Zombie allusions: They just keep on coming-"sort of like zombie-ism"

Research Center In OK Says Zombie Myth Has Scientific Roots

"There are historically some types of medical problems that are sort of like zombie-ism," he said.

Certain medications, illicit drugs and viruses like encephalitis, meningitis and even rabies can mimic zombie like behaviors.

"People who get rabies because they get inflammation in their brain, they don't think properly and they can be a little crazed, rabid if you will, for brief time in their illness," said Dr. Prescott.

In fact, in West Africa, a disease known as Trypanosomiasis or "sleeping sickness" carries some pretty scary traits of a zombie infection.

Gene. 2013 Dec 1;531(2):168-74. doi: 10.1016/j.gene.2013.09.034. Epub 2013 Sep 18.

Knockdown of a putative Halloween gene Shade reveals its role in ecdysteroidogenesis in the small brown planthopper Laodelphax striatellus.

Jia S, Wan PJ, Zhou LT, Mu LL, Li GQ.

Source

Education Ministry Key Laboratory of Integrated Management of Crop Diseases and Pests, College of Plant Protection, Nanjing Agricultural University, Nanjing 210095, China.

Abstract

Ecdysteroid hormone 20-hydroxyecdysone (20E) plays fundamental roles in insect development and reproduction, whereas the primary role of ecdysone (E) is the precursor for 20E. A cytochrome P450 monooxygenase (CYP), encoded by a Halloween gene Shade (Shd, cyp314a1), catalyzes the conversion of E into 20E in representative insect species in Diptera, Lepidoptera and Orthoptera. We describe here the cloning and characterization of LsShd in a hemipteran insect species, the small brown planthopper Laodelphax striatellus. LsSHD has five insect conserved P450 motifs, i.e., Helix-C, Helix-I, Helix-K, PERF and heme-binding motifs. Temporal expression pattern of LsShd was determined through the fourth-instar and the early fifth-instar stages by qPCR. LsShd showed two expression peaks in day 2 and day 5 fourth-instar nymphs, and two troughs in day 1 fourth and fifth instars. Dietary introduction of double-stranded RNA (dsRNA) of LsShd into nymphs successfully knocked down the target gene, decreased expression level of ecdysone receptor (LsEcR) gene, and caused nymphal lethality and delayed development. Ingestion of 20E did not increase LsShd expression level, but almost completely rescued LsEcR mRNA level, and relieved the negative effects on the survival and development in LsShd-dsRNA-exposed nymphs. In contrast, dietary introduction of E had little rescue effects. Thus, our data suggest that the ecdysteroidogenic pathway is conserved in insects, and LsSHD functions to regulate metamorphotic processes by converting E to 20E even in a hemipteran insect, L. striatellus.

J Cancer Educ. 2013 Dec;28(4):603-10. doi: 10.1007/s13187-013-0553-2.

Attitudes of Polish Physicians and Medical Students toward Breaking Bad News, Euthanasia and Morphine Administration in Cancer Patients.

Leppert W, Majkowicz M, Forycka M.

Source

Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Osiedle Rusa 25 A, 61-245, Poznan, Poland, wojciechleppert@wp.pl.

Abstract

Medical students and physicians should possess basic knowledge concerning medical ethics and palliative care. The aim of the study was to explore the knowledge on the end-of-life ethics and palliative care in third-year medical students and physicians during internal medicine specialty training and their attitude towards breaking bad news and euthanasia. A voluntary and anonymous questionnaire survey with the participation of 401 students and 217 physicians filled after lectures concerning ethics for medical students and after palliative medicine course for physicians during internal medicine specialty training. A total of 28 % students and 24 % physicians (p = 0.282) were ready to reveal full information to advanced cancer patients. A total of 82 % of students and 90 % of physicians (p = 0.008) would not practice euthanasia; 67 % of students and 75 % of physicians (p = 0.039) were opponents of euthanasia legalisation. A total of 70 % doctors and 23 % students indicated oral as the most preferable route of morphine administration. A total of 74 % physicians and 43 % students stated that there is no maximal dose of morphine; 64 % of doctors and 6 % of students indicated constipation as a constant adverse effect of morphine. Breaking bad news is a significant difficulty for both students and physicians. There is a small percentage of those tending to practice euthanasia and bigger accepting its legalisation with fewer physicians than students. In contrast to medical students, the majority of physicians have knowledge concerning chronic morphine use in the treatment of cancer patients.

