Double-lung transplantation in the rat: an acute, syngeneic in situ model

BACKGROUND. The high rate of reperfusion injury in clinical lung transplantation mandates significant improvements in lung preservation. Innovations should be validated using standardized and low-cost experimental models. METHODS. The model introduced here is analyzed by comparing global lung function after varying ischemic times (2, 4, 8, 16, and 24 hours). A rat double-lung block is flush-perfused, and the main pulmonary artery and left atrium are connected to the left pulmonary artery and vein of a syngeneic recipient using a T-shaped stent. With pressure side ports and incorporated flow crystals, measurement of vascular resistance and graft oxygenation can be performed. The transplant is ventilated separately, and compliance and resistance are determined. RESULTS. The increase in the ischemic interval from 2 to 24 hours caused an increase in the alveolar arterial oxygen difference from 220 +/- 20 to 600 +/- 34 mm Hg, pulmonary vascular resistance from 198 +/- 76 to 638 +/- 212 mm Hg.mL-1.min-1, and resistance to airflow from 274 +/- 50 to 712 +/- 30 cm H2O/L H2O, and a decrease in pulmonary compliance from 0.4 +/- 0.05 to 0.12 +/- 0.06 mL/cm H2O. CONCLUSIONS. This in situ, syngeneic rat lung transplantation model offers an alternative to large animal models for verification of lung preservation solutions and for modification of donor or recipient treatment regimens.

Quantifying the influence of bone density and thickness on resonance frequency analysis: an in vitro study of biomechanical test materials

PURPOSE: Resonance frequency analysis (RFA) offers the opportunity to monitor the osseointegration of an implant in a simple, noninvasive way. A better comprehension of the relationship between RFA and parameters related to bone quality would therefore help clinicians improve diagnoses. In this study, a bone analog made from polyurethane foam was used to isolate the influences of bone density and cortical thickness in RFA. MATERIALS AND METHODS: Straumann standard implants were inserted in polyurethane foam blocks, and primary implant stability was measured with RFA. The blocks were composed of two superimposed layers with different densities. The top layer was dense to mimic cortical bone, whereas the bottom layer had a lower density to represent trabecular bone. Different densities for both layers and different thicknesses for the simulated cortical layer were tested, resulting in eight different block combinations. RFA was compared with two other mechanical evaluations of primary stability: removal torque and axial loading response. RESULTS: The primary stability measured with RFA did not correlate with the two other methods, but there was a significant correlation between removal torque and the axial loading response (P < .005). Statistical analysis revealed that each method was sensitive to different aspects of bone quality. RFA was the only method able to detect changes in both bone density and cortical thickness. However, changes in trabecular bone density were easier to distinguish with removal torque and axial loading than with RFA. CONCLUSIONS: This study shows that RFA, removal torque, and axial loading are sensitive to different aspects of the bone-implant interface. This explains the absence of correlation among the methods and proves that no standard procedure exists for the evaluation of primary stability.

Multi-locus microsatellite analysis supports the hypothesis of an autochthonous focus of Echinococcus multilocularis in northern Italy

Echinococcus multilocularis is characterised by a wide geographical distribution, encompassing three continents (North America, Asia and Europe) yet very low genetic variability is documented. Recently, this parasite has been detected in red foxes (Vulpes vulpes) circulating in an Alpine region of Italy, close to Austria. This finding raised the question as to whether an autochthonous cycle exists in Italy or whether the infected foxes originated from the neighbouring regions of Austria. Studies have shown that multi-locus microsatellite analysis can identify genomic regions carrying mutations that result in a local adaptation. We used a tandem repeated multi-locus microsatellite (EmsB) to evaluate the genetic differences amongst adult worms of E. multilocularis collected in Italy, worms from neighbouring Austria and from other European and extra-European countries. Fluorescent PCR was performed on a panel of E. multilocularis samples to assess intra-specific polymorphism. The analysis revealed four closed genotypes for Italian samples of E. multilocularis which were unique compared with the other 25 genotypes from Europe and the five genotypes from Alaska. An analysis in the Alpine watershed, comparing Italian adult worms with those from neighbouring areas in Austria, showed a unique cluster for Italian samples. This result supports the hypothesis of the presence of an autochthonous cycle of E. multilocularis in Italy. EmsB can be useful for 'tracking' the source of infection of this zoonotic parasite and developing appropriate measures for preventing or reducing the risk of human alveolar echinococcosis.

