Cardiac and Metabolic Responses to “Space Invaders”: An Instance of Metabolically-Exaggerated Cardiac Adjustment?

Heart rate, plus various ventilatory and metabolic indices, were monitored while 24 male subjects played a computer game of the “space invaders” type and during a control condition, in which analogous but ineffective actions were requested and the game proceeded automatically. Relative to baseline, subjects showed much larger increases in heart rate during “space invaders” than during the control condition. However, oxygen consumption, carbon dioxide production, respiratory rate and volume also increased more. While the absolute magnitude of metabolic differences between conditions could be regarded as modest relative to heart rate differences, given the effective range of variations possible for each parameter, the existence of highly significant differences in oxygen consumption and carbon dioxide production militates against assertions of overall cardiac-metabolic independence during “space invaders.” Nevertheless, analysis of individual differences in heart rate reactivity would seem to provide some evidence of metabolically-unjustified heart rate changes during “space invaders.” High heart rate reactors during “space invaders” did not differ from low reactors in either oxygen consumption or carbon dioxide production. In addition, this relatively high heart rate reactivity was specific to the “space invaders” condition; high and low heart rate reactors displayed no differences in heart rate, or in any other physiological measure, during the control condition or during baseline.     

Infant regulation of the vagal “brake” predicts child behavior problems: A psychobiological model of social behavior

Cardiac vagal tone is a construct that describes the functional relationship between the brainstem and the heart. Cardiac vagal tone is measured by quantifying the amplitude of respiratory sinus arrhythmia, a component of heart rate variability reflecting the functional output of vagal pathways on the heart. Although there is an extensive literature evaluating baseline vagal tone and its relation to behavior, the relation between individual differences in the ability to regulate cardiac vagal tone and behavior has been theoretically vague. This article introduces a theoretical model to explain the relation between vagal tone during steady states and vagal reactivity (i.e., the vagal brake) in response to environmental challenges. Based upon the proposed model, it was hypothesized that infants who had difficulties in regulating the vagal brake (i.e., decreasing cardiac vagal tone) during social/attention tasks would have difficulties developing appropriate social interactions requiring reciprocal engagement and disengagement strategies. Data from 24 infants are presented. The findings support the model and demonstrate that infants with difficulties in decreasing vagal tone during a social/attention task at 9 months of age had significantly more behavioral problems at 3 years of age. © 1996 John Wiley & Sons, Inc.     

Metabolic responses in feline “red” and “white” skeletal muscle to shock and ischemia

In order to investigate possible differences in the reaction to hypoxic conditions between “red” and “white” skeletal muscle, cats were subjected to a 2 h period of either hemorrhagic shock or hind limb tourniquet ischemia, and the hypoxia induced changes were studied in the soleus and lateral gastrocnemius muscles. Muscle biopsies were analysed for ATP, CP, glucose, G 6–P and lactate. Using microelectrodes, the resting membrane potential was repeatedly measured. Both experimental models resulted in increased tissue lactate levels and a successive decrease in the membrane potential of both muscles studied. No reduction of the high energy phosphagen content (ATP+CP) occurred in any of the muscles during shock. The tourniquet ischemia resulted in a 40% reduction of the ATP+CP content in the soleus muscle, whereas in the gastrocnemius muscle no significant reduction occurred. A significant correlation was found between the tissue lactate content and the membrane potential under both conditions and in both muscles studied. It is concluded that “red” muscles are more susceptible to metabolic derangement than “white” muscles during total ischemia, whereas during hypovolemia “red” muscles appear to be protected from early hypoxic damage, probably due to a redistribution of skeletal muscle blood flow.     

Heart Rate and Respiratory Responses as a Function of Task Difficulty: The Use of Discriminant Analysis in the Selection of Psychologically Sensitive Physiological Responses

The relationship between physiological response patterns.and task difficulty was investigated by evaluating heart rate and respiratory responses during a choice reaction lime tusk with three levels of task difficulty. The data fit a two-component model or attention containing reactive and sustained responses. There were two reactive responses: An immediate deceleration which was independent of task manipulation; and a short latency response, monotonically paralleling task difficulty, which was characterized by acceleration and an increase in heart rate variability. The sustained component exhibited task dependent deceleration and u generalized reduction in heart rate variability and respiration amplitude variability. A stepwise discriminant analysis was performed on the task conditions using physiological responses to determine responses sensitive to task demands. Physiological response patterns were monotonically ordered as a function of task difficulty, suggesting that this technique may have advantages for determining physiological responses most sensitive to psychological manipulation.     

