Disease burden, clinical management and unmet treatment need of patients with moderate to severe atopic dermatitis; consensus statements, insights and practices from CERTADE (Central/Eastern EU, Russia, Turkiye AD Experts) Delphi panel.

Background: There is limited insight into the current disease burden and everyday clinical management of moderate-to- severe AD in Poland, Czechia, Russia, and Turkiye. Therefore, this study aimed to get information-driven insights regarding the current disease burden and clinical management of patients with moderate-to-severe AD with common and differentiating aspects of the patient journey and establish a consensus. Methods: In this modified 2-round Delphi panel, 133 questions were asked in total to 27 dermatologists. A consensus was achieved when 70% of the panel members strongly agreed or agreed (or strongly disagreed or disagreed) with an item. Statements with <40% agreement dropped from the Delphi rounds and were not repeated. Results: The results state that AD has a significant impact on the quality of life for both patients and their families with social and economic consequences in these countries. While there were significant dissimilarities regarding the current treatment approach by preference order and treatment duration among participants, there was also a high percentage of consensus on literature and guideline-based statements. Current topical therapies and the immune response modifiers were not found to be sufficient by panelists to cover the therapeutic needs of patients with moderate-to-severe AD. Moreover, panelists highlighted the significant burden of adverse events with the off-label use of currently available immunosuppressants. Conclusions: These results underlined that there is a significant disease burden with an unmet treatment need for patients with moderate-to-severe AD in Poland, Czechia, Russia, and Turkiye.

Two distinct networks for encoding goals and forms of action: An effective connectivity study.

Goal-directed actions are characterized by two main features: the content (i.e., the action goal) and the form, called vitality forms (VF) (i.e., how actions are executed). It is well established that both the action content and the capacity to understand the content of another's action are mediated by a network formed by a set of parietal and frontal brain areas. In contrast, the neural bases of action forms (e.g., gentle or rude actions) have not been characterized. However, there are now studies showing that the observation and execution of actions endowed with VF activate, in addition to the parieto-frontal network, the dorso-central insula (DCI). In the present study, we established-using dynamic causal modeling (DCM)-the direction of information flow during observation and execution of actions endowed with gentle and rude VF in the human brain. Based on previous fMRI studies, the selected nodes for the DCM comprised the posterior superior temporal sulcus (pSTS), the inferior parietal lobule (IPL), the premotor cortex (PM), and the DCI. Bayesian model comparison showed that, during action observation, two streams arose from pSTS: one toward IPL, concerning the action goal, and one toward DCI, concerning the action vitality forms. During action execution, two streams arose from PM: one toward IPL, concerning the action goal and one toward DCI concerning action vitality forms. This last finding opens an interesting question concerning the possibility to elicit VF in two distinct ways: cognitively (from PM to DCI) and affectively (from DCI to PM).

Binding of the monoacylglycerol lipase (MAGL) radiotracer [3H]T-401 in the rat brain after status epilepticus.

OBJECTIVES: Monoacylglycerol lipase (MAGL) is a cytosolic serine hydrolase considered a potential novel drug target for the treatment of CNS disorders including epilepsy. Here we examined MAGL levels in a rat model of epilepsy. METHODS: Autoradiography has been used to validate the binding properties of the MAGL radiotracer, [3H]T-401, in the rat brain, and to explore spatial and temporal changes in binding levels in a model of temporal lobe epilepsy model using unilateral intra-hippocampal injections of kainic acid (KA) in rats. RESULTS: Specific and saturable binding of [3H]T-401 was detected in both cortical grey and subcortical white matter. Saturation experiments revealed a KD in the range between 15 nM and 17 nM, and full saturation was achieved at concentrations around 30 nM. The binding could be completely blocked with the cold ligand (Ki 44.2 nM) and at higher affinity (Ki 1.27 nM) with another structurally different MAGL inhibitor, ABD 1970. Bilateral reduction in [3H]T-401 binding was observed in the cerebral cortex and the hippocampus few days after status epilepticus that further declined to a level of around 30% compared to the control. No change in binding was observed in either the hypothalamus nor the white matter at any time point. Direct comparison to [3H]UCB-J binding to synaptic vesicle glycoprotein 2 A (SV2A), another protein localized in the pre-synapse, revealed that while binding to MAGL remained low in the chronic phase, SV2A was increased significantly in some cortical areas. SIGNIFICANCE: These data show that MAGL is reduced in the cerebral cortex and hippocampus in a chronic epilepsy model and indicate that MAGL inhibitors may further reduce MAGL activity in the treatment resistant epilepsy patient.

