ROS generate dalle NAD(P)H ossidasi nella segnalazione redox in linee cellulari leucemiche

Discovery of the Nox family has led to the concept that ROS are “intentionally” generated and are biologically functional in various cell types. Over the last decades, ROS have been shown to be involved in several physiological and pathological processes and ROS producing enzymes have been suggested as a target for drug development. The mechanism involved in the prosurvival effect of cytokines on the human acute myeloid leukaemia cell lines M07e and B1647 is investigated. A decrease in intracellular reactive oxygen species (ROS) content, glucose transport activity and cell survival was observed in the presence of inhibitors of plasma membrane ROS sources, such as DPI and apocynin, and by small interference RNA for NOX2 in M07e cells. Furthermore, Nox generated ROS are required to sustain B1647 cell viability and proliferation; in fact, antioxidants such as EUK-134 or Nox inhibitors and siRNA direct cells to apoptotic cell death, suggesting that manipulation of cellular NOX2 and NOX4 could affect survival of leukemic cells. Moreover, hydrogen peroxide has been long thought to be freely diffusible but recent evidence suggest that specific mammalian aquaporin homologues (AQP8) possess the capacity to channel H2O2 across membrane. In this thesis is shown that inhibition of aquaporins diminishes intracellular ROS accumulation either when H2O2 is produced by Nox enzymes or when is added exogenously to the medium. These data suggest that specific inhibition of Nox enzymes and AQP8 could be an interesting novel anti-leukemic strategy.

Stabilizzazione del Blu di Prussia con film politiofenici depositati per via elettrochimica

Hydrogen peroxide (H2O2) is a powerful oxidant which is commonly used in a wide range of applications in the industrial field. Several methods for the quantification of H2O2 have been developed. Among them, electrochemical methods exploit the ability of some hexacyanoferrates (such as Prussian Blue) to detect H2O2 at potentials close to 0.0 V (vs. SCE) avoiding the occurrence of secondary reactions, which are likely to run at large overpotentials. This electrocatalytic behaviour makes hexacyanoferrates excellent redox mediators. When deposited in the form of thin films on the electrode surfaces, they can be employed in the fabrication of sensors and biosensors, normally operated in solutions at pH values close to physiological ones. As hexacyanoferrates show limited stability in not strongly acidic solutions, it is necessary to improve the configuration of the modified electrodes to increase the stability of the films. In this thesis work, organic conducting polymers were used to fabricate composite films with Prussian Blue (PB) to be electro-deposited on Pt surfaces, in order to increase their pH stability. Different electrode configurations and different methods of synthesis of both components were tested, and for each one the achievement of a possible increase in the operational stability of Prussian Blue was verified. Good results were obtained for the polymer 3,3''-didodecyl-2,2':5',2''-terthiophene (poly(3,3''-DDTT)), whose presence created a favourable microenvironment for the electrodeposition of Prussian Blue. The electrochemical behaviour of the modified electrodes was studied in both aqueous and organic solutions. Poly(3,3''-DDTT) showed no response in aqueous solution in the potential range where PB is electroactive, thus in buffered aqueous solution is was possible to characterize the composite material, focusing only on the redox behaviour of PB. A combined effect of anion and cation of the supporting electrolyte was noticed. The response of Pt electrodes modified with films of the PB /poly(3,3''-DDTT) composite was evaluated for the determination of H2O2. The performance of such films was found better than that of the PB alone. It can be concluded that poly(3,3''-DDTT) plays a key role in the stabilization of Prussian Blue causing also a wider linearity range for the electrocatalytic response to H2O2.

