An unusual case of a peritoneal dialysis catheter causing hydronephrosis: A case report.

Peritoneal dialysis (PD) catheter migration is a common complication of PD which usually results in obstruction of dialysate outflow. We report the first known case in the literature of a 62-year-old male with end-stage renal disease on PD who presented with acute renal colic secondary to the PD catheter overlying right mid-ureter causing hydronephrosis with spontaneous resolution of pain and hydronephrosis two days later. The patient was discharged home with a functioning dialysis catheter and complete resolution of both symptoms and radiographic findings of hydronephrosis. While management of migrated PD catheters usually require surgical intervention, our case resolved without intervention.

Does inhibitory (dys)function account for involuntary autobiographical memory and déjà vu experience?

External cues and internal configuration states are the likely instigators of involuntary autobiographical memories (IAMs) and déjà vu experience. Indeed, Barzykowski and Moulin discuss relevant neuroscientific evidence in this direction. A complementary line of enquiry and evidence is the study of inhibition and its role in memory retrieval, and particularly how its (dys)function may contribute to IAMs and déjà vu.

Breastfeeding and Antepartum Breast Milk Expression (BABE): A Randomized Control Trial Utilizing an Electric Breast Pump and its Effect on Postpartum Breastfeeding.

Objective: To evaluate the effect of antenatal breast milk expression (ABE) on exclusive breastfeeding. Materials and Methods: A randomized control study was performed with the primary outcome being formula use during the postpartum hospital stay. Secondary outcomes were the exclusive breastfeeding rate at 6 months postpartum and peripartum safety outcomes. Participants included multiparous and nulliparous patients who planned to breastfeed. Exclusion criteria included exclusively breastfeeding in prior pregnancies for greater than 6 months, medical contraindications for breastfeeding, multiple gestation, history of preterm delivery, or any contraindication to vaginal delivery. ABE group participants were instructed to pump for 20 minutes, three times daily, starting at 37 weeks of gestation. Results: Three-hundred four participants from two clinics were enrolled. There was no significant difference in formula use during hospital admission (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.34-1.22) or in exclusive breastfeeding at 6 months postpartum (OR 0.66, 95% CI 0.34-1.29). Colostrum use was more prevalent in the ABE group (OR 5.31, 95% CI 2.63-10.76). ABE participants were more likely to present in spontaneous labor (OR 2.09, 95% CI 1.05-4.14). Conclusion: ABE did not significantly improve exclusive breastfeeding rates, but safely provides women opportunities to become familiar with breastfeeding before delivery and can provide readily available colostrum. There was no negative secondary safety outcome related to ABE identified. Prenatal care providers can consider recommending ABE to patients with minimal to no experience with breastfeeding.

Multiscale and Extended Retrieval of Associative Memory Structures in a Cortical Model of Local-Global Inhibition Balance.

Inhibitory neurons take on many forms and functions. How this diversity contributes to memory function is not completely known. Previous formal studies indicate inhibition differentiated by local and global connectivity in associative memory networks functions to rescale the level of retrieval of excitatory assemblies. However, such studies lack biological details such as a distinction between types of neurons (excitatory and inhibitory), unrealistic connection schemas, and nonsparse assemblies. In this study, we present a rate-based cortical model where neurons are distinguished (as excitatory, local inhibitory, or global inhibitory), connected more realistically, and where memory items correspond to sparse excitatory assemblies. We use this model to study how local-global inhibition balance can alter memory retrieval in associative memory structures, including naturalistic and artificial structures. Experimental studies have reported inhibitory neurons and their subtypes uniquely respond to specific stimuli and can form sophisticated, joint excitatory-inhibitory assemblies. Our model suggests such joint assemblies, as well as a distribution and rebalancing of overall inhibition between two inhibitory subpopulations, one connected to excitatory assemblies locally and the other connected globally, can quadruple the range of retrieval across related memories. We identify a possible functional role for local-global inhibitory balance to, in the context of choice or preference of relationships, permit and maintain a broader range of memory items when local inhibition is dominant and conversely consolidate and strengthen a smaller range of memory items when global inhibition is dominant. This model, while still theoretical, therefore highlights a potentially biologically-plausible and behaviorally-useful function of inhibitory diversity in memory.

