Rivalry of homeostatic and sensory-evoked emotions: dehydration attenuates olfactory disgust and its neural correlates

Neural correlates have been described for emotions evoked by states of homeostatic imbalance (e.g. thirst, hunger, and breathlessness) and for emotions induced by external sensory stimulation (such as fear and disgust). However, the neurobiological mechanisms of their interaction, when they are experienced simultaneously, are still unknown. We investigated the interaction on the neurobiological and the perceptional level using subjective ratings, serum parameters, and functional magnetic resonance imaging (fMRI) in a situation of emotional rivalry, when both a homeostatic and a sensory-evoked emotion were experienced at the same time. Twenty highly dehydrated male subjects rated a disgusting odor as significantly less repulsive when they were thirsty. On the neurobiological level, we found that this reduction in subjective disgust during thirst was accompanied by a significantly reduced neural activity in the insular cortex, a brain area known to be considerably involved in processing of disgust. Furthermore, during the experience of disgust in the satiated condition, we observed a significant functional connectivity between brain areas responding to the disgusting odor, which was absent during the stimulation in the thirsty condition. These results suggest interference of conflicting emotions: An acute homeostatic imbalance can attenuate the experience of another emotion evoked by the sensory perception of a potentially harmful external agent. This finding offers novel insights with regard to the behavioral relevance of biologically different types of emotions, indicating that some types of emotions are more imperative for behavior than others. As a general principle, this modulatory effect during the conflict of homeostatic and sensory-evoked emotions may function to safeguard survival.

Detection of haemorrhagic shock: Are vital signs obsolete? A commentary by Dr M. Luginbühl

