RESUMEN
A SARS-CoV-2 P.1 (Gamma) variant outbreak occurred at a skilled nursing facility in Washington, USA, in April 2021. Effectiveness of 2 doses of mRNA vaccines against P.1 infection among residents in this outbreak was 75.0% (95% CI 44.5%-88.7%), similar to effectiveness for other pre-Delta variants among long-term care residents.
Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Washingtón/epidemiología , Eficacia de las Vacunas , COVID-19/epidemiología , COVID-19/prevención & controlRESUMEN
G-protein-coupled receptors (GPCRs) comprise the largest and most pharmacologically targeted membrane protein family. Here, we used the visual receptor rhodopsin as an archetype for understanding membrane lipid influences on conformational changes involved in GPCR activation. Visual rhodopsin was recombined with lipids varying in their degree of acyl chain unsaturation and polar headgroup size using 1-palmitoyl-2-oleoyl-sn-glycero- and 1,2-dioleoyl-sn-glycerophospholipids with phosphocholine (PC) or phosphoethanolamine (PE) substituents. The receptor activation profile after light excitation was measured using time-resolved ultraviolet-visible spectroscopy. We discovered that more saturated POPC lipids back shifted the equilibrium to the inactive state, whereas the small-headgroup, highly unsaturated DOPE lipids favored the active state. Increasing unsaturation and decreasing headgroup size have similar effects that combine to yield control of rhodopsin activation, and necessitate factors beyond proteolipid solvation energy and bilayer surface electrostatics. Hence, we consider a balance of curvature free energy with hydrophobic matching and demonstrate how our data support a flexible surface model (FSM) for the coupling between proteins and lipids. The FSM is based on the Helfrich formulation of membrane bending energy as we previously first applied to lipid-protein interactions. Membrane elasticity and curvature strain are induced by lateral pressure imbalances between the constituent lipids and drive key physiological processes at the membrane level. Spontaneous negative monolayer curvature toward water is mediated by unsaturated, small-headgroup lipids and couples directly to GPCR activation upon light absorption by rhodopsin. For the first time to our knowledge, we demonstrate this modulation in both the equilibrium and pre-equilibrium evolving states using a time-resolved approach.
Asunto(s)
Membrana Dobles de Lípidos , Rodopsina , Electrónica , Lípidos de la Membrana , Fosfatidilcolinas , Análisis EspectralRESUMEN
The object of this study was to extensively characterize a region of periventricular nodular heterotopia (PVNH) in an epilepsy patient to reveal its possible neurocognitive functional role(s). The authors used 3-T MRI approaches to exhaustively characterize a single, right hemisphere heterotopion in a high-functioning adult male with medically responsive epilepsy, which had manifested during late adolescence. The heterotopion proved to be spectroscopically consistent with a cortical-like composition and was interconnected with nearby ipsilateral cortical fundi, as revealed by fiber tractography (diffusion-weighted imaging) and resting-state functional connectivity MRI (rsfMRI). Moreover, the region of PVNH demonstrated two novel characterizations for a heterotopion. First, functional MRI (fMRI), as distinct from rsfMRI, showed that the heterotopion was significantly modulated while the patient watched animated video scenes of biological motion (i.e., cartoons). Second, rsfMRI, which demonstrated correlated brain activity during a task-negative state, uniquely showed directionality within an interconnected network, receiving positive path effects from patent cortical and cerebellar foci while outputting only negative path effects to specific brain foci.These findings are addressed in the context of the impact on noninvasive presurgical brain mapping strategies for adult and pediatric patient workups, as well as the impact of this study on an understanding of the functional cortical architecture underlying cognition from a neurodiversity and evolutionary perspective.
