'Neurons in Action' in Action - Educational settings for simulations and tutorials using NEURON

Neurons in Action (NIA1, 2000; NIA1.5, 2004; NIA2, 2007), a set of tutorials and linked simulations, is designed to acquaint students with neuronal physiology through interactive, virtual laboratory experiments. Here we explore the uses of NIA in lecture, both interactive and didactic, as well as in the undergraduate laboratory, in the graduate seminar course, and as an examination tool through homework and problem set assignments. NIA, made with the simulator NEURON (http://www.neuron.yale.edu/neuron/), displays voltages, currents, and conductances in a membrane patch or signals moving within the dendrites, soma and/or axon of a neuron. Customized simulations start with the plain lipid bilayer and progress through equilibrium potentials; currents through single Na and K channels; Na and Ca action potentials; voltage clamp of a patch or a whole neuron; voltage spread and propagation in axons, motoneurons and nerve terminals; synaptic excitation and inhibition; and advanced topics such as channel kinetics and coincidence detection. The user asks and answers "what if" questions by specifying neuronal parameters, ion concentrations, and temperature, and the experimental results are then plotted as conductances, currents, and voltage changes. Such exercises provide immediate confirmation or refutation of the student's ideas to guide their learning. The tutorials are hyperlinked to explanatory information and to original research papers. Although the NIA tutorials were designed as a sequence to empower a student with a working knowledge of fundamental neuronal principles, we find that faculty are using the individual tutorials in a variety of educational situations, some of which are described here. Here we offer ideas to colleagues using interactive software, whether NIA or another tool, for educating students of differing backgrounds in the subject of neurophysiology.

Cost-effectiveness of point-of-care viral load monitoring of antiretroviral therapy in resource-limited settings: mathematical modelling study

BACKGROUND Monitoring of HIV viral load in patients on combination antiretroviral therapy (ART) is not generally available in resource-limited settings. We examined the cost-effectiveness of qualitative point-of-care viral load tests (POC-VL) in sub-Saharan Africa. DESIGN Mathematical model based on longitudinal data from the Gugulethu and Khayelitsha township ART programmes in Cape Town, South Africa. METHODS Cohorts of patients on ART monitored by POC-VL, CD4 cell count or clinically were simulated. Scenario A considered the more accurate detection of treatment failure with POC-VL only, and scenario B also considered the effect on HIV transmission. Scenario C further assumed that the risk of virologic failure is halved with POC-VL due to improved adherence. We estimated the change in costs per quality-adjusted life-year gained (incremental cost-effectiveness ratios, ICERs) of POC-VL compared with CD4 and clinical monitoring. RESULTS POC-VL tests with detection limits less than 1000 copies/ml increased costs due to unnecessary switches to second-line ART, without improving survival. Assuming POC-VL unit costs between US$5 and US$20 and detection limits between 1000 and 10,000 copies/ml, the ICER of POC-VL was US$4010-US$9230 compared with clinical and US$5960-US$25540 compared with CD4 cell count monitoring. In Scenario B, the corresponding ICERs were US$2450-US$5830 and US$2230-US$10380. In Scenario C, the ICER ranged between US$960 and US$2500 compared with clinical monitoring and between cost-saving and US$2460 compared with CD4 monitoring. CONCLUSION The cost-effectiveness of POC-VL for monitoring ART is improved by a higher detection limit, by taking the reduction in new HIV infections into account and assuming that failure of first-line ART is reduced due to targeted adherence counselling.

Extended-spectrum cephalosporin-resistant Escherichia coli in community, specialized outpatient clinic and hospital settings in Switzerland