Response to Government Moving to Ban the Word "Government." (HT:GB)

Response to Government Moving to Ban the Word 

"Government."

"The word "defendant" should be banned. At trial, Mr. Powell hereby demands be addressed only by his full name, preceded by the title "Mister." Alternatively, he may be called simply "the Citizen Accused." This latter title sounds more respectable than the criminal "Defendant." The designation "That innocent man" would also be acceptable."

From the NIH: Biospecimen policy: Family matters

Nature. 2013 Aug 8;500(7461):141-2. doi: 10.1038/500141a.

Biospecimen policy: Family matters.

Hudson KL, Collins FS.

Source

National Institutes of Health, Bethesda, Maryland, USA. kathy.hudson@nih.gov

PMID:

 

23925224

 

[PubMed - indexed for MEDLINE]

"In March, two of the most deeply held values in the medical-research community — public data-sharing and respect for research participants — collided when the genome of the ubiquitous cell line HeLa was published¹ and posted in a public database. Controversy ensued. The full sequence data could potentially uncover unwanted information about people whose identity is widely known: the family of the woman from whom this immortal line was derived 62 years ago, Henrietta Lacks."

Am J Public Health. 2013 Oct 22. [Epub ahead of print]

Homelessness and Money Mismanagement in Iraq and Afghanistan Veterans.

Elbogen EB, Sullivan CP, Wolfe J, Wagner HR, Beckham JC.

Source

Eric B. Elbogen, Connor P. Sullivan, and James Wolfe are with the Department of Psychiatry, University of North Carolina, Chapel Hill. Eric B. Elbogen, Henry Ryan Wagner, and Jean C. Beckham are with the Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC. Henry Ryan Wagner and Jean C. Beckham are also with the Department of Psychiatry, Duke University Medical Center, Durham.

Abstract

Objectives. We examined the empirical link between money mismanagement and subsequent homelessness among veterans. Methods. We used a random sample of Iraq and Afghanistan War era veterans from the National Post-Deployment Adjustment Survey in 2009-2011. Results. Veterans were randomly selected from a roster of all U.S. military service members in Operation Iraqi Freedom or Operation Enduring Freedom who were separated from active duty or in the Reserves/National Guard. Veterans (n = 1090) from 50 states and all military branches completed 2 waves of data collection 1 year apart (79% retention rate). Thirty percent reported money mismanagement (e.g., bouncing or forging a check, going over one's credit limit, falling victim to a money scam in the past year). Multivariate analysis revealed money mismanagement (odds ratio [OR] = 4.09, 95% CI = 1.87, 8.94) was associated with homelessness in the next year, as were arrest history (OR = 2.65, 95% CI = 1.33, 5.29), mental health diagnosis (OR = 2.59, 95% CI = 1.26, 5.33), and income (OR = 0.30, 95% CI = 0.13, 0.71). Conclusions. Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness. 

The circadian rhythm made me do it?

Psychol Sci. 2013 Oct 28. [Epub ahead of print]

The Morning Morality Effect: The Influence of Time of Day on Unethical Behavior.

Kouchaki M, Smith IH.

Source

1Edmond J. Safra Center for Ethics, Harvard University.

Abstract

Are people more moral in the morning than in the afternoon? We propose that the normal, unremarkable experiences associated with everyday living can deplete one's capacity to resist moral temptations. In a series of four experiments, both undergraduate students and a sample of U.S. adults engaged in less unethical behavior (e.g., less lying and cheating) on tasks performed in the morning than on the same tasks performed in the afternoon. This morning morality effect was mediated by decreases in moral awareness and self-control in the afternoon. Furthermore, the effect of time of day on unethical behavior was found to be stronger for people with a lower propensity to morally disengage. These findings highlight a simple yet pervasive factor (i.e., the time of day) that has important implications for moral behavior.

