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Objectives. To examine drug overdoses in Colombia by type of substance, sex, age, and intent using data from a health surveillance system from 2010 to 2021. Methods. We characterized data by year, type of substance, and sociodemographic variables. We calculated age-adjusted overdose rates by substance type, sex, age groups, and intent. We used Poisson regression models to examine trend differences across sex and age groups. Results. Age-adjusted rates of drug overdoses increased from 8.51 to 40.52 per 100 000 during 2010 to 2021. Men, compared with women, had higher overdose rates for every substance, except for opioids and psychotropics. Drug overdose rates involving cannabis and stimulants increased steadily until 2017 but decreased afterward. Overdose rates involving psychotropic medication increased greatly during 2018 to 2021, mainly because of intentional overdoses in young women. Conclusions. Overdoses involving illegal drugs decreased in recent years in Colombia; however, the continuous increase in intentional psychotropic overdose rates highlights the need for prevention efforts to curb this trend. Health surveillance systems are an important tool that can guide overdose prevention efforts in countries with limited data resources. (Am J Public Health. 2024;114(11):1252–1260. https://doi.org/10.2105/AJPH.2024.307786) [ABSTRACT FROM AUTHOR]

Background and objectives: Visits by youth to the emergency department (ED) with mental and behavioral health (MBH) conditions are increasing, yet use of psychotropic medications during visits has not been well described. We aimed to assess changes in psychotropic medication use over time, overall and by medication category, and variation in medication administration across hospitals. Methods: We conducted a retrospective cross-sectional study of ED encounters by youth aged 3-21 with MBH diagnoses using the Pediatric Health Information System, 2013-2022. Medication categories included psychotherapeutics, stimulants, anticonvulsants, antihistamines, antihypertensives, and other. We constructed regression models to examine trends in use over time, overall and by medication category, and variation by hospital. Results: Of 670 911 ED encounters by youth with a MBH diagnosis, 12.3% had psychotropic medication administered. The percentage of MBH encounters with psychotropic medication administered increased from 7.9% to16.3% from 2013-2022 with the odds of administration increasing each year (odds ratio, 1.09; 95% confidence interval, 1.05-1.13). Use of all medication categories except for antianxiety medications increased significantly over time. The proportion of encounters with psychotropic medication administered ranged from 4.2%-23.1% across hospitals (P < .001). The number of psychotropic medications administered significantly varied from 81 to 792 medications per 1000 MBH encounters across hospitals (P < .001). Conclusions: Administration of psychotropic medications during MBH ED encounters is increasing over time and varies across hospitals. Inconsistent practice patterns indicate that opportunities are available to standardize ED management of pediatric MBH conditions to enhance quality of care. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nursing / Pielegniarstwo Polskie is the property of Poznan University of Medical Sciences Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent widely publicized shortages in the U.S. supply of first-line medications for treatment of attention-deficit/hyperactivity disorder (ADHD) are thought to reflect increases in public awareness, help seeking, and treatment. ADHD is one of the most common neurodevelopmental disorders and is typically identified in childhood. In adulthood, ADHD symptoms are less likely to include hyperactivity, but inattention, impulsivity, and emotional dysregulation are common. Clinical evaluation of symptomatic adults who were not diagnosed as children requires corroboration of ADHD diagnostic symptoms in childhood and careful differentiation of ADHD from frequently co-occurring psychiatric and substance use disorders. Treatment of adult ADHD can result in improved functioning across multiple dimensions and comorbid disorders. Existing guidelines and consensus statements recommend an integrated approach to treating ADHD and all existing comorbid disorders, prioritizing the disorder that is creating the most difficulty for the individual. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 8–11.] [ABSTRACT FROM AUTHOR]

Purpose: To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV). Methods: Population‐based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February 2020 and June 2022. A composite substance use variable included 9 categories: "no substance use," "opioids," "cannabis," "sedatives/hypnotics," "stimulants," "opioids and cannabis," "opioids and stimulants," "cannabis and stimulants," and "opioids, cannabis, and stimulants." These data were gathered through self‐report, medical records, and/or positive drug screen at labor and delivery. Findings: 12.4% of women used one or more substances (opioids, cannabis, stimulants, and sedatives/hypnotics) during their current pregnancy. The mean age of women using cannabis was 25.34 (SD = 5.31), stimulants was 28.88 (SD = 5.62), and opioid was 30.19 (SD = 4.78). White women were more likely to use opioids (aOR = 2.19, 95% CI 1.46, 3.28) and less likely to use cannabis (aOR = 0.39, 95% CI 0.34, 0.44) compared to minority racial groups. Women with cannabis use were more likely to live in urban versus rural regions (aOR = 1.47, 95% CI 1.33, 1.62). The odds of using any type of substance(s) were significantly higher in women who smoked (aOR range 4.17‐30.85), had Medicaid (aOR range 1.52‐7.65), and those receiving inadequate prenatal care (aOR range 1.96‐16.83). Conclusions: In this rural Appalachian state, 1 in 8 women used 1 or more substances (opioids, cannabis, stimulants, and/or sedatives/hypnotics) during pregnancy and the type of substance used varied by sociodemographic and health‐related factors. These factors should inform state‐level strategies and initiatives to address the substance use crisis for this population. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the impact of pre-injury stimulant use (amphetamine, cocaine, methamphetamine and/or ecstasy) on outcomes after isolated severe traumatic brain injury (TBI). Methods: Retrospective 2017 TQIP study, including adult trauma patients (≥16 years old) who underwent drug and alcohol screening on admission and sustained an isolated severe TBI (head AIS ≥3). Patients with significant extracranial trauma (AIS ≥3) were excluded. Epidemiological and clinical characteristics, procedures and outcome variables were collected. Patients with isolated stimulant use were matched 1:1 for age, gender, mechanism of injury, head AIS and overall comorbidities, with patients with negative toxicology and alcohol screen. Outcomes in the two groups were compared with univariable and multivariable regression analysis. Results: 681 patients with isolated TBI and stimulant use were matched with 681 patients with negative toxicology and alcohol screen. The incidence of hypotension and CGS <9 was similar in the two groups. In multivariable regression analysis, stimulant use was not independently associated with mortality (OR 0.95, 95% CI 0.61–1.49). However, stimulant use was associated with longer hospital length of stay (HLOS) (RC 1.13, 95%CI 1.03–1.24). Conclusion: Pre-injury stimulant use is common in patients admitted for severe TBI, but was not independently associated with mortality when compared to patients with negative toxicology. However, stimulant use was associated with a significant longer HLOS. [ABSTRACT FROM AUTHOR]