Asunto(s)
Mapeo Encefálico/métodos , Epilepsia/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Heterotopia Nodular Periventricular/diagnóstico por imagen , Descanso/fisiología , Convulsiones/diagnóstico por imagen , Epilepsia/fisiopatología , Humanos , Masculino , Heterotopia Nodular Periventricular/fisiopatología , Cuidados Preoperatorios/métodos , Convulsiones/fisiopatología , Adulto JovenRESUMEN
The exploitable properties of many materials are intimately linked to symmetry-lowering structural phase transitions. We present an automated and exhaustive symmetry-mode method for systematically exploring and solving such structures which will be widely applicable to a range of functional materials. We exemplify the method with an investigation of the Bi2Sn2O7 pyrochlore, which has been shown to undergo transitions from a parent γ cubic phase to ß and α structures on cooling. The results include the first reliable structural model for ß-Bi2Sn2O7 (orthorhombic Aba2, a = 7.571833(8), b = 21.41262(2), and c = 15.132459(14) Å) and a much simpler description of α-Bi2Sn2O7 (monoclinic Cc, a = 13.15493(6), b = 7.54118(4), and c = 15.07672(7) Å, ß = 125.0120(3)°) than has been presented previously. We use the symmetry-mode basis to describe the phase transition in terms of coupled rotations of the Bi2O' anti-cristobalite framework, which allow Bi atoms to adopt low-symmetry coordination environments favored by lone-pair cations.
RESUMEN
BACKGROUND: Mobile upright PET devices have the potential to enable previously impossible neuroimaging studies. Currently available options are imagers with deep brain coverage that severely limit head/body movements or imagers with upright/motion enabling properties that are limited to only covering the brain surface. METHODS: In this study, we test the feasibility of an upright, motion-compatible brain imager, our Ambulatory Motion-enabling Positron Emission Tomography (AMPET) helmet prototype, for use as a neuroscience tool by replicating a variant of a published PET/fMRI study of the neurocorrelates of human walking. We validate our AMPET prototype by conducting a walking movement paradigm to determine motion tolerance and assess for appropriate task related activity in motor-related brain regions. Human participants (n = 11 patients) performed a walking-in-place task with simultaneous AMPET imaging, receiving a bolus delivery of F18-Fluorodeoxyglucose. RESULTS: Here we validate three pre-determined measure criteria, including brain alignment motion artifact of less than <2 mm and functional neuroimaging outcomes consistent with existing walking movement literature. CONCLUSIONS: The study extends the potential and utility for use of mobile, upright, and motion-tolerant neuroimaging devices in real-world, ecologically-valid paradigms. Our approach accounts for the real-world logistics of an actual human participant study and can be used to inform experimental physicists, engineers and imaging instrumentation developers undertaking similar future studies. The technical advances described herein help set new priorities for facilitating future neuroimaging devices and research of the human brain in health and disease.
Brain imaging plays an important role in understanding how the human brain functions in both health and disease. However, traditional brain scanners often require people to remain still, limiting the study of the brain in motion, and excluding people who cannot remain still. To overcome this, our team developed an imager that moves with a person's head, which uses a suspended ring of lightweight detectors that fit to the head. Using our imager, we were able to obtain clear brain images of people walking in place that showed the expected brain activity patterns during walking. Further development of our imager could enable it to be used to better understand real-world brain function and behavior, enabling enhanced knowledge and treatment of neurological conditions.
RESUMEN
Numerous species possess cortical regions that are most sensitive to vocalizations produced by their own kind (conspecifics). In humans, the superior temporal sulci (STSs) putatively represent homologous voice-sensitive areas of cortex. However, superior temporal sulcus (STS) regions have recently been reported to represent auditory experience or "expertise" in general rather than showing exclusive sensitivity to human vocalizations per se. Using functional magnetic resonance imaging and a unique non-stereotypical category of complex human non-verbal vocalizations-human-mimicked versions of animal vocalizations-we found a cortical hierarchy in humans optimized for processing meaningful conspecific utterances. This left-lateralized hierarchy originated near primary auditory cortices and progressed into traditional speech-sensitive areas. Our results suggest that the cortical regions supporting vocalization perception are initially organized by sensitivity to the human vocal tract in stages before the STS. Additionally, these findings have implications for the developmental time course of conspecific vocalization processing in humans as well as its evolutionary origins.
