Complications following type 3 excision by needle excision of the transformation zone: a case series report.

OBJECTIVE: To determine short-term complications and related risk factors following needle excision of the transformation zone (NETZ). MATERIALS AND METHODS: A case series of 105 women with NETZ for cervical pathology between 2006-2013 in a single center. RESULTS: The overall complication rate was 22.9%. Heavy primary bleeding occurred in 12.4% of cases (<500 ml), secondary hemorrhage 7.6%, emergency hysterectomy 1.9%, and cervical stenosis 2.9%. Where excision depth was > 20 mm, this was a non-significant increase in the risk of hemorrhage, but a significant reduction in the risk of a subsequent hysterectomy (p = 0.035). CONCLUSION: NETZ is associated with a number of complications and recognition of risk factors should be considered when planning type 3 excisional procedures and counseling women.

Treatable childhood neuronopathy caused by mutations in riboflavin transporter RFVT2.

Childhood onset motor neuron diseases or neuronopathies are a clinically heterogeneous group of disorders. A particularly severe subgroup first described in 1894, and subsequently called Brown-Vialetto-Van Laere syndrome, is characterized by progressive pontobulbar palsy, sensorineural hearing loss and respiratory insufficiency. There has been no treatment for this progressive neurodegenerative disorder, which leads to respiratory failure and usually death during childhood. We recently reported the identification of SLC52A2, encoding riboflavin transporter RFVT2, as a new causative gene for Brown-Vialetto-Van Laere syndrome. We used both exome and Sanger sequencing to identify SLC52A2 mutations in patients presenting with cranial neuropathies and sensorimotor neuropathy with or without respiratory insufficiency. We undertook clinical, neurophysiological and biochemical characterization of patients with mutations in SLC52A2, functionally analysed the most prevalent mutations and initiated a regimen of high-dose oral riboflavin. We identified 18 patients from 13 families with compound heterozygous or homozygous mutations in SLC52A2. Affected individuals share a core phenotype of rapidly progressive axonal sensorimotor neuropathy (manifesting with sensory ataxia, severe weakness of the upper limbs and axial muscles with distinctly preserved strength of the lower limbs), hearing loss, optic atrophy and respiratory insufficiency. We demonstrate that SLC52A2 mutations cause reduced riboflavin uptake and reduced riboflavin transporter protein expression, and we report the response to high-dose oral riboflavin therapy in patients with SLC52A2 mutations, including significant and sustained clinical and biochemical improvements in two patients and preliminary clinical response data in 13 patients with associated biochemical improvements in 10 patients. The clinical and biochemical responses of this SLC52A2-specific cohort suggest that riboflavin supplementation can ameliorate the progression of this neurodegenerative condition, particularly when initiated soon after the onset of symptoms.

Two-Channel Indirect-Gap Photoluminescence and Competition between the Conduction Band Valleys in Few-Layer MoS2.

MoS2 is a two-dimensional layered transition metal dichalcogenide with unique electronic and optical properties. The fabrication of ultrathin MoS2 is vitally important, since interlayer interactions in its ultrathin varieties will become thickness-dependent, providing thickness-governed tunability and diverse applications of those properties. Unlike with a number of studies that have reported detailed information on direct bandgap emission from MoS2 monolayers, reliable experimental evidence for thickness-induced evolution or transformation of the indirect bandgap remains scarce. Here, the sulfurization of MoO3 thin films with nominal thicknesses of 30 nm, 5 nm and 3 nm was performed. All sulfurized samples were examined at room temperature with spectroscopic ellipsometry and photoluminescence spectroscopy to obtain information about their dielectric function and edge emission spectra. This investigation unveiled an indirect-to-indirect crossover between the transitions, associated with two different Λ and K valleys of the MoS2 conduction band, by thinning its thickness down to a few layers.

Neural correlates of decision making on whole body yaw rotation: An fNIRS study.

Prominent accounts of decision making state that decisions are made on the basis of an accumulation of sensory evidence, orchestrated by networks of prefrontal and parietal neural populations. Here we assess whether these findings generalize to decisions on self-motion. Participants were presented with whole body yaw rotations of different durations in a 2-Interval-Forced-Choice paradigm, and tasked to discriminate motions on the basis of their amplitude. The cortical hemodynamic response was recorded using functional near-infrared spectroscopy (fNIRS) while participants were performing the task. The imaging data was used to predict the specific response on individual experimental trials, and to predict whether the comparison stimulus would be judged larger than the reference. Classifier performance on the former variable was negligible. However, considerable performance was achieved for the latter variable, specifically using parietal imaging data. The findings provide support for the notion that activity in the parietal cortex reflects modality independent decision variables that represent the strength of the neural evidence in favor of a decision. The results are encouraging for the use of fNIRS as a method to perform neuroimaging in moving individuals.