Introduction: Complex regional pain syndrome (CRPS) is characterized by nociplastic pain with alterations in sympathetic function. Neuromodulation could be a useful alternative therapy option. Dorsal root ganglion (DRG) stimulation has demonstrated better results than conventional spinal cord stimulation (SCS) for patients with CRPS in lower limbs. Methods: We report a case series of seven patients treated with cervical DRG stimulation for CRPS of the hand that required neuromodulation for pain relief, after no response with other analgesic techniques (medication and interventional). We report retrospective data collection of seven consecutive patients with a 1‐year follow‐up. Results: Seven patients were trialed, and six were implanted with a permanent pulse generator after achieving more than 50% pain relief during 2–7 days of trial phase. The average pain relief (rated on a standard 100 mm visual analog scale) after 1 year of treatment was 64.3% ± 16.6. No major complications were observed during a 1‐year follow‐up. Discussion: The results for cervical DRG stimulation are similar to other DRG stimulation studies for the treatment of refractory CRPS at lower levels. The cervical DRG implant technique guided with C‐arm fluoroscopy and under conscious sedation could be a safe and effective option for relieving pain of the upper limbs CRPS. Monitoring neural status is required for cervical DRG stimulation either with a responder awake patient or with intraoperative neural monitoring in non‐responder patients. [ABSTRACT FROM AUTHOR]

Objectives: To monitor stimulant-involved overdose (SOD) trends, the Centers for Disease Control and Prevention (CDC) developed and evaluated the validity of a syndromic surveillance definition for suspected nonfatal, unintentional/undetermined intent stimulant-involved overdose (UUSOD). Methods: We analyzed all emergency department (ED) visits in CDC's surveillance system that met the UUSOD syndrome definition (January 2018–December 2019). We classified visits as true positive, possible, or not UUSODs after reviewing diagnosis codes and chief complaints. We first assessed whether visits were acute SODs, subsequently classifying acute SODs by intent. The percentage of true-positive UUSODs did not include intentional or possibly intentional visits. We considered all visits with UUSOD diagnosis codes to be acute SODs and reviewed them for intent. We manually reviewed and double-coded a 10% random sample of visits without UUSOD diagnosis codes using decision rules based on signs and symptoms. The overall percentage of true-positive UUSODs was a weighted average of the percentage of true-positive UUSODs based on diagnosis codes and the percentage of true-positive UUSODs determined by manually reviewing visits without codes. Results: During 2018-2019, 40 045 ED visits met the syndrome definition for UUSOD. Approximately half (n = 18 793; 46.9%) of 40 045 visits had UUSOD diagnosis codes, indicating acute SOD; of these, 98.6% (n = 18 534) were true-positive UUSODs. Of 2125 manually reviewed visits without UUSOD diagnosis codes, 32.6% (n = 693) were true-positive UUSODs, 54.2% (n = 1151) were possible UUSODs, and 13.2% (n = 281) were not UUSODs. Overall, 63.6% of visits were true-positive UUSODs, 29.3% were possible UUSODs, and 7.1% were not UUSODs. Practice Implications: CDC's UUSOD definition may assist in surveillance efforts with further refinement to capture data on SOD clusters and trends. [ABSTRACT FROM AUTHOR]

The Monitoring the Future (MTF) study released in August by the National Institute on Drug Abuse (NIDA) found that marijuana use has reached historic highs among young adults ages 19 to 30 years old, with 29% using marijuana in the past 30 days, and 43% using it in the past year; 10.8% used it on a daily or near daily basis (more than 20 days in the past 30 days). The study uses self‐reports; most recent data is from 2021. [ABSTRACT FROM AUTHOR]

Medication-assisted treatment can reduce mortality and withdrawal symptoms, yet treatments can have side effects and are cost ineffective. Research has supported alternative approaches to withdrawal symptoms, specifically percutaneous nerve field stimulator (PNFS); yet, to date, there is a lack of understanding of the initial acceptability within treatment programs. A retrospective case series evaluated PNFS to reduce opioid withdrawal symptoms for five adult patients participating in an in-home withdrawal management program. The device was worn for five consecutive days, in which a licensed practical nurses monitored their care. Evaluation included the clinical opiate withdrawal scale (COWS) and clinical reviews based on self-report and clinician interview. Significant reductions were noted for all five participants, with the average COWS score for Day 1 at 19.1 reducing to 2.6 at Day 5. In addition, 2-day post-COWS scores demonstrated a continual reduction to 1.4. Qualitative feedback from the patients was recorded, and generalized themes were recorded and addressed. Future controlled, prospective studies should investigate the possibility that PNFS can significantly reduce negative symptoms of opiate withdrawal symptoms, along with providing alternatives to medication-assisted treatments for those who are suffering from opiate use disorder. [ABSTRACT FROM AUTHOR]

Background: Substance use is a significant health crisis for the Veteran population. Prior research has thoroughly examined Veteran substance use within Veterans Health Administration (VHA) settings. However, such data tends to be outdated, and there is minimal research on substance use services delivered outside of VHA systems. This study examines historical patterns of Veteran substance use using a large sample of community-based substance-use treatment admissions. Methods: Data were drawn from the Substance Abuse and Mental Health Data Archive Treatment Episode Data Set-Admissions. Of the 39,425,886 total admissions between 2000 and 2019, 1,361,339 were of Veterans. Analyses compared Veteran versus non-Veteran admissions on demographics and historical trends in nature of substance-use admissions. Results: Relative to non-Veterans, Veteran admissions were more likely to be prompted by alcohol use. Over time, heterogeneity in substances prompting admissions has increased dramatically for both Veterans and non-Veterans, with particularly notable increases in opiate and stimulant use. Conclusion: Results suggest Veterans admitted to community substance-use treatment are unique relative to their non-Veteran peers. Development and implementation of treatments to target a range of substances while also considering the environmental challenges (e.g., homelessness) commonly faced by this population appear essential to best servicing community-based Veterans. [ABSTRACT FROM AUTHOR]

Background: Compared to heterosexual adults, lesbian, gay, and bisexual (LGB) adults have higher rates of any illicit drug use and any prescription drug misuse, yet disparities regarding specific drugs remain poorly characterized. Methods: We examined disparities by sexual identity and sex for 8 illicit and prescription drugs using 2015-2019 National Survey on Drug Use and Health data. Outcomes included past-year use/misuse of cocaine/crack, hallucinogens, inhalants, methamphetamine, heroin, prescription opioids, prescription stimulants, prescription tranquilizers/sedatives, and level of polydrug use/misuse (2 substances; 3+ substances). For each outcome, odds ratios relative to heterosexual adults of same sex were estimated using logistic regression controlling for demographics; significant estimates were interpreted as a disparity. Results: Among gay men, significant disparities were present for all drugs except prescription stimulants and heroin; inhalant use was particularly elevated. Bisexual women exhibited significant disparities for every drug examined, as did bisexual men (except heroin). Among lesbian/gay women, disparities were only present for prescription opioids and stimulants. Relative to heterosexual peers, use of 3+ substances was 3 times higher among gay men and bisexual women and 2 times higher among bisexual men. Conclusions: Consistent with minority stress theory, prevalences of illicit and prescription drug use/misuse were 2-3 times higher among LGB adults than heterosexual adults. Illicit drug use should not be perceived as only impacting gay/bisexual men – bisexual women had similar – or higher – prevalences of hallucinogen, cocaine, methamphetamine, and heroin use. Yet, in contrast to bisexual women, lesbian/gay women did not exhibit disparities for any illicit drugs. [ABSTRACT FROM AUTHOR]