John Dekker and Lyn Duncan: Lack of Standards for the Detection of Melanoma in Sentinel Lymph Nodes: A Survey and Recommendations

John Dekker and Lyn M. Duncan (2013) Lack of Standards for the Detection of Melanoma in Sentinel Lymph Nodes: A Survey and Recommendations. Archives of Pathology & Laboratory Medicine: November 2013, Vol. 137, No. 11, pp. 1603-1609.

ORIGINAL ARTICLES

Lack of Standards for the Detection of Melanoma in Sentinel Lymph Nodes: A Survey and Recommendations

John Dekker , MD, PhD; Lyn M. Duncan , MD

From the Department of Pathology, Massachusetts General Hospital, Boston.

Context.—Detection of microscopic melanoma metastases in sentinel lymph nodes drives clinical care; patients without metastases are observed, and patients with metastases are offered completion lymphadenectomy and adjuvant therapy.

Objective.—We sought to determine common elements in currently used analytic platforms for sentinel lymph nodes in melanoma patients.

Design.—An electronic survey was distributed to 83 cancer centers in North America.

Results.—Seventeen responses (20%) were received. The number of sentinel lymph node mapping procedures for melanoma ranged from less than 11 to more than 100 patients per year, with 72% of institutions mapping more than 50 melanoma patients a year. Uniform practices included (1) processing all of the lymph node tissue rather than submitting representative sections and (2) use of immunohistochemical stains if no tumor was identified on the hematoxylin-eosin–stained sections. Significant variability existed regarding the method of sectioning lymph nodes at grossing and in the histology laboratory; most bisected nodes longitudinally (94%) and performed deeper levels into the block (67%), but these were not uniform practices. S-100 was the most commonly used immunohistochemical stain (78%), followed by Melan-A (56%), MART-1 (50%), HMB-45 (44%), tyrosinase (33%), MiTF (11%), and pan-melanoma (6%).

Conclusions.—There is a need for a standardized platform for detecting melanoma in sentinel lymph nodes. Current practices by a majority of laboratories and findings in the reported literature support the following: histologic evaluation of all lymph node tissue, use of immunohistochemical stains, bisecting lymph nodes longitudinally, and performing deeper levels into the tissue block.http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0550-OA

From U Oxford: Attentional sampling of multiple wagon wheels

Atten Percept Psychophys. 2013 Oct 10. [Epub ahead of print]

Attentional sampling of multiple wagon wheels.

Macdonald JS, Cavanagh P, Vanrullen R.

Source

Department of Experimental Psychology, University of Oxford, Oxford, UK.

Abstract

Attending to a periodic motion stimulus can induce illusory reversals of the direction of motion. This continuous wagon wheel illusion (c-WWI) has been taken to reflect discrete sampling of motion information by visual attention. An alternative view is that it is caused by adaptation. Here, we attempt to discriminate between these two interpretations by asking participants to attend to multiple periodic motion stimuli: The discrete attentional sampling account, but not the adaptation account, predicts a decrease of c-WWI temporal-frequency tuning with set size (with a single periodic motion stimulus the c-WWI is tuned to a temporal frequency of 10 Hz). We presented one to four rotating gratings that occasionally reversed direction while participants counted reversals. We considered reversal overestimations as manifestations of the c-WWI and determined the temporal-frequency tuning of the illusion for each set size. Optimal temporal frequency decreased with increasing set size. This outcome favors the discrete attentional sampling interpretation of the c-WWI, with a sampling rate for each individual stimulus dependent on the number of stimuli attended.

Need another reason to exercise? "Long-term exercise is needed to enhance synaptic plasticity in the hippocampus"

Learn Mem. 2013 Oct 16;20(11):642-7. doi: 10.1101/lm.030635.113.

Long-term exercise is needed to enhance synaptic plasticity in the hippocampus.

Patten AR, Sickmann H, Hryciw BN, Kucharsky T, Parton R, Kernick A, Christie BR.