“Glass fairies” and “bone children”: Adolescents and young adults with anorexia nervosa show positive reactions towards extremely emaciated body pictures measured by the startle reflex paradigm

In this study, we investigated the emotional processing of extremely emaciated body cues in adolescents and young adults with (n = 36) and without (n = 36) anorexia nervosa (AN), introducing a new picture type, which was taken from websites that promote extreme thinness and is targeted specifically at adolescents interested in extreme thinness. A startle reflex paradigm was used for implicit reactions, while a self‐assessment instrument was used for subjective responses. We found a significant group difference with a startle inhibition (appetitive response) among the patients and a startle potentiation (aversive response) among the controls, whereas no such difference for subjective measures was found. The results are in contrast to previous studies, which proposed a general failure to activate the appetitive motivational system in AN, but in keeping with findings from other addictions, where the same response pattern has been found. Implications for prevention and therapy are discussed.     

Intrafamilial “DOA‐plus” phenotype variability related to different OMI/HTRA2 expression

Dominant Optic Atrophy and Deafness (DOAD) may be associated with one or more of the following disorders such as myopathy, progressive external ophthalmoplegia, peripheral neuropathy, and cerebellar atrophy (“DOA‐plus”). Intra‐ and interfamilial variability of the “DOA‐plus” phenotype is frequently observed in the majority of the patients carrying the same mutation in the OPA1 gene. We are describing two familial cases of “DOA‐plus” carrying the same c.1334G>A (p.Arg445His) mutation in OPA1 and disclosing different clinical, pathological and biochemical features. The two patients showed different expression levels of the mitochondrial OMI/HTRA2 molecule, which acts as a mitochondrial stress sensor and has been described to interplay with OPA1 in in vitro studies. Our data offer the cue to inquire the role of OMI/HTRA2 as a modifier gene in determining the “DOAplus” phenotype variability.     

“Low-risk” and “High-risk” HPV-infection and K-ras Gene Point Mutations in Human Cervical Cancer: A Study of 31 Cases

To analyze the coexistence of human papilloma virus (HPV) infection and K-ras gene activation in cervical neoplasia, we investigated 31 (seven pre-invasive and 24 invasive) cervical carcinomas for “low-risk” (types 6 and 11) and “high-risk” (types 16 and 18) HPVs and K-ras point mutations using PCR-based technology. “Low-risk” HPVs were not detected in the group investigated; however, 20 of 31 (64%) cases were HPV 16 positive, while HPV 18 was found in only three (9.7%) samples (HPV 6/11 v. HPV 16/18, p < 0.0001; HPV 16 v. HPV 18, p < 0.0001; Fisher's exact test). There was a K-ras codon 12 point mutation in two of 31 (6.4%) neoplasms, with none of the cases showing a K-ras codon 13 point mutation. Two moderately differentiated squamous carcinomas showed K-ras exon 2 gene alterations. Interestingly, none of the pre-invasive cervical carcinomas displayed K-ras gene point mutations. The mean patient age did not differ significantly in the number of HPV-positive and -negative cases. A coexistence of “high-risk” human papillomavirus DNA with K-ras gene alterations was observed in three of 31 (9.7%) neoplasms (one IIA and two IB moderately differentiated cervical carcinomas). Our results suggest that “high-risk” HPVs coexist with K-ras gene alterations in a subset of moderately differentiated carcinomas of the cervix uteri.     

Linear Polyethyleneimine: Optimized Synthesis and Characterization – On the Way to “Pharmagrade” Batches

The synthesis of linear polyethyleneimine (LPEI) by acidic hydrolysis of poly(2‐ethyl‐2‐oxazoline) is studied and optimized to reach the highest degree of hydrolysis within the shortest time range using a microwave synthesizer. In addition, the purification procedure is significantly improved; the fast batch processing combined with an excellent control of the actual heating time represents a well‐suited alternative to the conventional synthesis on the way to “pharmagrade” PEI. The developed protocol for the preparation of methyl and proton‐initiated LPEIs shows a high reproducibility, and the identity and purity of the LPEIs is proven by means of ¹H NMR and IR spectroscopy as well as MALDI‐TOF‐ and ESI‐Q‐TOF‐MS.

     

Perceptions of the “anorexic voice”: A qualitative study of health care professionals

People with anorexia nervosa (AN) often report experiencing a highly critical inner voice (AV) focused on their eating, shape, and weight. There are promising preliminary findings for its role in the treatment of AN, and the support of staff is vital for the AV to be embedded in treatment, but their views remain unknown. The aims of this study were to undertake a qualitative exploration of the perceptions of the AV among health care professionals (HCPs) in specialist eating disorder services. A thematic analysis was applied to interviews with 15 HCPs, including nurses, therapists, psychiatrists, health care assistants, psychologists, and dietitians. Two overarching themes were identified: “The AV is a vehicle for increasing compassion” and “It's not a one‐size‐fits‐all.” The AV was seen as a means of developing and sustaining compassion, but participants noted that it does not resonate for all clients. All HCPs in this study believed that there was potential benefit in utilizing the AV in their work with people with AN, and it is likely that doing so would help to reduce burnout and frustration within clinical teams.     