Introduction: Given the general lack of literature on opioid and naloxone prescribing guidelines for patients with substance use disorder, we aimed to explore how a physician’s behavior and prescribing habits are altered by knowledge of the patient’s concomitant use of psychotropic compounds as evident on urine and serum toxicology screens. Methods: We conducted a retrospective chart review study at a tertiary, academic, Level I trauma center between November 2017–October 2018 that included 358 patients who were discharged from the emergency department (ED) with a diagnosis of fracture, dislocation, or amputation and received an opioid prescription upon discharge. We extracted urine and serum toxicology results, number and amount of prescription opioids upon discharge, and the presence of a naloxone script. Results: The study population was divided into five subgroups that included the following: negative urine and serum toxicology screen; depressants; stimulants; mixed; and no toxicology screens. When comparing the 103 patients in which toxicology screens were obtained to the 255 patients without toxicology screens, we found no statistically significant differences in the total prescribed morphine milligram equivalent (75.0 and 75.0, respectively) or in the number of pills prescribed (15.0 and 13.5, respectively). Notably, none of the 103 patients who had toxicology screens were prescribed naloxone upon discharge. Conclusion: Our study found no association between positive urine toxicology results for psychotropically active substances and the rates of opioid prescribing within a single-center, academic ED. Notably, none of the 103 patients who had toxicology screens were prescribed naloxone upon discharge. More research on the associations between illicit drug use, opioids, and naloxone prescriptions is necessary to help establish guidelines for high-risk patients. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of stimulant medication misuse is rising in college students. Motivations to use stimulant medications differ from motivation to use other substances such as alcohol or cannabis. However, no previous research has examined the impact of achievement goal orientation on stimulant misuse in college students. Participants: 309 college students (mean age = 18.9; 117 males) without an ADHD diagnosis were invited to participate. Methods: Participants completed an online research questionnaire that assessed factors associated with stimulant medication misuse as well as achievement goal orientations (Learning and Performance Orientations). Results: Approximately 12% endorsed a history of stimulant misuse within the past year. More males (17.1%) than females (9.4%) reported stimulant misuse. Those with and without a history of stimulant misuse differed on Performance Orientation (misuse > no misuse) yet were comparable on Learning Orientation. Conclusions: Having a higher Performance Orientation independently predicted stimulant misuse. [ABSTRACT FROM AUTHOR]

Aims: To understand the role of comorbid substance use disorders (SUDs), or polysubstance use, in the treatment of opioid use disorder (OUD), this study compared patients with OUD only to those with additional SUDs and examined association with OUD treatment receipt. Design, setting and participants: Retrospective national cohort study of Veterans diagnosed with OUD (n = 65 741) receiving care from the US Veterans Health Administration (VHA) in fiscal year (FY) 2017. Measurements: Patient characteristics were compared among those diagnosed with OUD only versus those with one other SUD (OUD + 1 SUD) and with multiple SUDs (OUD + ≥ 2 SUDs). The study examined the relationship between comorbid SUDs and receipt of buprenorphine, methadone and SUD outpatient treatment during 1‐year follow‐up, adjusting for patient demographic characteristics and clinical conditions. Findings Among the 65 741 Veterans with OUD in FY 2017, 41.2% had OUD only, 22.9% had OUD + 1 SUD and 35.9% had OUD + ≥ 2 SUDs. Common comorbid SUDs included alcohol use disorder (41.3%), cocaine/stimulant use disorder (30.0%) and cannabis use disorder (22.4%). Adjusting for patient characteristics, patients with OUD + 1 SUD [adjusted odds ratio (aOR) = 0.87, 95% confidence interval (CI) = 0.82–0.93] and patients with OUD +≥ 2 SUDs (aOR = 0.65, 95% CI = 0.61–0.69) had lower odds of receiving buprenorphine compared with OUD only patients. There were also lower odds of receiving methadone for patients with OUD + 1 SUD (aOR = 0.91, 95% CI = 0.86–0.97)and for those with OUD + ≥2 SUDs (aOR = 0.79, 95% CI = 0.74–0.84). Patients with OUD + 1 SUD (aOR = 1.85, 95% CI = 1.77–1.93) and patients with OUD + ≥2 SUDs (aOR = 3.25, 95% CI = 3.103.41) were much more likely to have a SUD clinic visit. Conclusions: The majority of Veterans in the US Veterans Health Administration diagnosed with opioid use disorder appeared to have at least one comorbid substance use disorder and many have multiple substance use disorders. Despite the higher likelihood of a substance use disorder clinic visit, having a non‐opioid substance use disorder is associated with lower likelihood of buprenorphine treatment, suggesting the importance of addressing polysubstance use within efforts to expand treatment for opioid use disorder. [ABSTRACT FROM AUTHOR]

The article comments on several abstracts and citations of research papers. Topics include the hypothesis that statistically defined subgroups of migraine, migraine and vasovagal syncope that are comorbid conditions, evaluation of the epidemiological and clinical characteristics of pediatric patients with orthostatic intolerance (OI) and positive head-up tilt test (HUTT).

Medial ganglionic eminence (MGE)-derived somatostatin (SST)+ and parvalbumin (PV)+ cortical interneurons (CINs), have characteristic molecular, anatomical and physiological properties. However, mechanisms regulating their diversity remain poorly understood. Here, we show that conditional loss of the Tuberous Sclerosis Complex (TSC) gene, Tsc1, which inhibits the mammalian target of rapamycin (MTOR), causes a subset of SST+ CINs, to express PV and adopt fast-spiking (FS) properties, characteristic of PV+ CINs. Milder intermediate phenotypes also occur when only one allele of Tsc1 is deleted. Notably, treatment of adult mice with rapamycin, which inhibits MTOR, reverses the phenotypes. These data reveal novel functions of MTOR signaling in regulating PV expression and FS properties, which may contribute to TSC neuropsychiatric symptoms. Moreover, they suggest that CINs can exhibit properties intermediate between those classically associated with PV+ or SST+ CINs, which may be dynamically regulated by the MTOR signaling. Although cortical GABAergic interneuron (CIN) dysfunction is implicated in several neuropsychiatric disorders, we still know very little about how they attain their unique properties or how their dysfunction impacts neuropsychiatric disorders. In this study, authors show that conditional loss of Tsc1, causes SST+ CINs, which are distinct from PV+ CINs, to express PV and adopt fast-spiking properties, via MTOR activity [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Pain is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers information about the classes of psychotropic drugs and their effect on cardiac function, cardiac screening and electrocardiography (ECG). Topics mentioned include the adverse cardiovascular effects of tricyclic antidepressants including hypertension and stroke, the usefulness of echocardiography in the diagnosis of clozapine-associated cardiotoxicity, and the use of corrected QT interval on ECG as a sign of torsades de pointes.

