How the forensic multidisciplinary approach can solve a fatal dog pack attack.

The authors present the case of a 61-year-old man found dead in an agricultural plot. The first investigation of the scene revealed the corpse laid face up in a spot of partially dried blood, next to an olive tree. His face, arms, legs, and abdomen showed signs of severe contusion and laceration of dogs' bite wounds. Next to the victim, an olives bin had been found overturned on the ground. A multi-disciplinary approach, including crime scene analysis, autopsy findings, veterinary animals review, odontologist bite mark study, and forensic genetics DNA correlations, was performed. The present case is a documented watchdogs lethal pack attack and provides an example of how to recognize the more active participants thanks to their odontological alterations. It could be considered the first described dog pack attack case solved by dysgnathia alteration. Comparisons between the dental casts obtained from the dogs and the inflicted wounds were made, resulting in positive correlations between the injuries and the dental arches from two of the six involved dogs, thanks to dental abnormalities and DNA founding. The victim's clothes were also compared with the dogs' dental casts, confirming that they were the most active participants during the pack attack. Dogs' DNA was finally matched with saliva traces found on victim's clothes and skin bite marks.

Augmented manipulation ability in humans with six-fingered hands.

Neurotechnology attempts to develop supernumerary limbs, but can the human brain deal with the complexity to control an extra limb and yield advantages from it? Here, we analyzed the neuromechanics and manipulation abilities of two polydactyly subjects who each possess six fingers on their hands. Anatomical MRI of the supernumerary finger (SF) revealed that it is actuated by extra muscles and nerves, and fMRI identified a distinct cortical representation of the SF. In both subjects, the SF was able to move independently from the other fingers. Polydactyly subjects were able to coordinate the SF with their other fingers for more complex movements than five fingered subjects, and so carry out with only one hand tasks normally requiring two hands. These results demonstrate that a body with significantly more degrees-of-freedom can be controlled by the human nervous system without causing motor deficits or impairments and can instead provide superior manipulation abilities.

Non-invasive brain stimulation of motor cortex induces embodiment when integrated with virtual reality feedback.

Previous evidence highlighted the multisensory-motor origin of embodiment - that is, the experience of having a body and of being in control of it - and the possibility of experimentally manipulating it. For instance, an illusory feeling of embodiment towards a fake hand can be triggered by providing synchronous visuo-tactile stimulation to the hand of participants and to a fake hand or by asking participants to move their hand and observe a fake hand moving accordingly (rubber hand illusion). Here, we tested whether it is possible to manipulate embodiment not through stimulation of the participant's hand, but by directly tapping into the brain's hand representation via non-invasive brain stimulation. To this aim, we combined transcranial magnetic stimulation (TMS), to activate the hand corticospinal representation, with virtual reality (VR), to provide matching (as contrasted to non-matching) visual feedback, mimicking involuntary hand movements evoked by TMS. We show that the illusory embodiment occurred when TMS pulses were temporally matched with VR feedback, but not when TMS was administered outside primary motor cortex, (over the vertex) or when stimulating motor cortex at a lower intensity (that did not activate peripheral muscles). Behavioural (questionnaires) and neurophysiological (motor-evoked-potentials, TMS-evoked-movements) measures further indicated that embodiment was not explained by stimulation per se, but depended on the temporal coherence between TMS-induced activation of hand corticospinal representation and the virtual bodily feedback. This reveals that non-invasive brain stimulation may replace the application of external tactile hand cues and motor components related to volition, planning and anticipation.

Long-term sexual outcomes after holmium laser enucleation of the prostate: which patients could benefit the most?