Source

Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia V8P 5C2, Canada.

Abstract

Exercise can have many benefits for the body, but it also benefits the brain by increasing neurogenesis, synaptic plasticity, and performance on learning and memory tasks. The period of exercise needed to realize the structural and functional benefits for the brain have not been well delineated, and previous studies have used periods of exercise exposure that range from as little as 3 d to up to 6 mo. In this study, we systematically evaluated the effects of differential running periods (3, 7, 14, 28, and 56 d) on both structural (cell proliferation and maturation) and functional (in vivo LTP) changes in the dentate gyrus of adult male Sprague-Dawley rats. We found that voluntary access to a running wheel for both short- and long-term periods can increase cell proliferation in the adult DG; however, increases in neurogenesis required longer term exposure to exercise. Increases in immature neurons were not observed until animals had been running for a minimum of 14 d. Similarly, short-term periods of wheel running did not facilitate LTP in the DG of adult animals, and reliable increases in LTP were only observed with 56 d of running. These results provide us with a greater understanding of the time course of wheel running access needed to enhance DG function. Furthermore, the results indicate that the new neurons produced in response to exercise in rats do not contribute significantly to synaptic plasticity until they mature.

J Empir Res Hum Res Ethics. 2013 Oct;8(4):42-52. doi: 10.1525/jer.2013.8.4.42.

Participants' recall and understanding of genomic research and large-scale data sharing.

Robinson JO, Slashinski MJ, Wang T, Hilsenbeck SG, McGuire AL.

Source

Baylor College of Medicine.

Abstract

As genomic researchers are urged to openly share generated sequence data with other researchers, it is important to examine the utility of informed consent documents and processes, particularly as these relate to participants' engagement with and recall of the information presented to them, their objective or subjective understanding of the key elements of genomic research (e.g., data sharing), as well as how these factors influence or mediate the decisions they make. We conducted a randomized trial of three experimental informed consent documents (ICDs) with participants (n = 229) being recruited to genomic research studies; each document afforded varying control over breadth of release of genetic information. Recall and understanding, their impact on data sharing decisions, and comfort in decision making were assessed in a follow-up structured interview. Over 25% did not remember signing an ICD to participate in a genomic study, and the majority (54%) could not correctly identify with whom they had agreed to share their genomic data. However, participants felt that they understood enough to make an informed decision, and lack of recall did not impact final data sharing decisions or satisfaction with participation. These findings raise questions about the types of information participants need in order to provide valid informed consent, and whether subjective understanding and comfort with decision making are sufficient to satisfy the ethical principle of respect for persons.

J Med Ethics. 2013 Oct 29. doi: 10.1136/medethics-2013-101480. [Epub ahead of print]

Wish-fulfilling medicine in practice: the opinions and arguments of lay people.

Asscher EC, Schermer M.

Source

Department of Medical Ethics and Philosophy of Medicine, ErasmusMC, , Rotterdam, The Netherlands.

Abstract

BACKGROUND:

Wish-fulfilling medicine appears to be on the rise. It can be defined as 'doctors and other health professionals using medical means (medical technology, drugs, and so on) in a medical setting to fulfil the explicitly stated, prima facie non-medical wish of a patient'. Some instances of wish fulfilling medicine can be understood as 'human enhancements'.

AIM:

The aim of this study is to map the normative opinions and arguments of lay people about wish-fulfilling medicine.

METHODS:

We conducted a qualitative study with lay people (five focus groups). We asked their opinions about five cases and the arguments for these opinions. Furthermore, we enquired about the role of the medical profession and the treating physician, and whether the participants saw a role for the government.

RESULTS:

The opinions and arguments used varied according to the example discussed. For instance, increased familiarity with a procedure like breast enhancement seems to garner more acceptance for that procedure, whereas completely new examples were considered less acceptable. Various different arguments were raised in focus groups; these included: people should be allowed to make up their own minds about this (autonomy); payment of the treatment; and concerns about risks.