The ATLS program by the American college of surgeons is probably the most important globally active training organization dedicated to improve trauma management. Detection of acute haemorrhagic shock belongs to the key issues in clinical practice and thus also in medical teaching. (In this issue of the journal William Schulz and Ian McConachrie critically review the ATLS shock classification Table 1), which has been criticized after several attempts of validation have failed [1]. The main problem is that distinct ranges of heart rate are related to ranges of uncompensated blood loss and that the heart rate decrease observed in severe haemorrhagic shock is ignored [2]. Table 1. Estimated blood loos based on patient's initial presentation (ATLS Students Course Manual, 9th Edition, American College of Surgeons 2012). Class I Class II Class III Class IV Blood loss ml Up to 750 750–1500 1500–2000 >2000 Blood loss (% blood volume) Up to 15% 15–30% 30–40% >40% Pulse rate (BPM) <100 100–120 120–140 >140 Systolic blood pressure Normal Normal Decreased Decreased Pulse pressure Normal or ↑ Decreased Decreased Decreased Respiratory rate 14–20 20–30 30–40 >35 Urine output (ml/h) >30 20–30 5–15 negligible CNS/mental status Slightly anxious Mildly anxious Anxious, confused Confused, lethargic Initial fluid replacement Crystalloid Crystalloid Crystalloid and blood Crystalloid and blood Table options In a retrospective evaluation of the Trauma Audit and Research Network (TARN) database blood loss was estimated according to the injuries in nearly 165,000 adult trauma patients and each patient was allocated to one of the four ATLS shock classes [3]. Although heart rate increased and systolic blood pressure decreased from class I to class IV, respiratory rate and GCS were similar. The median heart rate in class IV patients was substantially lower than the value of 140 min−1 postulated by ATLS. Moreover deterioration of the different parameters does not necessarily go parallel as suggested in the ATLS shock classification [4] and [5]. In all these studies injury severity score (ISS) and mortality increased with in increasing shock class [3] and with increasing heart rate and decreasing blood pressure [4] and [5]. This supports the general concept that the higher heart rate and the lower blood pressure, the sicker is the patient. A prospective study attempted to validate a shock classification derived from the ATLS shock classes [6]. The authors used a combination of heart rate, blood pressure, clinically estimated blood loss and response to fluid resuscitation to classify trauma patients (Table 2) [6]. In their initial assessment of 715 predominantly blunt trauma patients 78% were classified as normal (Class 0), 14% as Class I, 6% as Class II and only 1% as Class III and Class IV respectively. This corresponds to the results from the previous retrospective studies [4] and [5]. The main endpoint used in the prospective study was therefore presence or absence of significant haemorrhage, defined as chest tube drainage >500 ml, evidence of >500 ml of blood loss in peritoneum, retroperitoneum or pelvic cavity on CT scan or requirement of any blood transfusion >2000 ml of crystalloid. Because of the low prevalence of class II or higher grades statistical evaluation was limited to a comparison between Class 0 and Class I–IV combined. As in the retrospective studies, Lawton did not find a statistical difference of heart rate and blood pressure among the five groups either, although there was a tendency to a higher heart rate in Class II patients. Apparently classification during primary survey did not rely on vital signs but considered the rather soft criterion of “clinical estimation of blood loss” and requirement of fluid substitution. This suggests that allocation of an individual patient to a shock classification was probably more an intuitive decision than an objective calculation the shock classification. Nevertheless it was a significant predictor of ISS [6]. Table 2. Shock grade categories in prospective validation study (Lawton, 2014) [6]. Normal No haemorrhage Class I Mild Class II Moderate Class III Severe Class IV Moribund Vitals Normal Normal HR > 100 with SBP >90 mmHg SBP < 90 mmHg SBP < 90 mmHg or imminent arrest Response to fluid bolus (1000 ml) NA Yes, no further fluid required Yes, no further fluid required Requires repeated fluid boluses Declining SBP despite fluid boluses Estimated blood loss (ml) None Up to 750 750–1500 1500–2000 >2000 Table options What does this mean for clinical practice and medical teaching? All these studies illustrate the difficulty to validate a useful and accepted physiologic general concept of the response of the organism to fluid loss: Decrease of cardiac output, increase of heart rate, decrease of pulse pressure occurring first and hypotension and bradycardia occurring only later. Increasing heart rate, increasing diastolic blood pressure or decreasing systolic blood pressure should make any clinician consider hypovolaemia first, because it is treatable and deterioration of the patient is preventable. This is true for the patient on the ward, the sedated patient in the intensive care unit or the anesthetized patients in the OR. We will therefore continue to teach this typical pattern but will continue to mention the exceptions and pitfalls on a second stage. The shock classification of ATLS is primarily used to illustrate the typical pattern of acute haemorrhagic shock (tachycardia and hypotension) as opposed to the Cushing reflex (bradycardia and hypertension) in severe head injury and intracranial hypertension or to the neurogenic shock in acute tetraplegia or high paraplegia (relative bradycardia and hypotension). Schulz and McConachrie nicely summarize the various confounders and exceptions from the general pattern and explain why in clinical reality patients often do not present with the “typical” pictures of our textbooks [1]. ATLS refers to the pitfalls in the signs of acute haemorrhage as well: Advanced age, athletes, pregnancy, medications and pace makers and explicitly state that individual subjects may not follow the general pattern. Obviously the ATLS shock classification which is the basis for a number of questions in the written test of the ATLS students course and which has been used for decades probably needs modification and cannot be literally applied in clinical practice. The European Trauma Course, another important Trauma training program uses the same parameters to estimate blood loss together with clinical exam and laboratory findings (e.g. base deficit and lactate) but does not use a shock classification related to absolute values. In conclusion the typical physiologic response to haemorrhage as illustrated by the ATLS shock classes remains an important issue in clinical practice and in teaching. The estimation of the severity haemorrhage in the initial assessment trauma patients is (and was never) solely based on vital signs only but includes the pattern of injuries, the requirement of fluid substitution and potential confounders. Vital signs are not obsolete especially in the course of treatment but must be interpreted in view of the clinical context. Conflict of interest None declared. Member of Swiss national ATLS core faculty.