Assess rate and predictors of erectile function (EF) outcomes at long-term follow-up (FU) after holmium laser enucleation of the prostate (HoLEP). Cross-sectional analyses were performed on 135 patients with a mean FU of 12 years post HoLEP. Patients completed both a baseline and a FU International Index of Erectile Function (IIEF)-EF domain and the International Prostatic Symptoms Score (IPSS). Postoperative EF outcomes, including rate and predictors of EF improvement considering minimal clinically important differences (MCIDs) criteria, were assessed. Logistic regression models tested the association between predictors and EF. At a mean (median) FU of 152.1 (163) months, patients showed a significant decrease in the IIEF-EF score P<0.01) and significant IPSS improvement (P<0.01). Overall, 50 (37%) patients worsened by at least one IIEF-EF category. Conversel, 23 (17%) patients reported an improvement in postoperative IIEF-EF score; 75 (55.6%) and 10 (7.4%) patients maintained and eventually improved their IIEF-EF category, respectively. Patients reporting a decrease in the postoperative IIEF-EF score were significantly older (P=0.03) and showed a significantly longer mean FU (P<0.01) than those reporting postoperative improvements of IIEF-EF. Nine (6.7%) patients showed significant EF improvement according to MCIDs criteria. Both higher IPSS scores (odds ratio (OR): 1.12; P=0.02) and lower IIEF-EF (OR: 0.88; P<0.01) at baseline, emerged as independent predictors of postoperative EF improvement. HoLEP was associated with a decrease in EF and a persistent amelioration of BPH-related urinary symptoms at long-term FU. Almost one third of patients worsened by at least one IIEF-EF category. However, a clinically meaningful EF improvement was observed in roughly 7% of the individuals. Patients with more severe preoperative urinary symptoms and ED benefited more from HoLEP in terms of EF.

Metabolic syndrome in white European men presenting for primary couple's infertility: investigation of the clinical and reproductive burden.

Despite complex interactions between obesity, dyslipidemia, hyperinsulinaemia, and the reproductive axis, the impact of metabolic syndrome on human male reproductive function has not been analysed comprehensively. Complete demographic, clinical, and laboratory data from 1337 consecutive primary infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (categorised 0 vs. 1 vs. 2 or higher). NCEP-ATPIII criteria were used to define metabolic syndrome. Semen analysis values were assessed based on the 2010 World Health Organisation (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and metabolic syndrome. Metabolic syndrome was found in 128 (9.6%) of 1337 men. Patients with metabolic syndrome were older (p < 0.001) and had a greater Charlson Comorbidity Index of 1 or higher (chi-square: 15.6; p < 0.001) compared with those without metabolic syndrome. Metabolic syndrome patients had lower levels of total testosterone (p < 0.001), sex hormone-binding globulin (p = 0.004), inhibin B (p = 0.03), and anti-Müllerian hormone (p = 0.009), and they were hypogonadal at a higher rate (chi-square: 32.0; p < 0.001) than patients without metabolic syndrome. Conversely, the two groups did not differ significantly in further hormonal levels, semen parameters, and rate of either obstructive or non-obstructive azoospermia. At multivariate logistic regression analysis, testicular volume (OR: 0.90; p = 0.002) achieved independent predictor status for WHO pathological semen concentration; conversely, age, Charlson Comorbidity Index scores, metabolic syndrome, and inhibin B values did not. No parameters predicted normal sperm morphology and total progressive motility. Metabolic syndrome accounts for roughly 9% of men presenting for primary couple's infertility. Although metabolic syndrome patients have a lower general male health status, semen analysis values seem independent of the presence of metabolic syndrome.

Effects of silodosin on sexual function - realistic picture from the everyday clinical practice.

