Virtual lesion of right posterior superior temporal sulcus modulates conscious visual perception of fearful expressions in faces and bodies.

The posterior Superior Temporal Suclus (pSTS) represents a central hub in the complex cerebral network for person perception and emotion recognition as also suggested by its heavy connections with face- and body-specific cortical (e.g., the fusiform face area, FFA and the extrastriate body area, EBA) and subcortical structures (e.g., amygdala). Information on whether pSTS is causatively involved in sustaining conscious visual perception of emotions expressed by faces and bodies is lacking. We explored this issue by combining a binocular rivalry procedure (where emotional and neutral face and body postures rivaled with house images) with off-line, 1-Hz repetitive transcranial magnetic stimulation (rTMS). We found that temporary inhibition of the right pSTS reduced perceptual dominance of fearful faces and increased perceptual dominance of fearful bodies, while leaving unaffected the perception of neutral face and body images. Inhibition of the vertex had no effect on conscious visual perception of neutral or emotional face or body stimuli. Thus, the right pSTS plays a causal role in shortening conscious vision of fearful faces and in prolonging conscious vision of fearful bodies. These results suggest that pSTS selectively modulates the activity of segregated networks involved in the conscious visual perception of emotional faces or bodies. We speculate that the opposite role of the right pSTS for conscious perception of fearful face and body may be explained by the different connections that this region entertains with face- and body-selective visual areas as well as with amygdalae and premotor regions.

A computational feedforward model predicts categorization of masked emotional body language for longer, but not for shorter, latencies.

Given the presence of massive feedback loops in brain networks, it is difficult to disentangle the contribution of feedforward and feedback processing to the recognition of visual stimuli, in this case, of emotional body expressions. The aim of the work presented in this letter is to shed light on how well feedforward processing explains rapid categorization of this important class of stimuli. By means of parametric masking, it may be possible to control the contribution of feedback activity in human participants. A close comparison is presented between human recognition performance and the performance of a computational neural model that exclusively modeled feedforward processing and was engineered to fulfill the computational requirements of recognition. Results show that the longer the stimulus onset asynchrony (SOA), the closer the performance of the human participants was to the values predicted by the model, with an optimum at an SOA of 100 ms. At short SOA latencies, human performance deteriorated, but the categorization of the emotional expressions was still above baseline. The data suggest that, although theoretically, feedback arising from inferotemporal cortex is likely to be blocked when the SOA is 100 ms, human participants still seem to rely on more local visual feedback processing to equal the model's performance.

Event-related repetitive transcranial magnetic stimulation of posterior superior temporal sulcus improves the detection of threatening postural changes in human bodies.

Perceiving others' emotions through their body movements and postures is crucial for successful social interaction. While imaging studies indicate that perceiving body emotions relies upon a wide network of subcortico-cortical neural regions, little is known on the causative role of different nodes of this network. We applied event-related repetitive transcranial magnetic stimulation (rTMS) over nonfacial, body- and action-related extrastriate (EBA), temporal (pSTS), and premotor (vPM) cortices to test their active contribution in perceiving changes between two successive images of either threatening or neutral human body or animal postures. While stimulation of EBA and vPM showed no selective effect on threatening stimuli with respect to neutral ones, rTMS over pSTS selectively impaired neutral posture detection and increased the accuracy in detecting changes of threatening human postures with respect to all other experimental conditions. No such effect was found for animal stimuli. These results support the notion that pSTS is crucially devoted to the detection of socially relevant information concerning others' actions, fostering the notion that amygdalo-temporo-cortical modulatory connections mediate perception of emotionally salient body postures.

Fear modulates visual awareness similarly for facial and bodily expressions.

BACKGROUND: Social interaction depends on a multitude of signals carrying information about the emotional state of others. But the relative importance of facial and bodily signals is still poorly understood. Past research has focused on the perception of facial expressions while perception of whole body signals has only been studied recently. In order to better understand the relative contribution of affective signals from the face only or from the whole body we performed two experiments using binocular rivalry. This method seems to be perfectly suitable to contrast two classes of stimuli to test our processing sensitivity to either stimulus and to address the question how emotion modulates this sensitivity. METHOD: In the first experiment we directly contrasted fearful, angry, and neutral bodies and faces. We always presented bodies in one eye and faces in the other simultaneously for 60 s and asked participants to report what they perceived. In the second experiment we focused specifically on the role of fearful expressions of faces and bodies. RESULTS: Taken together the two experiments show that there is no clear bias toward either the face or body when the expression of the body and face are neutral or angry. However, the perceptual dominance in favor of either the face of the body is a function of the stimulus class expressing fear.