Abstract: A morphofunctional investigation of the different neuronal subpopulations projecting through each of the nerves IV–VI emerging bilaterally from the terminal abdominal ganglion (TAG) was correlated with the octopaminergic activity in the ganglion that controls the ovipositor movements associated with calling behavior in the female gypsy moth Lymantria dispar. Tetramethylrodamine‐dextran backfills from nerve stumps resulted in a relatively low number of TAG projections, ranging from 12 to 13 for nerve pair IV, 12 to 14 for nerve pair V, and 8 to 9 for nerve pair VI. Furthermore, as assessed by electrophysiological recordings, a number of fibers within each of these nerves displays spontaneous tonic activity, also when the ganglion is fully disconnected from the ventral nerve cord (VNC). Octopamine (OA) applications to the TAG strongly enhanced the activity of these nerves, either by increasing the firing rate of a number of spontaneously firing units or by recruiting new ones. This octopaminergic activity affected calling behavior, and specifically the muscle activity leading to cycling extensions of the intersegmental membrane (IM) between segments VIII and IX (ovipositor). Our results indicate that in the female gypsy moth the octopaminergic neural activity of the TAG is coupled with extensions and retractions of IM for the purpose of releasing pheromone, where motor units innervated by nerve pair IV appear antagonistic with respect to those innervated by nerve pair V. [ABSTRACT FROM AUTHOR]

Gastric vagal afferents play an important role in the peripheral control of food intake. Apelin, a central appetite regulating hormone, is also abundantly released from the stomach. Whether apelin modulates gastric vagal afferent signalling is unknown. We aimed to determine whether apelin modulates gastric vagal afferent signalling under different states of nutrition. Female C57BL/6 mice were fed either a standard laboratory diet (SLD) or a high fat diet (HFD) for 12 weeks. An in vitro gastric vagal afferent preparation was used to determine the effect of apelin on gastric vagal afferent mechanosensitivity in SLD mice, fed ad libitum or fasted overnight, and HFD mice. To determine the signalling pathway of apelin via gastric vagal afferents, we determined the expression of apelin receptor (APJ receptor) in the gastric mucosa, the whole nodose ganglion and in gastric vagal afferent neurons innervating the stomach using retrograde tracing and real-time quantitative reverse-transcription polymerase chain reaction (qRT-PCR). The location of apelin and APJ receptor within the gastric mucosa was determined by immunohistochemistry. Expression of apelin and APJ receptor mRNA in gastric mucosa was determined using qRT-PCR. Apelin inhibited the response of gastric mucosal vagal afferents to mucosal stroking in fasted SLD mice, but not in mice fed ad libitum a SLD or HFD. Apelin inhibited the response of gastric tension sensitive afferents to circular stretch in SLD mice fed ad libitum or fasted, an effect not observed in HFD mice. APJ receptor mRNA was detected in the gastric mucosa and whole nodose ganglion, but not specifically in gastric vagal afferents neurons. In the gastric mucosa, APJ receptor immunoreactive cells were co-localised or closely associated with apelin containing cells and co-localised with serotonin, gastrin, histamine and gastric intrinsic factor containing cells. In conclusion, apelin modulates gastric vagal afferent signalling in a nutritional status dependent manner. Further, apelin modulates gastric vagal afferents through an indirect pathway, possibly through the release of hormones/peptides from the gastric mucosa. [ABSTRACT FROM AUTHOR]

Objective: To develop a treatment for tinnitus called xenon phototherapy of the stellate ganglion (XPSG) and analyze its effect on tinnitus. Methods: Patients with chronic tinnitus received XPSG. Symptoms were assessed subjectively with tinnitus handicap inventory (THI) and numerical rating scale (NRS). THI and NRS scores were analyzed in XPSG (n = 43) and sham treatment (non-XPSG) (n = 18) groups. Results: THI and NRS scores improved significantly after 3 months of XPSG. Severe cases with high THI or NRS score showed greater improvement. No significant difference was observed between before and after sham treatment in non-XPSG groups. Conclusions: XPSG significantly improved THI and NRS scores with high patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: The NRG1/ErbB4 signaling mechanism has been widely studied in the central nervous system for many years. However, the role of this pathway in modulating the intrinsic cardiac nervous system is largely unknown. Objective: The present study investigated whether the NRG1/ErbB4 signaling system affects the activity of major atrial ganglionated plexi (GP) in a paroxysmal atrial fibrillation (AF) model by 6-h rapid atrial pacing (RAP). Methods: Twenty-four dogs were randomly divided into (1) a control group (saline microinjections into GP), (2) RAP group (saline microinjections into GP plus 6 h-RAP), (3) NRG1 group (microinjections of neuregulin-1 into GP plus 6 h-RAP) and (4) NRG1 + ERA group (microinjections of neuregulin-1 and ErbB4 receptor antagonist-ERA into GP plus 6 h-RAP). The effective refractory period (ERP), window of vulnerability (WOV), anterior right GP (ARGP) function and neural activity were measured. ARGP tissues were excised for histological study and western blotting. Results: When compared to the control group, 6 h-RAP produced a significant (1) decrease in ERP, an increase in ΣWOV, (2) an increase in ARGP neural activity and neural function, and (3) an increase in c-fos and nerve growth factor protein expression in the ARGP. However, microinjection of NRG1 into the ARGP prior to RAP prevented ERP shortening and AGRP activity enhancement and inhibited the expression of c-Fos and NGF proteins. Furthermore, these changes were significantly attenuated by pretreatment with an ErbB4 receptor antagonist. Conclusion: The NRG1/ErbB4 signaling pathway may exist in the GP, and activation of this pathway suppressed RAP-induced GP activation, atrial electrical remodeling and AF. [ABSTRACT FROM AUTHOR]