The treatment with α1-blockers in patients complaining of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is associated with potential adverse events (AEs), thus including ejaculatory dysfunction (EjD). We sought to assess the effects of a 3-month course of silodosin 8 mg daily dosing on sexual functioning, mainly including ejaculation and orgasm, in a cohort of 100 consecutive sexually active men in the real-life setting. Patients completed the International Index of Erectile Function-Orgasmic Function (IIEF-OF) domain and the International Prostate Symptom Score (IPSS) both at baseline and at survey. Likewise, patients completed a 16-item self-administered questionnaire with closed questions also including specific questions regarding treatment-related adverse events on sexual functioning. Rates and predictors of OF impairment and drug discontinuation were investigated. At survey, silodosin resulted highly effective in improving IPSS-total and subscales (all p < 0.01). Anejaculation, hypospermia, reduced or absent orgasmic feeling, low sexual desire and erectile dysfunction were subjectively reported by 48 (48%), 23 (23%), 11 (11%), 6 (6%), 7 (7%) and 11 (11%) patients respectively. Overall, a reduction in IIEF-OF domain score was observed in 64 (64%) patients. Patients with decreased IIEF-Q9 and/or IIEF-Q10 scores were significantly younger than those without any decrease (p = 0.02). Of all, only 7% of the patients discontinued silodosin because of anejaculation. Silodosin confirms to be highly effective in patients with LUTS/BPH; of them, almost 70% report either anejaculation or hypospermia, with a concomitant OF impairment in 17% of the patients. Younger patients showed higher rates of a concomitant impairment of ejaculation and OF. Overall, anejaculation caused drug discontinuation in 7% of the patients.

Lower urinary tract symptoms among Caucasian-European men who have sex with men: findings from a real-life survey.

BACKGROUND: Prevalence of and severity of lower urinary tract symptoms (LUTS) according to male sexual orientation have been scantly analysed. We aimed to assess the prevalence and severity of LUTS in a cohort of Caucasian-European men who have sex with men seeking medical help for uroandrologic reasons other than LUTS. METHODS: Data from 949 consecutive individuals in an outpatient setting were analysed. Severity of LUTS was measured with the International Prostate Symptom Score (IPSS). Men with storage symptoms scored 1-3 and ⩾ 4 (of 15), and voiding symptoms scored 1-4 and ⩾ 5 (of 20) were considered as having mild and moderate-to-severe symptoms, respectively. For individual symptoms, patients with scores ⩾ 1 were deemed symptomatic (according to Apostolidis et al.(15)). Descriptive statistics and logistic regression models tested the association between LUTS and sexual orientation. RESULTS: Complete data were available for 213 (22.4%) men who have sex with men (MSM) and 736 (77.6%) heterosexuals (mean age (s.d.): 41.0 (12.2) vs 39.9 (12.1) years). Compared with heterosexuals, MSM reported higher rates of total IPSS scores suggestive of moderate (21.6% vs 20%) and severe LUTS (3.8% vs 2.4%) (P=0.004). Similarly, MSM showed higher rates of mild (48.8% vs 45.2%) and moderate-to-severe (39.4% vs 30.4%) storage symptoms (all P<0.001), and of mild (45.1% vs 34.8%) and moderate-to-severe (20.2% vs 19.2%) voiding symptoms (all P<0.01). MSM status was an independent predictor of mild voiding symptoms (odds ratio (OR): 1.40; P=0.004), moderate-to-severe storage symptoms (OR: 1.40; P=0.04) and severe total IPSS (OR: 1.49; P=0.03), after adjusting for other variables. CONCLUSIONS: These findings suggest a higher prevalence and severity of LUTS in MSM compared with heterosexual men seeking medical help for uroandrologic reasons other than LUTS.

Large capillary telangiectasia and developmental venous anomaly of the Basal Ganglia: an unusual finding.

Brain capillary telangiectasias are small, benign, asymptomatic, angiographically occult lesions that are incidentally discovered either at autopsy or on MR imaging in most cases. They are commonly located in the pons and can be associated with other vascular malformations. We describe a case of an unusually large capillary telangiectasia associated with a developmental venous anomaly involving the basal ganglia in a young woman, in which MR serial imaging suggested the diagnosis and avoided an unnecessary stereotaxic biopsy.

Voluntary physical activity and leucine correct impairments in muscle protein synthesis in partially pancreatectomised rats.