Temporal activity patterns of layer II and IV rat barrel cortex neurons in healthy and injured conditions.

Neurons are known to encode information not just by how frequently they fire, but also at what times they fire. However, characterizations of temporal encoding in sensory cortices under conditions of health and injury are limited. Here we characterized and compared the stimulus-evoked activity of 1210 online-sorted units in layers II and IV of rat barrel cortex under healthy and diffuse traumatic brain injury (TBI) (caused by a weight-drop model) conditions across three timepoints post-injury: four days, two weeks, and eight weeks. Temporal activity patterns in the first 50 ms post-stimulus recording showed four categories of responses: no response or 1, 2, or 3 temporally-distinct response components, that is, periods of high unit activity separated by silence. The relative proportions of unit response categories were similar between layers II and IV in healthy conditions but not in early post-TBI conditions. For units with multiple response components, inter-component timings were reliable in healthy and late post-TBI conditions but disrupted by injury. Response component times typically shifted earlier with increasing stimulus intensity and this was more pronounced in layer IV than layer II. Surprisingly, injury caused a reversal of this trend and in the late post-TBI condition no stimulus intensity-dependence differences were observed between layers II and IV. We speculate this indicates a potential compensatory mechanism in response to injury. These results demonstrate how temporal encoding features maladapt or functionally recover differently in sensory cortex after TBI. Such maladaptation or functional recovery is layer-dependent, perhaps due to differences in thalamic input or local inhibitory neuronal makeup.

A longitudinal evaluation of a penetrating traumatic brain injury: Theories of plasticity and vulnerability.

Penetrating traumatic brain injury (TBI) is uncommon in infancy. The consequences may be devastating, especially when the injury is extensive and affects eloquent areas of the brain. There is the potential for neuropsychological dysfunction that may impact the individual's development and well-being into adulthood. In the context of early brain injury, the developing brain is both remarkably resilient and vulnerable. The present case study describes a patient who experienced a penetrating TBI at 9 days of age, subsequently developed intractable seizures, and underwent left hemispherectomy. Neuropsychological testing at ages 5, 10, 11, and 19 years are presented alongside fMRI and Wada testing. While the patient initially developed cognitive functions in the low-average range by age 5, scores on neuropsychological assessments began to decrease thereafter. This case is discussed with attention to vulnerability and plasticity theories. It highlights the ability of the brain to reorganize and allow the development of functions that would normally be sub-served by damaged areas and the limits of plasticity. Further, this case illustrates the vulnerability of the early brain to insult, the potential to grow into deficits, and the need to consider a variety of factors when predicting outcomes for cases of pediatric brain injury.

Exploring the Predictability of Temperatures in a Scaled Model of a Smarthome.

In modern smarthomes, temperature regulation is achieved through a mix of traditional and emergent technologies including air conditioning, heating, intelligent utilization of the effects of sun, wind, and shade as well as using stored heat and cold. To achieve the desired comfort for the inhabitants while minimizing environmental impact and cost, the home controller must predict how its actions will impact the temperature and other environmental factors in various parts of the home. The question we are investigating in this paper is whether the temperature values in different rooms in a home are predictable based on readings from sensors in the home. We are also interested in whether increased accuracy can be achieved by adding sensors to capture the state of doors and windows of the given room and/or the whole home, and what type of machine learning algorithms can take advantage of the additional information. As experimentation on real-world homes is highly expensive, we use ScaledHome, a 1:12 scale, IoT-enabled model of a smart home for data acquisition. Our experiments show that while additional data can improve the accuracy of the prediction, the type of machine learning models needs to be carefully adapted to the number of data features available.

Classic Hebbian learning endows feed-forward networks with sufficient adaptability in challenging reinforcement learning tasks.

A common pitfall of current reinforcement learning agents implemented in computational models is in their inadaptability postoptimization. Najarro and Risi [Najarro E, Risi S. Proc 33rd Conf Neural Inf Process Systems (NeurIPS 2020). 2020: 20719-20731, 2020] demonstrate how such adaptability may be salvaged in artificial feed-forward networks by optimizing coefficients of classic Hebbian rules to dynamically control the networks' weights instead of optimizing the weights directly. Although such models fail to capture many important neurophysiological details, allying the fields of neuroscience and artificial intelligence in this way bears many fruits for both fields, especially when computational models engage with topics with a rich history in neuroscience such as Hebbian plasticity.

