The multimodal world of medical monitoring displays

A vision of the future of intraoperative monitoring for anesthesia is presented-a multimodal world based on advanced sensing capabilities. I explore progress towards this vision, outlining the general nature of the anesthetist's monitoring task and the dangers of attentional capture. Research in attention indicates different kinds of attentional control, such as endogenous and exogenous orienting, which are critical to how awareness of patient state is maintained, but which may work differently across different modalities. Four kinds of medical monitoring displays are surveyed: (1) integrated visual displays, (2) head-mounted displays, (3) advanced auditory displays and (4) auditory alarms. Achievements and challenges in each area are outlined. In future research, we should focus more clearly on identifying anesthetists' information needs and we should develop models of attention in different modalities and across different modalities that are more capable of guiding design. (c) 2006 Elsevier Ltd. All rights reserved.

Cross-sectional Study Comparing Different Therapeutic Modalities For Cystic Lymphangiomas In Children.

Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities. We performed a retrospective, cross-sectional study including patients treated from 1998 to 2011. The effects on macrocystic lymphangiomas and adverse reactions were evaluated. Twenty-nine children with cystic lymphangiomas without any previous treatment were included. Under general anesthesia, patients given sclerosing agents underwent puncture of the lesion (guided by ultrasound when necessary) and complete aspiration of the intralesional liquid. The patients were evaluated with ultrasound and clinical examinations for a maximum follow-up time of 4 years. The proportions of patients considered cured after the first therapeutic approach were 44% in the surgery group, 29% in the bleomycin group and 31% in the OK-432 group. These proportions were not significantly different. Sequential treatment increased the rates of curative results to 71%, 74% and 44%, respectively, after the final treatment, which in our case was approximately 1.5 applications per patient. The results of this study indicate that most patients with cystic lymphangiomas do not show complete resolution after the initial therapy, regardless of whether the therapy is surgical or involves the use of sclerosing agents. To achieve complete resolution of the lesions, either multiple operations or a combination of surgery and sclerotherapy must be used and should be tailored to the characteristics of each patient.

Minor and Unsystematic Cortical Topographic Changes of Attention Correlates between Modalities

In this study we analyzed the topography of induced cortical oscillations in 20 healthy individuals performing simple attention tasks. We were interested in qualitatively replicating our recent findings on the localization of attention-induced beta bands during a visual task [1], and verifying whether significant topographic changes would follow the change of attention to the auditory modality. We computed corrected latency averaging of each induced frequency bands, and modeled their generators by current density reconstruction with Lp-norm minimization. We quantified topographic similarity between conditions by an analysis of correlations, whereas the inter-modality significant differences in attention correlates were illustrated in each individual case. We replicated the qualitative result of highly idiosyncratic topography of attention-related activity to individuals, manifested both in the beta bands, and previously studied slow potential distributions [2]. Visual inspection of both scalp potentials and distribution of cortical currents showed minor changes in attention-related bands with respect to modality, as compared to the theta and delta bands, known to be major contributors to the sensory-related potentials. Quantitative results agreed with visual inspection, supporting to the conclusion that attention-related activity does not change much between modalities, and whatever individual changes do occur, they are not systematic in cortical localization across subjects. We discuss our results, combined with results from other studies that present individual data, with respect to the function of cortical association areas.

Activation of endogenous p53 by combined p19Arf gene transfer and nutlin-3 drug treatment modalities in the murine cell lines B16 and C6