DISCUSSION:

An ethical analysis of the emerging practice of wish-fulfilling medicine should take the normative views of all parties involved into account. Thus, it is important to establish what lay people think about wish-fulfilling medicine and in particular their arguments.

"So then what was this? A butterfly graph, the calling card of chaos theory mathematics..."

NICK BROWN SMELLED BULL

ByVinnie Rotondaro

A plucky amateur dared to question a celebrated psychological finding. He wound up blowing the whole theory wide open.


"So then what was this? A butterfly graph, the calling card of chaos theory mathematics, purporting to show the tipping point upon which individuals and groups “flourish” or “languish.” Not a metaphor, no poetic allusion, but an exact ratio: 2.9013 positive to 1 negative emotions. Cultivate a “positivity ratio” of greater than 2.9-to-1 and sail smoothly through life; fall below it, and sink like a stone."

One Man's Quest for Grammatical Perfection (How quaint)

For Who the Bell Tolls: One Man's Quest for Grammatical Perfection by David Marsh – review

A grammar guide that knows when to break the rules

• Steven Poole
• The Guardian, Wednesday 23 October 2013

"Guardian readers especially will enjoy the fact that Marsh happily hangs out for our ridicule many examples of horrible writing from the Guardian." 

Hollis Viray, Kevin Li, Thomas A. Long, Patricia Vasalos, Julia A. Bridge, Lawrence J. Jennings, Kevin C. Halling, Meera Hameed, and David L. Rimm (2013) A Prospective, Multi-Institutional Diagnostic Trial to Determine Pathologist Accuracy in Estimation of Percentage of Malignant Cells. Archives of Pathology & Laboratory Medicine: November 2013, Vol. 137, No. 11, pp. 1545-1549.

doi: http://dx.doi.org/10.5858/arpa.2012-0561-CP

CAP LABORATORY IMPROVEMENT PROGRAMS

A Prospective, Multi-Institutional Diagnostic Trial to Determine Pathologist Accuracy in Estimation of Percentage of Malignant Cells

Hollis Viray , BS; Kevin Li ; Thomas A. Long , MPH; Patricia Vasalos , BS; Julia A. Bridge , MD; Lawrence J. Jennings , MD; Kevin C.Halling , MD; Meera Hameed , MD; David L. Rimm , MD, PhD

From the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Viray, Mr Li, Dr Rimm); the Biostatistics (Mr Long) and Surveys (Ms Vasalos) Departments, College of American Pathologists, Northfield, Illinois; the Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha (Dr Bridge); the Department of Pathology & Laboratory Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Jennings); the Department of Pathology, Mayo Clinic, Rochester, Minnesota (Dr Halling); and the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Hameed).

Context.—The fraction of malignant cells in tumor tissue submitted for tests of genetic alterations is a critical variable in testing accuracy. That fraction is currently determined by pathologist visual estimation of the percentage of malignant cells. Inaccuracy could lead to a false-negative test result.

Objective.—To describe a prospective, multi-institutional study to determine pathologist estimation accuracy.

Design.—Ten ×20 magnification images of hematoxylin-eosin–stained colon tissue specimens were sent as an educational component of the College of American Pathologists KRAS-B 2011 Survey. Data from 194 labs were analyzed and compared to a criterion standard with comprehensive manual nuclear counts.

Results.—Survey responses indicated low interlaboratory precision of pathologist estimation, but mean estimates were fairly accurate. A total of 5 of the 10 cases assessed showed more than 10% of respondents overestimating in a manner that could lead to false-negative test results.

Conclusions.—The significance of estimation errors resulting in molecular testing failures with implications for patient care is unknown, but the current study suggests false-negative test results may occur.

Timothy Craig Allen (2013) US Food and Drug Administration–Approved Laboratory Tests After Caronia. Archives of Pathology & Laboratory Medicine: November 2013, Vol. 137, No. 11, pp. 1543-1544.

