Common and specific brain responses to scenic emotional stimuli

Processing of emotions has been an enduring topic of interest in neuroimaging research, but studies have mostly used facial emotional stimuli. The aim of this study was to determine neural networks involved in emotion processing using scenic emotional visual stimuli. One hundred and twenty photographs from the International Affective Picture System (IAPS), including ecological scenes of disgust, fear, happiness, and sadness, were presented to 40 healthy participants while they underwent functional magnetic imaging resonance (fMRI). Afterwards they evaluated the emotional content of the pictures in an offline task. The occipito-temporal cortex and the amygdala–hippocampal complex showed a non-specific emotion-related activation, which was more marked in response to negative emotions than to happiness. The temporo-parietal cortex and the ventral anterior cingulate gyrus showed deactivation, with the former being marked for all emotions except fear and the latter being most marked for disgust. The fusiform gyrus showed activation in response to disgust and deactivation in response to happiness or sadness. Brain regions involved in processing of scenic emotion therefore resemble those reported for facial expressions of emotion in that they respond to a range of different emotions, although there appears to be specificity in the intensity and direction of the response.     

PET/CT-Based Response Evaluation in Cancer—a Systematic Review of Design Issues

Molecular Imaging and Biology - Positron emission tomography/x-ray computed tomography (PET/CT) has long been discussed as a promising modality for response evaluation in cancer. When designing...     

DIetary ASSessment (DIASS) Study: Design of an Evaluation Study to Assess Validity,Usability and Perceived Burden of an Innovative Dietary Assessment Methodology

During recent years, the integration of technology has substantially improved self-reported dietary assessment methods, such as food frequency questionnaires (FFQ), food records, and 24-h recalls. To further reduce measurement error, additional innovations are urgently needed. Memory-related measurement error is one of the aspects that warrants attention, which is where new smartphone technologies and ecological momentary assessment (EMA) approaches provide a unique opportunity. In this article, we describe the DIASS study, which was designed to evaluate an innovative 2-h recall (2hR) smartphone-based methodology, against traditional 24-h recalls, FFQ, and biomarkers, to assess both actual and habitual dietary intake. It is hypothesized that a 2-h reporting window decreases reliance on memory and reporting burden, and increases data accuracy. We included 215 men (28%) and women (72%), with a mean ± SD age of 39 ± 19 years and a mean ± SD BMI of 23.8 ± 4.0. Most participants were highly educated (58%). Response rates for the various dietary assessment methods were >90%. Besides the evaluation of the accuracy, usability, and perceived burden of the 2hR methodology, the study set-up also allows for (further) evaluation of the other administrated dietary assessment tools.     

Phosphorylation of proteoglycans from human articular cartilage

Previous studies have shown that sulfated proteoglycans from human articular and epiphyseal cartilage were phosphorylated. These macromolecules contribute to the stiffness and resiliency of this tissue. We demonstrate here that the phosphate moieties are an integral part of proteoglycan subunits. Specifically, evidence is presented which indicates that proteoglycan monomers contain 3 to 4 phosphate moieties per core protein and that these appear to exist as phosphoserine residues. Furthermore, the data illustrate that human articular cartilage also contains more than 20 different phospho-proteins, some of which are closely associated with proteoglycan aggregates. Proteoglycan subunits were purified from extracts of articular cartilage or from media fractions which had been used to label tissue specimens with ³²P-orthophosphate. Chemical and radiographic analyses revealed that the phosphate concentration with respect to sulfate and uronic acid content remained constant when purified proteoglycan monomers were subjected to equilibrium ultracentrifugation and size-exclusion chromatography. That the phosphate moieties were bound to proteoglycan monomers via monoester linkages was indicated by the release of ³²P-orthophosphate from proteoglycan subunits incubated under mild alkaline conditions or reacted with acid or alkaline phosphatases. Identification of serine residues in the core protein as the sites of phosphorylation was made by autoradiography of thin layer plates on which hydrolyzed samples of purified ³²P-proteoglycan sub-units had been subjected to 2-dimensional electrophoresis/chromatography. Quantification of 3 to 4 phosphate moieties per core protein of 200,000 daltons was made by chemical analysis of inorganic phosphate released from proteoglycans by acid hydrolysis.     