Sensing and processing whisker deflections in rodents.

The classical view of sensory information mainly flowing into barrel cortex at layer IV, moving up for complex feature processing and lateral interactions in layers II and III, then down to layers V and VI for output and corticothalamic feedback is becoming increasingly undermined by new evidence. We review the neurophysiology of sensing and processing whisker deflections, emphasizing the general processing and organisational principles present along the entire sensory pathway-from the site of physical deflection at the whiskers to the encoding of deflections in the barrel cortex. Many of these principles support the classical view. However, we also highlight the growing number of exceptions to these general principles, which complexify the system and which investigators should be mindful of when interpreting their results. We identify gaps in the literature for experimentalists and theorists to investigate, not just to better understand whisker sensation but also to better understand sensory and cortical processing.

Correction to 'Buried treasure-marine turtles do not "disguise" or "camouflage" their nests but avoid them and create a decoy trail'.

[This corrects the article DOI: 10.1098/rsos.200327.].

Buried treasure-marine turtles do not 'disguise' or 'camouflage' their nests but avoid them and create a decoy trail.

After laying their eggs and refilling the egg chamber, sea turtles scatter sand extensively around the nest site. This is presumed to camouflage the nest, or optimize local conditions for egg development, but a consensus on its function is lacking. We quantified activity and mapped the movements of hawksbill (Eretmochelys imbricata) and leatherback (Dermochelys coriacea) turtles during sand-scattering. For leatherbacks, we also recorded activity at each sand-scattering position. For hawksbills, we recorded breathing rates during nesting as an indicator of metabolic investment and compared with published values for leatherbacks. Temporal and inferred metabolic investment in sand-scattering was substantial for both species. Neither species remained near the nest while sand-scattering, instead moving to several other positions to scatter sand, changing direction each time, progressively displacing themselves from the nest site. Movement patterns were highly diverse between individuals, but activity at each sand-scattering position changed little between completion of egg chamber refilling and return to the sea. Our findings are inconsistent with sand-scattering being to directly camouflage the nest, or primarily for modifying the nest-proximal environment. Instead, they are consistent with the construction of a series of dispersed decoy nests that may reduce the discovery of nests by predators.

COVID-19: a retrospective cohort study with focus on the over-80s and hospital-onset disease.

BACKGROUND: Data from the UK COVID-19 outbreak are emerging, and there are ongoing concerns about a disproportionate effect on ethnic minorities. There is very limited information on COVID-19 in the over-80s, and the rates of hospital-onset infections are unknown. METHODS: This was a retrospective cohort study from electronic case records of the first 450 patients admitted to our hospital with PCR-confirmed COVID-19, 77% of the total inpatient caseload to date. Demographic, clinical and biochemical data were extracted. The primary endpoint was death during the index hospital admission. The characteristics of all patients, those over 80 years of age and those with hospital-onset COVID-19 were examined. RESULTS: The median (IQR) age was 72 (56, 83), with 150 (33%) over 80 years old and 60% male. Presenting clinical and biochemical features were consistent with those reported elsewhere. The ethnic breakdown of patients admitted was similar to that of our underlying local population. Inpatient mortality was high at 38%. Patients over 80 presented earlier in their disease course and were significantly less likely to present with the typical features of cough, breathlessness and fever. Cardiac co-morbidity and markers of cardiac dysfunction were more common, but not those of bacterial infection. Mortality was significantly higher in this group (60% vs 28%, p < 0.001). Thirty-one (7%) patients acquired COVID-19 having continuously been in hospital for a median of 20 (14, 36) days. The peak of hospital-onset infections occurred at the same time as the overall peak of admitted infections. Despite being older and more frail than those with community-onset infection, their outcomes were no worse. CONCLUSIONS: Inpatient mortality was high, especially among the over-80s, who are more likely to present atypically. The ethnic composition of our caseload was similar to the underlying population. While a significant number of patients acquired COVID-19 while already in hospital, their outcomes were no worse.