EDITORIALS

US Food and Drug Administration–Approved Laboratory Tests After Caronia

Timothy Craig Allen , MD, JD
"Caronia changed the paradigm, freeing drug vendors to speak openly, with First Amendment protection, about FDA-approved and FDA-nonapproved (“off-label”) uses for drugs and medical devices. The success of “companion tests” has depended on the pre-Caronia environment allowing the FDA to restrict speech about alternative, off-label tests; however, now that Caronia allows truthful, nonmisleading speech about these other tests, the marketing appeal of the companion test may rapidly wane. Taken in full, the holding could eliminate the newly minted companion test entirely, by eliminating the FDA-produced monopoly incentives that come with a test being labeled a companion test."

From Diane Davey: " Past practices of maintaining board remembrance files or distributing any recalled test items either electronically or through copied documents are unacceptable and this type of behavior needs to cease."

Diane Davis Davey (2013) Recalled Items and the American Board of Pathology Certification Examinations: What Constitutes Cheating?. Archives of Pathology & Laboratory Medicine: November 2013, Vol. 137, No. 11, pp. 1540-1542.

EDITORIALS

Recalled Items and the American Board of Pathology Certification Examinations: What Constitutes Cheating?

Diane Davis Davey , MD

From the College of Medicine, University of Central Florida, Orlando, and the VA Medical Center, Orlando, Florida.

"The pathology profession needs to take a proactive position and agree that cheating will not be tolerated. Our image as a profession devoted to quality patient care depends on maintaining the trust of the public and other health care providers that we are competent and professional. Residency training programs and peer residents provide valuable didactics, training, and experiences that should prepare candidates to successfully pass the ABP examinations. Past practices of maintaining board remembrance files or distributing any recalled test items either electronically or through copied documents are unacceptable and this type of behavior needs to cease."

From Andy Renshaw and Edwin Gould: Should “Indeterminate” Diagnoses Be Used for Thyroid Fine-Needle Aspirates of Nodules Smaller Than 1 cm?

Andrew A. Renshaw and Edwin W. Gould (2013) Should “Indeterminate” Diagnoses Be Used for Thyroid Fine-Needle Aspirates of Nodules Smaller Than 1 cm?. Archives of Pathology & Laboratory Medicine: November 2013, Vol. 137, No. 11, pp. 1627-1629.

ORIGINAL ARTICLES

Should “Indeterminate” Diagnoses Be Used for Thyroid Fine-Needle Aspirates of Nodules Smaller Than 1 cm?

Andrew A. Renshaw , MD; Edwin W. Gould , MD

From the Department of Pathology, Baptist Hospital of Miami, Miami, Florida.

Context.—The Bethesda System for thyroid fine-needle aspirates does not account for the size of the lesion that is aspirated.

Objective.—To determine whether the size of the lesion would be helpful in order to reduce indeterminate thyroid aspirations.

Design.—We correlated the results of all thyroid aspirations and surgical resection for the last 16 years at our institutions.

Results.—A total of 9080 cases were aspirated and 1393 resections were performed. Of those resected, a total of 236 (17%) were classified as atypical follicular cells of undetermined significance, and 256 (18%) were classified as suspicious for a follicular/Hürthle cell neoplasm. A total of 52 incidental papillary carcinomas were identified in these indeterminate cases at resection (52 of 492; 11%). Thirty-seven (16%) atypical follicular cells of undetermined significance cases and 21 (8%) suspicious for a follicular/Hürthle cell neoplasm cases were for nodules smaller than 1 cm in diameter. When cases subtyped as atypical, a papillary carcinoma cannot be ruled out, were removed (13 cases), the remaining 24 and 21 aspirates identified 3 tumors each (13% and 14%), all papillary carcinomas. Together, the incidence of identified carcinomas was not significantly different than that of incidental carcinomas (13% versus 11%, P = .48). The rate of identified carcinomas was significantly less than for similar indeterminate cases smaller than 1 cm (excluding cases of atypical, papillary carcinoma cannot be ruled out) (88 of 330 cases; 27%; P = .05).

Conclusions.—For nodules smaller than 1 cm in our series, indeterminate aspirates without features of papillary carcinomas have the same risk of malignancy as benign aspirates.