Background: Reactivation of p53 by either gene transfer or pharmacologic approaches may compensate for loss of p19Arf or excess mdm2 expression, common events in melanoma and glioma. In our previous work, we constructed the pCLPG retroviral vector where transgene expression is controlled by p53 through a p53-responsive promoter. The use of this vector to introduce p19Arf into tumor cells that harbor p53wt should yield viral expression of p19Arf which, in turn, would activate the endogenous p53 and result in enhanced vector expression and tumor suppression. Since nutlin-3 can activate p53 by blocking its interaction with mdm2, we explored the possibility that the combination of p19Arf gene transfer and nutlin-3 drug treatment may provide an additive benefit in stimulating p53 function. Methods: B16 (mouse melanoma) and C6 (rat glioma) cell lines, which harbor p53wt, were transduced with pCLPGp19 and these were additionally treated with nutlin-3 or the DNA damaging agent, doxorubicin. Viral expression was confirmed by Western, Northern and immunofluorescence assays. p53 function was assessed by reporter gene activity provided by a p53-responsive construct. Alterations in proliferation and viability were measured by colony formation, growth curve, cell cycle and MTT assays. In an animal model, B16 cells were treated with the pCLPGp19 virus and/or drugs before subcutaneous injection in C57BL/6 mice, observation of tumor progression and histopathologic analyses. Results: Here we show that the functional activation of endogenous p53wt in B16 was particularly challenging, but accomplished when combined gene transfer and drug treatments were applied, resulting in increased transactivation by p53, marked cell cycle alteration and reduced viability in culture. In an animal model, B16 cells treated with both p19Arf and nutlin-3 yielded increased necrosis and decreased BrdU marking. In comparison, C6 cells were quite susceptible to either treatment, yet p53 was further activated by the combination of p19Arf and nutlin-3. Conclusions: To the best of our knowledge, this is the first study to apply both p19Arf and nutlin-3 for the stimulation of p53 activity. These results support the notion that a p53 responsive vector may prove to be an interesting gene transfer tool, especially when combined with p53- activating agents, for the treatment of tumors that retain wild-type p53.

Identification and Characterization of Ixodes scapularis Antigens That Elicit Tick Immunity Using Yeast Surface Display

Repeated exposure of rabbits and other animals to ticks results in acquired resistance or immunity to subsequent tick bites and is partially elicited by antibodies directed against tick antigens. In this study we demonstrate the utility of a yeast surface display approach to identify tick salivary antigens that react with tick-immune serum. We constructed an Ixodes scapularis nymphal salivary gland yeast surface display library and screened the library with nymph-immune rabbit sera and identified five salivary antigens. Four of these proteins, designated P8, P19, P23 and P32, had a predicted signal sequence. We generated recombinant (r) P8, P19 and P23 in a Drosophila expression system for functional and immunization studies. rP8 showed anti-complement activity and rP23 demonstrated anti-coagulant activity. Ixodes scapularis feeding was significantly impaired when nymphs were fed on rabbits immunized with a cocktail of rP8, rP19 and rP23, a hall mark of tick-immunity. These studies also suggest that these antigens may serve as potential vaccine candidates to thwart tick feeding.

Comparison of multispectral wide-field optical imaging modalities to maximize image contrast for objective discrimination of oral neoplasia

Multispectral widefield optical imaging has the potential to improve early detection of oral cancer. The appropriate selection of illumination and collection conditions is required to maximize diagnostic ability. The goals of this study were to (i) evaluate image contrast between oral cancer/precancer and non-neoplastic mucosa for a variety of imaging modalities and illumination/collection conditions, and (ii) use classification algorithms to evaluate and compare the diagnostic utility of these modalities to discriminate cancers and precancers from normal tissue. Narrowband reflectance, autofluorescence, and polarized reflectance images were obtained from 61 patients and 11 normal volunteers. Image contrast was compared to identify modalities and conditions yielding greatest contrast. Image features were extracted and used to train and evaluate classification algorithms to discriminate tissue as non-neoplastic, dysplastic, or cancer; results were compared to histologic diagnosis. Autofluorescence imaging at 405-nm excitation provided the greatest image contrast, and the ratio of red-to-green fluorescence intensity computed from these images provided the best classification of dysplasia/cancer versus non-neoplastic tissue. A sensitivity of 100% and a specificity of 85% were achieved in the validation set. Multispectral widefield images can accurately distinguish neoplastic and non-neoplastic tissue; however, the ability to separate precancerous lesions from cancers with this technique was limited. (C) 2010 Society of Photo-Optical Instrumentation Engineers. [DOI: 10.1117/1.3516593]