Background Studies have shown regional and functional selectivity of cardiac postganglionic neurones indicating there might exist a similar heterogeneity in spinal segmental preganglionic neurones, which requires further investigation. Methods Right and left sympathetic chains were electrically stimulated from T6 to T1 in the innervated isolated rabbit heart preparation ( n  = 18). Sinus rate, left ventricular pressure, retrograde ventriculo-atrial conduction, monophasic action potential duration, effective refractory period, ventricular fibrillation threshold and electrical restitution were measured. Results Right sympathetic stimulation had a greater influence on heart rate (T1-T2: right; 59.9 ± 6.0%, left; 41.1 ± 5.6% P  < 0.001) and left stimulation had greater effects on left ventricular pressure (T1-T2: right; 20.7 ± 3.2%, left; 40.3 ± 5.4%, P  < 0.01) and ventriculo-atrial conduction (T1-T2: right; −6.8 ± 1.1%, left; −15.5 ± 0.2%) at all levels, with greater effects at rostral levels (T1-T3). Left sympathetic stimulation caused shorter monophasic action potentials at the base (T4-T5: right; 119.3 ± 2.7 ms, left; 114.7 ± 2.5 ms. P  < 0.05) and apex (T4-T5: right; 118.8 ± 1.2 ms, left; 114.6 ± 2.6 ms. P  < 0.05), greater shortening of effective refractory period (T4-T5: right; −3.6 ± 1.3%, left; −7.7 ± 1.8%. P  < 0.05), a steeper maximum slope of restitution (T4-T5 base: right; 1.3 ± 0.2, left; 1.8 ± 0.2. P  < 0.01. T4-T5 apex: right; 1.0 ± 0.2, left; 1.6 ± 0.3. P  < 0.05) and a greater decrease in ventricular fibrillation threshold (T4-T5: right; −22.3 ± 6.8%, left;-39.0 ± 1.7%), with dominant effects at caudal levels (T4-T6). Conclusions The preganglionic sympathetic efferent axons show functionally distinct pathways to the heart. The caudal segments (T4-T6) of the left sympathetic chain had a greater potential for arrhythmia generation and hence could pose a target for more focused clinical treatments for impairments in cardiac function. [ABSTRACT FROM AUTHOR]

In vitro differentiation of human pluripotent stem cell into relevant cell types is a desirable model system that has the human biological context, is a renewable source, and is scalable. GABA interneurons and basal forebrain cholinergic neurons, derivates of the medial ganglionic eminence (MGE), are implicated in diverse neuropsychiatric diseases. Various protocols have been proposed to generate MGE progenitors: the embryoid body- (EB-) based rosette-derived (RD), the adherent (AdD), and the nonadherent (NAdD) approaches. While Wnt inhibition is frequently incorporated into the strategy, the timing varies between protocols and there is a lack of standardized outcome reporting, which precludes direct comparison. Here, we report a head-to-head comparison in three distinct experimental models to establish whether Wnt inhibition during neural stem cell, NSC (stage 1), or neural progenitor cell, NPC (stage 2), formation facilitates MGE differentiation. Wnt inhibition at both stages promotes MGE progenitor differentiation when compared to no inhibition. However, NSC (stage 1) Wnt inhibition markedly reduces the number of MGE progenitors available for downstream applications in the RD and the NAdD protocols due to early inhibition of proliferation. NPC (stage 2) Wnt inhibition in the adherent system is comparable to the EB-based methods offering a techically less challenging alternative. [ABSTRACT FROM AUTHOR]

Background and Purpose: TREK two-pore-domain potassium (K2P ) channels play a critical role in regulating the excitability of somatosensory nociceptive neurons and are important mediators of pain perception. An understanding of the roles of TREK channels in pain perception and, indeed, in other pathophysiological conditions, has been severely hampered by the lack of potent and/or selective activators and inhibitors. In this study, we describe a new, selective opener of TREK channels, GI-530159.Experimental Approach: The effect of GI-530159 on TREK channels was demonstrated using 86 Rb efflux assays, whole-cell and single-channel patch-clamp recordings from recombinant TREK channels. The expression of K2P 2.1 (TREK1), K2P 10.1 (TREK2) and K2P 4.1 (TRAAK) channels was determined using transcriptome analysis from single dorsal root ganglion (DRG) cells. Current-clamp recordings from cultured rat DRG neurons were used to measure the effect of GI-530159 on neuronal excitability.Key Results: For recombinant human TREK1 channels, GI-530159 had similar low EC50 values in Rb efflux experiments and electrophysiological recordings. It activated TREK2 channels, but it had no detectable action on TRAAK channels nor any significant effect on other K channels tested. Current-clamp recordings from cultured rat DRG neurones showed that application of GI-530159 at 1 μM resulted in a significant reduction in firing frequency and a small hyperpolarization of resting membrane potential.Conclusions and Implications: This study provides pharmacological evidence for the presence of mechanosensitive TREK K2P channels in sensory neurones and suggests that development of selective K2P channel openers like GI-530159 could aid in the development of novel analgesic agents.Linked Articles: This article is part of a themed section on Recent Advances in Targeting Ion Channels to Treat Chronic Pain. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc. [ABSTRACT FROM AUTHOR]

The article discusses oral pharmacologic agents for building new tissue and healing wounds, and oral medications that disrupt wound healing. Topics covered include four major anabolic hormones that can impact wound healing, the benefits of increased oral intake of nutrients and weight gain, menopausal hormone therapy, and oral medication for lower-extremity wounds. Also noted is the insufficient evidence of complementary approaches like nonvitamin, nonmineral, oral supplements for wound care.

Lasting modifications of sensory input induce structural and functional changes in the brain, but the involvement of primary sensory neurons in this plasticity has been practically ignored. Here, we examine qualitatively and quantitatively the central axonal terminations of a population of trigeminal ganglion neurons, whose peripheral axons innervate a single mystacial vibrissa. Vibrissa follicles are heavily innervated by myelinated and unmyelinated fibers that exit the follicle mainly through a single deep vibrissal nerve. We made intraneural injections of a mixture of cholera-toxin B (CTB) and isolectin B4, tracers for myelinated and unmyelinated fibers, respectively, in three groups of young adult rats: controls, animals subjected to chronic haptic touch deprivation by unilateral whisker trimming, and rats exposed for 2 months to environmental enrichment. The regional and laminar pattern of terminal arborizations in the trigeminal nuclei of the brain stem did not show gross changes after sensory input modification. However, there were significant and widespread increases in the number and size of CTB-labeled varicosities in the enriched condition, and a prominent expansion in both parameters in laminae III-IV of the caudal division of the spinal nucleus in the whisker trimming condition. No obvious changes were detected in IB4-labeled terminals in laminae I-II. These results show that a prolonged exposure to changes in sensory input without any neural damage is capable of inducing structural changes in terminals of primary afferents in mature animals, and highlight the importance of peripheral structures as the presumed earliest players in sensory experience-dependent plasticity. [ABSTRACT FROM AUTHOR]

