal antibiotics did not improve his condition. With repeated vitreal taps, the causative organism was eventually identified as a fungus, Pseudozyma aphidis. Treatment with oral and intravitreal voriconazole, as well as pars plana vitrectomy, led to resolution of the endophthalmitis and recovery of vision to 20/25.

Conclusions and importance

Fungal endophthalmitis is a rare, potentially blinding complication of cataract surgery. We report our approach to this previously unreported organism, that led to an excellent visual outcome. There are no specific guidelines for fungal endophthalmitis. The management approach has to be tailored to the clinical response and emerging laboratory data from the microbiologist. Identification of the organism will require specialist laboratory references that may not be available in all hospitals. Ophthalmologists must work closely with microbiologists in order to ensure an optimal outcome.

Differentiation of endogenous and exogenous γ-Hydroxybutyrate in rat and human urine by GC/C/IRMS

Gamma (γ)-hydroxybutyric acid (GHB) has been reported to be an endogenous compound in the mammalian brain. It used to treat symptoms of alcohol, opioid, and drug withdrawal and cataplexy of narcolepsy. However, it is often used for criminal purposes because it is colorless, tasteless, and has short half-life. For this reason, there is a need for a method of distinguishing between endogenous and exogenous GHB administration. Therefore, urine from rat before administration of GHB and GHB urine after the single intraperitoneal injection of GHB as 30 mg/100 g were collected from Sprague-Dawley rats (7 weeks old, 10 males and females). Negative control urine, urine from individuals suspected of taking GHB, and urine from victims who were GHB-involved crime were collected. In urine samples, GHB was extracted with two-step SPE and collected fraction was derivatized and analyzed by GC/MS and GC/C/IRMS. In GC/MS and GC/C/IRMS analysis of rat urine, there was a statistically significant difference between urine from rat before administration of GHB and GHB rat urine (p < 0.05). In GC/MS analysis of human urine samples, there was no significant difference among human urine groups (negative control, suspects' urine, and victims' urine), but in GC/C/IRMS analysis of human urine samples, there was a statistically significant difference among human urine groups (p = 0.0001). Through these results, GC/C/IRMS can be more effective tool to identify endogenous and exogenous GHB in urine than GC/MS. This study can build a drug management system in forensic investigation agency and offer interpretation method to forensic science and court.

Multisensory enhancement of attention depends on whether you are already paying attention

Multisensory stimuli are argued to capture attention more effectively than unisensory stimuli due to their ability to elicit a super-additive neuronal response. However, behavioural evidence for enhanced multisensory attentional capture is mixed. Furthermore, the notion of multisensory enhancement of attention conflicts with findings suggesting that multisensory integration may itself be dependent upon top-down attention. The present research resolves this discrepancy by examining how both endogenous attentional settings and the availability of attentional capacity modulate capture by multisensory stimuli. Across a series of four studies, two measures of attentional capture were used which vary in their reliance on endogenous attention: facilitation and distraction. Perceptual load was additionally manipulated to determine whether multisensory stimuli are still able to capture attention when attention is occupied by a demanding primary task. Multisensory stimuli presented as search targets were consistently detected faster than unisensory stimuli regardless of perceptual load, although they are nevertheless subject to load modulation. In contrast, task irrelevant multisensory stimuli did not cause greater distraction than unisensory stimuli, suggesting that the enhanced attentional status of multisensory stimuli may be mediated by the availability of endogenous attention. Implications for multisensory alerts in practical settings such as driving and aviation are discussed, namely that these may be advantageous during demanding tasks, but may be less suitable to signaling unexpected events.

Covert attention beyond the range of eye-movements: Evidence for a dissociation between exogenous and endogenous orienting

The relationship between covert shift of attention and the oculomotor system has been the subject of numerous studies. A widely held view, known as Premotor Theory, is that covert attention depends upon activation of the oculomotor system. However, recent work has argued that Premotor Theory is only true for covert, exogenous orienting of attention and that covert endogenous orienting is largely independent of the oculomotor system. To address this issue we examined how endogenous and exogenous covert orienting of attention was affected when stimuli were presented at a location outside the range of saccadic eye movements. Results from Experiment 1 showed that exogenous covert orienting was abolished when stimuli were presented beyond the range of saccadic eye movements, but preserved when stimuli were presented within this range. In contrast, in Experiment 2 endogenous covert orienting was preserved when stimuli appeared beyond the saccadic range. Finally, Experiment 3 confirmed the observations of Exp.1 and 2. Our results demonstrate that exogenous, covert orienting is limited to the range of overt saccadic eye movements, whereas covert endogenous orienting is not. These results are consistent with a weak, exogenous-only version of Premotor Theory.