Biological motion perception in the theoretical framework of perceptual decision-making: An event-related potential study.

Biological motion perception plays a critical role in various decisions in daily life. Failure to decide accordingly in such a perceptual task could have life-threatening consequences. Neurophysiology and computational modeling studies suggest two processes mediating perceptual decision-making. One of these signals is associated with the accumulation of sensory evidence and the other with response selection. Recent EEG studies with humans have introduced an event-related potential called Centroparietal Positive Potential (CPP) as a neural marker aligned with the sensory evidence accumulation while effectively distinguishing it from motor-related lateralized readiness potential (LRP). The present study aims to investigate the neural mechanisms of biological motion perception in the framework of perceptual decision-making, which has been overlooked before. More specifically, we examine whether CPP would track the coherence of the biological motion stimuli and could be distinguished from the LRP signal. We recorded EEG from human participants while they performed a direction discrimination task of a point-light walker stimulus embedded in various levels of noise. Our behavioral findings revealed shorter reaction times and reduced miss rates as the coherence of the stimuli increased. In addition, CPP tracked the coherence of the biological motion stimuli with a tendency to reach a common level during the response, albeit with a later onset than the previously reported results in random-dot motion paradigms. Furthermore, CPP was distinguished from the LRP signal based on its temporal profile. Overall, our results suggest that the mechanisms underlying perceptual decision-making generalize to more complex and socially significant stimuli like biological motion.

Neural processing of bottom-up perception of biological motion under attentional load.

Considering its importance for one's survival and social significance, biological motion (BM) perception is assumed to occur automatically. Previous behavioral results showed that task-irrelevant BM in the periphery interfered with task performance at the fovea. Under selective attention, BM perception is supported by a network of regions including the occipito-temporal (OTC), parietal, and premotor cortices. Retinotopy studies that use BM stimulus showed distinct maps for its processing under and away from selective attention. Based on these findings, we investigated how bottom-up perception of BM would be processed in the human brain under attentional load when it was shown away from the focus of attention as a task-irrelevant stimulus. Participants (N = 31) underwent an fMRI study in which they performed an attentionally demanding visual detection task at the fovea while intact or scrambled point light displays of BM were shown at the periphery. Our results showed the main effect of attentional load in fronto-parietal regions and both univariate activity maps and multivariate pattern analysis results support the attentional load modulation on the task-irrelevant peripheral stimuli. However, this effect was not specific to intact BM stimuli and was generalized to motion stimuli as evidenced by the motion-sensitive OTC involvement during the presence of dynamic stimuli in the periphery. These results confirm and extend previous work by showing that task-irrelevant distractors can be processed by stimulus-specific regions when there are enough attentional resources available. We discussed the implications of these results for future studies.

Effects of coenzyme Q10 in a propofol infusion syndrome model of rabbits.

Background: Coenzyme Q (CoQ) might be the main site of interaction with propofol on the mitochondrial respiratory chain in the propofol infusion syndrome (PRIS) because of the structural similarity between coenzyme Q10 (CoQ10) and propofol. Aim: To investigate the effects of CoQ10 on survival and organ injury in a PRIS model in rabbits. Methods: Sixteen male New Zealand white rabbits were divided into 4 groups: (1) propofol infusion group, (2) propofol infusion and CoQ10, 100 mg/kg was administered intravenously, (3) sevoflurane inhalation was administered, and (4) sevoflurane inhalation and CoQ10, 100 mg/kg intravenously, was administered. Arterial blood gas and biochemical analyses were repeated every 2 h and every 12 h, respectively. Animals that were alive on the 24th hour after anesthesia induction were euthanized. The organ damages were investigated under light and transmission electron microscopy (TEM). Results: The propofol infusion group had the highest troponin T levels when compared with the other three groups at the 12th hour. The propofol + CoQ10 group had lower troponin T levels when compared with the propofol and sevoflurane groups (P < 0.05). Administration of CoQ10 decreased total liver injury scores and total organ injury scores both in the propofol and sevoflurane groups. The propofol and sevoflurane organ toxicities were attenuated with CoQ10 in liver, gallbladder, urinary bladder, and spleen. Conclusion: The addition of CoQ10 to propofol and sevoflurane anesthesia prevented the propofol-associated increase in troponin T levels at the 12th hour of infusion and decreased anesthetic-induced total liver and organ injury scores.