Development of empirical potentials for amorphous silica

Development of empirical potentials for amorphous silica Amorphous silica (SiO2) is of great importance in geoscience and mineralogy as well as a raw material in glass industry. Its structure is characterized as a disordered continuous network of SiO4 tetrahedra. Many efforts have been undertaken to understand the microscopic properties of silica by classical molecular dynamics (MD) simulations. In this method the interatomic interactions are modeled by an effective potential that does not take explicitely into account the electronic degrees of freedom. In this work, we propose a new methodology to parameterize such a potential for silica using ab initio simulations, namely Car-Parrinello (CP) method [Phys. Rev. Lett. 55, 2471 (1985)]. The new potential proposed is compared to the BKS potential [Phys. Rev. Lett. 64, 1955 (1990)] that is considered as the benchmark potential for silica. First, CP simulations have been performed on a liquid silica sample at 3600 K. The structural features so obtained have been compared to the ones predicted by the classical BKS potential. Regarding the bond lengths the BKS tends to underestimate the Si-O bond whereas the Si-Si bond is overestimated. The inter-tetrahedral angular distribution functions are also not well described by the BKS potential. The corresponding mean value of theSiOSi angle is found to be ≃ 147◦, while the CP yields to aSiOSi angle centered around 135◦. Our aim is to fit a classical Born-Mayer/Coulomb pair potential using ab initio calculations. To this end, we use the force-matching method proposed by Ercolessi and Adams [Europhys. Lett. 26, 583 (1994)]. The CP configurations and their corresponding interatomic forces have been considered for a least square fitting procedure. The classical MD simulations with the resulting potential have lead to a structure that is very different from the CP one. Therefore, a different fitting criterion based on the CP partial pair correlation functions was applied. Using this approach the resulting potential shows a better agreement with the CP data than the BKS ones: pair correlation functions, angular distribution functions, structure factors, density of states and pressure/density were improved. At low temperature, the diffusion coefficients appear to be three times higher than those predicted by the BKS model, however showing a similar temperature dependence. Calculations have also been carried out on crystalline samples in order to check the transferability of the potential. The equilibrium geometry as well as the elastic constants of α-quartz at 0 K are well described by our new potential although the crystalline phases have not been considered for the parameterization. We have developed a new potential for silica which represents an improvement over the pair potentials class proposed so far. Furthermore, the fitting methodology that has been developed in this work can be applied to other network forming systems such as germania as well as mixtures of SiO2 with other oxides (e.g. Al2O3, K2O, Na2O).

Elektrochemisch gesteuerte zeitaufgelöste Infrarotspektroskopie an Redox-Membranproteinen in einer biomimetischen Membran-Architektur

Das Protein Cytochrom c Oxidase (CcO) ist ein Enzym der mitochondrialen Atmungskette. Als letzter Komplex (Komplex IV) einer Elektronentransportkette katalysiert sie die Reduktion von molekularem Sauerstoff zu Wasser. Hierbei werden Elektronen von Cytochrom c (Cc) in das Enzym geleitet. Die durch den Redoxprozess freiwerdende freie Enthalpie wird dazu genutzt, einen Protonengradienten über die innere Mitochondrien-Membran aufzubauen. Die zurückwandernden Protonen treiben in der ATP-Synthase die Produktion von Adenosintriphosphat (ATP) an, dem universellen Energieträger in lebenden Organismen. Gegenstand dieser Dissertation sind zeitaufgelöste ATR-FTIR-Messungen des direkten Elektronentransfers in die CcO. Das Protein wird hierzu orientiert auf einer Goldelektrode immobilisiert und in eine künstliche Membran rekonstituiert (Protein-tethered Bilayer Lipid Membrane, ptBLM). Das ptBLM-System wird hinsichtlich einer möglichst hohen Protein-Aktivität optimiert. Elektronen werden durch elektrochemische Anregung von der Elektrode in die CcO injiziert. Die Goldoberfläche wird auf die reflektierende Oberfläche eines Silizium-ATR-Kristalls aufgebracht. Durch die Präparation einer rauen Oberfläche (RMS-Rauigkeit ca. 5 nm) wird eine Verstärkung der IR-Absorption erreicht. Die mit den Ladungstransferprozessen einhergehenden Konformationsänderungen der die Redoxzentren umgebenden Gruppen (CONH-Gerüst und Aminosäure-Seitenketten) können durch Infrarot-Spektroskopie nachgewiesen werden. Phasensensitive Detektion (PSD) wird zur Rauschminderung eingesetzt, um Geschwindigkeitskonstanten für die Redox-Übergänge zu bestimmen. Im Bereich der Amid-I-Bande werden etliche Peaks identifiziert, die sich mit dem Redoxzustand des Proteins ändern. Für das CuA-Zentrum, welches als erstes der vier Redoxzentren der CcO reduziert wird, wird die schnellste Geschwindigkeitskonstante ks=4870/s ermittelt. Für das Häm a3-Zentrum wird eine Geschwindigkeitskonstante von ks=13,8/s ermittelt. Die Ergebnisse sind konsistent zu elektrochemischen und Raman-Spektroskopie-Experimenten, welche ebenfalls in unserer Gruppe durchgeführt wurden. Weitere Themen dieser Dissertation sind der Nachweis der Anwendbarkeit des ptBLM-Systems für andere Membranproteine (Beispiel: bakterielles photosynthetisches Reaktionszentrum) und der Einsatz des ATR-FTIR-Setups für verschiedene künstliche Membransysteme (Aktivitätsnachweis des OR5-Geruchsrezeptors in einer peptidgestützten Membran, Eigenschaften eines Oligoethylenglycol-Spacers).