Two-photon fluorescent probe with enhanced absorption cross section for relay recognition of Zn2+/P2O74- and in vivo imaging

A novel multifunctional probe, L, based on triphenylamine o-hydroxyl Schiff base was constructed for the sequential detection of Zn²⁺/P₂O₇^4-. Interestingly, probe L also showed two-photon fluorescent "off-on" response to Zn²⁺ along with a large effective two-photon absorption cross-section value of 240 GM at 720 nm, a low cytotoxic and a moderate photostability, which made L a good candidate for two-photon fluorescence microscopy imaging and monitoring the fluctuation of exogenous Zn²⁺.

Longitudinal and transverse variation of trace element concentrations in elephant and giraffe hair: implication for endogenous and exogenous contributions

The spatial distribution of trace elements in hair is highly heterogeneous at the microscale. The relatively mild spatial variation of endogenous signal incorporated during hair growth may be amplified by orders of magnitude due to later exogenous contaminations. Here, we studied the longitudinal and transverse distributions of trace elements in elephant and giraffe hair and discussed the possible endogenous and exogenous contributions. Laser ablation ICP-MS analyses were performed on cross sections of hair to assess the surface contamination and transverse variation. We also removed the contaminated surface layer at various distances from hair root of single hair strands using physical abrasion and measured the concentrations by microwave digestion followed by ICP-MS. By comparing the concentrations of 11 trace elements between the intact and abraded hair segments as a function of distance from root and their laser ablation profiles, we rationalized the endogenous and exogenous contributions: Al and Ti concentrations are dominated by the exogenous contamination on the elephant hair surface, probably in the form of insoluble particles, but not in the giraffe hair; Mg, Ca, Sr, Ba, and Mn are enhanced on the elephant hair surface by exogenous contaminations, but a comparable amount was found in the hair interior suggesting migration of these elements from the surface towards the core; Cu, Zn, Se, and Pb did not have surface accumulation and thus were dominated by the endogenous signal. Overall, giraffe hair had minimal surficial contamination, suggesting the origin of its trace elements is predominantly endogenous, except for Mn, which might get contaminated with airborne particles. We thus demonstrate that contamination of hair may be strongly related to behavioral traits and that the interpretation of trace elemental analyses in hair as a biomonitor or for provenance studies would be highly dependent on the species considered.

Breast milk microRNAs harsh journey towards potential effects in infant development and maturation. Lipid encapsulation can help

The possibility that diet-derived miRNAs survive the gastrointestinal tract and exert biological effects in target cells is triggering considerable research in the potential abilities of alimentary preventive and therapeutic approaches. Many validation attempts have been carried out and investigators disagree on several issues. The barriers exogenous RNAs must surpass are harsh and adequate copies must reach target cells for biological actions to be carried out. This prospect opened a window for previously unlikely scenarios concerning exogenous non-coding RNAs, such as a potential role for breast milk microRNAs in infants' development and maturation. This review is focused on the thorny path breast milk miRNAs face towards confirmation as relevant role players in infants' development and maturation, taking into consideration the research carried out so far on the uptake, gastrointestinal barriers and potential biological effects of diet-derived miRNAs. We also discuss the future pharmacological and pharma-nutritional consequences of appropriate miRNAs research.

Comparative Study of Withanolide Biosynthesis-Related miRNAs in Root and Leaf Tissues of Withania somnifera

Withania somnifera, popularly known as Indian ginseng, is one of the most important medicinal plants. The plant is well studied in terms of its pharmaceutical activities and genes involved in biosynthetic pathways. However, not much is known about the regulatory mechanism of genes responsible for the production of secondary metabolites. The idea was to identify miRNA transcriptome responsible for the regulation of withanolide biosynthesis, specifically of root and leaf tissues individually. The transcriptome data of in vitro culture of root and leaf tissues of the plant was considered for miRNA identification. A total of 24 and 39 miRNA families were identified in root and leaf tissues, respectively. Out of these, 15 and 27 miRNA families have shown their involvement in different biological functions in root and leaf tissues, respectively. We report here, specific miRNAs and their corresponding target genes for corresponding root and leaf tissues. The target genes have also been analyzed for their role in withanolide metabolism. Endogenous root-miR5140, root-miR159, leaf-miR477, and leaf-miR530 were reported for regulation of withanolide biosynthesis.