Asunto(s)
Corteza Cerebral/fisiología , Comunicación , Vocalización Animal , Adulto , Animales , Percepción Auditiva/fisiología , Entropía , Femenino , Lateralidad Funcional/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Procesos Mentales , Oxígeno/sangre , Psicofísica , Habla , Adulto JovenRESUMEN
A persisting need remains for developing methods for inspiring and teaching undergraduate medical students to quickly learn to identify the hundreds of human brain structures, tracts and spaces that are clinically relevant (viewed as three-dimensional volumes or two-dimensional neuroimages), and to accomplish this with the option of virtual on-line methods. This notably includes teaching the essentials of recommended diagnostic radiology to allow students to be familiar with patient neuroimages routinely acquired using magnetic resonance imaging (MRI) and computed tomography (CT). The present article includes a brief example video plus details a clinically oriented interactive neuroimaging exercise for first year medical students (MS1s) in small groups, conducted with instructors either in-person or as an entirely online virtual event. This "find-the-brain-structure" (FBS) event included teaching students to identify brain structures and other regions of interest in the central nervous system (and potentially in head and neck gross anatomy), which are traditionally taught using brain anatomy atlases and anatomical specimens. The interactive, small group exercise can be conducted in person or virtually on-line in as little as 30 min depending on the scope of objectives being covered. The learning exercise involves coordinated interaction between MS1s with one or several non-clinical faculty and may include one or several physicians (clinical faculty and/or qualified residents). It further allows for varying degrees of instructor interaction online and is easy to convey to instructors who do not have expertise in neuroimaging. Anonymous pre-event survey (n = 113, 100% response rate) versus post-event surveys (n = 92, 81% response rate) were attained from a cohort of MS1s in a neurobiology course. Results showed multiple statistically significant group-level shifts in response to several of the questions, showing an increase in MS1 confidence with reading MRI images (12% increase shift in mean, p < 0.001), confidence in their approaching physicians for medical training (9%, p < 0.01), and comfort levels in working online with virtual team-based peers and with team-based faculty (6%, p < 0.05). Qualitative student feedback revealed highly positive comments regarding the experience overall, encouraging this virtual medium as a desirable educational approach.
Asunto(s)
Educación de Pregrado en Medicina , Estudiantes de Medicina , Humanos , Aprendizaje , Encéfalo/diagnóstico por imagen , Curriculum , Tomografía Computarizada por Rayos X , Neuroimagen , EnseñanzaRESUMEN
Molecular structure and function studies of vertebrate ultraviolet (UV) cone visual pigments are needed to understand the molecular evolution of these photoreceptors, which uniquely contain unprotonated Schiff base linkages between the 11-cis-retinal chromophore and the opsin proteins. In this study, the Siberian hamster ultraviolet cone pigment (SHUV) was expressed and purified in an n-dodecyl-ß-D-maltoside suspension for optical characterization. Time-resolved absorbance measurements, over a spectral range from 300 to 700 nm, were taken for the purified pigment at time delays from 30 ns to 4.64 s after photoexcitation using 7 ns pulses of 355 nm light. The resulting data were fit globally to a sum of exponential functions after noise reduction using singular-value decomposition. Four exponentials best fit the data with lifetimes of 1.4 µs, 210 µs, 47 ms, and 1 s. The first photointermediate species characterized here is an equilibrated mixture similar to the one formed after rhodopsin's Batho intermediate decays into equilibrium with its successor, BSI. The extremely large red shift of the SHUV Batho component relative to the pigment suggests that SHUV Batho has a protonated Schiff base and that the SHUV cone pigment itself has an unprotonated Schiff base. In contrast to SHUV Batho, the portion of the equilibrated mixture's spectrum corresponding to SHUV BSI is well fit by a model spectrum with an unprotonated Schiff base. The spectra of the next two photointermediate species revealed that they both have unprotonated Schiff bases and suggest they are analogous to rhodopsin's Lumi I and Lumi II species. After decay of SHUV Lumi II, the correspondence with rhodopsin photointermediates breaks down and the next photointermediate, presumably including the G protein-activating species, is a mixture of protonated and unprotonated Schiff base photointermediate species.
