When and where perceptual load interacts with voluntary visuospatial attention: an event-related potential and dipole modeling study

Perceptual load is recognized to affect visual selective attention, but at an unknown spatiotemporal locus in the brain. To examine this issue, event-related potentials (ERPs) were recorded while participants performed an orientation discrimination task, under conditions of low or high perceptual load. Participants were required to respond to targets (10% of trials) presented in the attended visual field while ignoring all stimuli in the unattended visual field. The interaction between voluntary attention and perceptual load was significant for the posterior N1 component (190 ms) but not for the earlier C1 (84 ms) or P1 (100 ms) components. This load by attention interaction for N1 was localized to the temporoparietal-occipital (TPO) gyrus by dipole modeling analysis. Dipole modeling also showed that a reversed attentional effect in the C1 time range was due to ERP overlap from the subsequent attention-sensitive P1 component. Results suggest that perceptual load affects voluntary visuospatial attention at an early (but not the earliest) processing stage and that the TPO gyrus mediates target selection at the discrimination stage.     

Unusual Clinical Manifestations in a Case of Alagille Syndrome

Alagille syndrome, also known as arteriohepatic dysplasia, is a multisystem autosomal dominant disorder characterized by chronic cholestasis due to a paucity of intrahepatic bile ducts, peripheral pulmonary artery stenosis with associated vertebral, ocular, and renal anomalies, and characteristic facies. We report a case of Alagille syndrome in a 3‐year‐old boy with associated pruritus, follicular keratoses, palmar pits, and keratoderma‐like changes over the dorsum of the hands. There have been single isolated case reports of phrynoderma and keratoderma. Palmar pits have not been reported in the literature.     

预防青光眼性失明——优先使用现有检查进行更好的筛查

诊断和治疗原发性开角型青光眼是卫生保健工作的重点。原发性开角型青光眼是全球第二大致盲性眼病，全球共有6680万人受累，其中有670万人因此而双目失明。在英国，人口的老龄化意味着在今后的20年内，原发性开角型青光眼患者的数目可能要增长30％。     

Hsp27 inhibits release of mitochondrial protein Smac in multiple myeloma cells and confers dexamethasone resistance

Smac, second mitochondria-derived activator of caspases, promotes apoptosis via activation of caspases. Heat shock protein 27 (Hsp27) negatively regulates another mitochondrial protein, cytochrome c, during apoptosis; however, the role of Hsp27 in modulating Smac release is unknown. Here we show that Hsp27 is overexpressed in both dexamethasone (Dex)-resistant multiple myeloma (MM) cell lines (MM.1R, U266, RPMI-8226) and primary patient cells. Blocking Hsp27 by an antisense (AS) strategy restores the apoptotic response to Dex in Dex-resistant MM cells by triggering the release of mitochondrial protein Smac, followed by activation of caspase-9 and caspase-3. Moreover, AS-Hsp27 overcomes interleukin-6 (IL-6)-mediated protection against Dex-induced apoptosis. These data demonstrate that Hsp27 inhibits the release of Smac, and thereby confers Dex resistance in MM cells.     

Reducing Unnecessary and Duplicate Ordering for Ovum and Parasite Examinations and Clostridium difficile PCR in Immunocompromised Patients by Using an Alert at the Time of Request in the Order Management System

We implemented hospital information system (HIS) alerts to deter unnecessary test orders for ovum and parasite (O&P) exams and Clostridium difficile PCR. The HIS alerts decreased noncompliant O&P orders (orders after >72 h of hospitalization) from 49.8% to 30.9%, an overall decrease of 19%, and reduced noncompliant C. difficile PCR orders (orders <7 days after a previous positive result) from 30.6% to 19.2%, an overall decrease of 31.9%.