Emotional voice and emotional body postures influence each other independently of visual awareness.

Multisensory integration may occur independently of visual attention as previously shown with compound face-voice stimuli. We investigated in two experiments whether the perception of whole body expressions and the perception of voices influence each other when observers are not aware of seeing the bodily expression. In the first experiment participants categorized masked happy and angry bodily expressions while ignoring congruent or incongruent emotional voices. The onset between target and mask varied from -50 to +133 ms. Results show that the congruency between the emotion in the voice and the bodily expressions influences audiovisual perception independently of the visibility of the stimuli. In the second experiment participants categorized the emotional voices combined with masked bodily expressions as fearful or happy. This experiment showed that bodily expressions presented outside visual awareness still influence prosody perception. Our experiments show that audiovisual integration between bodily expressions and affective prosody can take place outside and independent of visual awareness.

Fear detection and visual awareness in perceiving bodily expressions.

Many research reports have concluded that emotional information can be processed without observers being aware of it. The case for perception without awareness has almost always been made with the use of facial expressions. In view of the similarities between facial and bodily expressions for rapid perception and communication of emotional signals, we conjectured that perception of bodily expressions may also not necessarily require visual awareness. Our study investigates the role of visual awareness in the perception of bodily expressions using a backward masking technique in combination with confidence ratings on a trial-by-trial basis. Participants had to detect in three separate experiments masked fearful, angry and happy bodily expressions among masked neutral bodily actions as distractors and subsequently the participants had to indicate their confidence. The onset between target and mask (Stimulus Onset Asynchrony, SOA) varied from -50 to +133 ms. Sensitivity measurements (d-prime) as well as the confidence of the participants showed that the bodies could be detected reliably in all SOA conditions. In an important finding, a lack of covariance was observed between the objective and subjective measurements when the participants had to detect fearful bodily expressions, yet this was not the case when participants had to detect happy or angry bodily expressions.

Professional doctorate and professional nursing practice.

The professional doctorate degree in nursing is a novel approach to gaining a doctoral qualification other than the traditional Doctor of Philosophy (PhD) degree. This taught programme aims at linking theory and practice innovations in addressing clinical nursing problems. This paper outlines the evolution of the professional doctorate in the USA, the UK and Australia and its differences from the traditional PhD. I argue that nurses enrolled in this course work programme will not only have the opportunity to pursue studies at the doctoral level, but it will also facilitate nurses to challenge and share their experiences in solving practice problems in a collegial manner. By understanding the broader perspective of an environment dominated by scarce resources and intricate socio-political relationship, nurses will be able to influence policy decisions and ultimately improve the standard of health care and enhance the professional status of nursing. It may even reduce the antagonism of the anti-intellectual environment of the workplace through practice-oriented research.

Patient autonomy in physical restraint.

Despite initiatives to raise the awareness of patient autonomy among healthcare providers, the use of physical restraints on frail or confused older patients continues to be a common practice in many healthcare settings. This paper examines the relationship between patient autonomy and the use of physical restraints by drawing on the literature contradicting its efficacy and the assumption that its use is necessary to protect the welfare of patients. It argues that the paternalistic use of physical restraints without patient's informed consent is morally unjustified and is an unequivocal violation of their autonomy. The duty to respect individual autonomy should be extended to a duty to respect the autonomy of older people who are being restrained. Only in this way can their human dignity and quality of life be enhanced.

From vocation to profession: the quest for professionalization of nursing.

This article examines some of the complex factors in the transition of nursing from vocation to profession. These factors include university education, knowledge, gender, and workplace environment. It argues that the conventional definitions and characteristics of the professions and knowledge are tainted with gender bias. The uniqueness of nursing knowledge lies in the combination of scientific and holistic knowledge required for patient care, which is different from other healthcare professions. It suggests an alternative means of recognizing the clinical expertise of frontline nurses so that their contribution to patient care can be acknowledged. Together with the extended and expanded role of specialist nurses and nurse managers, nurses can impose their presence and consolidate their power base in the quest for professionalization.

The Medi-RIVAGE study (Mediterranean Diet, Cardiovascular Risks and Gene Polymorphisms): rationale, recruitment, design, dietary intervention and baseline characteristics of participants.