A Naturalistic Setup for Presenting Real People and Live Actions in Experimental Psychology and Cognitive Neuroscience Studies.

Perception of others' actions is crucial for survival, interaction, and communication. Despite decades of cognitive neuroscience research dedicated to understanding the perception of actions, we are still far away from developing a neurally inspired computer vision system that approaches human action perception. A major challenge is that actions in the real world consist of temporally unfolding events in space that happen "here and now" and are actable. In contrast, visual perception and cognitive neuroscience research to date have largely studied action perception through 2D displays (e.g., images or videos) that lack the presence of actors in space and time, hence these displays are limited in affording actability. Despite the growing body of knowledge in the field, these challenges must be overcome for a better understanding of the fundamental mechanisms of the perception of others' actions in the real world. The aim of this study is to introduce a novel setup to conduct naturalistic laboratory experiments with live actors in scenarios that approximate real-world settings. The core element of the setup used in this study is a transparent organic light-emitting diode (OLED) screen through which participants can watch the live actions of a physically present actor while the timing of their presentation is precisely controlled. In this work, this setup was tested in a behavioral experiment. We believe that the setup will help researchers reveal fundamental and previously inaccessible cognitive and neural mechanisms of action perception and will be a foundation for future studies investigating social perception and cognition in naturalistic settings.

Relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during the COVID-19 pandemic.

AIM: The study aimed to determine the relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during COVID-19. METHODS: The population of the study was women with gynecologic cancer who received chemotherapy in a university hospital. The study sample was calculated using G*Power 3.1.9.4 analysis program and completed with 64 patients who agreed to participate and met the research criteria. The personal information form, supportive care needs survey-short form (SCNS-SF29Tr ), coronavirus anxiety scale (CAS), and death anxiety scale (DAS) were used for data collection. RESULTS: The participants' SCNS-SF29Tr mean score was 105.7 ± 17.26, CAS mean score was 11.19 ± 3.96, and DAS mean score was 40.13 ± 15.5. There was a positive, very high-level correlation between the health system and information and psychological needs subscales of SCNS-SF29Tr and CAS (r = 0.809, r = 0.878, respectively; p < 0.05). In addition, a high-level relationship was found between the daily life subscale of SCNS-SF29Tr and CAS (r = 0.674; p < 0.001). A positive low-level relationship was determined between the health system and information, daily life, and psychological needs (except for the sexuality) subscales of SCNS-SF29Tr and DAS (r = 0.357, r = 0.252, r = 0.353 respectively; p < 0.05). CONCLUSION: Gynecologic cancer participants had unmet supportive care needs in all subscales except for the sexuality. The participants had higher supportive care needs, high-level coronavirus anxiety, and medium-level death anxiety. In addition, the participants' all supportive care needs have increased as their coronavirus anxiety levels have increased. The participants' supportive care needs have increased, except for sexuality, as their death anxiety levels have increased.

Gendered Actions with a Genderless Robot: Gender Attribution to Humanoid Robots in Action.