AIMS/HYPOTHESIS: Poorly controlled type 1 diabetes mellitus can cause reduced skeletal muscle mass and weakness during adolescence, which may affect long-term management of the disease. The aim of this study was to determine whether regular voluntary physical activity and leucine feeding restore rates of protein synthesis and deficits in skeletal muscle mass in a young, hypoinsulinaemic/hyperglycaemic rat model of diabetes. METHODS: Four-week-old male Sprague-Dawley rats were partially pancreatectomised (Px) to induce hypoinsulinaemia/hyperglycaemia and housed with/without access to running wheels for 3 weeks (n = 12-14/group). Sham surgery rats (shams) served as sedentary controls (n = 18). Protein synthesis and markers of protein anabolism were assessed in the fasted state and following leucine gavage. Fibre type and cross-sectional areas of the gastrocnemius muscle were measured using a metachromatic ATPase stain. RESULTS: Compared with sedentary behaviour, regular activity lowered fasting glycaemia and reduced fed hyperglycaemia in Px rats. Active-Px rats, which ran 2.2 ± 0.71 km/night, displayed greater muscle mass and fibre areas similar to shams, while sedentary-Px rats displayed a 20-30% loss in muscle fibre areas. Muscle protein synthesis (basal and in response to leucine gavage) was impaired in sedentary-Px (by ~65%), but not in active-Px rats, when compared with shams. Following leucine gavage, the phosphorylation status of eIF4E binding protein 1 (4E-BP1) and ribosomal S6 kinase 1 (S6K1), markers of mammalian target of rapamycin complex 1 (mTORC1) signalling, increased in shams (by two- and ninefold, respectively) and in active-Px (1.5- and fourfold, respectively) rats, but not in sedentary-Px rats. CONCLUSION/INTERPRETATION: Moderate physical activity in young Px rats normalises impairments in skeletal muscle growth and protein synthesis. These findings illustrate the critical compensatory role that modest physical activity and targeted nutrition can have on skeletal muscle growth during periods of hypoinsulinaemia in adolescent diabetes.

Regulation of glucagon secretion by zinc: lessons from the ß cell-specific Znt8 knockout mouse model.

In type-2 diabetes, hyperglucagonaemia aggravates elevated blood glucose levels. Relative to our knowledge of the ß-cell and insulin secretion, there remains a limited understanding of glucagon secretion in α-cells. Regulation of glucagon may be dependent on a combination of factors, which include direct glucose sensing by the α-cell, innervations from the autonomic nervous system and potential 'paracrine' actions by hormones and factors that are released by adjacent endocrine cells within the islets. The list of potential 'paracrine' regulators within the islet includes insulin, somatostatin, γ-aminobutyric acid, glutamate and zinc. Zinc crystallises with insulin in ß-cells and is co-secreted with insulin. In the scientific literature, the effect of exogeneous zinc on glucagon secretion has been debated. Here, we confirm that an increase in exogeneous zinc does inhibit glucagon secretion. To determine if there are physiological effects of zinc on glucagon secretion we used a ß-cell-specific ZnT8 knockout (Znt8BKO) mouse model. Znt8BKO mice, despite showing lower granular zinc content in ß-cells, showed no changes in fasted plasma glucagon levels and glucose regulated glucagon secretion. These findings suggest that zinc secreted from ß-cell does not regulate glucagon secretion.

Selective and integrated rehabilitation programs for disturbances of visual/spatial attention and executive function after brain damage: a neuropsychological evidence-based review.

The present evidence-based review systematically examines the literature on the neuropsychological rehabilitation of attentional and executive dysfunctions in patients with acquired brain lesions. Four areas are considered: 1) neuropsychological rehabilitation of attentional disorders; 2) neuropsychological rehabilitation of neglect disorders; 3) neuropsychological rehabilitation of dysexecutive disorders and 4) rehabilitation trainings for patients with mild traumatic brain injury (TBI). In each area, search and selection of papers were performed on several databases and integrated by crosschecking references from relevant and recent reviews. The literature up to 2007 was examined (in some areas the search was limited from 2000 to 2007). Class of evidence for each selected study was evaluated according to the SPREAD (2010) criteria. Based on this analysis, recommendations on the effectiveness of rehabilitation trainings are proposed separately for each rehabilitation method in each of the four areas considered. Information on follow-up data and impact on activities of daily living is provided whenever available.

MRI in a woman with late onset ornithine transcarbamylase deficiency.