Identification of Novel Immunoregulatory Molecules in Human Thymic Regulatory CD4(+)CD25(+) T Cells by Phage Display

Thymic CD4(+)CD25(+) cells play an important role in immune regulation and are continuously developed in the thymus as an independent lineage. How these cells are generated, what are their multiple pathways of suppressive activity and which are their specific markers are questions that remain unanswered. To identify molecules involved in the function and development of human CD4(+)CD25(+) T regulatory cells we targeted thymic CD4(+)CD25(+) cells by peptide phage display. A phage library containing random peptides was screened ex vivo for binding to human thymic CD4(+)CD25(+) T cells. After four rounds of selection on CD4(+)CD25(+) enriched populations of thymocytes, we sequenced several phage displayed peptides and selected one with identity to the Vitamin D Receptor (VDR). We confirmed the binding of the VDR phage to active Vitamin D in vitro, as well as the higher expression of VDR in CD4(+)CD25(+) cells. We suggest that differential expression of VDR on natural Tregs may be related to the relevance of Vitamin D in function and ontogeny of these cells.

Denisiuk-type reflection holography display with sillenite crystals for imaging and interferometry of small objects

A novel setup for imaging and interferometry through reflection holography with Bi12TiPO20(BTO) sillenite photorefractive crystals is proposed. A variation of the lensless Denisiuk arrangement was developed resulting in a compact, robust and simple interferometer. A red He-Ne laser was used as light source and the holographic recording occurred by diffusion with the grating vector parallel to the crystal [0 0 1]-axis. In order to enhance the holographic image quality and reduce noise a polarizing beam splitter (PBS) was positioned at the BTO input and the crystal was tilted around the [0 0 1]-axis. This enabled the orthogonally polarized transmission and diffracted beams to be separated by the PBS, providing the holographic image only. The possibility of performing deformation and strain analysis as well as vibration measurement of small objects was demonstrated. (C) 2007 Elsevier B.V. All rights reserved.

Malnourished mice display an impaired hematologic response to granulocyte colony-stimulating factor administration

The aim of this Study was to determine if protein-energy malnutrition Could affect the hematologic response to granulocyte colony-stimulating factor (G-CSF). Swiss mice were fled a low-protein diet containing 4% protein, whereas control mice were fed a 20% protein-containing diet. After the malnourished group lost 20% of their original body weight, the mice were subdivided in 2 treatment groups, and hematopoietic parameters were studied. Mice were injected with either 8 mu g/kg per day of G-CSF or saline twice daily for 4 days. Malnourished mice developed anemia with reticulopenia and leukopenia with depletion of granulocytes and lymphocytes. Both malnourished and control mice treated with G-CSF showed a significant increase in neutrophils; however, in the control group, this increase was more pronounced compared to the malnourished group (4.5-fold and 3.4-fold, respectively). Granulocyte colony-stimulating factor administration increased bone marrow blastic (P < .001) and granulocytic (P < .01) compartments in the controls bill had no significant effect oil these hematopoietic compartments in the Malnourished animals (P = .08 and P = .62, respectively). We report that malnourished mice display an impaired response to G-CSF, which contributes to the decreased production of leukocytes in protein-energy malnutrition. (C) 2008 Elsevier Inc. All rights reserved.

Visual Display Height

We examined the influence of backrest inclination and vergence demand on the posture and gaze angle that-workers adopt to view visual targets placed in different vertical locations. In the study 12 participants viewed a small video monitor placed in 7 locations around a 0.65-m radius arc (from 650 below to 300 above horizontal eye height). Trunk posture was manipulated by changing the backrest inclination of an adjustable chair. Vergence demand was manipulated by using ophthalmic lenses and prisms to mimic the visual consequences of varying target distance. Changes in vertical target location caused large changes in atlantooccipital posture and gaze angle. Cervical posture was altered to a lesser extent by changes in vertical target location. Participants compensated for changes in backrest inclination by changing cervical posture, though they did not significantly alter atlanto-occipital posture and gaze angle. The posture adopted to view any target represents a compromise between visual and musculoskeletal demands. These results provide support for the argument that the optimal location of visual targets is at least 15 below horizontal eye level. Actual or potential applications of this work include the layout of computer workstations and the viewing of displays from a seated posture.

