Temperature Control in Acute Brain Injury: An Update.

Temperature control in severe acute brain injury (SABI) is a key component of acute management. This manuscript delves into the complex role of temperature management in SABI, encompassing conditions like traumatic brain injury (TBI), acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), aneurysmal subarachnoid hemorrhage (aSAH), and hypoxemic/ischemic brain injury following cardiac arrest. Fever is a common complication in SABI and is linked to worse neurological outcomes due to increased inflammatory responses and intracranial pressure (ICP). Temperature management, particularly hypothermic temperature control (HTC), appears to mitigate these adverse effects primarily by reducing cerebral metabolic demand and dampening inflammatory pathways. However, the effectiveness of HTC varies across different SABI conditions. In the context of post-cardiac arrest, the impact of HTC on neurological outcomes has shown inconsistent results. In cases of TBI, HTC seems promising for reducing ICP, but its influence on long-term outcomes remains uncertain. For AIS, clinical trials have yet to conclusively demonstrate the benefits of HTC, despite encouraging preclinical evidence. This variability in efficacy is also observed in ICH, aSAH, bacterial meningitis, and status epilepticus. In pediatric and neonatal populations, while HTC shows significant benefits in hypoxic-ischemic encephalopathy, its effectiveness in other brain injuries is mixed. Although the theoretical basis for employing temperature control, especially HTC, is strong, the clinical outcomes differ among various SABI subtypes. The current consensus indicates that fever prevention is beneficial across the board, but the application and effectiveness of HTC are more nuanced, underscoring the need for further research to establish optimal temperature management strategies. Here we provide an overview of the clinical evidence surrounding the use of temperature control in various types of SABI.

Sample-comparison mapping and joint stimulus control.

A matching-to-sample task with a 3-sample, 2-comparison mapping has been found to engender joint control by the stimuli that signaled the samples (keylight) and the inter-trial interval (houselight), with a trade-off in the degree of control exerted by each stimulus. To learn about the boundary conditions for the establishment of that joint stimulus control, we trained pigeons in a similar task, but featuring a one-to-one sample-comparison mapping, with two samples and two comparisons. To assess their relative influences, we ran two tests where each of the stimuli was removed: in one test, no sample keylight was presented, and in the other, the ITI was spent in darkness. Results were consistent with both stimuli influencing choice but there was no clear evidence of a trade-off between them. These results suggest that sample-comparison mapping and/or total number of samples may influence how an animal directs its attention to the stimuli available.

Improved triamcinolone acetonide-eluting contact lenses based on cyclodextrins and high hydrostatic pressure assisted complexation.

Contact lenses (CLs) constitute an advantageous platform for the topical release of corticosteroids due to their prolonged contact with the eye. However, the lipophilic nature of corticosteroids hampers CLs' ability to release therapeutic amounts. Two approaches to improve loading and release of triamcinolone acetonide (TA) from poly(2-hydroxyethyl methacrylate)-based hydrogels were investigated: adding 2-hydroxypropyl-ß-cyclodextrin (HP-ß-CD) to the monomers solution before polymerization (HEMA/i-CD) and an hydrogels' post-treatment with HP-ß-CD (HEMA/p-CD). The effect of HP-ß-CD and sterilization by high hydrostatic pressure (HHP) on the hydrogel properties (water content, oxygen and ion permeability, roughness, transmittance, and stiffness) was evaluated. The HEMA/i-CD hydrogels had stronger affinity for TA, sustaining its release for one day. HHP sterilization promoted the formation of cyclodextrin-TA complexes within the hydrogels, improving their drug-loading capacity ¼60 %. Cytotoxicity and irritability tests confirmed the safety of the therapeutic CLs. TA released from the hydrogels permeated through ocular tissues ex vivo and showed anti-inflammatory activity. Finally, a previously validated mathematical model was used to estimate the ability of the TA-loaded CLs to deliver therapeutic drug concentrations to the posterior part of the eye. Overall, HP-ß-CD-containing CLs are promising candidates for the topical ocular application of TA as an alternative delivery system to intraocular injections.

Dexamethasone phosphate and penetratin co-eluting contact lenses: a strategy to enhance ocular drug permeability.

