Multifocal tDCS targeting the resting state motor network increases cortical excitability beyond traditional tDCS targeting unilateral motor cortex.

Scientists and clinicians have traditionally targeted single brain regions with stimulation to modulate brain function and disease. However, brain regions do not operate in isolation, but interact with other regions through networks. As such, stimulation of one region may impact and be impacted by other regions in its network. Here we test whether the effects of brain stimulation can be enhanced by simultaneously targeting a region and its network, identified with resting state functional connectivity MRI. Fifteen healthy participants received two types of transcranial direct current stimulation (tDCS): a traditional two-electrode montage targeting a single brain region (left primary motor cortex [M1]) and a novel eight-electrode montage targeting this region and its associated resting state network. As a control, 8 participants also received multifocal tDCS mismatched to this network. Network-targeted tDCS more than doubled the increase in left M1 excitability over time compared to traditional tDCS and the multifocal control. Modeling studies suggest these results are unlikely to be due to tDCS effects on left M1 itself, however it is impossible to completely exclude this possibility. It also remains unclear whether multifocal tDCS targeting a network selectively modulates this network and which regions within the network are most responsible for observed effects. Despite these limitations, network-targeted tDCS appears to be a promising approach for enhancing tDCS effects beyond traditional stimulation targeting a single brain region. Future work is needed to test whether these results extend to other resting state networks and enhance behavioral or therapeutic effects.

Intrinsic functional architecture in the anaesthetized monkey brain.

The traditional approach to studying brain function is to measure physiological responses to controlled sensory, motor and cognitive paradigms. However, most of the brain's energy consumption is devoted to ongoing metabolic activity not clearly associated with any particular stimulus or behaviour. Functional magnetic resonance imaging studies in humans aimed at understanding this ongoing activity have shown that spontaneous fluctuations of the blood-oxygen-level-dependent signal occur continuously in the resting state. In humans, these fluctuations are temporally coherent within widely distributed cortical systems that recapitulate the functional architecture of responses evoked by experimentally administered tasks. Here, we show that the same phenomenon is present in anaesthetized monkeys even at anaesthetic levels known to induce profound loss of consciousness. We specifically demonstrate coherent spontaneous fluctuations within three well known systems (oculomotor, somatomotor and visual) and the 'default' system, a set of brain regions thought by some to support uniquely human capabilities. Our results indicate that coherent system fluctuations probably reflect an evolutionarily conserved aspect of brain functional organization that transcends levels of consciousness.

Offshore pelagic subsidies dominate carbon inputs to coral reef predators.

Coral reefs were traditionally perceived as productive hot spots in oligotrophic waters. While modern evidence indicates that many coral reef food webs are heavily subsidized by planktonic production, the pathways through which this occurs remain unresolved. We used the analytical power of carbon isotope analysis of essential amino acids to distinguish between alternative carbon pathways supporting four key reef predators across an oceanic atoll. This technique separates benthic versus planktonic inputs, further identifying two distinct planktonic pathways (nearshore reef-associated plankton and offshore pelagic plankton), and revealing that these reef predators are overwhelmingly sustained by offshore pelagic sources rather than by reef sources (including reef-associated plankton). Notably, pelagic reliance did not vary between species or reef habitats, emphasizing that allochthonous energetic subsidies may have system-wide importance. These results help explain how coral reefs maintain exceptional productivity in apparently nutrient-poor tropical settings, but also emphasize their susceptibility to future ocean productivity fluctuations.

Galanin: a novel intraovarian regulatory peptide.