Asunto(s)
Fotólisis , Protones , Células Fotorreceptoras Retinianas Conos/metabolismo , Pigmentos Retinianos/química , Bases de Schiff/química , Rayos Ultravioleta , Animales , Cricetinae , Células HEK293 , Humanos , Phodopus , Células Fotorreceptoras Retinianas Conos/efectos de la radiación , Pigmentos Retinianos/metabolismoRESUMEN
INTRODUCTION: One of the most difficult dilemmas in relationship science and couple therapy concerns the interaction between sexual desire and love. As two mental states of intense longing for union with others, sexual desire and love are, in fact, often difficult to disentangle from one another. AIM: The present review aims to help understand the differences and similarities between these two mental states using a comprehensive statistical meta-analyses of all functional magnetic resonance imaging (fMRI) studies on sexual desire and love. METHODS: Systematic retrospective review of pertinent neuroimaging literature. MAIN OUTCOME MEASURES: Review of published literature on fMRI studies illustrating brain regions associated with love and sexual desire to date. RESULTS: Sexual desire and love not only show differences but also recruit a striking common set of brain areas that mediate somatosensory integration, reward expectation, and social cognition. More precisely, a significant posterior-to-anterior insular pattern appears to track sexual desire and love progressively. CONCLUSIONS: This specific pattern of activation suggests that love builds upon a neural circuit for emotions and pleasure, adding regions associated with reward expectancy, habit formation, and feature detection. In particular, the shared activation within the insula, with a posterior-to-anterior pattern, from desire to love, suggests that love grows out of and is a more abstract representation of the pleasant sensorimotor experiences that characterize desire. From these results, one may consider desire and love on a spectrum that evolves from integrative representations of affective visceral sensations to an ultimate representation of feelings incorporating mechanisms of reward expectancy and habit learning.
Asunto(s)
Encéfalo/fisiología , Interpretación de Imagen Asistida por Computador , Imagenología Tridimensional , Libido/fisiología , Amor , Imagen por Resonancia Magnética , Mapeo Encefálico , Dominancia Cerebral/fisiología , Femenino , Humanos , Masculino , Red Nerviosa/fisiología , Estudios RetrospectivosRESUMEN
Time-dependent studies of membrane protein function are hindered by extensive light scattering that impedes application of fast optical absorbance methods. Detergent solubilization reduces light scattering but strongly perturbs rhodopsin activation kinetics. Nanodiscs may be a better alternative if they can be shown to be free from the serious kinetic perturbations associated with detergent solubilization. To resolve this, we monitored absorbance changes due to photointermediates formed on the microsecond to hundred millisecond time scale after excitation of bovine rhodopsin nanodiscs and compared them to photointermediates that form in hypotonically washed native membranes as well as to those that form in lauryl maltoside suspensions at 15 and 30 °C over a pH range from 6.5 to 8.7. Time-resolved difference spectra were collected from 300 to 700 nm at a series of time delays after photoexcitation and globally fit to a sum of time-decaying exponential terms, and the photointermediates present were determined from the spectral coefficients of the exponential terms. At the temperatures and pHs studied, photointermediates formed after photoexcitation of rhodopsin in nanodiscs are extremely similar to those that form in native membrane, in particular displaying the normal forward shift of the Meta I(480) â Meta II equilibrium with increased temperature and reduced pH which occurs in native membrane but which is not observed in lauryl maltoside detergent suspensions. These results were obtained using the amount of rhodopsin in nanodiscs which is required for optical experiments with rhodopsin mutants. This work demonstrates that late, physiologically important rhodopsin photointermediates can be characterized in nanodiscs, which provide the superior optical properties of detergent without perturbing the activation sequence.
Asunto(s)
Nanoestructuras/química , Rodopsina/química , Animales , Bovinos , Glucósidos/química , Glucósidos/metabolismo , Concentración de Iones de Hidrógeno , Cinética , Rodopsina/metabolismo , Segmento Externo de la Célula en Bastón , TemperaturaRESUMEN
In contrast to visual object processing, relatively little is known about how the human brain processes everyday real-world sounds, transforming highly complex acoustic signals into representations of meaningful events or auditory objects. We recently reported a fourfold cortical dissociation for representing action (nonvocalization) sounds correctly categorized as having been produced by human, animal, mechanical, or environmental sources. However, it was unclear how consistent those network representations were across individuals, given potential differences between each participant's degree of familiarity with the studied sounds. Moreover, it was unclear what, if any, auditory perceptual attributes might further distinguish the four conceptual sound-source categories, potentially revealing what might drive the cortical network organization for representing acoustic knowledge. Here, we used functional magnetic resonance imaging to test participants before and after extensive listening experience with action sounds, and tested for cortices that might be sensitive to each of three different high-level perceptual attributes relating to how a listener associates or interacts with the sound source. These included the sound's perceived concreteness, effectuality (ability to be affected by the listener), and spatial scale. Despite some variation of networks for environmental sounds, our results verified the stability of a fourfold dissociation of category-specific networks for real-world action sounds both before and after familiarity training. Additionally, we identified cortical regions parametrically modulated by each of the three high-level perceptual sound attributes. We propose that these attributes contribute to the network-level encoding of category-specific acoustic knowledge representations.
