Key role of neuronal diversity in structured reservoir computing.

Chaotic time series have been captured by reservoir computing models composed of a recurrent neural network whose output weights are trained in a supervised manner. These models, however, are typically limited to randomly connected networks of homogeneous units. Here, we propose a new class of structured reservoir models that incorporates a diversity of cell types and their known connections. In a first version of the model, the reservoir was composed of mean-rate units separated into pyramidal, parvalbumin, and somatostatin cells. Stability analysis of this model revealed two distinct dynamical regimes, namely, (i) an inhibition-stabilized network (ISN) where strong recurrent excitation is balanced by strong inhibition and (ii) a non-ISN network with weak excitation. These results were extended to a leaky integrate-and-fire model that captured different cell types along with their network architecture. ISN and non-ISN reservoir networks were trained to relay and generate a chaotic Lorenz attractor. Despite their increased performance, ISN networks operate in a regime of activity near the limits of stability where external perturbations yield a rapid divergence in output. The proposed framework of structured reservoir computing opens avenues for exploring how neural microcircuits can balance performance and stability when representing time series through distinct dynamical regimes.

Albumin administration is associated with acute kidney injury in cardiac surgery: a propensity score analysis.

INTRODUCTION: The risk of acute kidney injury (AKI) with the use of albumin-containing fluids compared to starches in the surgical intensive care setting remains uncertain. We evaluated the adjusted risk of AKI associated with colloids following cardiac surgery. METHODS: We performed a retrospective cohort study of patients undergoing on-pump cardiac surgery in a tertiary care center from 2008 to 2010. We assessed crystalloid and colloid administration until 36 hours after surgery. AKI was defined by the RIFLE (risk, injury, failure, loss and end-stage kidney disease) risk and Acute Kidney Injury Network (AKIN) stage 1 serum creatinine criterion within 96 hours after surgery. RESULTS: Our cohort included 984 patients with a baseline glomerular filtration rate of 72 ± 19 ml/min/1.73 m(2). Twenty-three percent had a reduced left ventricular ejection fraction (LVEF), thirty-one percent were diabetics and twenty-three percent underwent heart valve surgery. The incidence of AKI was 5.3% based on RIFLE risk and 12.0% based on the AKIN criterion. AKI was associated with a reduced LVEF, diuretic use, anemia, heart valve surgery, duration of extracorporeal circulation, hemodynamic instability and the use of albumin, pentastarch 10% and transfusions. There was an important dose-dependent AKI risk associated with the administration of albumin, which also paralleled a higher prevalence of concomitant risk factors for AKI. To address any indication bias, we derived a propensity score predicting the likelihood to receive albumin and matched 141 cases to 141 controls with a similar risk profile. In this analysis, albumin was associated with an increased AKI risk (RIFLE risk: 12% versus 5%, P = 0.03; AKIN stage 1: 28% versus 13%, P = 0.002). We repeated this methodology in patients without postoperative hemodynamic instability and still identified an association between the use of albumin and AKI. CONCLUSIONS: Albumin administration was associated with a dose-dependent risk of AKI and remained significant using a propensity score methodology. Future studies should address the safety of albumin-containing fluids on kidney function in patients undergoing cardiac surgery.

[Not Available]. / Toxicité sérotoninergique résultant d'une interaction médicamenteuse entre le bleu de méthylène et les inhibiteurs de la recapture de la sérotonine.

BACKGROUND: Methylene blue is used in medical practice for various reasons. Recent findings point to a potential interaction with serotonin reuptake inhibitors (SRIs) that could lead to serotonergic toxicity. OBJECTIVE: To describe the risk of serotonergic toxicity associated with the interaction between methylene blue and SRIs. DATA SOURCES: Relevant publications were searched systematically via MEDLINE (1946 to March 21, 2013) and Embase (1974 to 2013, week 11) with the following search terms: "methylene blue", "methylthioninium", "monoamine oxidase inhibitors", "serotonin reup-take inhibitors", and "serotonin syndrome". No restrictions were applied in relation to the indication for methylene blue or the language of publication. The reference lists of identified articles were also searched. STUDY SELECTION AND DATA EXTRACTION: Eighteen case reports and 2 case series were identified for inclusion. To date, no randomized controlled trials have been published. DATA SYNTHESIS: The first case report indicating suspicion of an interaction between methylene blue and SRIs was published in 2003. Seventeen other case reports describing the same type of interaction have been published since then. The 2 case series provided data from about 325 parathyroidectomies in which methylene blue was used for staining. The 17 patients who experienced central nervous system toxicity were all taking SRIs in the preoperative period. CONCLUSION: When administered in combination with SRIs, methylene blue may lead to serotonergic toxicity at doses as low as 0.7 mg/kg. Methylene blue would seem to have monoamine oxidase A inhibitory properties. Precautions should be taken to avoid this interaction. [Publisher's translation].