Galanin is a 29-amino acid peptide that acts as a neuropeptide in many tissues. To date, galanin action and the hormonal regulation of galanin gene expression have not been described in the ovary of any species. To study possible ovarian expression and regulation of galanin, immature gonadotropin-primed rats were given hCG (10 IU), and their ovaries were collected 0, 4, 8, 12, and 20 h after hCG treatment for determination of galanin messenger RNA (mRNA) concentration by solution hybridization. Galanin mRNA levels progressively increased after hCG administration, peaking at 12 h (2.4-fold increase vs. 0 h), with a subsequent return to 0 h levels at 20 h. To determine a possible ovarian role for galanin, rats were killed 48 h after gonadotropin administration, their ovaries were removed, and granulosa cells were harvested. These cells and the ovarian tissue remaining after granulosa cell collection (i.e. "shells") were each cultured for 24 h with increasing concentrations of galanin (0, 10, 100, and 1000 nM) in the presence or absence of LH. The medium was examined for steroid production and metalloproteinase inhibitor activity. In granulosa cell cultures, galanin increased the levels of estradiol by 26% and had no effect on progesterone, but decreased metalloproteinase inhibitor activity by 61% in the conditioned medium. In the shell cultures, galanin increased estradiol, progesterone, and androstenedione in the medium, suggesting that galanin acts on cells other than granulosa cells or that galanin action requires a paracrine interaction between granulosa and thecal cells. Our data demonstrate that galanin message is increased by hCG, and that galanin acts to amplify ovarian steroidogenesis while decreasing metalloproteinase inhibitor activity. These findings establish that ovarian galanin mRNA is hormonally stimulated and that galanin acts as an intraovarian regulatory peptide.

Airborne spread of brucellosis.

review of epidemic and endemic brucellosis at six abattoirs demonstrates a correlation between case distribution and flow of air from the kill department (stage II) to other areas within an abattoir. Air from the kill department disseminated to nearby departments led to abnormally high brucellosis attack rates for persons who worked in these areas at two abattoirs. Complete physical separation or maintaining negative air pressure in the kill department was associated with reduced risk for workers in other areas at four abattoirs. Cases in persons who had exposure to kill department air but no contact with animal tissues provide strong evidence for airborne transmission of infection. Brucellosis is also contracted through skin contact with infectious animal tissues, but this route of transmission appears less important than formerly believed.

Enhancement of chest radiographs with gradient operators.

Reference is made to the Sobel and Roberts gradient operators used to enhance image edges. Overall, the Sobel operator was found to be superior to the Roberts operator in edge enhancement. A theoretical explanation for the superior performance of the Sobel operator was developed based on the concept of analyzing the x and y Sobel masks as linear filters. By applying pill-box, Gaussian, or median filtering prior to applying a gradient operator, noise was reduced. The pill-box and Gaussian filters were more computationally efficient than the median filter with approximately equal effectiveness in noise reduction.

Fast Hartley transforms for image processing.

The fast Hartley transform (FHT) is used to transform two-dimensional image data. Because the Hartley transform is real-valued, it does not require complex operations. Both spectra and autocorrelations of two-dimensional ultrasound images of normal and abnormal livers were computed.

Classifying mammographic lesions using computerized image analysis.

The classification of 3 common breast lesions, fibroadenomas, cysts, and cancers, was achieved using computerized image analysis of tumor shape in conjunction with patient age. The process involved the digitization of 69 mammographic images using a video camera and a commercial frame grabber on a PC-based computer system. An interactive segmentation procedure identified the tumor boundary using a thresholding technique which successfully segmented 57% of the lesions. Several features were chosen based on the gross and fine shape describing properties of the tumor boundaries as seen on the radiographs. Patient age was included as a significant feature in determining whether the tumor was a cyst, fibroadenoma, or cancer and was the only patient history information available for this study. The concept of a radial length measure provided a basis from which 6 of the 7 shape describing features were chosen, the seventh being tumor circularity. The feature selection process was accomplished using linear discriminant analysis and a Euclidean distance metric determined group membership. The effectiveness of the classification scheme was tested using both the apparent and the leaving-one-out test methods. The best results using the apparent test method resulted in correctly classifying 82% of the tumors segmented using the entire feature space and the highest classification rate using the leaving-one-out test method was 69% using a subset of the feature space. The results using only the shape descriptors, and excluding patient age resulted in correctly classifying 72% using the entire feature space (except age), and 51% using a subset of the feature space.

Fractal feature analysis and classification in medical imaging.