Asunto(s)
Percepción Auditiva/fisiología , Mapeo Encefálico , Corteza Cerebral/fisiología , Reconocimiento en Psicología , Sonido , Estimulación Acústica , Adulto , Corteza Cerebral/irrigación sanguínea , Ambiente , Femenino , Lateralidad Funcional , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética/métodos , Masculino , Red Nerviosa/irrigación sanguínea , Red Nerviosa/fisiología , Vías Nerviosas/irrigación sanguínea , Vías Nerviosas/fisiología , Oxígeno/sangre , Semántica , Adulto JovenRESUMEN
Both sighted and blind individuals can readily interpret meaning behind everyday real-world sounds. In sighted listeners, we previously reported that regions along the bilateral posterior superior temporal sulci (pSTS) and middle temporal gyri (pMTG) are preferentially activated when presented with recognizable action sounds. These regions have generally been hypothesized to represent primary loci for complex motion processing, including visual biological motion processing and audio-visual integration. However, it remained unclear whether, or to what degree, life-long visual experience might impact functions related to hearing perception or memory of sound-source actions. Using functional magnetic resonance imaging (fMRI), we compared brain regions activated in congenitally blind versus sighted listeners in response to hearing a wide range of recognizable human-produced action sounds (excluding vocalizations) versus unrecognized, backward-played versions of those sounds. Here, we show that recognized human action sounds commonly evoked activity in both groups along most of the left pSTS/pMTG complex, though with relatively greater activity in the right pSTS/pMTG by the blind group. These results indicate that portions of the postero-lateral temporal cortices contain domain-specific hubs for biological and/or complex motion processing independent of sensory-modality experience. Contrasting the two groups, the sighted listeners preferentially activated bilateral parietal plus medial and lateral frontal networks, whereas the blind listeners preferentially activated left anterior insula plus bilateral anterior calcarine and medial occipital regions, including what would otherwise have been visual-related cortex. These global-level network differences suggest that blind and sighted listeners may preferentially use different memory retrieval strategies when hearing and attempting to recognize action sounds.
Asunto(s)
Percepción Auditiva/fisiología , Ceguera/fisiopatología , Mapeo Encefálico , Corteza Cerebral/fisiología , Reconocimiento en Psicología/fisiología , Adulto , Potenciales Evocados Auditivos/fisiología , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética , Masculino , Memoria Episódica , Persona de Mediana Edad , SonidoRESUMEN
First-year medical student groups rotated through classrooms, each containing a Neurology patient and physician, as a "Neuro Day" event to make direct clinical connections with the basic sciences. Inspired by post-graduate Clerkships, this event provided timely first-hand experiences focusing on pathological neurologic exam findings. Qualitative and quantitative data were collected from end-of-course surveys. The results show how the event served to reinvigorate enthusiasm for learning Clinical Neurobiology outside the traditional lecture environment and could empower patients as educators within a teaching community.
RESUMEN
OBJECTIVE: To determine whether increased patient interaction, exposure to the neurologic examination, and access to positive neurology mentors increase interest in neurology for first-year medical students. METHODS: Neuro Day was a 2-part experience for first-year medical students. The first part consisted of a flipped classroom to teach the standard neurologic examination. The second part involved patient encounters modeled off of the traditional patient rounds. Students rotated from room to room, listening to patients' experiences with different neurologic diseases and eliciting pathologic neurologic examinations. Students were surveyed before and after Neuro Day. RESULTS: The result of the binomial test indicated that the proportion of medical students interested in neurology significantly increased from 78% to 85% (95% confidence interval [CI] 0.79-0.92; p = 0.034) after participating in Neuro Day. The proportion of students' knowledge of clinical neurology increased from 45% to 63.1% (95% CI 0.54-0.72; p < 0.0001), comfort with performing a neurologic examination increased from 30% to 78.4% (95% CI 0.70-0.86; p < 0.0001), and fear of studying neurology decreased from 46% to 26% (95% CI 0.17-0.34; p < 0.0001) following Neuro Day. One hundred percent of students indicated that they would recommend Neuro Day to their peers. CONCLUSION: Neuro Day is a feasible and effective model to incorporate into medical education. There was increased interest in and decreased fear of neurology. We anticipate that this paradigm can be used in the future to encourage students to consider a career in neurology.