Localized potentials in electrical impedance tomography

In this work we study localized electric potentials that have an arbitrarily high energy on some given subset of a domain and low energy on another. We show that such potentials exist for general L-infinity-conductivities (with positive infima) in almost arbitrarily shaped subregions of a domain, as long as these regions are connected to the boundary and a unique continuation principle is satisfied. From this we deduce a simple, but new, theoretical identifiability result for the famous Calderon problem with partial data. We also show how to construct such potentials numerically and use a connection with the factorization method to derive a new non-iterative algorithm for the detection of inclusions in electrical impedance tomography.

Statistical problems related to excitation threshold and reset value of membrane potentials

Die vorliegende Arbeit ist motiviert durch biologische Fragestellungen bezüglich des Verhaltens von Membranpotentialen in Neuronen. Ein vielfach betrachtetes Modell für spikende Neuronen ist das Folgende. Zwischen den Spikes verhält sich das Membranpotential wie ein Diffusionsprozess X der durch die SDGL dX_t= beta(X_t) dt+ sigma(X_t) dB_t gegeben ist, wobei (B_t) eine Standard-Brown'sche Bewegung bezeichnet. Spikes erklärt man wie folgt. Sobald das Potential X eine gewisse Exzitationsschwelle S überschreitet entsteht ein Spike. Danach wird das Potential wieder auf einen bestimmten Wert x_0 zurückgesetzt. In Anwendungen ist es manchmal möglich, einen Diffusionsprozess X zwischen den Spikes zu beobachten und die Koeffizienten der SDGL beta() und sigma() zu schätzen. Dennoch ist es nötig, die Schwellen x_0 und S zu bestimmen um das Modell festzulegen. Eine Möglichkeit, dieses Problem anzugehen, ist x_0 und S als Parameter eines statistischen Modells aufzufassen und diese zu schätzen. In der vorliegenden Arbeit werden vier verschiedene Fälle diskutiert, in denen wir jeweils annehmen, dass das Membranpotential X zwischen den Spikes eine Brown'sche Bewegung mit Drift, eine geometrische Brown'sche Bewegung, ein Ornstein-Uhlenbeck Prozess oder ein Cox-Ingersoll-Ross Prozess ist. Darüber hinaus beobachten wir die Zeiten zwischen aufeinander folgenden Spikes, die wir als iid Treffzeiten der Schwelle S von X gestartet in x_0 auffassen. Die ersten beiden Fälle ähneln sich sehr und man kann jeweils den Maximum-Likelihood-Schätzer explizit angeben. Darüber hinaus wird, unter Verwendung der LAN-Theorie, die Optimalität dieser Schätzer gezeigt. In den Fällen OU- und CIR-Prozess wählen wir eine Minimum-Distanz-Methode, die auf dem Vergleich von empirischer und wahrer Laplace-Transformation bezüglich einer Hilbertraumnorm beruht. Wir werden beweisen, dass alle Schätzer stark konsistent und asymptotisch normalverteilt sind. Im letzten Kapitel werden wir die Effizienz der Minimum-Distanz-Schätzer anhand simulierter Daten überprüfen. Ferner, werden Anwendungen auf reale Datensätze und deren Resultate ausführlich diskutiert.