Store-operated calcium channels (SOCs) are highly calcium-selective channels that mediate calcium entry in various cell types. We have previously reported that intraplantar injection of YM-58483 (a SOC inhibitor) attenuates chronic pain. A previous study has reported that the function of SOCs in dorsal root ganglia (DRG) is enhanced after nerve injury, suggesting that SOCs may play a peripheral role in chronic pain. However, the expression, functional distribution and significance of the SOC family in DRG neurons remain elusive and the key components that mediate SOC entry (SOCE) are still controversial. Here, we demonstrated that the SOC family (STIM1, STIM2, Orai1, Orai2, and Orai3) was expressed in DRGs and STIM1 was mainly present in small- and medium-sized DRG neurons. Using confocal live cell imaging, Ca2+ imaging and electrophysiology techniques, we demonstrated that depletion of the endoplasmic reticulum Ca2+ stores induced STIM1 and STIM2 translocation, and that inhibition of STIM1 or blockage of Orai channels with pharmacological tools attenuated SOCE and SOC currents. Using the small inhibitory RNA knockdown approach, we identified STIM1, STIM2, Orai1, and Orai3 as the key components of SOCs mediating SOCE in DRG neurons. Importantly, activation of SOCs by thapsigargin induced plasma membrane depolarization and increased neuronal excitability, which were completely abolished by inhibition of SOCs or double knockdown of Orai1 and Orai3. Our findings suggest that SOCs exert an excitatory action in DRG neurons and provide a potential peripheral mechanism for modulation of pain hypersensitivity by SOC inhibition. [ABSTRACT FROM AUTHOR]

Neuronal nitric oxide synthase (nNOS) 1 , mainly responsible for NO release in central nervous system (CNS) 2 , plays a significant role in multiple physiological functions. However, the function of nNOS + interneurons in fear learning has not been much explored. Here we focused on the medial ganglionic eminences (MGE) 3 -derived nNOS + interneurons in fear learning. To determine the origin of nNOS + interneurons, we cultured neurons in vitro from MGE, cortex, lateral ganglionic eminence (LGE) 4 , caudal ganglionic eminences (CGE) 5 and preoptic area (POA) 6 . The results showed that MGE contained the most abundant precursors of nNOS + interneurons. Moreover, donor cells from E12.5 embryos demonstrated the highest positive rate of nNOS + interneurons compared with other embryonic periods (E11.5, E12, E13, E13.5 and E14). Additionally, these cells from E12.5 embryos showed long axonal and abundant dendritic arbors after 10 days culture, indicating the capability to disperse and integrate in host neural circuits after transplantation. To investigate the role of MGE-derived nNOS + interneurons in fear learning, donor MGE cells were transplanted into dentate gyrus (DG) 7 of nNOS knock-out (nNOS −/− ) or wild-type mice. Results showed that the transplantation of MGE cells promoted the acquisition of nNOS −/− but not the wild-type mice, suggesting the importance of nNOS + neurons in fear acquisition. Moreover, we transplanted MGE cells from nNOS −/− mice or wild-type mice into DG of the nNOS −/- mice and found that only MGE cells from wild-type mice but not the nNOS −/− mice rescued the deficit in acquisition of the nNOS −/− mice, further confirming the positive role of nNOS + neurons in fear learning. [ABSTRACT FROM AUTHOR]

It was lately suggested that cilia inside the pharynx of Gnathostomulida are a novel finding and that Herlyn and Ehlers (Zoomorphology 117:135-145, 1997) did not observe anything corresponding to a buccal ganglion in the pharynx of Gnathostomula paradoxa (Gnathostomulida). However, monociliated pharyngeal receptors were repeatedly reported for Gnathostomulida since the 1980th, and every statement of absent ciliation in the cited study referred to the pharyngeal epithelium excluding the imbedded receptors. Moreover, Herlyn and Ehlers stated that they did not regard the questionable nervous differentiation in the hind pharynx of Gnathostomulida as a buccal ganglion due to lacking evidence of an extra basal lamina sheath. The present study shows that it is also uncertain if the structure fulfills another frequently applied criterion of a ganglion, i.e., an arrangement of perikarya and neuropil in such a manner that the first enclose the latter. Notwithstanding the alternative definitions used, the transmission electron micrographs presented herein also confirm previous findings. Thus, the nervous differentiation in the posterior pharynx (buccal ganglion) gives rise to one weaker dorso-median nerve and two stronger lateral nerves which connect with the distal ciliated portions of the pharyngeal receptors. The single cilium of each receptor extends from the bottom of a pit into the pharyngeal cavity, whereby its proximal section is surrounded by eight microvilli. A survey on the considerable discrepancies between the descriptions of buccal/mastax/pharyngeal ganglia in Gnathostomulida, Micrognathozoa, Monogononta, Bdelloidea, Seisonidea, and Acanthocephala (present/absent, inside/outside the pharynx, ventrally/dorsally in the pharynx, ganglion/plexus, etc.) concludes this study. [ABSTRACT FROM AUTHOR]

Contingency management (CM) is efficacious for reinforcing stimulant abstinence, and technical assistance (TA) is increasingly sought to aid its community-based implementation. In an interagency partnership involving a sponsoring single-state authority and statewide treatment agency in Oregon, an intermediary purveyor organization provided a robust TA package to support design, implementation, and evaluation of CM programming for an opioid treatment program (OTP) over the course of a 12-month implementation service project. In addition to an online training offering OTP leaders and staff conceptual foundation for CM, the TA package included purveyor-led activities to: 1) engage leaders in collaborative design to customize CM programming; 2) assemble a local implementation team to logistically prepare OTP systems for CM delivery; 3) provide virtual coaching-to-criterion to assure readiness of counseling staff to deliver CM programming; 4) compile a tailored CM resource library of implementation support materials; and 5) avail ongoing consultation during implementation. Stimulant abstinence was targeted via a voucher-based protocol with escalating reinforcement, for which gift cards from local vendors served as reinforcers. Virtual coaching eventuated in individual role-play assessments, wherein staff delivery of CM programming with a standardized patient was scored via Likert scale (1 = Very Poor, 7 = Excellent) on six CM fidelity dimensions. This observational cohort design subsequently assessed clinical effectiveness during active implementation via OTP records review for CM-exposed and comparison client groups. In role-play assessments, all counseling staff exceeded an a priori fidelity benchmark signifying implementation readiness (M = 31.33, SD = 3.72). Among 73 clients enrolled in the CM programming, rate of stimulant-free urine drug screens was 11 % greater than among 120 clients serving as historical controls (p <.01; Cohen's D = 0.40). The study also identified secondary therapeutic benefit in six-month treatment retention, with clients enrolled in CM retained at a 14 % greater rate than 162 CM-ineligible clients concurrently enrolled in OTP services (p <.05). Findings from this interagency partnership offer reason for optimism regarding community-based implementation. Beyond the demonstrated empirical support for this TA package and resulting clinical effectiveness of the CM programming, an eventual sustainment decision by OTP leadership strengthens the rationale for customizing CM to clinical settings' local needs and resources. • A robust technical assistance package was provided for contingency management (CM). • Through collaborative design, CM programming was customized for a clinical setting. • Virtual coaching sufficiently prepared setting staff to deliver CM programming. • An 11 % higher rate of stimulant abstinence was observed among CM-exposed clients. • A 14 % higher six-month retention rate was observed among CM-exposed clients. [ABSTRACT FROM AUTHOR]