Emotional contagion in team sports and its impact on individual performance – an experimental study

In sport psychology research about emotional contagion in sport teams has been scarce (Reicherts & Horn, 2008). Emotional contagion is a process leading to a specific emotional state in an individual caused by the perception of another individual’s emotional expression (Hatfield, Cacioppo & Rapson, 1994). Apitzsch (2009) described emotional contagion as one reason for collapsing sport teams. The present study examined the occurrence of emotional contagion in dyads during a basketball task and the impact of a socially induced emotional state on performance. An experiment with between-subjects design was conducted. Participants (N=81, ♀=38, M=21.33 years, SD=1.45) were randomly assigned to one of two experimental conditions, by joining a confederate to compose a same gender, ad hoc team. The team was instructed to perform a basketball task as quickly as possible. The between-factor of the experimental design was the confederate’s emotional expression (positive or negative valence). The within-factor was participants’ emotional state, measured pre- and post-experimentally using PANAS (Krohne, Egloff, Kohlmann & Tausch, 1996). The basketball task was video-taped and the number of frames participants needed to complete the task was used to determine the individual performance. The confederate’s emotional expression was appraised in a significantly different manner across both experimental conditions by participants and video raters (MC). Mixed between-within subjects ANOVAs were conducted to examine the impact of the two conditions on participants’ scores on the PANAS subscales across two time periods (pre- and post-experimental). No significant interaction effects but substantial main effects for time were found on both PANAS subscales. Both groups showed an increase in positive and a reduction in negative PANAS scores across these two time periods. Nevertheless, video raters assessment of the emotional states expressed by participants was significantly different between the positive (M=3.23, SD=0.45) and negative condition (M=2.39, SD=0.53; t=7.64, p<.001, eta squared=.43). An independent-samples t-test indicated no difference in performance between conditions. Furthermore, no significant correlation between the extent of positive or negative emotional contagion and the number of frames was observed. The basketball task lead to an improvement of the emotional state of participants, independently of the condition. Even though participants PANAS scores indicated a tendency to emotional contagion, it was not statistically significant. This could be explained by the low task duration of approximately three minutes. Moreover, the performance of participants was unaffected by the experimental condition or the extent of positive or negative emotional contagion. Apitzsch, E. (2009). A case study of a collapsing handball team. In S. Jern & J. Näslund (Eds.), Dynamics within and outside the lab. Proceedings from The 6th Nordic Conference on Group and Social Psychology, May 2008, Lund, pp. 35-52. Hatfield, E., Cacioppo, J. T. & Rapson, R. L. (1994). Emotional contagion. Cambridge: University Press. Krohne, H. W., Egloff, B., Kohlmann, C.-W. & Tausch, A. (1996). Untersuchungen mit einer deutschen Version der „Positive und Negative Affect Schedule“ (PANAS). Diagnostica, 42 (2), 139-156. Reicherts, M. & Horn, A. B. (2008). Emotionen im Sport. In W. Schlicht & B. Strauss (Eds.), Enzyklopädie der Psychologie. Grundlagen der Sportpsychologie (Bd. 1) (S. 563-633). Göttingen: Hogrefe.

Psoriasis beyond the skin: an expert group consensus on the management of psoriatic arthritis and common co-morbidities in patients with moderate-to-severe psoriasis

BACKGROUND Psoriatic arthritis (PsA) and co-morbidities of psoriasis represent a significant clinical and economic burden for patients with moderate-to-severe psoriasis. Often these co-morbidities may go unrecognized or undertreated. While published data are available on the incidence and impact of some of them, practical guidance for dermatologists on detection and management of these co-morbidities is lacking. OBJECTIVE To prepare expert recommendations to improve the detection and management of common co-morbidities in patients with moderate-to-severe psoriasis. METHODS A systematic literature review was conducted on some common co-morbidities of psoriasis-cardiovascular (CV) diseases (including obesity, hypertension, hyperglycaemia and dyslipidaemia), psychological co-morbidities (including depression, alcohol abuse and smoking) and PsA-to establish the incidence and impact of each. Data gaps were identified and a Delphi survey was carried out to obtain consensus on the detection and management of each co-morbidity. The expert panel members for the Delphi survey comprised 10 dermatologists with substantial clinical expertise in managing moderate-to-severe psoriasis patients, as well as a cardiologist and a psychologist (see appendix) with an interest in dermatology. Agreement was defined using a Likert scale of 1-7. Consensus regarding agreement for each statement was defined as ≥75% of respondents scoring either 1 (strongly agree) or 2 (agree). RESULTS The expert panel members addressed several topics including screening, intervention, monitoring frequency, and the effects of anti-psoriatic treatment on each co-morbidity. Consensus was achieved on 12 statements out of 22 (3 relating to PsA, 4 relating to psychological factors, 5 relating to CV factors). The panel members felt that dermatologists have an important role in screening their psoriasis patients for PsA and in assessing them for psychological and CV co-morbidities. In most cases, however, patients should be referred for specialist management if other co-morbidities are detected. CONCLUSION This article provides useful and practical guidance for the detection and management of common co-morbidities in patients with moderate-to-severe psoriasis.