Time-resolved surface enhanced resonance Raman spectro-electrochemistry of heme proteins

The membrane protein Cytochrome c Oxidase (CcO) is one of the most important functional bio-molecules. It appears in almost every eukaryotic cell and many bacteria. Although the different species differ in the number of subunits, the functional differences are merely marginal. CcO is the terminal link in the electron transfer pathway of the mitochondrial respiratory chain. Electrons transferred to the catalytic center of the enzyme conduce to the reduction of molecular oxygen to water. Oxygen reduction is coupled to the pumping of protons into the inter-membrane space and hence generates a difference in electrochemical potential of protons across the inner mitochondrial membrane. This potential difference drives the synthesis of adenosine triphosphate (ATP), which is the universal energy carrier within all biological cells. rnrnThe goal of the present work is to contribute to a better understanding of the functional mechanism of CcO by using time-resolved surface enhanced resonance Raman spectroscopy (TR-SERRS). Despite intensive research effort within the last decades, the functional mechanism of CcO is still subject to controversial discussions. It was the primary goal of this dissertation to initiate electron transfer to the redox centers CuA, heme a, heme a3 and CuB electrochemically and to observe the corresponding redox transitions in-situ with a focus on the two heme structures by using SERRS. A measuring cell was developed, which allowed combination of electrochemical excitation with Raman spectroscopy for the purpose of performing the accordant measurements. Cytochrome c was used as a benchmark system to test the new measuring cell and to prove the feasibility of appropriate Raman measurements. In contrast to CcO the heme protein cc contains only a single heme structure. Nevertheless, characteristic Raman bands of the hemes can be observed for both proteins.rnrnIn order to investigate CcO it was immobilized on top of a silver substrate and embedded into an artificial membrane. The catalytic activity of CcO and therefore the complete functional capability of the enzyme within the biomimetic membrane architecture was verified using cyclic voltammetry. Raman spectroscopy was performed using a special nano-structured silver surface, which was developed within the scope of the present work. This new substrate combined two fundamental properties. It facilitated the formation of a protein tethered bilayer lipid membrane (ptBLM) and it allowed obtaining Raman spectra with sufficient high signal-to-noise ratios.rnSpectro-electrochemical investigations showed that at open circuit potential the enzyme exists in a mixed-valence state, with heme a and and heme a3 in the reduced and oxidized state, respectively. This was considered as an intermediate state between the non-activated and the fully activated state of CcO. Time-resolved SERRS measurements revealed that a hampered electron transfer to the redox center heme a3 characterizes this intermediate state.rn

Emotional engagement and brain potentials: repetition in affective picture processing

The present thesis addresses several experimental questions regarding the nature of the processes underlying the larger centro-parietal Late Positive Potential (LPP) measured during the viewing of emotional(both pleasant and unpleasant) compared to neutral pictures. During a passive viewing condition, this modulatory difference is significantly reduced with picture repetition, but it does not completely habituate even after a massive repetition of the same picture exemplar. In order to investigate the obligatory nature of the affective modulation of the LPP, in Study 1 we introduced a competing task during repetitive exposure of affective pictures. Picture repetition occurred in a passive viewing context or during a categorization task, in which pictures depicting any mean of transportation were presented as targets, and repeated pictures (affectively engaging images) served as distractor stimuli. Results indicated that the impact of repetition on the LPP affective modulation was very similar between the passive and the task contexts, indicating that the affective processing of visual stimuli reflects an obligatory process that occurs despite participants were engaged in a categorization task. In study 2 we assessed whether the decrease of the LPP affective modulation persists over time, by presenting in day 2 the same set of pictures that were massively repeated in day 1. Results indicated that the reduction of the emotional modulation of the LPP to repeated pictures persisted even after 1-day interval, suggesting a contribution of long-term memory processes on the affective habituation of the LPP. Taken together, the data provide new information regarding the processes underlying the affective modulation of the late positive potential.