Exosomal microRNA remodels the tumor microenvironment

Tumor occurrence, progression and metastasis depend on the crosstalk between tumor cells and stromal cells and on extrinsic factors outside the tumor microenvironment. Exosomal microRNA (miRNA) not only is involved in communications within the tumor microenvironment but also mediates communications between the extrinsic environment and tumor microenvironment. However, most reviews have been limited to the role of endogenous exosomal miRNA in remodeling the tumor microenvironment. Hence, we herein review the role of endogenous exosomal miRNA in mediating intercellular crosstalk within the tumor microenvironment, inducing the formation of the premetastatic niche. To place our vision outside the microenvironment, we also summarize for the first time the most recent studies regarding how exogenous miRNA derived from milk, plants and microbes influences the tumor microenvironment. Furthermore, to improve the value of exosomal miRNA in cancer research and clinical applications, we also provide some novel ideas for future research based on the comprehensive role of exosomal miRNA in remodeling the tumor microenvironment.

Ancestral resurrection of anthropoid estrogen receptor β demonstrates functional consequences of positive selection

Anthropoid primates arose during the Eocene approximately 55 million years ago (mya), and extant anthropoids share a most recent common ancestor ∼40mya. Paleontology has been very successful at describing the morphological phenotypes of extinct anthropoids. Less well understood is the molecular biology of these extinct species as well as the phenotypic consequences of evolutionary variation in their genomes. Here we resurrect the most recent common ancestral anthropoid estrogen receptor β gene (ESR2) and demonstrate that the function of this ancestral estrogen receptor has been maintained during human descent but was altered during early New World monkey (NWM) evolution by becoming a more potent transcriptional activator. We tested hypotheses of adaptive evolution in the protein coding sequences of ESR2, and determined that ESR2 evolved via episodic positive selection on the NWM stem lineage. We separately co-transfected ESR2 constructs for human, NWM, and the anthropoid ancestor along with reporter gene vectors and performed hormone binding dose response experiments that measure transactivation activity. We found the transactivation potentials of the ancestral and human sequences to be significantly lower (p<0.0001 in each comparison) than that of the NWM when treated with estradiol, the most prevalent estrogen. We conclude the difference in fold activation is due to positive selection in the NWM ERβ ligand binding domain. Our study validates inferential methods for detecting adaptive evolution that predict functional consequences of nucleotide substitutions and points a way toward examining the functional consequences of positive Darwinian selection.

Carbon monoxide-releasing molecule, CORM-3, modulates alveolar macrophage M1/M2 phenotype in vitro

Alveolar macrophages are key contributors to both the promotion and resolution of inflammation in the lung and are categorized into pro-inflammatory (M1) and anti-inflammatory (M2) phenotypes. The change in M1/M2 balance has been reported in various pulmonary diseases and is a target for therapeutic intervention. The aim of this study was to assess the modulation of M1/M2 phenotype in alveolar macrophages by water-soluble carbon monoxide-releasing molecule-3 (CORM-3). Rat alveolar macrophages (AM) (NR8383) in culture were stimulated with LPS (5 ng/ml)/IFN-γ (10 U/ml) or IL-4 (10 ng/ml)/IL-13 (10 ng/ml) to induce M1 and M2 phenotypes, respectively. Expression of M1 phenotype markers, iNOS and TNF-α, and M2 phenotype markers, CD206 and Ym-1, was assessed by western blotting after 1, 3, 6, or 24 h in the absence or presence of CORM-3 (0.15 mM) treatment. Inactive CORM-3 (iCORM-3) was used as a control. Treatment of naïve (unstimulated) AM with CORM-3 promoted progression of the M2 phenotype as evidenced by the increased expression of CD206 (at 1 h; 1.8-fold) and Ym-1 (at 3 h; 1.9-fold), respectively. Surprisingly, CORM-3 treatment also upregulated the expression of iNOS protein as assessed 6 h following stimulation of AM with CORM-3 (2.6-fold). On the contrary, CORM-3 effectively reduced LPS/IFN-γ-induced expression of iNOS protein (0.6-fold); however, it had no effect on TNF-α expression. Finally, CORM-3 acutely (1-3 h) upregulated CD206 (1.4-fold) and Ym-1 (1.6-fold) levels in IL-4-/IL-13-treated (M2-stimulus) macrophages. These findings indicate that CORM-3 modulates macrophage M1 and M2 phenotypes in vitro with respect to continuous suppression of iNOS expression in M1-polarized macrophages and transient (early-phase) upregulation of CD206 and Ym-1 proteins in M2-polarized macrophages.