Early Iron Age Kinneret – Early Aramaean or Just Late Canaanite? Remarks on the Material Culture of a Border Site in Northern Palestine at the Turn of an Era

In recent years, scholars have identified Early Iron Age Kinneret as belonging either to the kingdom of Geshur1 or at least as being part of an early Aramaean polity.2 It is the purpose of this paper to reexamine the archaeological evidence for such an assumption and to critically test the currently available data against this hypothesis.

Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

QUESTION UNDER STUDY Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. METHODS We used ETCs with simulated patients (SPs), with each student randomly allocated two of four possible cases. After the training, 137 students reported on any insecurity that they had in the various ETC phases. We analysed the reasons for insecurity using descriptive statistics. The association between the students' advice that urgent action was needed and their insecurity was analysed with Spearman rank correlation. RESULTS Overall, 95% of the students felt insecure in at least one phase of their ETC. History taking was the phase in which students felt most insecure (63.1%), followed by the phase of analysing the information given by the patient (44.9%). Perceived insecurity was associated with more urgent advice in one case scenario (abdominal pain; correlation r = 0.46; p <0.01). The other two cases (child with fever; chest pain) also had a positive, but not statistically significant, correlation trend (p <0.12; p <0.08). CONCLUSIONS Insecurity is highly prevalent among medical students in their ETC decision-making. ETC training in medical schools, with a focus on structured history taking and formulating discriminating questions, might help decrease insecurity in ETCs. Medical education should also teach management of insecurity.

Changes in cerebral hemodynamics and oxygenation induced by different speech tasks – an assessment by combining functional near‐infrared spectroscopy and capnography

Introduction In several studies, we found that during guided rhythmic speech exercises, a decrease in cerebral hemodynamics and oxygenation occurred as the result of a decrease in the partial pressure of carbon dioxide in the arterial blood (PaCO2) during speaking. To further explore the effect of PaCO2 variations on cerebral hemodynamics and oxygenation, the aim of the present study was to investigate the impact of spoken, inner and heard speech tasks on these parameters. Material and Methods Speech tasks included recitation or inner recitation or listening to hexameter, alliteration, prose, or performing mental arithmetic. The following physiological parameters were measured: tissue oxygen saturation (StO2) and absolute concentrations of oxyhemoglobin, deoxyhemoglobin, total hemoglobin (over the left and right anterior prefrontal cortex, using an ISS OxiplexTS frequency domain near-infrared spectrometer) and end-tidal CO2 (PETCO2; using Nellcor N1000 and Datex NORMOCAP capnographs). Statistical analysis was applied to the differences between baseline, 2 tasks, and 3 post-baseline periods. Data of 3 studies with 24, 7 and 29 healthy subjects, respectively, were combined, and linear regression analyses were calculated. Results Linear regression analyses revealed significant relations between changes in oxyhemoglobin, deoxyhemoglobin, total hemoglobin or StO2 and the participants’ age, the baseline PETCO2 or certain speech tasks. While hexameter verses affected changes during the tasks, alliteration verses only affected changes during the recovery phase. Discussion and Conclusion The observed effects in hemodynamics and oxygenation indicate a combination of neurovascular coupling (increased neuronal activity leading to an increase in the cerebral metabolic rate of oxygen resulting in an increase in cerebral flood flow/volume) and CO2 reactivity (increased breathing during speech tasks causing a decrease in PaCO2 leading to vasoconstriction and decrease in cerebral blood flow). The neurovascular coupling characteristics are task-dependent. References Scholkmann F, Gerber U, Wolf M, Wolf U. End-tidal CO2: An important parameter for a correct interpretation in functional brain studies using speech tasks. Neuroimage 2013;66:71-79. Scholkmann F, Wolf M, Wolf U. The effect of inner speech on arterial CO2, cerebral hemodynamics and oxygenation – A functional NIRS study. Adv Exp Med Biol 2013;789:81-87.