Interacting bosons and fermions in three-dimensional optical lattice potentials

This thesis reports on the realization, characterization and analysis of ultracold bosonic and fermionic atoms in three-dimensional optical lattice potentials. Ultracold quantum gases in optical lattices can be regarded as ideal model systems to investigate quantum many-body physics. In this work interacting ensembles of bosonic 87Rb and fermionic 40K atoms are employed to study equilibrium phases and nonequilibrium dynamics. The investigations are enabled by a versatile experimental setup, whose core feature is a blue-detuned optical lattice that is combined with Feshbach resonances and a red-detuned dipole trap to allow for independent control of tunneling, interactions and external confinement. The Fermi-Hubbard model, which plays a central role in the theoretical description of strongly correlated electrons, is experimentally realized by loading interacting fermionic spin mixtures into the optical lattice. Using phase-contrast imaging the in-situ size of the atomic density distribution is measured, which allows to extract the global compressibility of the many-body state as a function of interaction and external confinement. Thereby, metallic and insulating phases are clearly identified. At strongly repulsive interaction, a vanishing compressibility and suppression of doubly occupied lattice sites signal the emergence of a fermionic Mott insulator. In a second series of experiments interaction effects in bosonic lattice quantum gases are analyzed. Typically, interactions between microscopic particles are described as two-body interactions. As such they are also contained in the single-band Bose-Hubbard model. However, our measurements demonstrate the presence of multi-body interactions that effectively emerge via virtual transitions of atoms to higher lattice bands. These findings are enabled by the development of a novel atom optical measurement technique: In quantum phase revival spectroscopy periodic collapse and revival dynamics of the bosonic matter wave field are induced. The frequencies of the dynamics are directly related to the on-site interaction energies of atomic Fock states and can be read out with high precision. The third part of this work deals with mixtures of bosons and fermions in optical lattices, in which the interspecies interactions are accurately controlled by means of a Feshbach resonance. Studies of the equilibrium phases show that the bosonic superfluid to Mott insulator transition is shifted towards lower lattice depths when bosons and fermions interact attractively. This observation is further analyzed by applying quantum phase revival spectroscopy to few-body systems consisting of a single fermion and a coherent bosonic field on individual lattice sites. In addition to the direct measurement of Bose-Fermi interaction energies, Bose-Bose interactions are proven to be modified by the presence of a fermion. This renormalization of bosonic interaction energies can explain the shift of the Mott insulator transition. The experiments of this thesis lay important foundations for future studies of quantum magnetism with fermionic spin mixtures as well as for the realization of complex quantum phases with Bose-Fermi mixtures. They furthermore point towards physics that reaches beyond the single-band Hubbard model.

Simulating event related potentials in tasks involving conflict resolution: a neural network

In this thesis, the main Executive Control theories are exposed. Methods typical of Cognitive and Computational Neuroscience are introduced and the role of behavioural tasks involving conflict resolution in the response elaboration, after the presentation of a stimulus to the subject, are highlighted. In particular, the Eriksen Flanker Task and its variants are discussed. Behavioural data, from scientific literature, are illustrated in terms of response times and error rates. During experimental behavioural tasks, EEG is registered simultaneously. Thanks to this, event related potential, related with the current task, can be studied. Different theories regarding relevant event related potential in this field - such as N2, fERN (feedback Error Related Negativity) and ERN (Error Related Negativity) – are introduced. The aim of this thesis is to understand and simulate processes regarding Executive Control, including performance improvement, error detection mechanisms, post error adjustments and the role of selective attention, with the help of an original neural network model. The network described here has been built with the purpose to simulate behavioural results of a four choice Eriksen Flanker Task. Model results show that the neural network can simulate response times, error rates and event related potentials quite well. Finally, results are compared with behavioural data and discussed in light of the mentioned Executive Control theories. Future perspective for this new model are outlined.

Evolutionäre Veränderungen in der Nutzung redox-aktiver Aminosäuren und ihre Ursachen