We describe the brain MR imaging findings of a woman who developed neurologic symptoms due to an acute hyperammonemic encephalopathy resulting from late onset ornithine transcarbamylase deficiency (OCTD). MR images revealed injury (hyperintense foci on long TR images) to the subcortical white matter of the left precentral and supramarginal gyrus and in the left frontal lobe. These findings presumably reflect the distribution of brain injury from hypoperfusion secondary to severe hyperammonemia. If MR findings suggesting hypoperfusion are detected in a patient with hyperammonemia, the diagnosis of OCTD should be considered. Knowledge of the physiopathological mechanisms of OTCD and of MR imaging of hyperammonemic injury may help expedite diagnosis and treatment and prevent the exitus of patients with this genetic disorder.

Central executive system impairment in traumatic brain injury.

The aim of the present study was to identify cognitive functions affected by traumatic brain injury (TBI) and to verify the mechanism underlying cognitive impairment. More precisely, cognitive deficits following TBI can be considered as a consequence of (a) a speed processing deficit, that is a general slowing of perceptual, motor and cognitive subroutines; (b) an impairment of the Central Executive System of working memory (CES).Thirty-seven patients were submitted to a neuropsychological battery, aimed to evaluate different cognitive functions. Results showed severe deficits in speed processing, divided attention,working memory, executive functions and long term memory. Regression analyses, performed to test the two hypotheses, showed that the working memory deficit hypothesis is able to explain divided attention, executive functions and long term memory deficits more than speed processing hypothesis.

A rehabilitative program for central executive deficits after traumatic brain injury.

Deficits affecting Central Executive System (CES) of working memory (WM) are the main neuropsychological outcome after traumatic brain injury (TBI) and can also explain deficits in other domains, like divided attention, executive functions and long-term memory. For this reason we developed a rehabilitative program based on CES functions and we expected to find an improvement in WM as well as in those cognitive functions controlled by the CES. The experimental group was composed by 9 TBIs, selected for WM deficits, whereas the control group was composed by 6 TBIs, without WM deficits, but with speed processing deficits. All patients performed a cognitive training, based on PASAT (Gronwall & Wrightson, 1981)and two new versions of this task. The results showed in the experimental group an improvement in WM and in the cognitive functions controlled by the CES, whereas control patients did not show any improvement after the cognitive training.

Immobilization of oligodeoxyribonucleotides with multiple anchors to microchips.

Facile modification of oligodeoxyribonucleotides is required for efficient immobilization to a pre-activated glass surface. This report presents an oligodeoxyribonucleotide which contains a hairpin stem-loop structure with multiple phosphorothioate moieties in the loop. These moieties are used to anchor the oligo to glass slides that are pre-activated with bromoacetamidopropylsilane. The efficiency of the attachment reaction was improved by increasing the number of phosphorothioates in the loop, as shown in the remarkable enhancement of template hybridization and single base extension through catalysis by DNA polymerase. The loop and stem presumably serve as lateral spacers between neighboring oligodeoxyribonucleotides and as a linker arm between the glass surface and the single-stranded sequence of interest. The oligodeoxyribonucleotides of this hairpin stem-loop architecture with multiple phosphorothioate moieties have broad application in DNA chip-based gene analysis.

Age, strain, and semi-chronic hydergine treatment effects on motor activity and neuronal nucleic acid-protein metabolism in male mice.

This study was designed to examine the effects of Hydergine (DHET), co-dergocrine mesylate, treatment on motor activity and neuronal nucleoprotein metabolism in several motor areas of the aging rodent brain, specifically the caudate-putamen (CP), the substantia nigra (SN), and the cerebral cortex layer V (CX). Three age groups of two different strains of mice were used which represented two different aging rates: DBA/2 male mice (short lived) and C57BL/6 male mice (long lived). A representative sample of each age group was injected (IP) daily with a single dose of either DHET (1 mg/kg) or vehicle (0.9% saline) solution for one month. Total spontaneous motor activity was measured using a File apparatus to assess the functional ability of the selected brain areas. Histochemical parameters measured included the relative RNA and protein contents from a homogeneous population of neurons within each nuclei. The RNA and protein contents were assessed with a scanning microdensitometer using azure B and Coomassie staining protocols, respectively. The results of this study provide evidence that DHET does have significant effects on neuronal functioning in the motor compartments studied at the behavioral as well as the histochemical level for DBA/2 male mice. The C57BL/6 strain showed parallel, but less significant, changes in the histochemical parameters and no statistical differences in motor activity. In addition, DHET treatment produced no sign of neurotoxicity within any of the brain nuclei in either strain.