Computer Assisted Diagnosis and Treatment Planning of Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a dynamic conflict of the hip defined by a pathological, early abutment of the proximal femur onto the acetabulum or pelvis. In the past two decades, FAI has received increasing focus in both research and clinical practice as a cause of hip pain and prearthrotic deformity. Anatomical abnormalities such as an aspherical femoral head (cam-type FAI), a focal or general overgrowth of the acetabulum (pincer-type FAI), a high riding greater or lesser trochanter (extra-articular FAI), or abnormal torsion of the femur have been identified as underlying pathomorphologies. Open and arthroscopic treatment options are available to correct the deformity and to allow impingement-free range of motion. In routine practice, diagnosis and treatment planning of FAI is based on clinical examination and conventional imaging modalities such as standard radiography, magnetic resonance arthrography (MRA), and computed tomography (CT). Modern software tools allow three-dimensional analysis of the hip joint by extracting pelvic landmarks from two-dimensional antero-posterior pelvic radiographs. An object-oriented cross-platform program (Hip2Norm) has been developed and validated to standardize pelvic rotation and tilt on conventional AP pelvis radiographs. It has been shown that Hip2Norm is an accurate, consistent, reliable and reproducible tool for the correction of selected hip parameters on conventional radiographs. In contrast to conventional imaging modalities, which provide only static visualization, novel computer assisted tools have been developed to allow the dynamic analysis of FAI pathomechanics. In this context, a validated, CT-based software package (HipMotion) has been introduced. HipMotion is based on polygonal three-dimensional models of the patient’s pelvis and femur. The software includes simulation methods for range of motion, collision detection and accurate mapping of impingement areas. A preoperative treatment plan can be created by performing a virtual resection of any mapped impingement zones both on the femoral head-neck junction, as well as the acetabular rim using the same three-dimensional models. The following book chapter provides a summarized description of current computer-assisted tools for the diagnosis and treatment planning of FAI highlighting the possibility for both static and dynamic evaluation, reliability and reproducibility, and its applicability to routine clinical use.

Behavior competence development through e-learning: experience at the undergraduate level in the context of Aula a Distancia Abierta (ADA) Madrid, Spain

This communication presents the results of an innovative approach for competencedevelopment suggesting a new methodology for the integration of these elements in professional development within the ADA initiative (AulaaDistanciaAbierta, Distance and Open Classroom) of the Community of Madrid. The main objective of this initiative is to promote the use of Information and Communication Technologies (ICTs) for educational activities by creating a new learning environment structured on the premises of commitment to self–learning, individual work, communication and virtual interaction, and self and continuous assessment. Results from this experience showed that conceptualization is a positive contribution to learning, as students added names and characteristics to competences and abilities that were previously unknown or underestimated. Also, the diversity of participants’ disciplines indicated multidimensional interest in this idea and supported the theory that this approach to competencedevelopment could be successful in all knowledge areas.

Evolution and implementation of CDIO initiatives at ETSII-UPM

The School of Industrial Engineering at Universidad Politécnica de Madrid (ETSII-UPM) has been promoting student-centred teaching-learning activities, according to the aims of the Bologna Declaration, well before the official establishment of the European Area of Higher Education. Such student-centred teaching-learning experiences led us to the conviction that project based learning is rewarding, both for students and academics, and should be additionally promoted in our new engineering programmes, adapted to the Grade-Master structure. The level of commitment of our teachers with these activities is noteworthy, as the teaching innovation experiences carried out in the last ten years have led to the foundation of 17 Teaching Innovation Groups at ETSII-UPM, hence leading the ranking of teaching innovation among all UPM centres. Among interesting CDIO activities our students have taken part in especially complex projects, including the Formula Student, linked to the complete development of a competition car, and the Cybertech competition, aimed at the design, construction and operation of robots for different purposes. Additional project-based learning teamwork activities have been linked to toy design, to the development of medical devices, to the implementation of virtual laboratories, to the design of complete industrial installations and factories, among other activities detailed in present study. The implementation of Bologna process will culminate at ETSII-UPM with the beginning of the Master’s Degree in Industrial Engineering, in academic year 2014-15. The program has been successfully approved by the Spanish Agency for Accreditation (ANECA), with the inclusion of a set of subjects based upon the CDIO methodology denominated generally “INGENIA”, linked to the Spanish “ingeniar” (to provide ingenious solutions), also related etymologically in Spanish with “ingeniero”, engineer. INGENIA students will live through the complete development process of a complex product or system and there will be different kind of projects covering most of the engineering majors at ETSII-UPM.