Contact lenses (CLs) have been suggested as drug delivery platforms capable of increasing the drug residence time on the cornea and therefore its bioavailability. However, when targeting the posterior segment of the eye, the drug released from CLs still encounters the barrier effect of the ocular tissues, which considerably reduces the efficacy of administration. This work aims at the development of CLs able to simultaneously deliver an anti-inflammatory drug (dexamethasone sodium phosphate) and a cell-penetrating peptide (penetratin), the latter acting as a drug carrier across the tissues. Hydroxyethyl methacrylate (HEMA)-based hydrogels were functionalized with acrylic acid (AAc) and/or aminopropyl methacrylamide (APMA) to serve as CL materials with increased affinity for the drug and peptide. APMA-functionalized hydrogels sustained the dual release for 8 h, which is compatible with the wearing time of daily CLs. Hydrogels demonstrated suitable light transmittance, swelling capacity and in vitro biocompatibility. The anti-inflammatory activity of the drug was not compromised by the presence of the peptide nor by sterilization. The ocular distribution of the drug after 6 h of CL wearing was evaluated in vivo in rabbits and revealed that the amount of drug in the cornea and aqueous humor significantly increased when the drug was co-delivered with penetratin.

Effect of high cyclic hydrostatic pressure on osteogenesis of mesenchymal stem cells cultured in liquefied micro-compartments.

Bone resident cells are constantly subjected to a range of distinct mechanical loadings, which generates a complex microenvironment. In particular, hydrostatic pressure (HP) has a key impact on modulation of cell function and fate determination. Although HP is a constant mechanical stimulus, its role in regulating the osteogenesis process within a defined 3D microenvironment has not been comprehensively elucidated. Perceiving how environmental factors regulate the differentiation of stem cells is essential for expanding their regenerative potential. Inspired by the mechanical environment of bone, this study attempted to investigate the influence of different ranges of cyclic HP on human adipose-derived mesenchymal stem cells (MSCs) encapsulated within a compartmentalized liquefied microenvironment. Taking advantage of the liquefied environment of microcapsules, MSCs were exposed to cyclic HP of 5 or 50 MPa, 3 times/week at 37 °C. Biological tests using fluorescence staining of F-actin filaments showed a noticeable improvement in cell-cell interactions and cellular network formation of MSCs. These observations were more pronounced in osteogenic (OST) condition, as confirmed by fluorescent staining of vinculin. More interestingly, there was a significant increase in alkaline phosphatase activity of MSCs exposed to 50 MPa magnitude of HP, even in the absence of osteoinductive factors. In addition, a greater staining area of both osteopontin and hydroxyapatite was detected in the 50 MPa/OST group. These findings highlight the benefit of hydrostatic pressure to regulate osteogenesis of MSCs as well as the importance of employing simultaneous biochemical and mechanical stimulation to accelerate the osteogenic potential of MSCs for biomedical purposes.

Glial Fibrillary Acidic Protein (GFAP) Astrocytopathy: An Emerging Cause of Meningoencephalomyelitis in Children and Adolescents.

Introduction: We describe 5 children with GFAP astrocytopathy with the goal of further characterizing this rare form of meningoencephalomyelitis. Methods: Retrospective chart review of patients diagnosed with GFAP astrocytopathy between 2019 and 2021. Results: Patients were 8-17 years old, and all were male. Fever, headache, and vomiting were common presenting symptoms, and weakness, tremor, and ataxia were common initial examination findings. Initial magnetic resonance imaging (MRI) showed spinal cord abnormalities in 2 patients and leptomeningeal enhancement in 1. Most patients had cerebral spinal fluid pleocytosis, and all screened negative for malignancy. Three patients progressed to coma, and all were treated with immunosuppressant therapy. By discharge, all patients had improved over their clinical nadir, although none had returned to baseline. Discussion: GFAP astrocytopathy is a recently recognized cause of meningoencephalomyelitis in children. Here, we expand our understanding of this entity with the goal of aiding those treating children with GFAP astrocytopathy.

Giving time a chance in the midsession reversal task.