OBJECTIVES Resistance to extended-spectrum cephalosporins (ESCs) in Escherichia coli can be due to the production of ESBLs, plasmid-mediated AmpCs (pAmpCs) or chromosomal AmpCs (cAmpCs). Information regarding type and prevalence of β-lactamases, clonal relations and plasmids associated with the bla genes for ESC-R E. coli (ESC-R-Ec) detected in Switzerland is lacking. Moreover, data focusing on patients referred to the specialized outpatient clinics (SOCs) are needed. METHODS We analysed 611 unique E. coli isolated during September-December 2011. ESC-R-Ec were studied with microarrays, PCR/DNA sequencing for blaESBLs, blapAmpCs, promoter region of blacAmpC, IS elements, plasmid incompatibility group, and also implementing transformation, aIEF, rep-PCR and MLST. RESULTS The highest resistance rates were observed in the SOCs, whereas those in the hospital and community were lower (e.g. quinolone resistance of 22.6%, 17.2% and 9.0%, respectively; P = 0.003 for SOCs versus community). The prevalence of ESC-R-Ec in the three settings was 5.3% (n = 11), 7.8% (n = 22) and 5.7% (n = 7), respectively. Thirty isolates produced CTX-M ESBLs (14 were CTX-M-15), 5 produced CMY-2 pAmpC and 5 hyper-expressed cAmpCs due to promoter mutations. Fourteen isolates were of sequence type 131 (ST131; 10 with CTX-M-15). blaCTX-M and blaCMY-2 were associated with an intact or truncated ISEcp1 and were mainly carried by IncF, IncFII and IncI1plasmids. CONCLUSIONS ST131 producing CTX-M-15 is the predominant clone. The prevalence of ESC-R-Ec (overall 6.5%) is low, but an unusual relatively high frequency of AmpC producers (25%) was noted. The presence of ESC-R-Ec in the SOCs and their potential ability to be exchanged between hospital and community should be taken into serious consideration.

Analysis of polygonal cracking patterns in chloride-bearing terrains on Mars: Indicators of ancient playa settings

The ancient southern highlands on Mars (~3.5 Gyr old) contain > 600 regions that display spectral evidence in the infrared for the presence of chloride-bearing materials. Many of these locations were previously reported to display polygonal cracking patterns. We studied more than 80 of the chloride-bearing terrains using high-resolution (0.25-0.5 m/pixel) images, as well as near-infrared spectral data, to characterize the surface textures and the associated cracking patterns and mineralogies. Our study indicates that ~75% of the studied locations display polygonal cracks that resemble desiccation cracks, while some resemble salt expansion/thrust polygons. Furthermore, we detect, spectrally, the presence of smectites in association with ~30% of the studied fractured terrains. We note that smectites are a special class of swelling clay minerals that can induce formation of large desiccation cracks. As such, we suggest that the cracking patterns are indicative of the presence of smectite phyllosilicates even in the absence of spectral confirmation. Our results suggest that many chloride-bearing terrains have a lacustrine origin and a geologic setting similar to playas on Earth. Such locations would have contained ephemeral lakes that may have undergone repeated cycles of desiccation and recharging by a near-surface fluctuating water table in order to account for the salt-phyllosilicates associations. These results have notable implications for the ancient hydrology of Mars. We propose that the morphologies and sizes of the polygonal cracks can be used as paleoenvironmental, as well as lithological, indicators that could be helpful in planning future missions.

The performance of human papillomavirus high-risk DNA testing in the screening and diagnostic settings.

OBJECTIVE: We sought to evaluate the performance of the human papillomavirus high-risk DNA test in patients 30 years and older. MATERIALS AND METHODS: Screening (n=835) and diagnosis (n=518) groups were defined based on prior Papanicolaou smear results as part of a clinical trial for cervical cancer detection. We compared the Hybrid Capture II (HCII) test result with the worst histologic report. We used cervical intraepithelial neoplasia (CIN) 2/3 or worse as the reference of disease. We calculated sensitivities, specificities, positive and negative likelihood ratios (LR+ and LR-), receiver operating characteristic (ROC) curves, and areas under the ROC curves for the HCII test. We also considered alternative strategies, including Papanicolaou smear, a combination of Papanicolaou smear and the HCII test, a sequence of Papanicolaou smear followed by the HCII test, and a sequence of the HCII test followed by Papanicolaou smear. RESULTS: For the screening group, the sensitivity was 0.69 and the specificity was 0.93; the area under the ROC curve was 0.81. The LR+ and LR- were 10.24 and 0.34, respectively. For the diagnosis group, the sensitivity was 0.88 and the specificity was 0.78; the area under the ROC curve was 0.83. The LR+ and LR- were 4.06 and 0.14, respectively. Sequential testing showed little or no improvement over the combination testing. CONCLUSIONS: The HCII test in the screening group had a greater LR+ for the detection of CIN 2/3 or worse. HCII testing may be an additional screening tool for cervical cancer in women 30 years and older.