Asunto(s)
Curriculum , Internado y Residencia , Neurología/educación , Estudiantes de Medicina , Selección de Profesión , Prácticas Clínicas , Educación de Pregrado en Medicina , Humanos , Mentores , Pacientes , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
Our ability to perceive meaningful action events involving objects, people, and other animate agents is characterized in part by an interplay of visual and auditory sensory processing and their cross-modal interactions. However, this multisensory ability can be altered or dysfunctional in some hearing and sighted individuals, and in some clinical populations. The present meta-analysis sought to test current hypotheses regarding neurobiological architectures that may mediate audio-visual multisensory processing. Reported coordinates from 82 neuroimaging studies (137 experiments) that revealed some form of audio-visual interaction in discrete brain regions were compiled, converted to a common coordinate space, and then organized along specific categorical dimensions to generate activation likelihood estimate (ALE) brain maps and various contrasts of those derived maps. The results revealed brain regions (cortical "hubs") preferentially involved in multisensory processing along different stimulus category dimensions, including 1) living versus nonliving audio-visual events, 2) audio-visual events involving vocalizations versus actions by living sources, 3) emotionally valent events, and 4) dynamic-visual versus static-visual audio-visual stimuli. These meta-analysis results are discussed in the context of neurocomputational theories of semantic knowledge representations and perception, and the brain volumes of interest are available for download to facilitate data interpretation for future neuroimaging studies.
RESUMEN
The purpose of this study was to examine the association between rates of methicillin-resistant Staphylococcus aureus (MRSA)/Clostridioides difficile and quality and clinical outcomes in US acute care hospitals. The population was all Medicare-certified US acute care hospitals with MRSA/C difficile standardized infection ratio (SIR) data available from 2013 to 2017. Hospital-level data from the Centers for Medicare & Medicaid Services were used to estimate hospital and time fixed effects models for 30-day hospital readmissions, length of stay, 30-day mortality, and days in the intensive care unit. The key explanatory variables were SIR for MRSA and C difficile. No association was found between MRSA or C difficile rates and any of the 4 outcomes. The null results add to the mixed evidence in the field, but there are likely residual confounding factors. Future research should use larger samples of patient-level data and appropriate methods to provide evidence to guide efforts to tackle antimicrobial resistance.
Asunto(s)
Infección Hospitalaria , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Anciano , Clostridioides , Infección Hospitalaria/epidemiología , Hospitales , Humanos , Medicare , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: To estimate the impact of California's antimicrobial stewardship program (ASP) mandate on methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile infection (CDI) rates in acute-care hospitals. POPULATION: Centers for Medicare and Medicaid Services (CMS)-certified acute-care hospitals in the United States. DATA SOURCES: 2013-2017 data from the CMS Hospital Compare, Provider of Service File and Medicare Cost Reports. METHODS: Difference-in-difference model with hospital fixed effects to compare California with all other states before and after the ASP mandate. We considered were standardized infection ratios (SIRs) for MRSA and CDI as the outcomes. We analyzed the following time-variant covariates: medical school affiliation, bed count, quality accreditation, number of changes in ownership, compliance with CMS requirements, % intensive care unit beds, average length of stay, patient safety index, and 30-day readmission rate. RESULTS: In 2013, California hospitals had an average MRSA SIR of 0.79 versus 0.94 in other states, and an average CDI SIR of 1.01 versus 0.77 in other states. California hospitals had increases (P < .05) of 23%, 30%, and 20% in their MRSA SIRs in 2015, 2016, and 2017, respectively. California hospitals were associated with a 20% (P < .001) decrease in the CDI SIR only in 2017. CONCLUSIONS: The mandate was associated with a decrease in CDI SIR and an increase in MRSA SIR.
Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos , Infección Hospitalaria , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Anciano , California/epidemiología , Clostridioides , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Hospitales , Humanos , Medicare , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Estados UnidosRESUMEN
Higher cognitive functions such as linguistic comprehension must ultimately relate to perceptual systems in the brain, though how and why this forms remains unclear. Different brain networks that mediate perception when hearing real-world natural sounds has recently been proposed to respect a taxonomic model of acoustic-semantic categories. Using functional magnetic resonance imaging (fMRI) with Chinese/English bilingual listeners, the present study explored whether reception of short spoken phrases, in both Chinese (Mandarin) and English, describing corresponding sound-producing events would engage overlapping brain regions at a semantic category level. The results revealed a double-dissociation of cortical regions that were preferential for representing knowledge of human versus environmental action events, whether conveyed through natural sounds or the corresponding spoken phrases depicted by either language. These findings of cortical hubs exhibiting linguistic-perceptual knowledge links at a semantic category level should help to advance neurocomputational models of the neurodevelopment of language systems.
RESUMEN
The ability to detect and rapidly process harmonic sounds, which in nature are typical of animal vocalizations and speech, can be critical for communication among conspecifics and for survival. Single-unit studies have reported neurons in auditory cortex sensitive to specific combinations of frequencies (e.g., harmonics), theorized to rapidly abstract or filter for specific structures of incoming sounds, where large ensembles of such neurons may constitute spectral templates. We studied the contribution of harmonic structure to activation of putative spectral templates in human auditory cortex by using a wide variety of animal vocalizations, as well as artificially constructed iterated rippled noises (IRNs). Both the IRNs and vocalization sounds were quantitatively characterized by calculating a global harmonics-to-noise ratio (HNR). Using functional MRI, we identified HNR-sensitive regions when presenting either artificial IRNs and/or recordings of natural animal vocalizations. This activation included regions situated between functionally defined primary auditory cortices and regions preferential for processing human nonverbal vocalizations or speech sounds. These results demonstrate that the HNR of sound reflects an important second-order acoustic signal attribute that parametrically activates distinct pathways of human auditory cortex. Thus, these results provide novel support for the presence of spectral templates, which may subserve a major role in the hierarchical processing of vocalizations as a distinct category of behaviorally relevant sound.
Asunto(s)
Corteza Auditiva/anatomía & histología , Corteza Auditiva/fisiología , Potenciales Evocados Auditivos/fisiología , Acústica del Lenguaje , Percepción del Habla/fisiología , Vocalización Animal/fisiología , Estimulación Acústica , Adolescente , Adulto , Animales , Vías Auditivas/anatomía & histología , Vías Auditivas/fisiología , Mapeo Encefálico , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Percepción de la Altura Tonal , Procesamiento de Señales Asistido por Computador , Espectrografía del Sonido , Especificidad de la Especie , Adulto JovenRESUMEN
Time-resolved absorbance measurements, over a spectral range from 300 to 700 nm, were made at delays from 1 micros to 2 ms after photoexcitation of bovine rhodopsin in hypotonically washed membrane suspensions over a range of temperature from 10 to 35 degrees C. The purpose was to better understand the reversibility of the Lumi I-Lumi II process that immediately precedes Schiff base deprotonation in the activation of rhodopsin under physiological conditions. To prevent artifacts due to rotation of rhodopsin and its photoproducts in the membrane, probe light in the time-resolved absorbance studies was polarized at the magic angle (54.7 degrees) relative to the excitation laser polarization axis. The difference spectrum associated with the Lumi I to Lumi II reaction was found to have larger amplitude at 10 degrees C compared to higher temperatures, suggesting that a significant back-reaction exists for this process and that an equilibrated mixture forms. The equilibrium favors Lumi I entropically, and van't Hoff plot curvature shows the reaction enthalpy depends on temperature. The results suggest that Lumi II changes its interaction with the membrane in a temperature-dependent way, possibly binding a membrane lipid more strongly at lower temperatures (compared to its precursor). To elucidate the origin of the time-resolved absorbance changes, linear dichroism measurements were also made at 20 degrees C. The time constant for protein rotation in the membrane was found to be identical to the time constant for the Lumi I-Lumi II process, which is consistent with a common microscopic origin. We conclude that Lumi II (the last protonated Schiff base photointermediate under physiological conditions) is the first photointermediate whose properties depend on the protein-lipid environment.