Gewebe, Zellen und speziell Zellkompartimente unterscheiden sich in ihrer Sauerstoffkonzentration, Stoffwechselrate und in der Konzentration an gebildeten reaktiven Sauerstoffspezies. Um eine mögliche Änderung in der Aminosäurennutzung durch den Einfluss von Sauerstoff und seinen reaktiven Spezies untersuchen zu können wurden, Bereiche bzw. Kompartimente der menschlichen Zelle definiert, die einen Referenzrahmen bildeten und bekannt dafür sind, einen relativ hohen Grad an reaktiven Sauerstoffspezies aufzuweisen. Aus dem Vergleich wurde deutlich, dass vor allem die beiden redox-aktiven und schwefeltragenden Aminosäuren Cystein und Methionin durch eine besondere Verteilung und Nutzung charakterisiert sind. Cystein ist hierbei diejenige Aminosäure mit den deutlichsten Änderungen in den fünf untersuchten Modellen der oxidativen Belastung. In all diesen Modellen war die Nutzung von Cystein deutlich reduziert, wohingegen Methionin in Proteinen des Mitochondriums und der Elektronentransportkette angereichert war. Dieser auf den ersten Blick paradoxe Unterschied zwischen Cystein und Methionin wurde näher untersucht, indem die differenzierte Methioninnutzung in verschiedenen Zellkompartimenten von Homo sapiens charakterisiert wurde.rnDie sehr leicht zu oxidierende Aminosäure Methionin zeigt ein ungewöhnliches Verteilungsmuster in ihrer Nutzungshäufigkeit. Entgegen mancher Erwartung wird Methionin in zellulären Bereichen hoher oxidativer Belastung und starker Radikalproduktion intensiv verwendet. Dieses Verteilungsmuster findet man sowohl im intrazellulären Vergleich, als auch im Vergleich verschiedener Spezies untereinander, was daraufhin deutet, dass es einen lokalen Bedarf an redox-aktiven Aminosäuren gibt, der einen sehr starken Effekt auf die Nutzungshäufigkeit von Methionin ausübt. Eine hohe Stoffwechselrate, die im Allgemeinen mit einer erhöhten Produktion von Oxidantien assoziiert wird, scheint ein maßgeblicher Faktor der Akkumulation von Methionin in Proteinen der Atmungskette zu sein. Die Notwendigkeit, oxidiertes Antioxidans wieder zu reduzieren, findet auch bei Methionin Anwendung, denn zu Methioninsulfoxid oxidiertes Methionin wird durch die Methioninsulfoxidreduktase wieder zu Methionin reduziert. Daher kann die spezifische Akkumulation von Methionin in Proteinen, die verstärkt reaktiven Sauerstoffspezies ausgesetzt sind, als eine systematische Strategie angesehen werden, um andere labile Strukturen vor ungewollter Oxidation zu schützen. rnDa Cystein in allen untersuchten Modellen der oxidativen Belastung und im Besonderen in Membranproteinen der inneren Mitochondrienmembran lebensspannenabhängig depletiert war, wurde dieses Merkmal näher untersucht. Deshalb wurde die Hypothese getestet, ob ein besonderer Redox-Mechanismus der Thiolfunktion für diese selektive Depletion einer im Allgemeinen als harmlos oder antioxidativ geltenden Aminosäure verantwortlich ist. Um den Effekt von Cysteinresten in Membranen nachzustellen, wurden primäre humane Lungenfibroblasten (IMR90) mit diversen Modellsubstanzen behandelt. Geringe Konzentrationen der lipophilen Substanz Dodecanthiol verursachten eine signifikante Toxizität in IMR90-Zellen, die von einer schnellen Zunahme an polyubiquitinierten Proteinen und anderen Indikatoren des proteotoxischen Stresses, wie Sequestosom 1 (P62), HSP70 und HSP90 begleitet wurde. Dieser Effekt konnte spezifisch der Chemie der Thiolfunktion in Membranen zugeordnet werden, da Dodecanol (DOH), Dodecylmethylsulfid (DMS), Butanthiol oder wasserlösliche Thiole weder eine cytotoxische Wirkung noch eine Polyubiquitinierung von Proteinen verursachten. Die Ergebnisse stimmen mit der Hypothese überein, dass Thiole innerhalb von biologischen Membranen als radikalische Kettentransferagentien wirken. Diese Eigenschaft wird in der Polymerchemie durch Nutzung von lipophilen Thiolen in hydrophoben Milieus technisch für die Produktion von Polymeren benutzt. Da die Thiylradikal-spezifische Reaktion von cis-Fettsäuren zu trans-Fettsäuren in 12SH behandelten Zellen verstärkt ablief, kann gefolgert werden, dass 12SH zellulär radikalisiert wurde. In lebenden Organismen kann demnach die Oxidation von Cystein die Schädigung von Membranen beschleunigen und damit Einfallstore für die laterale Radikalisierung von integralen Membranproteinen schaffen, welche möglicherweise der Langlebigkeit abträglich ist, zumindest, wenn sie in der inneren Mitochondrienmembran auftritt.

Velocity recovery cycles of human muscle action potentials in chronic renal failure

To test the hypothesis that muscle fibers are depolarized in patients with chronic renal failure, by measuring velocity recovery cycles of muscle action potentials as indicators of muscle membrane potential.

A method to measure the distribution of latencies of motor evoked potentials in man

To measure the intra-individual distribution of the latencies of motor evoked potentials (MepL) using transcranial magnetic stimulation.