Evidence of anhedonia and differential reward processing in prefrontal cortex among post-withdrawal patients with prescription opiate dependence.

Anhedonia is an important but understudied element of a neuroadaptive model underlying vulnerability to relapse in opioid dependence. Previous research using fMRI has shown reduced activation to pleasant stimuli in rostral prefrontal cortex among heroin-dependent patients in early recovery. This study evaluated the presence of anhedonia among recently withdrawn prescription opiate dependent patients (PODP) in residential treatment compared to control subjects. Anhedonia was assessed using self-report, affect-modulated startle response (AMSR), and a cue reactivity task during which participant's rostral prefrontal cortex (RPFC) and ventrolateral prefrontal cortex (VLPFC) was monitored with functional near infrared spectroscopy (fNIRS). The cue reactivity task included three distinct categories of natural reward stimuli: highly palatable food, positive social situations, and intimate (non-erotic) interactions. PODP reported greater anhedonia on self-report (Snaith-Hamilton Pleasure Scale), and showed reduced hedonic response to positive stimuli in the AMSR task relative to controls. PODP also exhibited reduced neural activation in bilateral RPFC and left VLPFC in response to food images and reduced left VLPFC in response to images depicting positive social situations relative to controls. No differences were found for emotionally intimate stimuli. When patients were divided into groups based on the Snaith-Hamilton criteria for the presence or absence of anhedonia, patients endorsing anhedonia showed reduced neural responses to images depicting positive social stimuli and food relative to patients who did not endorse anhedonia. Activations were in areas of RPFC that support the retrieval of episodic memories. The results suggest the presence of anhedonia in a subsample of PODP.

Textile-templated electrospun anisotropic scaffolds for regenerative cardiac tissue engineering.

For patients with end-stage heart disease, the access to heart transplantation is limited due to the shortage of donor organs and to the potential for rejection of the donated organ. Therefore, current studies focus on bioengineering approaches for creating biomimetic cardiac patches that will assist in restoring cardiac function, by repairing and/or regenerating the intrinsically anisotropic myocardium. In this paper we present a simplified, straightforward approach for creating bioactive anisotropic cardiac patches, based on a combination of bioengineering and textile-manufacturing techniques in concert with nano-biotechnology based tissue-engineering stratagems. Using knitted conventional textiles, made of cotton or polyester yarns as template targets, we successfully electrospun anisotropic three-dimensional scaffolds from poly(lactic-co-glycolic) acid (PLGA), and thermoplastic polycarbonate-urethane (PCU, Bionate(®)). The surface topography and mechanical properties of textile-templated anisotropic scaffolds significantly differed from those of scaffolds electrospun from the same materials onto conventional 2-D flat-target electrospun scaffolds. Anisotropic textile-templated scaffolds electrospun from both PLGA and PCU, supported the adhesion and proliferation of H9C2 cardiac myoblasts cell line, and guided the cardiac tissue-like anisotropic organization of these cells in vitro. All cell-seeded PCU scaffolds exhibited mechanical properties comparable to those of a human heart, but only the cells on the polyester-templated scaffolds exhibited prolonged spontaneous synchronous contractility on the entire engineered construct for 10 days in vitro at a near physiologic frequency of ∼120 bpm. Taken together, the methods described here take advantage of straightforward established textile manufacturing strategies as an efficient and cost-effective approach to engineering 3D anisotropic, elastomeric PCU scaffolds that can serve as a cardiac patch.

Textile-templated electrospun anisotropic scaffolds for tissue engineering and regenerative medicine.

Cardiovascular diseases, specifically myocardial infarction and end-stage heart failure represent some of the major pathologies that threaten human life. Here we present a novel approach for a bioactive cardiac patch based on a combination of biomedical and textile manufacturing techniques in concert with nano-biotechnology based tissue-engineering stratagems. The technological goal is to create BioNanoTextiles™ (BNT) by using "conventional" fabrics as templates for creating three-dimensional nanofibrous scaffolds. Electrospinning nanofibrous scaffolds templated after "ordinary" textiles is a novel way to create complex-patterned, 3-D scaffolds intrinsically mimicking some of the anisotropic structural features of the ventricular wall's extracellular matrix. In preliminary studies, we established that this approach will yield anisotropic 3-D scaffolds with mechanical properties dependent upon the yarn type of the textile-templates. These scaffolds are biocompatible, as inferred from their support of H9C2 cardiac myoblast adhesion which promotes their proliferation as well as cardiac-like anisotropic organization. The use of textile manufacturing strategies will enhance the complexity of the 3-D scaffold structures and enable their commercialization, while providing an opportunity for the textile industry to advance established "low-tech" manufacturing technologies into the realm of "high-tech" BioNanoTextiles.