OBJECTIVE: To report the rationale, recruitment, design, dietary intervention and baseline characteristics of participants in the Medi-RIVAGE study (Mediterranean Diet, Cardiovascular Risks and Gene Polymorphisms). DESIGN: A randomised, parallel trial comparing a new nutritional programme with a conventional programme. SETTING: Centre for Detection and Prevention of Arteriosclerosis, Timone University Hospital, Marseille, France, and collaborating teams. SUBJECTS: Two hundred and twelve male and female volunteers with at least one cardiovascular risk factor. INTERVENTION: A Mediterranean-type diet characterised mainly by the quality of fatty acids, amount of fish, vegetable foodstuffs and fibre was proposed and compared with a usually prescribed, low-fat/cholesterol diet. Body mass index, fasting lipids and lipoproteins, apolipoproteins, glucose, insulin and homocysteine were the main outcome measures. Gene polymorphisms of interest were determined. RESULTS: Characteristics of men in the two arms were comparable with regard to sociodemographic variables, and clinical and biological cardiovascular risk factors. There were few differences between the groups of women (cholesterol-related parameters, P<0.05). There was no difference between arms in allelic distribution of the gene polymorphisms studied. Saturated fat and protein intakes were high while carbohydrate and fibre intakes were low, but with no difference between arms. Overall, the nutritional markers were comparable in both arms with few exceptions. Correlations between nutritional intakes and plasma nutrient levels ranged from 0.19 (beta-carotene) to 0.47 (folate). CONCLUSIONS: The comparability of the two arms is notable and warrants a low risk of biases. Current diet departs from the traditional Mediterranean one. The assessment of nutritional intake is validated by correlations obtained between dietary intake and relevant biomarkers. This will be important to estimate participant compliance and to analyse intervention data.

The Chinese version of the PSS:PICU.

BACKGROUND: Before an established research instrument is adopted for use in a cultural context different from that where it was developed, its validity and reliability must be reassessed so that it is applicable to and congruent with the culture of the population under study. OBJECTIVES: To translate the Parental Stressor Scale: Pediatric Intensive Care Unit (PSS:PICU) into Chinese, and to evaluate the psychometric properties of the Chinese version. METHODS: A prospective study investigated 81 parents of 75 children admitted to a PICU in two hospitals. Parents completed the Chinese versions of the PSS:PICU and the state anxiety scale of the Spielberger State-Trait Anxiety Inventory. RESULTS: Factor analysis and item-subscale correlations supported the conceptual dimensions of the original instrument. The internal consistency of the Chinese version was high. Most of the subscales were moderately correlated with each other and strongly correlated with the total score. The convergent validity with the state anxiety scale in the Chinese version of the Spielberger State-Trait Anxiety Inventory was reflected by a weak correlation for the overall scale and for the subscales. CONCLUSIONS: Although some satisfactory psychometric properties of the translated instrument were found in this study, they should be used as a reference for studies with larger samples. The current form is not ready for wide dissemination until more concrete research evidence is available.

Proliferation of human progenitor cells in a long-term culture system is more efficiently sustained by the addition of Flt-3 ligand or megakaryocyte growth and development factor than by Kit ligand.

INTRODUCTION: We compared the effects of the early-acting growth factors (GF), Flt-3 ligand (FL), c-Kit ligand (KL), and leukemia inhibitory factor (LIF), and the late-acting GF, granulocyte-colony stimulating factor (G-CSF) and megakaryocyte growth and development factor (MGDF), added alone in human long-term marrow culture (LTMC). MATERIALS AND METHODS: The GF were used in primary cultures of mononuclear cells (MNC) and in cocultures of CD34+ cells on murine preestablished MS-5 stromal layers. GF activity was assessed as nonadherent and adherent progenitor cell production and cobblestone area formation at week 5. RESULTS: In this system, only FL, KL, and MGDF significantly stimulated early stages of hematopoiesis, whereas only G-CSF stimulated the proliferation of mature progenitor cells within the granulo-monocyte lineage and no effect was observed with LIF. FL displayed the strongest activity, and MGDF was more efficient than KL, both in primary cultures of MNC and in cocultures of CD34+ cells. However, the stimulatory effects of these GF used alone were dependent on the presence of a stromal layer. CONCLUSION: These LTMC data emphasize the particular roles for FL and MGDF in the stimulation of primitive hematopoiesis.

The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial.