Following B.B. Mandelbrot's fractal theory (1982), it was found that the fractal dimension could be obtained in medical images by the concept of fractional Brownian motion. An estimation concept for determination of the fractal dimension based upon the concept of fractional Brownian motion is discussed. Two applications are found: (1) classification; (2) edge enhancement and detection. For the purpose of classification, a normalized fractional Brownian motion feature vector is defined from this estimation concept. It represented the normalized average absolute intensity difference of pixel pairs on a surface of different scales. The feature vector uses relatively few data items to represent the statistical characteristics of the medial image surface and is invariant to linear intensity transformation. For edge enhancement and detection application, a transformed image is obtained by calculating the fractal dimension of each pixel over the whole medical image. The fractal dimension value of each pixel is obtained by calculating the fractal dimension of 7x7 pixel block centered on this pixel.

No touch pulse measurement by optical interferometry.

Arterial pulsatility was measured using an optical interferometer. As opposed to laser Doppler flow meters, the prototype system we evaluated can detect pulsation profiles of major arteries with potentially useful information including pulse wave velocity, profile of pulse pressure, etc.

Magnetic backprojection imaging of the vascular lumen.

Current injected into a phantom model generated a magnetic field which was distorted above a simulated atherosclerotic lesion. The output of a Hall effect magnetic sensor was used in a backprojection to reconstruct the centroid of the simulated blood flow and thus localize the modeled atherosclerotic plaque region.

Noninvasive optical polarimetric glucose sensing using a true phase measurement technique.

The focus of this paper was to describe the development and testing of a noninvasive true phase optical polarimetry sensing system to monitor in vivo glucose concentrations. To demonstrate the applicability of this optical sensor for glucose measurement, we first calibrated the system and then tested it in vitro using both a glass test cell filled with glucose solution in the physiologic range, with a path length of 0.9 cm to approximate one centimeter path length present in the anterior chamber of the eye, and then on an excised human eye. Our technique used helium neon laser light which was coupled through a rotating linear polarizer along with two stationary linear polarizers and two detectors to produce reference and signal outputs whose amplitudes varied sinusoidally with a frequency of twice the angular velocity of the rotating polarizer, and whose phase was proportional to the rotation of the linear polarization vector passing through the glucose solution.

Neonatal morbidity between 34 and 37 weeks' gestation.

The objective of this study was to determine the risk of significant neonatal morbidity in women with preterm labor who deliver between 34 and 37 weeks' gestation. A total of 101 women between 34 and 37 weeks' gestation with documented preterm labor met inclusion and exclusion criteria; 90 gave informed consent and were randomly assigned to receive either intravenous magnesium tocolysis (treatment group) or conservative management with hydration, sedation, and observation (control group). Of the 90 women entering the study (45 in the treatment group and 45 in the control group), 2 discontinued tocolytic therapy because of gastrointestinal side effects. The gestational age on admission, cervical dilatation at diagnosis of preterm labor, interval to delivery, and birth weight were not significantly different between the treatment and control groups. There were no serious neonatal complications. In each group, three women had transient tachypnea and one had respiratory distress syndrome. We conclude that neonatal morbidity after delivery between 34 and 37 weeks' gestation is unchanged whether or not attempts to arrest labor are unsuccessful. The extra expense and maternal risk of tocolysis are not justified by beneficial results in the infant.

Laparoscopic Pomeroy tubal ligation as a teaching model for residents.

We reviewed our preliminary experience with laparoscopically directed bilateral midtubal resection for tubal ligation (endoscopic Pomeroy) as a potential teaching tool for the acquisition of endoscopic skills during residency training. Thirty-five laparoscopic Pomeroy and 206 banding procedures were reviewed. Age, parity and weight were similar in the two groups. The operative time for banding was reduced slightly after experience with > 10 procedures. In contrast, the operative time for laparoscopic Pomeroy procedures decreased dramatically after individual experience with only a few (< or = 5) procedures. The mean operative time for the Pomeroy group approached that of the more traditional banding technique at five procedures. Our data indicate that laparoscopic Pomeroy sterilization can be an effective teaching tool for operative laparoscopy, allowing residents to repeatedly perform an easy and safe procedure that incorporates basic techniques. Advanced operative endoscopic procedures could then be taught more efficiently after the acquisition of basic skills.