The present study aims to investigate how gender stereotypes affect people's gender attribution to social robots. To this end, we examined whether a robot can be assigned a gender depending on a performed action. The study consists of 3 stages. In the first stage, we determined masculine and feminine actions by a survey conducted with 54 participants. In the second stage, we selected a gender-neutral robot by having 76 participants rate several robot stimuli in the masculine-feminine spectrum. In the third stage, we created short animation videos in which the gender-neutral robot determined in stage two performed the masculine and feminine actions determined in stage one. We then asked 102 participants to evaluate the robot in the videos in the masculine-feminine spectrum. We asked them to rate the videos according to their own view (self-view) and how they thought society would evaluate them (society-view). We also used the Socialization of Gender Norms Scale (SGNS) to identify individual differences in gender attribution to social robots. We found the main effect of action category (feminine vs. masculine) on both self-view reports and society-view reports suggesting that a neutral robot was reported to be feminine if it performed feminine actions and masculine if it performed masculine actions. However, society-view reports were more pronounced than the self-view reports: when the neutral robot performed masculine actions, it was found to be more masculine in the society-view reports than the self-view reports; and when it performs feminine actions, it was found to be more feminine in the society-view reports than the self-view reports. In addition, the SGNS predicted the society-view reports (for feminine actions) but not the self-view reports. In sum, our study suggests that people can attribute gender to social robots depending on the task they perform.

Characterization of the Novel P2X7 Receptor Radioligand [3H]JNJ-64413739 in Human Brain Tissue.

Radioligands targeting microglia cells have been developed to identify and determine neuroinflammation in the living brain. One recently discovered ligand is JNJ-64413739 that binds selectively to the purinergic receptor P2X7R. The expression of P2X7R is increased under inflammation; hence, the ligand is considered useful in the detection of neuroinflammation in the brain. [18F]JNJ-64413739 has been evaluated in healthy subjects with positron emission tomography; however, the in vitro binding properties of the ligand in human brain tissue have not been investigated. Therefore, the purpose of this study was to measure Bmax and Kd of [3H]JNJ-64413739 using autoradiography on human cortical tissue sections resected from a total of 48 patients with treatment-resistant epilepsy. Correlations between the specific binding of [3H]JNJ-64413739 with age, sex, and duration of disease were explored. Finally, to examine the relationship between P2X7R and TSPO availability, specific binding of [3H]JNJ-64413739 and [123I]CLINDE was examined in the same tissue. The binding was measured in both cortical gray and subcortical white matter. Saturation revealed a Kd (5 nM) value similar between gray and white matter but a larger Bmax in the white than in the gray matter. The binding was completely displaced by the cold ligand and structurally different P2X7R ligands. The variability in saturable binding among the samples was found to be 38% in gray and white matter but was not correlated to either age, sex, or the duration of the disease. Interestingly, there was no significant correlation between [3H]JNJ-64413739 and [123I]CLINDE binding. These data demonstrate that [3H]JNJ-64413739 is a suitable radioligand for evaluating the distribution and expression of the P2X7R in the human brain.

An Exploratory Analysis of the Neural Correlates of Human-Robot Interactions With Functional Near Infrared Spectroscopy.

Functional near infrared spectroscopy (fNIRS) has been gaining increasing interest as a practical mobile functional brain imaging technology for understanding the neural correlates of social cognition and emotional processing in the human prefrontal cortex (PFC). Considering the cognitive complexity of human-robot interactions, the aim of this study was to explore the neural correlates of emotional processing of congruent and incongruent pairs of human and robot audio-visual stimuli in the human PFC with fNIRS methodology. Hemodynamic responses from the PFC region of 29 subjects were recorded with fNIRS during an experimental paradigm which consisted of auditory and visual presentation of human and robot stimuli. Distinct neural responses to human and robot stimuli were detected at the dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) regions. Presentation of robot voice elicited significantly less hemodynamic response than presentation of human voice in a left OFC channel. Meanwhile, processing of human faces elicited significantly higher hemodynamic activity when compared to processing of robot faces in two left DLPFC channels and a left OFC channel. Significant correlation between the hemodynamic and behavioral responses for the face-voice mismatch effect was found in the left OFC. Our results highlight the potential of fNIRS for unraveling the neural processing of human and robot audio-visual stimuli, which might enable optimization of social robot designs and contribute to elucidation of the neural processing of human and robot stimuli in the PFC in naturalistic conditions.

Task-Dependent Warping of Semantic Representations During Search for Visual Action Categories.