Prediction of MOF Performance in Vacuum Swing Adsorption Systems for Postcombustion CO2 Capture Based on Integrated Molecular Simulations, Process Optimizations, and Machine Learning Models.

Postcombustion CO2 capture and storage (CCS) is a key technological approach to reducing greenhouse gas emission while we transition to carbon-free energy production. However, current solvent-based CO2 capture processes are considered too energetically expensive for widespread deployment. Vacuum swing adsorption (VSA) is a low-energy CCS that has the potential for industrial implementation if the right sorbents can be found. Metal-organic framework (MOF) materials are often promoted as sorbents for low-energy CCS by highlighting select adsorption properties without a clear understanding of how they perform in real-world VSA processes. In this work, atomistic simulations have been fully integrated with a detailed VSA simulator, validated at the pilot scale, to screen 1632 experimentally characterized MOFs. A total of 482 materials were found to meet the 95% CO2 purity and 90% CO2 recovery targets (95/90-PRTs)-365 of which have parasitic energies below that of solvent-based capture (∼290 kWhe/MT CO2) with a low value of 217 kWhe/MT CO2. Machine learning models were developed using common adsorption metrics to predict a material's ability to meet the 95/90-PRT with an overall prediction accuracy of 91%. It was found that accurate parasitic energy and productivity estimates of a VSA process require full process simulations.

Differential antiseizure medication sensitivity of the Affective Reactivity Index: A randomized controlled trial in new-onset pediatric focal epilepsy.

BACKGROUND: Irritability is a adverse effect of many antiseizure medications (ASMs), but there are no validated measures currently available to characterize this behavioral risk. We examined both child and parent/guardian versions of the Affective Reactivity Index (ARI), a validated measure developed for application in adolescent psychiatry, to determine its sensitivity to ASM-related irritability. We hypothesized irritability increases associated with levetiracetam (LEV) but not lamotrigine (LTG) or oxcarbazepine (OXC). METHOD: The ARI was administered to 71 child and parent/guardian pairs randomized to one of three common ASMs (LEV, LTG, OXC) used to treat new-onset focal (localization-related) epilepsy. Subjects were recruited as part of a prospective multicenter, randomized, open-label, parallel group design. The ARI was administered at baseline prior to treatment initiation and again at 3 months after ASM initiation. RESULTS: There was a significant increase in ARI ratings for both child and parent/guardian ratings for LEV but not LTG or OXC when assessed 3 months after treatment initiation. When examined on the individual subject level using a criterion of at least a 3-point ARI increase, there was an increase associated with LEV for child ratings but not parent/guardian scores. CONCLUSION: Both child and parent/guardian versions of the ARI appear sensitive to medication-induced irritability associated with LEV on both the group and individual levels. The findings extend the applicability of ARI from characterizing the presence of clinical irritability as a psychiatric diagnostic feature to a more modifiable aspect of behavior change related to medication management and support its use in clinical trial applications.

A Mathematical Approach to Correlating Objective Spectro-Temporal Features of Non-linguistic Sounds With Their Subjective Perceptions in Humans.

Non-linguistic sounds (NLSs) are a core feature of our everyday life and many evoke powerful cognitive and emotional outcomes. The subjective perception of NLSs by humans has occasionally been defined for single percepts, e.g., their pleasantness, whereas many NLSs evoke multiple perceptions. There has also been very limited attempt to determine if NLS perceptions are predicted from objective spectro-temporal features. We therefore examined three human perceptions well-established in previous NLS studies ("Complexity," "Pleasantness," and "Familiarity"), and the accuracy of identification, for a large NLS database and related these four measures to objective spectro-temporal NLS features, defined using rigorous mathematical descriptors including stimulus entropic and algorithmic complexity measures, peaks-related measures, fractal dimension estimates, and various spectral measures (mean spectral centroid, power in discrete frequency ranges, harmonicity, spectral flatness, and spectral structure). We mapped the perceptions to the spectro-temporal measures individually and in combinations, using complex multivariate analyses including principal component analyses and agglomerative hierarchical clustering.

Perception of Western governments' hostility to Islam among European Muslims before and after ISIS: the important roles of residential segregation and education.