PIP: 25 gynecology residents performed laparoscopic banding (tubal rings) sterilization on 206 women and laparoscopic Pomeroy sterilization on 35 women, all of whom underwent tubal sterilization at the University of Mississippi Medical Center between September 1988 and October 1990. Three faculty members and a fourth year resident retrospectively analyzed the data of both groups to determine the effect of the Pomeroy method on operative laparoscopic skills acquired by the residents during training. Both groups were similar in age, parity, and weight. Each of the 23 residents performed 1-22 laparoscopic banding procedures. As residents gained experience, the time to perform both banding and Pomeroy methods decreased significantly (p = 0.026). After a resident had conducted 5 Pomeroy procedures, the surgery time had approached that of laparoscopic banding. These findings show that gynecology faculty can use laparoscopic Pomeroy tubal ligation as an effective teaching tool for laparoscopy by providing residents an opportunity to repeatedly perform an easy and safe procedure that includes basic techniques. After developing the basic skills, the residents can then learn more efficiently advanced operative endoscopic techniques.

Risk of preterm delivery from preterm labor in high-risk patients.

This study aimed to determine the incidence of preterm labor and birth (< 37 weeks' gestation) in patients at high risk for early delivery. In this retrospective, descriptive study, 17,186 women with high-risk factors for early delivery were studied over a five-year period (1986-1990). Study groups included women with prior preterm delivery, multifetal gestations, uterine abnormalities and cervical factors. The rate of preterm labor for all patients averaged 40% (range, 30-46%). The rate of preterm delivery in the four groups ranged from 14% to 30% and averaged 19.7%. In those who experienced preterm delivery, only 32% of cases were due to preterm labor with advanced cervical dilatation, failed tocolysis or preterm premature rupture of membranes. The majority of early deliveries were due to medical or obstetric disorders as well as to patient/physician factors. The incidence of preterm labor remains significant when women have high-risk factors for preterm delivery. However, the incidence of preterm delivery, particularly that due to avoidable factors, such as failed tocolysis and preterm rupture of the membranes, is considerably lower than that quoted in the literature.

Practical spread spectrum pulse compression for ultrasonic tissue imaging.

Spread spectrum pulse compression is a signal processing algorithm that enhances critical system performance parameters such as signal-to-noise ratio, peak power requirements, minimum detectable signal, and total dynamic range. For this research, a digital, real-time, Barker coded, bi-phase modulator was designed and constructed, as well as a simple ultrasonic test tank containing both synthetic targets and excised goat's liver. Upon reception and demodulation of the spread spectrum ultrasonic echo, cross-correlation with a sidelobe suppression filter was performed. Due to limitations such as narrow bandwidth, and very short minimum ranges, a practical ultrasonic pulse compression system must be restricted to short code lengths. For 13 bit Barker code compression, the expected increase in signal-to-noise ratio of 11 dB was realized; at the same time greater than 30 dB of instantaneous dynamic range was maintained.

Reticulate pigmented anomaly.

Reticulate pigmented anomaly of the flexures is a benign, recently described genodermatosis reported to involve the flexural areas as well as the scrotum. Described herein is a twenty-nine year old man in whom the characteristic speckled macules were limited to the scrotal and penile skin. The authors suggest that the anomaly be designated reticulate pigmented anomaly without reference to specific anatomic sites. It is possible that this pigmented eruption of the genitalia is a cutaneous marker of this patient's underlying testicular carcinoma.

An epizootiologic study of anthrax in Falls County, Texas.

In June and July, 1974, an anthrax epizootic in Falls County, Texas, resulted in the death of 236 animals (228 cattle, 5 horses, 2 mules, and 1 pig) on 48 premises. Death rates were highest for horses (18.2%) and bulls (16.8%). The epizootic was apparently precipitated by drought, and infection appeared to be the result of ingesting intrinsically contaminated soil and grass. Human illness was not associated with the epizootic.