Am J Physiol Heart Circ Physiol. 2013 Oct 25. [Epub ahead of print]

Pathogenesis of Pulmonary Hypertension:A Case for Caveolin-1 and Cell Membrane Integrity.

Mathew R.

Source

1Munger Pavilion.

Abstract

Pulmonary hypertension (PH) is a progressive disease with a high morbidity and mortality rate. Despite important advances in the field, the precise mechanism/s leading to PH is not yet understood. Main features of PH are loss of vasodilatory response, the activation of proliferative and antiapoptotic pathways leading to pulmonary vascular remodeling and obstruction, elevated pressure and right ventricular (RV) hypertrophy; resulting in RV failure and death. Experimental studies suggest that endothelial dysfunction may be the key underlying feature in PH. Caveolin-1, a major protein constituent of caveolae interacts with several signaling molecules including the ones implicated in PH, and modulates them. Disruption and progressive loss of endothelial caveolin-1 with reciprocal activation of proliferative pathways occur before the onset of PH, and the rescue of caveolin-1 inhibits proliferative pathways and attenuates PH. Extensive endothelial damage/loss occurs during the progression of the disease with subsequent enhanced expression of caveolin-1 in smooth muscle cells (SMC). This caveolin-1 in SMC switches from being an anti-proliferative factor to a pro-proliferative one, participating in cell proliferation, cell migration, and possibly leading to irreversible PH. In contrast, the disruption of endothelial caveolin-1 is not observed in the hypoxia-induced PH, a reversible form of PH. However, proliferative pathways are activated in this model, indicating caveolin-1 dysfunction. Thus, disruption or dysfunction of endothelial caveolin-1 leads to PH, and the status of caveolin-1 may determine the reversibility vs irreversibility of PH. This article reviews the role of caveolin-1 and cell membrane integrity in the pathogenesis and progression of PH.

Pediatrics. 2013 Oct 28. [Epub ahead of print]

Pediatric Palliative Care and Hospice Care Commitments, Guidelines, and Recommendations.

SECTION ON HOSPICE AND PALLIATIVE MEDICINE AND COMMITTEE ON HOSPITAL CARE.

Abstract

Pediatric palliative care and pediatric hospice care (PPC-PHC) are often essential aspects of medical care for patients who have life-threatening conditions or need end-of-life care. PPC-PHC aims to relieve suffering, improve quality of life, facilitate informed decision-making, and assist in care coordination between clinicians and across sites of care. Core commitments of PPC-PHC include being patient centered and family engaged; respecting and partnering with patients and families; pursuing care that is high quality, readily accessible, and equitable; providing care across the age spectrum and life span, integrated into the continuum of care; ensuring that all clinicians can provide basic palliative care and consult PPC-PHC specialists in a timely manner; and improving care through research and quality improvement efforts. PPC-PHC guidelines and recommendations include ensuring that all large health care organizations serving children with life-threatening conditions have dedicated interdisciplinary PPC-PHC teams, which should develop collaborative relationships between hospital- and community-based teams; that PPC-PHC be provided as integrated multimodal care and practiced as a cornerstone of patient safety and quality for patients with life-threatening conditions; that PPC-PHC teams should facilitate clear, compassionate, and forthright discussions about medical issues and the goals of care and support families, siblings, and health care staff; that PPC-PHC be part of all pediatric education and training curricula, be an active area of research and quality improvement, and exemplify the highest ethical standards; and that PPC-PHC services be supported by financial and regulatory arrangements to ensure access to high-quality PPC-PHC by all patients with life-threatening and life-shortening diseases.

Appreciate social norms? Thank your right lateral prefrontal cortex

Brain Stimulation Sparks 'Machiavellian' Choices

1. Elizabeth Culotta

The study establishes a specific brain region, the right lateral prefrontal cortex (rLPFC), as a crucial nerve center for fairness, researchers say. It "provides a full leap forward in understanding where and how in the brain we attend to possible punishments as we contemplate our next moves," says Owen D. Jones of Vanderbilt University in Nashville, an expert in law and neuroscience.