The midsession reversal task involves a simultaneous discrimination between stimuli S1 and S2. Choice of S1 but not S2 is reinforced during the first 40 trials, and choice of S2 but not S1 is reinforced during the last 40 trials. Trials are separated by a constant intertrial interval (ITI). Pigeons learn the task seemingly by timing the moment of the reversal trial. Hence, most of their errors occur around trial 40 (S2 choices before trial 41 and S1 choices after trial 40). It has been found that when the ITI is doubled on a test session, the reversal trial is halved, a result consistent with timing. However, inconsistent with timing, halving the ITI on a test session did not double the reversal trial. The asymmetry of ITI effects could be due to the intrusion of novel cues during testing, cues that preempt the timing cue. To test this hypothesis, we ran two types of tests after the regular training in the midsession reversal task, one with S1 and S2 choices always reinforced, and another with S1 always reinforced but S2 reinforced only after 20 trials when the ITI doubled or 40 trials when the ITI halved. For most pigeons, performance was consistent with timing both when the ITI doubled and when it was halved, but some pigeons appeared to follow strategies based on counting or on reinforcement contingencies.

High Pressure and Pasteurization Effects on Dairy Cream.

Dairy cream, a common ingredient in various dishes and food products, is susceptible to rapid microbial growth due to its high water activity (≈0.97) and pH (≈6.7). Thus, it requires proper processing conditions to ensure food safety and extend shelf life. High-pressure processing (HPP) has emerged as a nonthermal food pasteurization method, offering an alternative to conventional heat-based techniques to obtain tastier, fresh-like, and safe dairy products without undesirable heat-induced alterations. This study assessed the impact of HPP (450 and 600 MPa for 5 and 15 min at 7 °C) and thermal pasteurization (75 °C for 15 s) on the microbiological and physicochemical attributes of dairy cream immediately after processing and throughout refrigerated storage (4 °C). HPP-treated samples remained microbiologically acceptable even on the 51st day of storage, unlike thermally pasteurized samples. Moreover, HPP decreased inoculated Escherichia coli and Listeria innocua counts by more than 6 log units to undetectable levels (1.00 log CFU/mL). pH, color (maximum variation of ΔE* up to 8.43), and fatty acid profiles remained relatively stable under varying processing conditions and during storage. However, viscosity exhibited higher values for HPP-treated samples (0.028 ± 0.003 Pa·s) compared to thermally processed ones (0.016 ± 0.002 Pa·s) by the 28th day of storage. Furthermore, volatile compounds (VOCs) of all treated samples presented a tendency to increase throughout storage, particularly acids and aliphatic hydrocarbons. These findings show HPP's potential to significantly extend the shelf life of highly perishable dairy cream by at least 15 days compared to thermal pasteurization.

The Impact of HPP-Assisted Biocontrol Approach on the Bacterial Communities' Dynamics and Quality Parameters of a Fermented Meat Sausage Model.

Traditional foods are increasingly valued by consumers, whose attention and purchase willingness are highly influenced by other claims such as 'natural', 'sustainable', and 'clean label'. The purpose of the present study was to evaluate the impact of a novel non-thermal food processing method (i.e., HPP-assisted biocontrol combining mild high hydrostatic pressure, listeriophage Listex, and pediocin PA-1 producing Pediococcus acidilactici) on the succession of bacterial communities and quality of a fermented sausage model. A comparative analysis of instrumental color, texture, and lipid peroxidation revealed no significant differences (p > 0.05) in these quality parameters between non- and minimally processed fermented sausages throughout 60-day refrigerated storage (4 °C). The microbiota dynamics of biotreated and untreated fermented sausages were assessed by 16S rRNA next-generation sequencing, and the alpha and beta diversity analyses revealed no dissimilarity in the structure and composition of the bacterial communities over the analyzed period. The innovative multi-hurdle technology proposed herein holds valuable potential for the manufacture of traditional fermented sausages while preserving their unique intrinsic characteristics.

Cross-species oncogenomics offers insight into human muscle-invasive bladder cancer.