Endophthalmitis

Endophthalmitis is a rare but severe form of ocular inflammation due to infection of the intraocular cavity that can lead to irreversible visual loss if not treated properly and timely. It can be classified as exogenous or endogenous based on the transmission route of the infectious source. Exogenous endophthalmitis occurs when infecting organisms gain entry into the eye via direct inoculation, while endogenous endophthalmitis occurs when infectious agents hematogenously spread into the eye from a distant focus of infection. The diagnosis of endophthalmitis depends mostly on the clinical findings on ophthalmological examination. Delayed diagnosis of endogenous endophthalmitis can lead to not only visual loss, but also increased risk of mortality. Since ocular and systemic symptoms of endophthalmitis are usually non-specific, early diagnosis relies on the alertness of clinicians. Early diagnosis and proper treatment are keys to saving the eye. Following advances in vitreoretinal pharmacotherapy and surgical technology, early surgical intervention is the current trend in the management of endophthalmitis.

On the spatial specificity of audiovisual crossmodal exogenous cuing effects

It is generally-accepted that the presentation of an auditory cue will direct an observer's spatial attention to the region of space from where it originates and therefore facilitate responses to visual targets presented there rather than from a different position within the cued hemifield. However, to date, there has been surprisingly limited evidence published in support of such within-hemifield crossmodal exogenous spatial cuing effects. Here, we report two experiments designed to investigate within- and between-hemifield spatial cuing effects in the case of audiovisual exogenous covert orienting. Auditory cues were presented from one of four frontal loudspeakers (two on either side of central fixation). There were eight possible visual target locations (one above and another below each of the loudspeakers). The auditory cues were evenly separated laterally by 30° in Experiment 1, and by 10° in Experiment 2. The potential cue and target locations were separated vertically by approximately 19° in Experiment 1, and by 4° in Experiment 2. On each trial, the participants made a speeded elevation (i.e., up vs. down) discrimination response to the visual target following the presentation of a spatially-nonpredictive auditory cue. Within-hemifield spatial cuing effects were observed only when the auditory cues were presented from the inner locations. Between-hemifield spatial cuing effects were observed in both experiments. Taken together, these results demonstrate that crossmodal exogenous shifts of spatial attention depend on the eccentricity of both the cue and target in a way that has not been made explicit by previous research.

Comparison between the AC and DC measurement of electrodermal activity

Recording electrodermal activity is a well-accepted physiological measurement for clinical approaches and research. Historically, applying a DC (direct current) signal to the skin to measure the conductance is the most common practice for exogenous recordings. However, this method can be subject to error due to electrode polarization even with "nonpolarizing" electrodes-a problem that can be eliminated with alternating current (AC) methodology. For that reason, Boucsein et al. () called for research demonstrating an AC method that is validated by comparison to standard DC methodology. Additionally, the complex structure of human skin has electrical properties that include both resistance and capacitance, and AC recording enables the measurement of skin susceptance (associated with current flow through capacitors). Finally, AC recording permits the simultaneous recording of the endogenous skin potential. In this paper, the results from a direct comparison between both methods are presented, which has not been reported previously. The results demonstrated excellent agreement between a 20 Hz AC method and a standard DC method, supporting the validity of the AC recording methodology employed. The results also showed that an applied voltage of 0.2 V is sufficient for DC recordings.

Reprint of: Object-based attentional facilitation and inhibition are neuropsychologically dissociated

Salient peripheral cues produce a transient shift of attention which is superseded by a sustained inhibitory effect. Cueing part of an object produces an inhibitory cueing effect (ICE) that spreads throughout the object. In dynamic scenes the ICE stays with objects as they move. We examined object-centred attentional facilitation and inhibition in a patient with visual form agnosia. There was no evidence of object-centred attentional facilitation. In contrast, object-centred ICE was observed in 3 out of 4 tasks. These inhibitory effects were strongest where cues to objecthood were highly salient. These data are evidence of a neuropsychological dissociation between the facilitatory and inhibitory effects of attentional cueing. From a theoretical perspective the findings suggest that 'grouped arrays' are sufficient for object-based inhibition, but insufficient to generate object-centred attentional facilitation.