3.4 MU registrar informed Lloyd Gaines that he was not eligible to attend the University of Missouri due to the fact that Gaines was a Negro

After several weeks, Gaines finally received a reply to his application from Sy Woodson Canada, the MU registrar. Canada informed him that he was not eligible to attend the University of Missouri due to the fact that Gaines was a Negro and it was in conflict of Missouri state law for MU to admit him.

Cross-lineage expression of Ig-β (B29) in thymocytes: Positive and negative gene regulation to establish T cell identity

Developmental commitment involves activation of lineage-specific genes, stabilization of a lineage-specific gene expression program, and permanent inhibition of inappropriate characteristics. To determine how these processes are coordinated in early T cell development, the expression of T and B lineage-specific genes was assessed in staged subsets of immature thymocytes. T lineage characteristics are acquired sequentially, with germ-line T cell antigen receptor-β transcripts detected very early, followed by CD3ɛ and terminal deoxynucleotidyl transferase, then pTα, and finally RAG1. Only RAG1 expression coincides with commitment. Thus, much T lineage gene expression precedes commitment and does not depend on it. Early in the course of commitment to the T lineage, thymocytes lose the ability to develop into B cells. To understand how this occurs, we also examined expression of well defined B lineage-specific genes. Although λ5 and Ig-α are not expressed, the μ0 and Iμ transcripts from the unrearranged IgH locus are expressed early, in distinct patterns, then repressed just before RAG1 expression. By contrast, RNA encoding the B cell receptor component Ig-β was found to be transcribed in all immature thymocyte subpopulations and throughout most thymocyte differentiation. Ig-β expression is down-regulated only during positive selection of CD4+CD8– cells. Thus several key participants in the B cell developmental program are expressed in non-B lineage-committed cells, and one is maintained even through commitment to an alternative lineage, and repressed only after extensive T lineage differentiation. The results show that transcriptional activation of “lymphocyte-specific” genes can occur in uncommitted precursors, and that T lineage commitment is a composite of distinct positive and negative regulatory events.

Traumatic insemination and sexual conflict in the bed bug Cimex lectularius

The bed bug, Cimex lectularius, has a unique mode of copulation termed “traumatic” insemination [Carayon, J. (1966) in Monograph of the Cimicidae, ed. Usinger, R. (Entomol. Soc. Am., Philadelphia), pp. 81–167] during which the male pierces the female's abdominal wall with his external genitalia and inseminates into her body cavity [Carayon, J. (1966) in Monograph of the Cimicidae, ed. Usinger, R. (Entomol. Soc. Am., Philadelphia), pp. 81–167]. Under controlled natural conditions, traumatic insemination was frequent and temporally restricted. We show for the first time, to our knowledge, that traumatic insemination results in (i) last-male sperm precedence, (ii) suboptimal remating frequencies for the maintenance of female fertility, and (iii) reduced longevity and reproductive success in females. Experimental females did not receive indirect benefits from multiple mating. We conclude that traumatic insemination is probably a coercive male copulatory strategy that results in a sexual conflict of interests.