Nicotine, a major psychoactive component of tobacco smoke, alters gamma-aminobutyric acid (GABA) modulation of dopamine neurons in the ventral tegmental area (VTA). Changes in structural neuroplasticity can occur in GABAergic parvalbumin (PRV) positive neurons, which are enveloped by structures of the extracellular matrix called perineuronal nets (PNNs). In the current study, rats were trained to self-administer intravenous nicotine (0.03 mg/kg/infusion) for 21 days in 1-hour daily sessions with an incrementing fixed ratio requirement; a control group received saline infusions. At either 45 minutes or 72 hours after the last session, immunofluorescence measurements for PNNs, PRV and c-Fos were conducted. In VTA, nicotine self-administration reduced the number of PRV+ cells surrounded by PNNs at 45 minutes, as well as reducing the intensity of PNNs, suggesting a remodeling of GABA interneurons in this region; the number of PRV+ cells surrounded by PNNs was also reduced at 72 hours. A similar reduction of PNNs occurred in orbitofrontal cortex (OFC) but not in medial prefrontal cortex (prelimbic or infralimbic), 45 minutes after the last session; PNNs were not detected in nucleus accumbens (shell or core). The reduction of PNNs in VTA and OFC was unrelated to c-Fos + cells, as the percent of wisteria floribunda agglutinin + cells co-expressing c-Fos was decreased in OFC but not in VTA. Thus, nicotine self-administration remodeled PNNs surrounding GABA interneurons in VTA and its indirect connections to OFC, suggesting a new possible molecular target where nicotine-induced neuroplasticity takes place. PNN manipulations may prevent or reverse the different stages of tobacco addiction. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of low, moderate, and high myopia on the thickness of the retinal nerve fiber layer (RNFL) and Ganglion cell complex (GCC) measured by Spectral Domain Optical Coherence Tomography (SD-OCT) in non-glaucomatous subjects.Methods: The subjects were divided into three groups: low (n = 81, 35.6%), moderate (n = 79, 34.8%), and highly myopic eyes (n = 67, 29.5%). The RNFL thickness profile, including the average, superior, nasal, inferior, and temporal quadrant and each of the eight directional thicknesses, was measured. GCC parameters, including the average, superior, and inferior values, the focal loss volume (FLV), and the global loss volume (GLV), were measured. The correlation between the OCT measurements and the axial length was evaluated.Results: The average, superior, inferior, and nasal RNFL thicknesses of low and moderate myopic eyes were found to be significantly higher than those of highly myopic eyes. The temporal RNFL thicknesses were not different among the three groups. The average, superior, and inferior ganglion cell complex values of low and moderate myopic eyes were significantly higher than those of highly myopic eyes. The FLV and GLV of low and moderate myopic eyes were significantly higher than those of highly myopic eyes (p = 0.001 for all). In the moderate and high myopia groups, the average RNFL thickness and GCC thickness were both negatively correlated with the axial length.Conclusion: Highly myopic subjects tend to have thinner RNFL and GCC thicknesses than subjects with low and moderate myopia. [ABSTRACT FROM AUTHOR]

Ependymomas are glial neoplasms with rare cases exhibiting neuronal differentiation. We describe a case of spinal anaplastic ependymoma with ganglionic differentiation in a 28-year-old woman. The ganglionic component was labeled by synaptophysin, whereas the rest of the tumor showed features of an anaplastic ependymoma. Stem cell marker MELK was noted to stain both the neoplastic ependymal and ganglionic components, possibly suggesting a stem cell/progenitor origin for the tumor with subsequent divergent differentiation. [ABSTRACT FROM AUTHOR]

Context: Attention deficit hyperactivity disorder and stimulant use disorder commonly co-exist, and appropriate treatments have not been well established. Objective: To provide guidance for treatment of co-existing attention deficit hyperactivity disorder and stimulant use disorder. Data sources: A systematic review of published English articles using MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane, utilising consistent search terms. Study selection: Randomised controlled trials, comparing any treatment arm with a control group, for participants meeting Diagnostic and Statistical Manual of Mental Disorders or equivalent criteria for both attention deficit hyperactivity disorder and stimulant use disorder. Results: Eight trials were identified for inclusion in this review. Four of eight studies showed improvement in attention deficit hyperactivity disorder outcome measures compared with placebo. Two of six studies that reported substance use outcomes showed improvement in treatment arms compared with placebo. Studies to show effect tended to be those with the highest treatment dosage. Conclusion: Evidence for the efficacy of treatment of patients with comorbid stimulant use disorder and attention deficit hyperactivity disorder is limited. Promising outcomes need replication in further studies utilising higher treatment dosage. [ABSTRACT FROM AUTHOR]

As a new school year approaches, nurses will find themselves faced with students with symptoms of attention-deficit/hyperactivity disorder (ADHD). Navigating the diagnostic label changes and numerous psychopharmacological treatment options can prove time-consuming and confusing. The current article explores the early years of symptom identification, various diagnostic labels, and subsequent psychopharmacological treatments from psychostimulants to non-stimulant alternatives (including a prescription medical food). The current article also serves as a discussion guide for nurses and clinicians when providing education to patients and their loved ones, teachers, coaches, and others who may question the diagnosis and treatment of ADHD. This disorder can have a significant impact on one's ability to function within family, school, work, and social settings. A historical context is provided for the evolution of today's diagnostic criteria and the pharmacotherapy used in the treatment of ADHD. [ABSTRACT FROM AUTHOR]

The joint activity of neural populations is high dimensional and complex. One strategy for reaching a tractable understanding of circuit function is to seek the simplest dynamical system that can account for the population activity. By imaging Aplysia's pedal ganglion during fictive locomotion, here we show that its population-wide activity arises from a low-dimensional spiral attractor. Evoking locomotion moved the population into a low-dimensional, periodic, decaying orbit - a spiral - in which it behaved as a true attractor, converging to the same orbit when evoked, and returning to that orbit after transient perturbation. We found the same attractor in every preparation, and could predict motor output directly from its orbit, yet individual neurons' participation changed across consecutive locomotion bouts. From these results, we propose that only the low-dimensional dynamics for movement control, and not the high-dimensional population activity, are consistent within and between nervous systems. [ABSTRACT FROM AUTHOR]

The misuse of prescription stimulants among college undergraduates is a prevalent and dangerous problem on college campuses across the United States. Guided by a memorable messages framework, this research sought to examine the messages that college students recall about the misuse of prescription stimulants and examine how those messages are associated with students’ intention to use stimulants. We analyzed the recalled memorable messages of 129 undergraduates. Three predominant themes emerged from the analysis: academic implications, health implications, and ethical implications. Theme, source, and valence of the memorable messages were not associated with behavioral intention to engage in the misuse of prescription stimulants. These findings contribute to the scholarly and practical understanding of undergraduates’ experiences with illicit behaviors, and demonstrate a need to further investigate students’ sense-making in relation to risky decisions made during their college experience. [ABSTRACT FROM PUBLISHER]

The article focuses on the adverse impact of stimulant use over attention deficit hyperactivity disorder (ADHD) which involves cardiac arrhythmia and myocardial infarction. Topics discussed include need for utilizing Risk Evaluation and Mitigation Strategy (REMS) licensing for tracking ADHD medication; recommendation for undergoing behavioral therapy and medications other than stimulants; and suggestion for using non-pharmacological treatments as the first-line treatment of ADHD.