Exogenous sample contamination. Sources and interference

Clinical laboratory medicine is involved in the vast majority of patient care pathways. It has been estimated that pathology results inform 60-70% of critical patient care decisions. The primary goal of the laboratory is to produce precise and accurate results which reflect the true situation in vivo. It is not surprising that interference occurs in laboratory analysis given the complexity of some of the assays used to perform them. Interference is defined as "the effect of a substance upon any step in the determination of the concentration or catalytic activity of the metabolite". Exogenous interferences are defined as those that derive from outside of the body and are therefore not normally found in a specimen and can cause either a positive or negative bias in analytical results. Interferences in analysis can come from various sources and can be classified as endogenous or exogenous. Exogenous substances could be introduced at any point in the sample journey. The laboratory must take responsibility for the quality of results produced. It has a responsibility to have processes in place to identify and minimise the occurrence and effect contamination and interference. To do this well the laboratory needs to work with clinicians and manufacturers. Failure to identify an erroneous result could have an impact on patient care, patient safety and also on hospital budgets. However it is not always easy to recognise interferences. This review summarises the types and sources of exogenous interference and some steps to minimise the impact they have.

Carbon monoxide and anesthesia-induced neurotoxicity

The majority of commonly used anesthetic agents induce widespread neuronal degeneration in the developing mammalian brain. Downstream, the process appears to involve activation of the oxidative stress-associated mitochondrial apoptosis pathway. Targeting this pathway could result in prevention of anesthetic toxicity in the immature brain. Carbon monoxide (CO) is a gas that exerts biological activity in the developing brain and low dose exposures have the potential to provide neuroprotection. In recent work, low concentration CO exposures limited isoflurane-induced neuronal apoptosis in a dose-dependent manner in newborn mice and modulated oxidative stress within forebrain mitochondria. Because infants and children are routinely exposed to low levels of CO during low-flow general endotracheal anesthesia, such anti-oxidant and pro-survival cellular effects are clinically relevant. Here we provide an overview of anesthesia-related CO exposure, discuss the biological activity of low concentration CO, detail the effects of CO in the brain during development, and provide evidence for CO-mediated inhibition of anesthesia-induced neurotoxicity.

Relationship between subclinical thyroid dysfunction and the risk of fracture: a meta-analysis of prospective cohort studies

To identify the relationship between subclinical thyroid dysfunction and the risk of fracture, we conducted a meta-analysis of prospective cohort studies. Results showed that subclinical hyperthyroidism is associated with an increased risk of fracture, especially in elder.

INTRODUCTION

There are conflicting data on the association between subclinical thyroid dysfunction and the risk of fracture. This study is aimed at providing a summary of prospective evidence of the relationship between subclinical thyroid dysfunction and the risk of fracture.

METHODS

We systematically searched the MEDLINE, EMBASE, and the Chinese Biomedical literature database (CBM) from 1974 to August 2014 to identify prospective cohort studies which have studied the risk of fracture in patients with subclinical thyroid dysfunction. Various fractures were reported as the sole outcome.

RESULTS

Five population-based cohort studies including 314,146 participants with relationship of endogenous or exogenous subclinical thyroid dysfunction or euthyroidism and fractures were identified as eligible for the meta-analysis. In an unadjusted model, the relative risk (RR) of subclinical hypothyroidism for fracture was 1.30 (CI 1.08-1.56). Risk estimates were lower in a multivariable-adjusted model (RR = 1.20, CI 0.70-2.04) and when higher quality studies (RR = 0.95, CI 0.58-1.57) were analyzed. For subclinical hyperthyroidism, the RR was 1.52 (CI 1.33-1.73) in unadjusted model and 1.25 (CI 1.11-1.41) in a multivariable-adjusted model. An analysis of higher quality studies revealed a RR 1.18 (CI 1.07-1.29). Subgroup analysis indicated that the RR for risk of fracture was higher in the endogenous group than the exogenous group, taking thyroid-altering medicine in subclinical hyperthyroidism. Similar finding was also demonstrated in subclinical hypothyroidism.