Dim-Red-Light-Induced Increase in Polar Auxin Transport in Cucumber Seedlings1 : I. Development of Altered Capacity, Velocity, and Response to Inhibitors

We have developed and characterized a system to analyze light effects on auxin transport independent of photosynthetic effects. Polar transport of [3H]indole-3-acetic acid through hypocotyl segments from etiolated cucumber (Cucumis sativus L.) seedlings was increased in seedlings grown in dim-red light (DRL) (0.5 μmol m−2 s−1) relative to seedlings grown in darkness. Both transport velocity and transport intensity (export rate) were increased by at least a factor of 2. Tissue formed in DRL completely acquired the higher transport capacity within 50 h, but tissue already differentiated in darkness acquired only a partial increase in transport capacity within 50 h of DRL, indicating a developmental window for light induction of commitment to changes in auxin transport. This light-induced change probably manifests itself by alteration of function of the auxin efflux carrier, as revealed using specific transport inhibitors. Relative to dark controls, DRL-grown seedlings were differentially less sensitive to two inhibitors of polar auxin transport, N-(naphth-1-yl) phthalamic acid and 2,3,5-triiodobenzoic acid. On the basis of these data, we propose that the auxin efflux carrier is a key target of light regulation during photomorphogenesis.

Identification of the mRNA targets of tRNA-­specific regulation using genome-­wide simulation of translation

FUNDING Biotechnology and Biological Sciences Research Council (BBSRC) [BB/I020926/1 to I.S.]; BBSRC PhD studentship award [C103817D to I.S. and M.C.R.]; Scottish Universities Life Science Alliance PhD studentship award (to M.C.R. and I.S.]. Funding for open access charge: BBSRC. Conflict of interest statement. None declared.

Persisting to Graduation: A Grounded Theory Exploration of Nontraditional Undergraduate Women's Enrollment

While women maintain a numerical majority in undergraduate college enrollments and degrees earned, they also represent the numerical majority among students over 29 years old, students of color, students who are in the lowest income category, students who are single parents, and students who attend college part-time (Peter & Horn, 2005; Planty, et al., 2008). The National Center for Educational Statistics (NCES) has identified seven characteristics that place students at risk of not completing an undergraduate degree; (a) delayed enrollment between high school and college, (b) part-time enrollment, (c) financial independence, (d) students with dependents, (e) students who are single parents, (f) students who work full-time while enrolled, and (g) students who completed a GED as opposed to earning a high school diploma (Choy, 2002; Dickerson & Stiefer, 2006; Horn & Premo, 1995). The above characteristics overlap with the categories where women have a numerical majority, thereby placing women in greater jeopardy of not completing a bachelor's degree. A review of the existing persistence literature demonstrates a lack of research devoted to understanding the persistence experiences, challenges, strategies, and decisions of nontraditional undergraduate in favor of the "traditional" undergraduate student (Pascarella & Terenzini, 2005; Reason 2003). For this doctoral dissertation, I have based the research on a critical race feminist framework, informed by my experience working with the population of nontraditional undergraduate women at a women's college and employed a critique of the persistence literature as sensitizing concepts. Using a modified grounded theory research design, I collected and analyzed data which led to the development of a grounded theory of nontraditional undergraduate women's persistence. The emergent concepts of commitment, environment, and support interact in a theory of academic momentum and I offer a critical race feminist reading of the findings and theory to expose race neutrality, honor the voices of women of color, and deconstruct the evidence presented. The implications of this research include student, institutional, and inclusive excellence approaches to increasing the persistence of nontraditional undergraduate women and contribute to the success of this unique population of learners.