Overview: Individual and organizational perspectives on emotion management and display

As reported in Volume 1 of Research on Emotions in Organizations (Ashkanasy, Zerbe, & Härtel, 2005), the chapters in this volume are drawn from the best contributions to the 2004 International Conference on Emotion and Organizational Life held at Birkbeck College, London, complemented by additional, invited chapters. (This biannual conference has come to be known as the “Emonet” conference, after the listserv of members.) Previous edited volumes (Ashkanasy, Härtel, & Zerbe, 2000; Ashkanasy, Zerbe, & Härtel, 2002; Härtel, Zerbe, & Ashkanasy, 2004) were published every two years following the Emonet conference. With the birth of this annual Elsevier series came the opportunity for greater focus in the theme of each volume, and for greater scope for invited contributions. This volume contains eight chapters selected from conference contributions for their quality, interest, and appropriateness to the theme of this volume, as well as four invited chapters. We again acknowledge in particular the assistance of the conference paper reviewers (see the appendix). In the year of publication of this volume the 2006 Emonet conference will be held in Atlanta, USA and will be followed by Volumes 3 and 4 of Research on Emotions in Organizations. Readers interested in learning more about the conferences or the Emonet list should check the Emonet website http://www.uq.edu.au/emonet/.

Compact tiled display with uniform illumination

The demand for more pixels is beginning to be met as manufacturers increase the native resolution of projector chips. Tiling several projectors still offers a solution to augment the pixel capacity of a display. However, problems of color and illumination uniformity across projectors need to be addressed as well as the computer software required to drive such devices. We present the results obtained on a desktop-size tiled projector array of three D-ILA projectors sharing a common illumination source. A short throw lens (0.8:1) on each projector yields a 21-in. diagonal for each image tile; the composite image on a 3×1 array is 3840×1024 pixels with a resolution of about 80 dpi. The system preserves desktop resolution, is compact, and can fit in a normal room or laboratory. The projectors are mounted on precision six-axis positioners, which allow pixel level alignment. A fiber optic beamsplitting system and a single set of red, green, and blue dichroic filters are the key to color and illumination uniformity. The D-ILA chips inside each projector can be adjusted separately to set or change characteristics such as contrast, brightness, or gamma curves. The projectors were then matched carefully: photometric variations were corrected, leading to a seamless image. Photometric measurements were performed to characterize the display and are reported here. This system is driven by a small PC cluster fitted with graphics cards and running Linux. It can be scaled to accommodate an array of 2×3 or 3×3 projectors, thus increasing the number of pixels of the final image. Finally, we present current uses of the display in fields such as astrophysics and archaeology (remote sensing).

mRNA differential display of 2-amino-1-methyl-6-phenylinlidazo[4,5-b]pyridine-induced rat mammary gland tumors

The mRNA differential display technique was used to compare mRNAs between normal mammary gland and turner-derived epithelial cells from female Sprague-Dawley rat mammary gland tumors induced by the heterocyclic amine 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and promoted by a high-fat diet (23.5% corn oil). Two genes, beta-casein and transferrin, were identified as differentially expressed. The expression of these genes was examined across a bank of rat mammary gland tumors derived from animals on a low-fat diet (5% corn oil) or the high-fat diet. Carcinomas had over a 10- and 50-fold lower expression of beta-casein and transferrin, respectively than normal mammary gland. In addition, carcinomas from animals on the high-fat diet showed on average a 5-fold higher expression of beta-casein, and transferrin than carcinomas from animals on the low-fat diet. The results indicate the process of mammary gland tumorigenesis alters the expression of certain genes in the mammary gland, and that the level of dietary fat further modulates the expression of these genes.