Multivessel supercritical fluid extraction of food items in Total Diet Study.

An off-line, large capacity, multivessel supercritical fluid extractor (SFE) was designed and constructed for extraction of large samples. The extractor can simultaneously process 1-6 samples (15-25 g) by using supercritical carbon dioxide (SC-CO2), which is relatively nontoxic and nonflammable, as the solvent extraction medium. Lipid recoveries for the SFE system were comparable to those obtained by blending or Soxhlet extraction procedures. Extractions at 10,000 psi, 80 degrees C, expanded gaseous CO2 flow rates of 4-5 L/min (35 degrees C), and 1-3 h extraction times gave reproducible lipid recoveries for pork sausage (relative standard deviation [RSD], 1.32%), corn chips (RSD, 0.46%), cheddar cheese (RSD, 1.14%), and peanut butter (RSD, 0.44%). In addition, this SFE system gave reproducible recoveries (> 93%) for butter fortified with cis-chlordane and malathion at the 100 ppm and 0.1 ppm levels. Six portions each of cheddar cheese, saltine crackers, sandwich cookies, and ground hamburger also were simultaneously extracted with SC-CO2 and analyzed for incurred pesticide residues. Results obtained with this SFE system were reproducible and comparable with results from organic-solvent extraction procedures currently used in the Total Diet Study; therefore, use and disposal of large quantities of organic solvents can be eliminated.

Palladium(0)-assisted synthesis of C-glycopyranosyl compounds.

Tetrakis(triphenylphosphine)palladium(0) effects the regio- and stereo-selective alkylation of 2-acetoxy-5,6-dihydro-2H-pyrans and 1-S-acetyl-1-thiohex-2-enopyranosides. Use of stabilized carbanions resulted in the formation of alkylated dihydropyrans with net retention at the oxygen-bearing carbon atom. Examples include the preparation of 2-[acetamidobis(ethoxycarbonyl)methyl]-5,6-dihydro-2H-pyran, 2-[acetamidobis(methoxycarbonyl)methyl]-6-ethoxy-5,6-dihydro-2H-py ran, and 2-[acetamidobis(methoxycarbonyl)methyl]-6-methoxymethyl-5,6-dihydr o-2H- pyran. Use of nonstabilized carbanions, such as arylzinc chlorides, resulted in the formation of alkylated dihydropyrans and C-glycosyl compounds with net inversion at the oxygen-bearing carbon atom. Examples include the preparation of 2-[(6-ethoxy-5,6-dihydro-2H-pyranyl)methyl]-4,4-dimethyl-2-oxazoli ne, trans-methoxymethyl-2-phenyl-5,6-dihydro-2H-pyran, trans-methoxymethyl-2-vinyl-5,6-dihydro-2H-pyran, trans-2-[2,2-bis(ethoxy)ethyl]-6-methoxymethyl-5,6-dihydro-2H-pyran, (4,6-di-O-methyl-2,3-dideoxy-alpha-D-erythro-hex-2-enopyranosyl)be nzene, (2,3-dideoxy-4,6-di-O-methyl-beta-D-erythro-hex-2-enopyranosyl)ben zene, 1-(2,3-dideoxy-4,6-di-O-methyl-alpha and -beta-D-erythro-hex-2-enopyranosyl)naphthalene, 4-(2,3-dideoxy-4,6-di-O-methyl-alpha- and -beta-D-erythro-hex-2-enopyranosyl)toluene, and 1-(2,3-trideoxy-4-O-methyl-alpha-L-erythro-hex-2-enopyranosyl)naph thalene.