A hypothesis for reactivation of pulmonary tuberculosis: How thoracic wall shape affects the epidemiology of tuberculosis

This study was aimed at determining the cause for the high incidence of tuberculosis (TB) reactivation occurring in males with a low body mass index (BMI). Current thinking about pulmonary TB describes infection in the lung apex resulting in cavitation after reactivation. A different hypothesis is put forward for TB infection, suggesting that this occurs in subclinical apical cavities caused by increased pleural stress due to a low BMI body habitus. A finite element analysis (FEA) model of a lung was constructed including indentations for the first rib guided by paramedian sagittal CT reconstructions, and simulations were conducted with varying antero‐posterior (AP) diameters to mimic chests with a different thoracic index (ratio of AP to the transverse chest diameters). A Pubmed search was conducted about gender and thoracic index, and the effects of BMI on TB. FEA modeling revealed a tenfold increase in stress levels at the lung apex in low BMI chests, and a four‐fold increase with a low thoracic index, r² = 0.9748 P < 0.001. Low thoracic index was related to BMI, P = 0.001. The mean thoracic index was statistically significantly lower in males, P = 0.001, and increased with age in both genders. This article is the first to suggest a possible mechanism linking pulmonary TB reactivation to low BMI due to the flattened thoracic wall shape of young male adults. The low thoracic index in young males may promote TB reactivation due to tissue destruction in the lung apex from high pleural stress levels. Clin. Anat. 28:614–620, 2015. © 2015 Wiley Periodicals, Inc.     

Injury as a Global Phenomenon of Concern in Nursing Science

PURPOSE: To discuss injury research as a phenomenon of concern in nursing science. ORGANIZING CONSTRUCT: Injury is defined as the physical damage that results when the human body is briefly subjected to intolerable levels of energy. It is the leading cause of death in the first 4 decades of life in high-income nations and is second only to infectious diseases as a leading cause of death in low- and middle-income nations. METHODS: Review and discussion of relevant scientific and theoretical literature in both injury and nursing science. FINDINGS: Nurse scientists can apply unique perspectives to increase understanding of injury and its consequences. Fertile areas for nursing inquiry include identifying people at risk, developing models to explain the association between risk-taking and injury, testing interventions to prevent and limit injury, and creating and refining interventions that are culturally relevant to subpopulations most at risk for injury. CONCLUSIONS: The mandate to improve global heath should lead to nursing inquiry about this phenomenon, including developing and testing interventions to prevent and reduce injury.     

Cognitive Computation with Autonomously Active Neural Networks: An Emerging Field

The human brain is autonomously active. To understand the functional role of this self-sustained neural activity, and its interplay with the sensory data input stream, is an important question in cognitive system research and we review here the present state of theoretical modeling. This review will start with a brief overview of the experimental efforts, together with a discussion of transient versus self-sustained neural activity in the framework of reservoir computing. The main emphasis will be then on two paradigmal neural network architectures showing continuously ongoing transient-state dynamics: saddle point networks and networks of attractor relics. Self-active neural networks are confronted with two seemingly contrasting demands: a stable internal dynamical state and sensitivity to incoming stimuli. We show, that this dilemma can be solved by networks of attractor relics based on competitive neural dynamics, where the attractor relics compete on one side with each other for transient dominance, and on the other side with the dynamical influence of the input signals. Unsupervised and local Hebbian-style online learning then allows the system to build up correlations between the internal dynamical transient states and the sensory input stream. An emergent cognitive capability results from this set-up. The system performs online, and on its own, a nonlinear independent component analysis of the sensory data stream, all the time being continuously and autonomously active. This process maps the independent components of the sensory input onto the attractor relics, which acquire in this way a semantic meaning.     

Die Diagnostische Bedeutung der Flockungsreaktion mit Hayemscher Lösung im Ascites

Zusammenfassung Die von uns angegebene Flockungsprobe im Serum mit Hayemscher Lösung zur Diagnose der atrophischen Lebercirrhose und zur einfachen Erkennung der meisten Takata-positiven und Takata-negativen Seren eignet sich auch zur Untersuchung von Ascites bezüglich seiner Genese. Auf Zusatz von Hayemscher Lösung zeigt der Ascites bei Lebercirrhose ein wesentlich anderes Verhalten als der Ascites bei Carcinom, Nephrose oder Herzinsuffizienz. Die einfache und rasch ausführbare Untersuchung des frischen Ascites mit Hayemscher Losung gestattet daher einen Ascites bei Lebercirrhose von solchen anderer Genese in kurzer Zeit zu differenzieren.