Race and discourse analysis: Building a dialogue in health service research and health care settings

Using a framework for discourse analysis developed by Van Dijk, the investigator will pinpoint the pathological forms of discourse on race, defined as 'race talk' in three professional domains: health services research, public health provider organizations, and literature on multiculturalism. Attention will then turn to developing an analytical strategy for building more meaningful dialogue on race. The retrieval of potential resources for dialogue will be drawn from the third domain. Analysis will focus on enhancing the prospects of converting 'race talk' into dialogue. This will be accomplished by characterizing the normative preconditions as formal procedural requirements for dialogue and then supplementing these conditions with others related specifically to race. From here, the practical implications of combining procedural requirements and resources in each of the domains will be considered. Finally, the author will attempt to determine how these selected resources might be employed to transform 'race talk' in practice and lay the groundwork for a dialogue of understanding. ^

A Coastal Transect of McMurdo Dry Valleys (Antarctica) Snow and Firn: Marine and Terrestrial Influences on Glaciochemistry

Samples of snow and firn from accumulation zones on Clark, Commonwealth, Blue and Victoria Upper Glaciers in the McMurdo Dry Valleys (similar to 77-78 degrees S, 161-164 degrees E), Antarctica, are evaluated chemically and isotopically to determine the relative importance of local (site-specific) factors vs regional-scale influences in defining glaciochemistry. Spatial variation in snow and firn chemistry confirms documented trends within individual valleys regarding major-ion deposition relative to elevation and to distance from the coast. Sodium and methylsulfonate (MS-), for example, follow a decreasing gradient with distance from the coast along the axis of Victoria Valley (350-119 mu gL(-1) for Na+; 33-14 mu gL(-1) for MS-); a similar pattern exists between Commonwealth and Newall Glaciers in the Asgaard Range. When comparing major-ion concentrations (e.g. Na-+,Na- MS-, Ca2+) or trace metals (e.g. Al, Fe) among different valleys, however, site-specific exposures to marine and local terrestrial chemical sources play a dominant role. Because chemical signals at all sites respond to particulates with varying mixtures of marine and terrestrial sources, each of these influences on site glaciochemistry must be considered when drawing temporal climate inferences on regional scales.

Solar Forcing Recorded by Aerosol Concentrations in Coastal Antarctic Glacier Ice, McMurdo Dry Valleys

Ice-core chemistry data from Victoria Lower Glacier, Antarctica, suggest, at least for the last 50 years, a direct influence of solar activity variations on the McMurdo Dry Valleys (MDV) climate system via controls on air-mass input from two competing environments: the East Antarctic ice sheet and the Ross Sea. During periods of increased solar activity, when total solar irradiance is relatively high, the MDV climate system appears to be dominated by air masses originating from the Ross Sea, leading to higher aerosol deposition. During reduced solar activity, the Antarctic interior seems to be the dominant air-mass source, leading to lower aerosol concentration in the ice-core record. We propose that the sensitivity of the MDV to variations in solar irradiance is caused by strong albedo differences between the ice-free MDV and the ice sheet.

Circum-Antarctic Coastal Environmental Shifts During the Late Quaternary Reflected by Emerged Marine Deposits

This review assesses the circumpolar occurrence of emerged marine macrofossils and sediments from Antarctic coastal areas in relation to Late Quaternary climate changes. Radiocarbon ages of the macrofossils, which are interpreted in view of the complexities of the Antarctic marine radiocarbon reservoir and resolution of this dating technique, show a bimodal distribution. The data indicate that marine species inhabited coastal environments from at least 35000 to 20000 yr sp, during Marine Isotope Stage 3 when extensive iceberg calving created a 'meltwater lid' over the Southern Ocean. The general absence of these marine species from 20000 to 8500 yr sp coincides with the subsequent advance of the Antarctic ice sheets during the Last Glacial Maximum. Synchronous re-appearance of the Antarctic marine fossils in emerged beaches around the continent, all of wh ich have Holocene marine-limit elevations an order of magnitude lower than those in the Arctic, reflect minimal isostatic rebound as relative sea-level rise decelerated. Antarctic coastal marine habitat changes around the continent also coincided with increasing sea-ice extent and outlet glacial advances during the mid-Holocene. in view of the diverse environmental changes that occurred around the Earth during this period, it is suggested that Antarctic coastal areas were responding to a mid-Holocene climatic shift associated with the hydrological cycle. This synthesis of Late Quaternary emerged marine deposits demonstrates the application of evaluating circum-Antarctic phenomena from the glacial-terrestrial-marine transition zone.