BACKGROUND: In humans, muscle-invasive bladder cancer (MIBC) is highly aggressive and associated with a poor prognosis. With a high mutation load and large number of altered genes, strategies to delineate key driver events are necessary. Dogs and cats develop urothelial carcinoma (UC) with histological and clinical similarities to human MIBC. Cattle that graze on bracken fern also develop UC, associated with exposure to the carcinogen ptaquiloside. These species may represent relevant animal models of spontaneous and carcinogen-induced UC that can provide insight into human MIBC. RESULTS: Whole-exome sequencing of domestic canine (n = 87) and feline (n = 23) UC, and comparative analysis with human MIBC reveals a lower mutation rate in animal cases and the absence of APOBEC mutational signatures. A convergence of driver genes (ARID1A, KDM6A, TP53, FAT1, and NRAS) is discovered, along with common focally amplified and deleted genes involved in regulation of the cell cycle and chromatin remodelling. We identify mismatch repair deficiency in a subset of canine and feline UCs with biallelic inactivation of MSH2. Bovine UC (n = 8) is distinctly different; we identify novel mutational signatures which are recapitulated in vitro in human urinary bladder UC cells treated with bracken fern extracts or purified ptaquiloside. CONCLUSION: Canine and feline urinary bladder UC represent relevant models of MIBC in humans, and cross-species analysis can identify evolutionarily conserved driver genes. We characterize mutational signatures in bovine UC associated with bracken fern and ptaquiloside exposure, a human-linked cancer exposure. Our work demonstrates the relevance of cross-species comparative analysis in understanding both human and animal UC.

A chemical study of yoghurt produced under isostatic pressure during storage.

Yoghurt fermented under sub-lethal high pressure (10, 20, 30 and 40 MPa at 43 °C), and afterward placed under refrigeration (4 °C for 23 days) was studied and compared with yoghurt fermented at atmospheric pressure (0.1 MPa). For a deeper analysis, metabolite fingerprinting by nuclear magnetic resonance (NMR), sugars and organic acids assessment by high performance liquid chromatography (HPLC), total fatty acids (TFA) determination and quantification by gas chromatography with a flame ionization detector (GC-FID) were performed. Metabolomic analyses revealed that only 2,3-butanediol, acetoin, diacetyl and formate vary with the increase of pressure and probable relation with pressure influenced diacetyl reductase, acetoin reductase and acetolactate decarboxylase. Yoghurts fermented at 40 MPa had the lowest content in lactose (39.7 % of total sugar reduction) and the less content in TFA (56.1 %). Further research is of interest to understand more about fermentation processes under sub-lethal high pressure.

Combining high pressure and electric fields towards Nannochloropsis oculata eicosapentaenoic acid-rich extracts.

Nannochloropsis oculata is naturally rich in eicosapentaenoic acid (EPA). To turn this microalga into an economically viable source for commercial applications, extraction efficiency must be achieved. Pursuing this goal, emerging technologies such as high hydrostatic pressure (HHP) and moderate electric fields (MEF) were tested, aiming to increase EPA accessibility and subsequent extraction yields. The innovative approach used in this study combined these technologies and associated tailored, less hazardous different solvent mixtures (SM) with distinct polarity indexes. Although the classical Folch SM with chloroform: methanol (PI 4.4) provided the highest yield concerning total lipids (166.4 mglipid/gbiomass), diethyl ether: ethanol (PI 3.6) presented statistically higher values in terms of EPA per biomass, corresponding to 1.3-fold increase. When SM were used in HHP and MEF, neither technology independently improved EPA extraction yields, although the sequential combination of technologies did result in 62% increment in EPA extraction. Overall, the SM and extraction methodologies tested (HHP-200 MPa, 21 °C, 15 min, followed by MEF processing at 40 °C, 15 min) enabled increased EPA extraction yields from wet N. oculata biomass. These findings are of high relevance for the food and pharmaceutical industries, providing viable alternatives to the "classical" extraction methodologies and solvents, with increased yields and lower environmental impact. KEY POINTS: • Et2O: EtOH is a less toxic and more efficient alternative to Folch solvent mixture • HHP or MEF per se was not able to significantly increase EPA extraction yield • Combinations of HHP and MEF technologies increased both lipids and EPA yields.

Impact of Fermentation and Pasteurization on the Physico-Chemical and Phytochemical Composition of Opuntia ficus-indica Juices.