Perception of Western governments' hostility to Islam is one of the indicating features of Islamic fundamentalism and, in some cases, is serving as a pull to join extremist groups. In this paper, using data from two waves of a cross-national survey, we investigate what affects European Muslims' opinions about Western governments. We find that residential segregation is associated with perceived hostility of Western governments to Islam. Further, we find that Muslims living in segregated neighbourhoods and enclaves have a higher probability of believing that Western governments are hostile to Islam. National origins of Muslim immigrants have a significant impact, with people from African countries measuring less perceived hostility than others. We also find that education is associated with perceived hostility of Western governments to Islam in a non-linear way. People with the highest and lowest levels of education tend to be less likely to believe that Western governments are hostile to Islam, relative to people with mid-level education. This non-linear effect is best explained by education's differential effects on perceptions of key world events. During the time between 2011 - before ISIS's announcement of its Caliphate in Iraq and Syria - and 2013, subsequent to that announcement, we see a sharp decrease in perception of Western governments' hostility to Islam, particularly among more educated European Muslims. We make the case that this decrease can be attributed, in some ways, to the emergence of ISIS. We discuss our findings in terms of theoretical and policy implications.

Qualitative approach to comparative exposure in alternatives assessment.

Most alternatives assessments (AAs) published to date are largely hazard-based rankings, thereby ignoring potential differences in human and/or ecosystem exposures; as such, they may not represent a fully informed consideration of the advantages and disadvantages of possible alternatives. Building on the 2014 US National Academy of Sciences recommendations to improve AA decisions by including comparative exposure assessment into AAs, the Health and Environmental Sciences Institute's (HESI) Sustainable Chemical Alternatives Technical Committee, which comprises scientists from academia, industry, government, and nonprofit organizations, developed a qualitative comparative exposure approach. Conducting such a comparison can screen for alternatives that are expected to have a higher or different routes of human or environmental exposure potential, which together with consideration of the hazard assessment, could trigger a higher tiered, more quantitative exposure assessment on the alternatives being considered, minimizing the likelihood of regrettable substitution. This article outlines an approach for including chemical ingredient- and product-related exposure information in a qualitative comparison, including ingredient and product-related parameters. A classification approach was developed for ingredient and product parameters to support comparisons between alternatives as well as a methodology to address exposure parameter relevance and data quality. The ingredient parameters include a range of physicochemical properties that can impact routes and magnitude of exposure, whereas the product parameters include aspects such as product-specific exposure pathways, use information, accessibility, and disposal. Two case studies are used to demonstrate the application of the methodology. Key learnings and future research needs are summarized. Integr Environ Assess Manag 2018;00:000-000. © 2018 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Longitudinal Changes in Resting State Connectivity and White Matter Integrity in Adolescents With Sports-Related Concussion.

OBJECTIVES: The aim of this study was to investigate alterations in functional connectivity, white matter integrity, and cognitive abilities due to sports-related concussion (SRC) in adolescents using a prospective longitudinal design. METHODS: We assessed male high school football players (ages 14-18) with (n=16) and without (n=12) SRC using complementary resting state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) along with cognitive performance using the Immediate Post-Concussive Assessment and Cognitive Testing (ImPACT). We assessed both changes at the acute phase (<7 days post-SRC) and at 21 days later, as well as, differences between athletes with SRC and age- and team-matched control athletes. RESULTS: The results revealed rs-fMRI hyperconnectivity within posterior brain regions (e.g., precuneus and cerebellum), and hypoconnectivity in more anterior areas (e.g., inferior and middle frontal gyri) when comparing SRC group to control group acutely. Performance on the ImPACT (visual/verbal memory composites) was correlated with resting state network connectivity at both time points. DTI results revealed altered diffusion in the SRC group along a segment of the corticospinal tract and the superior longitudinal fasciculus in the acute phase of SRC. No differences between the SRC group and control group were seen at follow-up imaging. CONCLUSIONS: Acute effects of SRC are associated with both hyperconnectivity and hypoconnectivity, with disruption of white matter integrity. In addition, acute memory performance was most sensitive to these changes. After 21 days, adolescents with SRC returned to baseline performance, although chronic hyperconnectivity of these regions could place these adolescents at greater risk for secondary neuropathological changes, necessitating future follow-up. (JINS, 2018, 24, 781-792).