CONCLUSIONS

Despite heterogeneity across the studies, data suggest that subclinical hyperthyroidism is associated with an increased risk of fracture in the population older than 60 years. No evidence could prove a definite association between subclinical hypothyroidism and the risk of fracture yet.

Orienting of attention: Then and now

It is nearly 35 years since I gave the 7th Sir Frederick Bartlett lecture at Oxford University. This was published as a paper entitled "Orienting of attention in the quarterly journal". The topic was then primarily in psychology, but now equally often in neuroscience. This paper summarizes the background of the reaction time methods used in the original paper and findings that emerged later on the sensory consequences of orienting, mainly in the visual system. It then discusses the brain network that is the source of the sensory amplification and other brain networks that are involved in attention. Next, it reviews studies of the development of attentional networks in early life. Finally, it indicates how the new tools available to explore the human brain can lead to further progress.

Measuring effects of voluntary attention: a comparison among predictive arrow, colour, and number cues

The Posner cueing paradigm is one of the most widely used paradigms in attention research. Importantly, when employing it, it is critical to understand which type of orienting a cue triggers. It has been suggested that large effects elicited by predictive arrow cues reflect an interaction of involuntary and voluntary orienting. This conclusion is based on comparisons of cueing effects of predictive arrows, nonpredictive arrows (involuntary orienting), and predictive numbers (voluntary orienting). Experiment 1 investigated whether this conclusion is restricted to comparisons with number cues and showed similar results to those of previous studies, but now for comparisons to predictive colour cues, indicating that the earlier conclusion can be generalized. Experiment 2 assessed whether the size of a cueing effect is related to the ease of deriving direction information from a cue, based on the rationale that effects for arrows may be larger, because it may be easier to process direction information given by symbols such as arrows than that given by other cues. Indeed, direction information is derived faster and more accurately from arrows than from colour and number cues in a direction judgement task, and cueing effects are larger for arrows than for the other cues. Importantly though, performance in the two tasks is not correlated. Hence, the large cueing effects of arrows are not a result of the ease of information processing, but of the types of orienting that the arrows elicit.

A cross-sectional analysis of orienting of visuospatial attention in child and adult carriers of the fragile X premutation

Background

Fragile X premutation carriers (fXPCs) have an expansion of 55–200 CGG repeats in the FMR1 gene. Male fXPCs are at risk for developing a neurodegenerative motor disorder (fragile X-associated tremor/ataxia syndrome (FXTAS)) often accompanied by cognitive decline. Several broad domains are implicated as core systems of dysfunction in fXPCs, including perceptual processing of spatial information, orienting of attention to space, and inhibiting attention to irrelevant distractors. We tested whether orienting of spatial attention is impaired in fXPCs.

Methods

Participants were fXPCs or healthy controls (HCs) asymptomatic for FXTAS. In experiment 1, they were male and female children and adults (aged 7–45 years). They oriented attention in response to volitional (endogenous) and reflexive (exogenous) cues. In experiment 2, the participants were men (aged 18–48 years). They oriented attention in an endogenous cueing task that manipulated the amount of information in the cue.

Results

In women, fXPCs exhibited slower reaction times than HCs in both the endogenous and exogenous conditions. In men, fXPCs exhibited slower reaction times than HCs in the exogenous condition and in the challenging endogenous cueing task with probabilistic cues. In children, fXPCs did not differ from HCs.

Conclusions

Because adult fXPCs were slower even when controlling for psychomotor speed, results support the interpretation that a core dysfunction in fXPCs is the allocation of spatial attention, while perceptual processing and attention orienting are intact. These findings indicate the importance of considering age and sex when interpreting and generalizing studies of fXPCs.

Exogenous ochronosis After Prolonged Use of Topical Hydroquinone (2%) in a 50-Year-Old Indian Female

Ochronosis is a rare disease characterized by speckled and diffuse pigmentation symmetrically over the face, neck, and photo-exposed areas. It is characterized histologically by banana-shaped ochre-colored deposits in the dermis. It can present in exogenous or endogenous form. We report a case of exogenous ochronosis in a 50-year-old Indian woman after prolonged use of topical hydroquinone which is a rare complication with a commonly used drug which is available over the counter.