Opuntia ficus-indica fruits are a source of valuable compounds, presenting a high nutritional value and several health benefits. However, due to its low shelf life and increased production, there are considerable post-harvest losses of this cactus fruit. So, ways need to be found to drain the increased production of this fruit that is being wasted. The chemical composition of prickly pear makes it an appealing substrate for fermentation. This study investigates the production of fermented beverages produced from Opuntia ficus-indica cv 'Rossa' and evaluates the effects of different fermentation times (18 and 42 h) and post-fermentation pasteurization by high-pressure (500 MPa for 10 min) and temperature (71.1 °C for 30 s) on the physico-chemical and biological characteristics of the produced beverages. According to the results, the beverage produced from 48 h of fermentation has an alcohol content value of 4.90 ± 0.08% (v/v) and a pH of 3.91 ± 0.03. These values contribute to an extended shelf life and improved organoleptic characteristics compared to the sample fermented for 18 h. Additionally, the longer fermentation resulted in 50% fewer total soluble solids, 90% less turbidity, and lower pH when compared to the sample fermented for 18 h. Moreover, overall, high-pressure processing demonstrates better retention of "fresh-like" characteristics, along with higher levels of phytochemical compounds and antioxidant capacity, similar to those observed in the juice for SO•- and NO•-scavenging abilities.

High Hydrostatic Pressure in the Modulation of Enzymatic and Organocatalysis and Life under Pressure: A Review.

The interest in high hydrostatic pressure (HHP) is mostly focused on the inactivation of deleterious enzymes, considering the quality-related issues associated with enzymes in foods. However, more recently, HHP has been increasingly studied for several biotechnological applications, including the possibility of carrying out enzyme-catalyzed reactions under high pressure. This review aims to comprehensively present and discuss the effects of HHP on the kinetic catalytic action of enzymes and the equilibrium of the reaction when enzymatic reactions take place under pressure. Each enzyme can respond differently to high pressure, mainly depending on the pressure range and temperature applied. In some cases, the enzymatic reaction remains significantly active at high pressure and temperature, while at ambient pressure it is already inactivated or possesses minor activity. Furthermore, the effect of temperature and pressure on the enzymatic activity indicated a faster decrease in activity when elevated pressure is applied. For most cases, the product concentration at equilibrium under pressure increased; however, in some cases, hydrolysis was preferred over synthesis when pressure increased. The compiled evidence of the effect of high pressure on enzymatic activity indicates that pressure is an effective reaction parameter and that its application for enzyme catalysis is promising.

Externalizing forgetting: Delay testing in a long operant chamber.

In a long operant chamber, pigeons were trained to discriminate between 4-s and 12-s samples in a symbolic matching-to-sample task. Subsequently, delay and no-sample test trials were introduced. The location in the chamber in which the trial started and each comparison was presented varied across three experiments. Our main goals were to assess the effect of the delay and to compare preferences on delayed and no-sample trials. Both pigeons' preferences and their movement patterns were analyzed. In Experiments 1 and 3, pigeons learned to move immediately to the location where the correct comparison would be presented, allowing them to select a comparison at its onset and receive reinforcement. In Experiment 2, some birds moved differently-probably reflecting an interaction of travel distance with outcome certainty. On delay testing, as the delay increased, accuracy decreased and the pigeons tended to move to the middle of the chamber, irrespective if that location was associated with the beginning of the trials or with one of the comparisons. Inserting a delay seemed to lead to a disruption where stimulus control by the sample was reduced and replaced by control by the location at the moment of choice. On no-sample delayed testing, pigeons also showed a tendency to move toward the middle of the chamber, which was combined with a preference for the comparison associated with the short sample. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Repair of a Pulmonary Hernia after Thoracotomy with an Intrapleural Mesh: a Case Report.

Pulmonary hernias are rare. They can be congenital, but mostly are acquired. Usually asymptomatic, they are diagnosed on physical examination or, incidentally, on imaging exams. Surgical treatment is required for large, increasing, or symptomatic hernias, and incarcerated or strangulated ones. This is a clinical case of a symptomatic postoperative pulmonary hernia. It occurred two years after a posterolateral thoracotomy for the resection of an intercostal myxolipoma. The tumor was resected en bloc with a partial segment of the 10th left rib and immediate reconstruction was made with an onlay polypropylene mesh. The postoperative hernia was successfully treated with a double-faced mesh of polypropylene and ePTFE. This surgery provided a functional and aesthetic enhancement for the patient, greatly improving his quality of life. This approach is, therefore, considered safe and effective.

Development Control and Inactivation of Byssochlamys nivea Ascospores by Hyperbaric Storage at Room Temperature.