This study was a randomised controlled trial designed to assess the effectiveness of progressive muscle relaxation training (PMRT) in the clinical management of chemotherapy-related nausea and vomiting as an adjuvant intervention to accompany pharmacological antiemetic treatment (metoclopramide and dexamethasone i.v.). Seventy-one chemotherapy-naive breast cancer patients of an outpatient oncology unit of a university hospital in Hong Kong participated, with 38 subjects randomised to the experimental group and 33 to the control group. The intervention included the use of PMRT 1 h before chemotherapy was administered and daily thereafter for another 5 days (for a total of six PMRT sessions). Each session lasted for 25 min and was followed by 5 min of imagery techniques. The instruments used for data collection included the Chinese versions of the Profile of Mood States and the State-Trait Anxiety Inventory (measured before chemotherapy and then at day 7 and day 14 after chemotherapy), and the Morrow Assessment of Nausea and Vomiting Scale, which was used daily for the first 7 post-chemotherapy days. The use of PMRT considerably decreased the duration of nausea and vomiting in the experimental group compared with the control group ( P<0.05), whereas there were trends toward a lower frequency of nausea and vomiting ( P=0.07 and P=0.08 respectively). Neither nausea nor vomiting differed in intensity between the two groups. The significant effects were mainly evident on the first 4 post-chemotherapy days, when differences were statistically significant. Although there was a significantly less severe overall mood disturbance in the experimental group over time ( P<0.05), this did not apply in the case of anxiety. Such findings suggest that PMRT is a useful adjuvant technique to complement antiemetics for chemotherapy-induced nausea and vomiting and that incorporation of such interventions in the care plan can enhance the standards of care of cancer patients who experience side effects of chemotherapy.

Life after cancer: adaptation issues faced by Chinese gynaecological cancer survivors in Hong Kong.

An explorative study using qualitative data collection methods was used to look at the adaptation issues faced by Chinese survivors of gynaecological cancers. Eighteen women who were free from illness and between 2 and 16 years post-diagnosis participated. Content analysis of the data revealed that cancer and its treatment led to a positive revival of these women as they re-evaluated their life, started treasuring family relationships, improved their mood and became more sensitive to other people's needs. However, they also described problems with marital relationships, concerns about the future of their children, sexuality and femininity, loss of fertility and discomfort due to pain and weakness. A third of the sample reported that their husbands had extramarital affairs. Despite this, women, especially those who had good communication with their partners, commented that they maintained a loving relationship. Cultural beliefs and misconceptions about sexual functioning were also depicted as affecting adaptation to illness. Long-term psychosocial care may help these women to adapt better to the demands of the illness, especially sexual and psychosexual rehabilitation, as sexual problems were reported by all women in the study.

Evaluation of performance of white blood cell reduction filters: an original flow cytometric method for detection and quantification of cell-derived membrane fragments.

BACKGROUND: Contamination of blood products by white blood cells leads to a risk of transmission of infectious agents, particularly abnormal prion protein, the probable causative agent of new-variant Creutzfeldt-Jakob disease. Blood product filtration could reduce this risk, but the filtration systems might generate potentially infectious membrane fragments. We developed an original flow cytometric method that allows the detection and quantification of membrane fragments in filtered products and the evaluation of the quantity of destroyed cells. METHODS: This method has four technical requirements: cytofluorometric acquisition of forward scatter parameters on a log scale, use of a fluorescent aliphatic reporter molecule (PKH26-GL) to identify membrane fragments, quantification with fluorescent beads, and the drawing up of a standard curve on the basis of cells destroyed by freezing/thawing to generate cell debris (i.e., quantity of membrane fragments measured versus quantity of destroyed cells). RESULTS AND CONCLUSIONS: This original method can be used to test new filtration devices and it allows optimization of the filtration process or comparison of different filtration systems. We tested the method with three commercial white cell removal filters. We demonstrated that it is possible to evaluate the filter quality, particularly the likelihood of fragment removal during the filtration process.

Covalent modification of iron surfaces by electrochemical reduction of aryldiazonium salts.

Electrochemical reduction of aryldiazonium salts (in acetonitrile or acidic aqueous medium) on an iron or mild steel surface permits the strong bonding (which resists an ultrasonic cleaning) of aryl groups on these surfaces. Attachment of aryl groups was demonstrated by the combined used of electrochemistry, infrared spectroscopy and polarization modulation infrared reflection spectroscopy (PMIRRAS), Rutherford backscattering, X-ray photoelectron spectroscopy, and capacity measurements. The substituents of aryl groups, which can be widely varied, include NO2, I, COOH, and long alkyl chains. It is shown that the attachment of the aryl groups is to an iron and not to an oxygen atom and that the bond is covalent.