Objective To investigate the effect of the mutual regulation of the extrinsic cardiac nerves on atrial electrophysiology and atrial fibrillation (AF) vulnerability. Methods and results Fourteen dogs were randomly divided into two groups: spinal cord stimulation (SCS) group (n = 7) and spinal cord block (SCB) group (n = 7). SCS was performed with 90% of the threshold voltage stimulating the T1-T2 spinal level, while SCB was performed by injecting 2% lidocaine into the epidural space at the T2-3 level. The effective refractory period (ERP), ERP dispersion, and AF inducibility were measured during atrial pacing combined with different extrinsic cardiac nerve stimulation. ERPs were decreased in the atrium and pulmonary veins and ERP dispersion was increased from baseline during left cervical vagus nerve stimulation (VNS) or left stellate ganglion stimulation (SGS) in the two groups. When combined with SCS, VNS resulted in diminished ERPs at all recording sites, longer ERP dispersion and more episodes of AF than were observed during VNS, whereas ERPs were greater and correspondingly fewer episodes of AF occurred during SCS combined with SGS than SGS. In the SCB group, ERPs were shortened, ERP dispersion was lengthened, and episodes of AF were increased during SGS after SCB. SCS enhanced the activity of the left vagus nerve but attenuated the left stellate ganglion and superior left ganglionated plexus. Conclusion SCS modulates extrinsic and intrinsic cardiac nerve activity among the vagus nerve, stellate ganglion, and ganglionated plexus. SCS facilitates the effect of VNS and attenuates the effect of SGS on atrial electrophysiology. [ABSTRACT FROM AUTHOR]

Although ganglion cyst is a relatively common benign mass in soft tissues, there have been very few reports of intramuscular ganglion cyst. We encountered such a case located in the antecubital fossa originating from the supinator muscle. A 61-year-old woman presented with a painless mass in the antecubital fossa. However, the patient complained of a significant sensory deficit in the radial side of the thumb, index, and middle finger. She also had extensor weakness at the metacarpophalangeal joint. The mass was excised completely, with no post-surgical complications. Pathologic results revealed the ganglion cyst. The patient showed improvements in sensory dysfunction and extensor weakness. Intramuscular ganglion cyst can be misdiagnosed. This report might be useful for making an accurate diagnosis and rapidly initiating treatment for an intramuscular mass. [ABSTRACT FROM AUTHOR]

We investigate the epistemic uncertainties of parameters of a mathematical model that describes the dynamics of CaMKII-NMDAR complex related to memory formation in synapses using global sensitivity analysis (GSA). The model, which was published in this journal, is nonlinear and complex with Ca 2+ patterns with different level of frequencies as inputs. We explore the effects of parameter on the key outputs of the model to discover the most sensitive ones using GSA and partial ranking correlation coefficient (PRCC) and to understand why they are sensitive and others are not based on the biology of the problem. We also extend the model to add presynaptic neurotransmitter vesicles release to have action potentials as inputs of different frequencies. We perform GSA on this extended model to show that the parameter sensitivities are different for the extended model as shown by PRCC landscapes. Based on the results of GSA and PRCC, we reduce the original model to a less complex model taking the most important biological processes into account. We validate the reduced model against the outputs of the original model. We show that the parameter sensitivities are dependent on the inputs and GSA would make us understand the sensitivities and the importance of the parameters. A thorough phenomenological understanding of the relationships involved is essential to interpret the results of GSA and hence for the possible model reduction. [ABSTRACT FROM AUTHOR]

We investigate the importance of the degree of peripheral or central target differentiation for mouse auditory afferent navigation to the organ of Corti and auditory nuclei in three different mouse models: first, a mouse in which the differentiation of hair cells, but not central auditory nuclei neurons is compromised (Atoh1-cre; Atoh1f/f); second, a mouse in which hair cell defects are combined with a delayed defect in central auditory nuclei neurons (Pax2-cre; Atoh1f/f) and third, a mouse in which both hair cells and central auditory nuclei are absent (Atoh1-/-). Our results show that neither differentiated peripheral nor the central target cells of inner ear afferents are needed (hair cells, cochlear nucleus neurons) for segregation of vestibular and cochlear afferents within the hindbrain and some degree of base to apex segregation of cochlear afferents. These data suggest that inner ear spiral ganglion neuron processes may predominantly rely on temporally and spatially distinct molecular cues in the region of the targets rather than interaction with differentiated target cells for a crude topological organization. These developmental data imply that auditory neuron navigation properties may have evolved before auditory nuclei. [ABSTRACT FROM AUTHOR]

Cisplatin is a broad-spectrum anticancer drug that is commonly used in the clinic. Ototoxicity is one of the major side effects of this drug, which caused irreversible sensorineural hearing loss. Allicin, the main biologically active compound derived from garlic, has been shown to exert various anti-apoptotic and anti-oxidative activities in vitro and in vivo studies. We took advantage of C57 mice intraperitoneally injected with cisplatin alone or with cisplatin and allicin combined, to investigate whether allicin plays a protective role in vivo against cisplatin ototoxicity. The result showed that C57 mice in cisplatin group exhibited increased shift in auditory brainstem response, whereas the auditory fuction of mice in allicin + cisplatin group was protected in most frequencies, which was accordance with observed damages of outer hair cells (OHCs) and spiral ganglion neurons (SGNs) in the cochlea. Allicin markedly protected SGN mitochondria from damage and releasing cytochrome c, and significantly reduced pro-apoptosis factor expressions activated by cisplatin, including Bax, cleaved-caspase-9, cleaved-caspase-3and p53. Furthermore, allicin reduced the level of Malondialdehyde (MDA), but increased the level of superoxide dismutase (SOD). All data suggested that allicin could prevent hearing loss induced by cisplatin effectively, of which allicin protected SGNs from apoptosis via mitochondrial pathway while protected OHCs and supporting cells (SCs) from apoptosis through p53 pathway. [ABSTRACT FROM AUTHOR]