This study tested hyperbaric storage (25-150 MPa, for 30 days) at room-temperature (HS/RT, 18-23 °C) in order to control the development of Byssochlamys nivea ascospores in apple juice. In order to mimic commercially pasteurized juice contaminated with ascospores, thermal pasteurization (70 and 80 °C for 30 s) and nonthermal high pressure pasteurization (600 MPa for 3 min at 17 °C, HPP) took place, and the juice was afterwards placed under HS/RT conditions. Control samples were also placed in atmospheric pressure (AP) conditions at RT and were refrigerated (4 °C). The results showed that HS/RT, in samples without a pasteurization step and those pasteurized at 70 °C/30 s, was able to inhibit ascospore development, contrarily to samples at AP/RT and refrigeration. HS/RT for samples pasteurized at 80 °C/30 s evidenced ascospore inactivation, especially at 150 MPa, wherein an overall reduction of at least 4.73 log units of ascospores was observed to below detection limits (1.00 Log CFU/mL); meanwhile, for HPP samples, especially at 75 and 150 MPa, an overall reduction of 3 log units (to below quantification limits, 2.00 Log CFU/mL) was observed. Phase-contrast microscopy revealed that the ascospores do not complete the germination process under HS/RT, hence avoiding hyphae formation, which is important for food safety since mycotoxin development occurs only after hyphae formation. These findings suggest that HS/RT is a safe food preservation methodology, as it prevents ascospore development and inactivates them following commercial-like thermal or nonthermal HPP pasteurization, preventing mycotoxin production and enhancing ascospore inactivation.

Searching for nothing: placing zero on the temporal continuum.

Generalization allows responses acquired in one situation to be transferred to similar situations. For temporal stimuli, a discontinuity has been found between zero and non-zero durations: responses in trials with no (or 0-s) stimuli and in trials with very short stimuli differ more than what would be expected by generalization. This discontinuity may happen because 0-s durations do not belong to the same continuum as non-zero durations. Alternatively, the discontinuity may be due to generalization decrement effects: a 0-s stimulus differs from a short stimulus not only in duration, but also in its presence, thus leading to greater differences in performance. Aiming to reduce differences between trials with and without a stimulus, we used two procedures to test whether a potential reduction in generalization decrement would bring performance following zero and non-zero durations closer. In both procedures, there was a reduction in the discontinuity between 0-s and short durations, supporting the hypothesis that 0-s durations are integrated in the temporal subjective continuum.

A subxiphoid uniportal approach for a surgical biopsy.

The following case report demonstrates a surgical biopsy performed through a subxiphoid uniportal video-assisted thoracoscopic surgery approach. The patient was a 35-year-old male, non-smoker, obese, with a history of arterial hypertension. He was referred for a thoracic surgery consultation because nonspecific interstitial pneumonia was suspected. The histological analysis confirmed the nonspecific interstitial pneumonia. We describe the procedure step by step. The postoperative course was uneventful. The subxiphoid approach is associated with less postoperative pain than the transthoracic approaches and could be an alternative, even for patients who have to undergo major lung resection surgery.

Structural and Physicochemical Properties of Starch from Rejected Chestnut: Hydrothermal and High-Pressure Processing Dependence.

The quality standards for the export of chestnuts generate large quantities of rejected fruits, which require novel processing technologies for their safe industrial utilization. This study aimed to investigate the impact of high-pressure processing (HPP) and hydrothermal treatments (HT) on the physicochemical properties of rejected chestnut starch. Chestnuts were treated by HPP at 400, 500, and 600 MPa for 5 min and HT at 50 °C for 45 min. In general, all HPP treatments did not induce starch gelatinization, and their granules preserved the integrity and Maltese-cross. Moreover, starch granules' size and resistant starch content increased with the intensity of pressure. Native and HT chestnut starches were the most susceptible to digestion. HPP treatments did not affect the C-type crystalline pattern of native starch, but the crystalline region was gradually modified to become amorphous. HPP-600 MPa treated starch showed modified pasting properties and exhibited the highest values of peak viscosity. This study demonstrates for the first time that after HPP-600 MPa treatment, a novel chestnut starch gel structure is obtained. Moreover, HPP treatments could increase the slow-digesting starch, which benefits the development of healthier products. HPP can be considered an interesting technology to obtain added-value starch from rejected chestnut fruits.