Transcending Cultural and Language Differences: Ethical Codes of Conduct for Translators and Interpreters in Afghanistan

This project examines what an ethical code of conduct would look like in Afghanistan through analysis of historical, cultural and linguistic aspects found within its regions, as well as an examination of ethical codes of conduct for translators and interpreters in other countries. While numerous ethical guidelines and codes of conduct for translators and interpreters exist throughout global communities, it seems that creating a successful standardized ethical code of conduct in Afghanistan may be difficult to achieve given cultural and linguistic complexities. An ethical code of conduct for translators and interpreters in Afghanistan should include particular focus on: cultural sensitivity and courtesy, impartiality, conflict of interest, options for withdrawal, as well as reflect the importance of Pashtunwali.

Foreign policy at the service of modernisation: old wine in a new wineskin. OSW Commentary No. 39, 2010-08-31

Russia’s contacts with the external world over the past year have been characterised by a gradual improvement in its relations with the West, as well as the use of non-confrontational rhetoric, the most far-reaching example of which was the address President Dmitri Medvedev gave to Russian ambassadors this July. In an attempt to harmonise foreign policy with the widely propagated programme for the modernisation of Russia1 President Medvedev presented a vision of the Russian Federation as a responsible global power which is open to co-operation. According to this vision, Russian foreign policy would help to attract foreign investments and technologies. The West was presented as a partner, not a rival. Both this rhetoric and the atmosphere of co-operation in relations with the USA and the EU contrast with the assertive and aggressive Russian policy which was symbolised by and culminated in the Russian-Georgian conflict of 2008. The changes observed in Russian foreign policy are quite limited, and are not constructing a new external strategy. Those changes are rather an attempt to find more efficient ways to implement old strategic goals. The new image of a responsible global power is inconsistent, and Russian policy is still assertive and geopolitically motivated. Although a new rhetoric is really in place, the Russian political elite’s perception of their country’s place and role in the contemporary international order remains unchanged. Moscow’s readiness to become engaged in genuine co-operation with the West has not increased significantly; it is still to a great extent declarative in nature.

An Exercise in Legal Honesty: Re-writing the Court of Justice and the Bundesverfassungsgericht. IHS Political Science Series No. 136, February 2014

At a time of crisis – a true state of emergency – both the Court of Justice of the European Union and the German Federal Constitutional Court have failed the rule of law in Europe. Worse still, in their evaluation of the ersatz crisis law, which has been developed in response to financial and sovereign debt crises, both courts have undermined constitutionality throughout Europe. Each jurisdiction has been implicated within the techocratisation of democratic process. Each Court has contributed to an incremental process of the undermining of the political subjectivity of European Citizens. The results are depressing for lawyers who are still attached to notions of constitutionality. Yet, we must also ask whether the Courts could have acted otherwise. Given the original flaws in the construction of Economic and Monetary Union, as well as the politically pre-emptive constraints imposed by global financial markets, each Court might thus be argued to have been forced to suspend immediate legality in a longer term effort to secure the character of the legal jurisdiction as a whole. Crisis can and does defeat the law. Nevertheless, what continues to disturb is the failure of law in Europe to open up any perspective for a return to normal constitutionality post crisis, as well as its apparent inability to give proper and honest consideration to the hardship now being experienced by millions of Europeans within crisis. This contribution accordingly seeks to reimagine each Judgment in a language of legal honesty. Above all, this contribution seeks to suggest a new form of post-national constitutional language; a language which takes as its primary function, proper protection of democratic process against the ever encroaching powers of a post-national executive power. This contribution forms a part of an on-going effort to identify a new basis for the legitimacy of European Law, conducted jointly and severally with Christian Joerges, University of Bremen and Hertie School of Government, Berlin. Differences do remain in our theoretical positions; hence this individual essay. Nevertheless, the congruence between pluralist and conflict of law approaches to the topic are also readily apparent. See, for example, Everson & Joerges (2013).

Standards of ethical conduct for employees of the executive branch : final regulation issued by the U.S. Office of Government Ethics, codified in 5 C.F.R. part 2635 (1/1/02 edition), as amended at 67 FR 61761-61762 (Oct. 2, 2002).

Shipping list no.: 2003-0103-P