Adaptation and use of health services by primiparous women with urinary incontinence

OBJECTIVES: To describe the use of health services by primiparous women with urinary incontinence by (a) examining the quality of life of these women and (b) describing the different predictors associated with their use of health services. DESIGN AND SETTING: This correlative study is a secondary analysis of a broader epidemiologic study. PARTICIPANTS: The 382 women identified as having urinary incontinence in the main epidemiologic study in Quebec, Canada. MAIN OUTCOME MEASURES: Consultation rate; quality of life, predictors of quality of life, and use of health services; treatments received; and reasons for not seeking help. RESULTS: Consultation rate was 11.1%. Many sociodemographic, clinical, and urinary incontinence factors were significantly associated with a decreased quality of life. Only frequency of nocturia, severe urinary incontinence, use of sanitary protection, and lower scores on the quality-of-life scale were significantly associated with differences in consultation rates. Physiotherapy was the most popular treatment received (71.4%). Most women with urinary incontinence did not consult because they considered urinary incontinence to be normal (47.3%). CONCLUSIONS: Few women with urinary incontinence used health services for their urinary incontinence problem despite a decreased quality of life. Health professionals need to intervene early and promptly to help women with urinary incontinence deal more adequately with urinary incontinence and to inform women on how and where to seek help.     

Shoulder dystocia

Using an evidence-based, medical approach, the strengths and pitfalls of the causation- and standard-of-care-based arguments proffered by plaintiff and defense counsel in shoulder dystocia- associated birth injury litigation are reviewed based on medical plausibility. The role of the expert witness as arbiter of the relationship between medical care rendered and the untoward outcome of such care is distinguished from that of other court members. Proposed solutions to the medical malpractice litigation crisis are also examined in light of relevant differences in the pathogenetic bases for birth injuries of various types.     

After shoulder dystocia: managing the subsequent pregnancy and delivery

Among risk factors for shoulder dystocia, a prior history of delivery complicated by shoulder dystocia is the single greatest risk factor for shoulder dystocia occurrence, with odds ratios 7 to 10 times that of the general population. Recurrence rates have been reported to be as high as 16%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, intervention efforts directed at the particular subgroup of women with a prior history of shoulder dystocia can concentrate on potentially modifiable risk factors and individualized management strategies that can minimize recurrence and the associated significant morbidities and mortality.     

Optimizing shoulder dystocia management to prevent birth injury

A practical clinical review of those aspects of shoulder dystocia management that are directly relevant to birth injury is presented. In contrast to more popular viewpoints, the tenets of this paper are that, with few exceptions, clinically relevant, permanent brachial plexus injury is nearly universally associated with shoulder dystocia, injury is causally related to mechanical stresses induced during shoulder dystocia delivery, and management algorithms can be optimized to reduce the incidence of mechanical birth injury from shoulder dystocia. Advantages of direct rotational manipulation of the fetus within the birth canal are emphasized, supported by critical analysis of maneuver-related outcomes research. The competing issue of potential asphyxial insult with prolonged shoulder dystocia is addressed in light of evidence for differential time-dependency between central and peripheral nerve injury as head-to-body interval increases. The importance of proper execution of shoulder dystocia maneuvers for maximizing favorable outcome of shoulder dystocia is iterated, as is coordination of teamed response by multiple healthcare providers. To avoid permanent neurologic sequelae from shoulder dystocia, clinicians are encouraged to be ever mindful of traction applied to the fetal head and neck, to become adept at performance of alternative maneuvers that instead concentrate on finesse rather than force, and to be more favorably disposed to the use of such maneuvers early and often in shoulder dystocia management algorithms.     

Update on the use of dapsone in dermatology

Dapsone (4,4'-diaminodiphenylsulfone) is the only remaining sulfone used in anthropoid therapeutics and is commercially available as an oral formulation, an inhaled preparation, and a 5% or 7.5% cream. Dapsone has antimicrobial effects stemming from its sulfonamide-like ability to inhibit the synthesis of dihydrofolic acid. It also has anti-inflammatory properties such as inhibiting the production of reactive oxygen species, reducing the effect of eosinophil peroxidase on mast cells and down-regulating neutrophil-mediated inflammatory responses. This allows for its use in the treatment of a wide variety of inflammatory and infectious skin conditions. Currently in dermatology, the US Food and Drug Administration (FDA)-approved indications for dapsone are leprosy, dermatitis herpetiformis, and acne vulgaris. However, it proved itself as an adjunctive therapeutic agent to many other skin disorders. In this review, we discuss existing evidence on the mechanisms of action of dapsone, its FDA-approved indications, off-label uses, and side effects.