..........................................

"We're a species who rose to prominence because of our ultrasociality," Jones agrees. "That would have been flatly unachievable, were it not for evolved brain mechanisms enabling us to create, attend to, and enforce social norms."

From Durham U-UK: The evolutionary psychology of women's aggression

Philos Trans R Soc Lond B Biol Sci. 2013 Oct 28;368(1631):20130078. doi: 10.1098/rstb.2013.0078. Print 2013.

The evolutionary psychology of women's aggression.

Campbell A.

Source

Department of Psychology, Science Laboratories, Durham University, , Durham DH1 3LE, UK.

Abstract

Evolutionary researchers have identified age, operational sex ratio and high variance in male resources as factors that intensify female competition. These are discussed in relation to escalated intrasexual competition for men and their resources between young women in deprived neighbourhoods. For these women, fighting is not seen as antithetical to cultural conceptions of femininity, and female weakness is disparaged. Nonetheless, even where competitive pressures are high, young women's aggression is less injurious and frequent than young men's. From an evolutionary perspective, I argue that the intensity of female aggression is constrained by the greater centrality of mothers, rather than fathers, to offspring survival. This selection pressure is realized psychologically through a lower threshold for fear among women. Neuropsychological evidence is not yet conclusive but suggests that women show heightened amygdala reactivity to threatening stimuli, may be better able to exert prefrontal cortical control over emotional behaviour and may consciously register fear more strongly via anterior cingulate activity. The impact of testosterone and oxytocin on the neural circuitry of emotion is also considered.

Psychiatr Danub. 2013 Sep;25 Suppl 2:109-12.

Preventing toxicomania and addictive behaviour in adolescence.

Manceaux P, Maricq A, Zdanowicz N, Reynaert C.

Source

Université Catholique de Louvain, 1200 Brussel, Belgium, pmanceaux@hotmail.fr.

Abstract

OBJECTIVES:

Drug addicts are more and more stigmatized in our society. Recent data show a connection between substance abuse and other behaviors considered normal, such as passionate love. Adolescence is characterized by a biopsychosocial, cognitive and neurodevelopmental immaturity. This article aims to understand if these subjects are more likely to develop addictions to certain products or addictive behaviors such as passionate love. It also offers a better understanding of the current models for prevention of substance abuse during adolescence.

METHODS:

After defining the roles played, in the brain, by dopamine and by the reward circuit, as well as the different stages of development of the human brain, we compared neurobiological data and imaging studies both in cases of passionate love and substance addiction during adolescence.

RESULTS:

The brain imaging studies highlight the role of the prefrontal cortex in the cognitive and behavioral aspects of the addictive phenomenon. Now, the maturation of the prefrontal cortex occurs during adolescence, as do significant peaks in the expression of dopamine. These studies also suggest an increase in cortical activation (nucleus accumbens and amygdala) when processing emotional information, which is also increased during adolescence.

CONCLUSION:

Taken together, the results show a parallel between addiction and love relations, both at the level of neuroscience and imaging. A greater emotional lability and sensitivity may play a role in the higher incidence of substance abuse and dependence in love observed at this age. Preventing the use of illegal substances among young people therefore requires a very specific approach.

Pediatr Pulmonol. 2013 Oct 25. doi: 10.1002/ppul.22933. [Epub ahead of print]

Uncertain diagnosis after newborn screening for cystic fibrosis: An ethics-based approach to a clinical dilemma.

Massie J, Gillam L.

Source

Department of Respiratory Medicine, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Children's Bioethics Centre, Royal Children's Hospital, Parkville, Victoria, Australia.

Abstract

There is uncertainty about the diagnosis of cystic fibrosis after newborn screening (NBS) for some babies, either because of an intermediate sweat chloride test or inconclusive gene mutation analysis. There is considerable difficulty knowing how best to manage these babies, some of whom will develop cystic fibrosis, but many not. This article offers an ethics-based approach to this clinical dilemma that should be helpful to clinicians managing the baby with an uncertain diagnosis of cystic fibrosis after NBS.