A new method to measure higher visual functions in an immersive environment

BACKGROUND: Higher visual functions can be defined as cognitive processes responsible for object recognition, color and shape perception, and motion detection. People with impaired higher visual functions after unilateral brain lesion are often tested with paper pencil tests, but such tests do not assess the degree of interaction between the healthy brain hemisphere and the impaired one. Hence, visual functions are not tested separately in the contralesional and ipsilesional visual hemifields. METHODS: A new measurement setup, that involves real-time comparisons of shape and size of objects, orientation of lines, speed and direction of moving patterns, in the right or left visual hemifield, has been developed. The setup was implemented in an immersive environment like a hemisphere to take into account the effects of peripheral and central vision, and eventual visual field losses. Due to the non-flat screen of the hemisphere, a distortion algorithm was needed to adapt the projected images to the surface. Several approaches were studied and, based on a comparison between projected images and original ones, the best one was used for the implementation of the test. Fifty-seven healthy volunteers were then tested in a pilot study. A Satisfaction Questionnaire was used to assess the usability of the new measurement setup. RESULTS: The results of the distortion algorithm showed a structural similarity between the warped images and the original ones higher than 97%. The results of the pilot study showed an accuracy in comparing images in the two visual hemifields of 0.18 visual degrees and 0.19 visual degrees for size and shape discrimination, respectively, 2.56° for line orientation, 0.33 visual degrees/s for speed perception and 7.41° for recognition of motion direction. The outcome of the Satisfaction Questionnaire showed a high acceptance of the battery by the participants. CONCLUSIONS: A new method to measure higher visual functions in an immersive environment was presented. The study focused on the usability of the developed battery rather than the performance at the visual tasks. A battery of five subtasks to study the perception of size, shape, orientation, speed and motion direction was developed. The test setup is now ready to be tested in neurological patients.

Examining Gender Differences in Received, Provided and Invisible Social Control: An Application of the Dual-Effects-Model

The dual-effects model of social control not only assumes that social control leads to better health practices but also arouses psychological distress. However, findings are inconsistent. The present study advances the current literature by examining social control from a dyadic perspective in the context of smoking. In addition, the study examines whether control, continuous smoking abstinence, and affect are differentially related for men and women. Before and three weeks after a self-set quit attempt, we examined 106 smokers (77 men, mean age: 40.67, average number of cigarettes smoked per day: 16.59 [SD=8.52, range=1-40] at baseline and 5.27 [SD=6.97, range=0-40] at follow-up) and their nonsmoking heterosexual partners, assessing received and provided control, continuous abstinence, and affect. With regard to smoker's affective reactions, partner's provided control was related to an increase in positive and to a decrease in negative affect, but only for female smokers. Moreover, the greater the discrepancy between smoker received and partner's provided control was the more positive affect increased and the more negative affect decreased, but again only for female smokers. These findings demonstrate that female smokers' well-being was raised over time if they were not aware of the control attempts of their nonsmoking partners, indicating positive effects of invisible social control. This study's results emphasize the importance of applying a dyadic perspective and taking gender differences in the dual-effects model of social control into account.

Does outmigration lead to land degradation? Labour shortage and land management in a western Nepal watershed

In Nepal, changing demographic patterns are leading to changes in land use. The high level of outmigration of men in the hills of Kaski District, Western Development Region of Nepal, is affecting the household structure but also land management. Land is often abandoned, as the burden on those left behind is too high. How do these developments affect the state of the land in terms of land degradation? To find out, we studied land degradation, land abandonment caused by outmigration, and existing sustainable land management practices in a subwatershed in Kaski District. Mapping was done using the methodology of the World Overview of Conservation Approaches and Technologies (WOCAT). While previous studies expected land abandonment to exacerbate slope erosion, we demonstrate in this paper that it is in fact leading to an increase in vegetation cover due to favourable conditions for ecosystem recovery. However, negative impacts are several, including the increase of invasive species harmful to livestock and a decline in soil fertility. Traditional land management practices such as terraces and forest management exist. To date, however, these measures fail to take account of the changing population dynamics in the region, making the question of how migration and land degradation are linked worth revisiting.

Working memory training in children: Effectiveness depends on temperament

Studies revealing transfer effects of working memory (WM) training on non-trained cognitive performance of children hold promising implications for scholastic learning. However, the results of existing training studies are not consistent and provoke debates about the potential and limitations of cognitive enhancement. To examine the influence of individual differences on training outcomes is a promising approach for finding causes for such inconsistencies. In this study, we implemented WM training in an elementary school setting. The aim was to investigate near and far transfer effects on cognitive abilities and academic achievement and to examine the moderating effects of a dispositional and a regulative temperament factor, neuroticism and effortful control. Ninetynine second-graders were randomly assigned to 20 sessions of computer-based adaptiveWMtraining, computer-based reading training, or a no-contact control group. For the WM training group, our analyses reveal near transfer on a visual WM task, far transfer on a vocabulary task as a proxy for crystallized intelligence, and increased academic achievement in reading and math by trend. Considering individual differences in temperament, we found that effortful control predicts larger training mean and gain scores and that there is a moderation effect of both temperament factors on post-training improvement: WM training condition predicted higher post-training gains compared to both control conditions only in children with high effortful control or low neuroticism. Our results suggest that a short but intensive WM training program can enhance cognitive abilities in children, but that sufficient selfregulative abilities and emotional stability are necessary for WM training to be effective.