Importance of Suspended Particulates in Riverine Delivery of Bioavailable Nitrogen to Coastal Zones

Total nitrogen (TN) loadings in riverine sediments and their coastal depocenters were compared for Il river systems worldwide to assess the potential impact of riverine particulates on coastal nitrogen budgets. Strong relationships between sediment specific surface area and TN allow these impacts to be estimated without the intense sampling normally required to achieve such budgets. About half of the systems showed higher nitrogen loadings in the riverine sediments than those from the coastal depocenter. In spite of uncertainties, these comparisons indicate that large, turbid rivers, such as the Amazon, Huanghe, and the Mississippi, deliver sediments that in turn release significant or major fractions of the total riverine nitrogen delivery. Riverine particulates must therefore be considered an essential factor in watershed nutrient loading to coastal ecosystems and may affect delivered nutrient ratios as well as total nutrient loading. The relative importance of particulate versus dissolved delivery has decreased over recent decades in the Mississippi as a result of damming and fertilizer use in the watershed.

Observations of the Eastern Maine Coastal Current and Its Offshore Extensions in 1994

Cold surface temperatures, reflecting Scotian Shelf origins and local tidal mixing, serve as a tracer of the Eastern Maine Coastal Current and its offshore extensions, which appear episodically as cold plumes erupting from the eastern Maine shelf. A cold water plume emanating from the Eastern Maine Coastal Current in May 1994 was investigated using advanced very high resolution radiometer (AVHRR) imagery, shipboard surveys of physical and biochemical properties, and satellite-tracked drifters. Evidence is presented that suggests that some of the plume waters were entrained within the cyclonic circulation over Jordan Basin, while the major portion participated in an anticyclonic eddy at the distal end of the plume. Calculations of the nitrate transported offshore by the plume show that this feature can episodically export significant quantities of nutrients from the Eastern Maine Coastal Current to offshore regions that are generally nutrient depleted during spring-summer. A series of AVHRR images is used to document the seasonal along-shelf progression of the coastal plume separation point. We speculate on potential causes and consequences of plume separation from the coastal current and suggest that this feature may be an important factor influencing the patterns and overall biological productivity of the eastern Gulf of Maine.

A Model Study of the Circulation in the Pearl River Estuary (PRE) and Its Adjacent Coastal Waters: 1. Simulations and Comparison with Observations

The Princeton Ocean Model is used to study the circulation features in the Pearl River Estuary and their responses to tide, river discharge, wind, and heat flux in the winter dry and summer wet seasons. The model has an orthogonal curvilinear grid in the horizontal plane with variable spacing from 0.5 km in the estuary to 1 km on the shelf and 15 sigma levels in the vertical direction. The initial conditions and the subtidal open boundary forcing are obtained from an associated larger-scale model of the northern South China Sea. Buoyancy forcing uses the climatological monthly heat fluxes and river discharges, and both the climatological monthly wind and the realistic wind are used in the sensitivity experiments. The tidal forcing is represented by sinusoidal functions with the observed amplitudes and phases. In this paper, the simulated tide is first examined. The simulated seasonal distributions of the salinity, as well as the temporal variations of the salinity and velocity over a tidal cycle are described and then compared with the in situ survey data from July 1999 and January 2000. The model successfully reproduces the main hydrodynamic processes, such as the stratification, mixing, frontal dynamics, summer upwelling, two-layer gravitational circulation, etc., and the distributions of hydrodynamic parameters in the Pearl River Estuary and coastal waters for both the winter and the summer season.