The “muscular variant” of Pompe disease: Clinical,biochemical and histologic characteristics

We report on a 2-yr-old boy with progressive muscular weakness and respiratory failure. There was no clinical evidence of heart muscle involvement. Autopsy showed marked intralysosomal glycogen deposition in skeletal muscle and liver with no histological evidence of glycogen deposition in cardiac muscle. The activity of the lysosomal enzyme α-1,4-glucosidase was deficient in skin fibroblasts, skeletal muscle, cardiac muscle, and liver; however, the enzymatic activity in peripheral blood leukocytes was in the low normal range. The child's mother had normal enzymatic activity in leukocytes but heterozygote levels in skin fibroblasts.     

Communication,collaboration and contagion: “Virtualisation” of anatomy during COVID‐19

COVID‐19 has generated a global need for technologies that enable communication, collaboration, education and scientific discourse whilst maintaining physical distance. University closures due to COVID‐19 and physical distancing measures disrupt academic activities that previously occurred face‐to‐face. Restrictions placed on universities due to COVID‐19 have precluded most conventional forms of education, assessment, research and scientific discourse. Anatomists now require valid, robust and easy‐to‐use communication tools to facilitate remote teaching, learning and research. Recent advances in communication, video conferencing and digital technologies may facilitate continuity of teaching and research activities. Examples include highly‐interactive video conferencing technology, collaborative tools, social media and networking platforms. In this narrative review, we examine the utility of these technologies in supporting effective communication and professional activities of anatomists during COVID‐19 and after.     

Calvarial “doughnut lesions”: Clinical spectrum of the syndrome,report on a case,and review of the literature

Many pathologic fractures, lumps on the head, elevated serum alkaline phosphatase (ALP) levels, and dental caries are the main characteristics of the rare autosomal dominantly inherited calvarial “doughnut lesions” (MIM 126550). We report the sporadic case of a 16‐year‐old patient who has had 10 pathologic fractures between age 6 weeks and 15 years. An elevated serum ALP level was found at age 11 and skull lumps at age 15; radiography showed frontal and parietal round radiolucencies surrounded by sclerotic bone comparable to doughnuts. Magnetic resonance imaging (MRI) showed skull lesions at an early stage. Because the findings are reminiscent of osteogenesis imperfecta (OI), collagen types I, III, and V were analyzed in fibroblasts and shown to be normal in terms of quantities, proportions, electrophoretic mobility, and thermostability. Thus, this rare syndrome can be distinguished from OI by collagen analysis and MRI of the skull at an early stage, even before palpable skull lesions appear. © 2001 Wiley‐Liss. Inc.     

Cognitive flexibility,heart rate variability,and resilience predict fine‐grained regulation of arousal during prolonged threat

Emotion regulation in the ongoing presence of a threat is essential for adaptive behavior. Threatening situations change over time and, as a consequence, require a fine‐tuned, dynamic regulation of arousal to match the current state of the environment. Constructs such as cognitive flexibility, heart rate variability, and resilience have been proposed as resources for adaptive emotion regulation, especially in a moment‐to‐moment fashion. Nevertheless, none of these constructs has been empirically related to the dynamic regulation of arousal as it unfolds over the course of a prolonged threatening episode. Here, we do so by placing participants in a threatening and evolving immersive virtual environment called Room 101, while recording their skin conductance. Subsequently, participants rated their subjective arousal continuously over the course of the experience. Participants who had shown greater cognitive flexibility in a separate task (i.e., fewer task‐switching costs when switching to evaluating the valence of positive stimuli) showed better regulation of physiological arousal (skin conductance level), during less‐threatening phases of Room 101. Individuals with higher trait resilience and individuals with higher resting heart rate variability showed more regulation in terms of their subjective arousal experience. The results indicate that emotional, cognitive, and physiological flexibility support nuanced adaptive regulation of objective and experienced arousal in the ongoing presence of threats. Furthermore, the results indicate that these forms of flexibility differentially affect automatic and objective versus reflective and subjective processes.     

Introduction: “Mythos and logos in hesiod's theogony,Circa 700 B.C.”

We describe a profoundly intellectually disabled 24-year-old man with Wolf-Hirschhorn syndrome, left hemiplegia, epilepsy, atrophy of the right cerebral hemisphere, and dilatation of the right ventricle. The patient had a small ventricular septal defect, was wheelchair bound, and totally dependent. He had no speech, but vocalised to show his feelings. In this patient, the del(4)(p15) was subtle and arose due to the inheritance of a recombinant chromosome (4) from a maternal pericentric inversion—46,XX,inv(4) (p15.32q35). Fluorescence in situ hybridisation with probe D4S96 confirmed the deletion. This is the second case of Wolf-Hirschhorn syndrome resulting from a large pericentric inversion of chromosome 4. © 1996 Wiley-Liss, Inc.