Object and action perception in cluttered dynamic natural scenes relies on efficient allocation of limited brain resources to prioritize the attended targets over distractors. It has been suggested that during visual search for objects, distributed semantic representation of hundreds of object categories is warped to expand the representation of targets. Yet, little is known about whether and where in the brain visual search for action categories modulates semantic representations. To address this fundamental question, we studied brain activity recorded from five subjects (1 female) via functional magnetic resonance imaging while they viewed natural movies and searched for either communication or locomotion actions. We find that attention directed to action categories elicits tuning shifts that warp semantic representations broadly across neocortex, and that these shifts interact with intrinsic selectivity of cortical voxels for target actions. These results suggest that attention serves to facilitate task performance during social interactions by dynamically shifting semantic selectivity towards target actions, and that tuning shifts are a general feature of conceptual representations in the brain.SIGNIFICANCE STATEMENTThe ability to swiftly perceive the actions and intentions of others is a crucial skill for humans, which relies on efficient allocation of limited brain resources to prioritise the attended targets over distractors. However, little is known about the nature of high-level semantic representations during natural visual search for action categories. Here we provide the first evidence showing that attention significantly warps semantic representations by inducing tuning shifts in single cortical voxels, broadly spread across occipitotemporal, parietal, prefrontal, and cingulate cortices. This dynamic attentional mechanism can facilitate action perception by efficiently allocating neural resources to accentuate the representation of task-relevant action categories.

Spatio-Temporal Alterations in Synaptic Density During Epileptogenesis in the Rat Brain.

Synaptic vesicle glycoprotein 2A (SV2A) is a transmembrane protein that binds levetiracetam and is involved in neurotransmission via an unknown mechanism. SV2A-immunoreactivity is reduced in animal models of epilepsy, and in postmortem hippocampi from patients with temporal lobe epilepsy. It is not known if other regions outside the hippocampus are affected in epilepsy, and whether SV2A expression is permanently reduced or regulated over time. In this study, we induced a generalized status epilepticus (SE) by systemic administration of lithium-pilocarpine to adult female rats. The brains from all animals experiencing SE were collected at different time points after the treatment. The radiotracer, [11C]-UCB-J, binds to SV2A with high affinity, and has been used for in vivo imaging as an a-proxy marker for synaptic density. Here we determined the level of tritiated UCB-J binding by semiquantitative autoradiography in the cerebral cortex, hippocampus, thalamus, and hypothalamus, and in cortical subregions. A prominent and highly significant reduction in SV2A binding capacity was observed over the first days after SE in the cerebral cortex and the hippocampus, but not in the thalamus and hypothalamus. The magnitude in reduction was larger and occurred earlier in the hippocampus and the piriform cortex, than in other cortical subregions. Interestingly, in all areas examined, the binding capacity returned to control levels 12 weeks after the SE comparable to the chronic epileptic phase. These data indicate that lithium-pilocarpine-induced epileptogenesis involves both loss and gain of synapses in the in a time-dependent manner.

Expression profile of synaptic vesicle glycoprotein 2A, B, and C paralogues in temporal neocortex tissue from patients with temporal lobe epilepsy (TLE).

Synaptic vesicle glycoprotein-2 (SV2) is a family of proteins consisting of SV2A, SV2B, and SV2C. This protein family has attracted attention in recent years after SV2A was shown to be an epileptic drug target and a perhaps a biomarker of synaptic density. So far, the anatomical localization of these proteins in the rodent and human brain have been reported, but co-expression of SV2 genes on a cellular level, their expressions in the human brain, comparison to radioligand binding, any possible regulation in epilepsy are not known. We have here analyzed the expression of SV2 genes in neuronal subtypes in the temporal neocortex in selected specimens by using single nucleus-RNA sequencing, and performed quantitative PCR in populations of temporal lobe epilepsy (TLE) patients and healthy controls. [3H]-UCB-J autoradiography was performed to analyze the correlation between the mRNA transcript and binding capacity to SV2A. Our data showed that the SV2A transcript is expressed in all glutamatergic and GABAergic cortical subtypes, while SV2B expression is restricted to only the glutamatergic neurons and SV2C has very limited expression in a small subgroup of GABAergic interneurons. The level of [3H]-UCB-J binding and the concentration of SV2A mRNA is strongly correlated in each patient, and the expression is lower in the TLE patients. There is no relationship between SV2A expression and age, sex, seizure frequency, duration of epilepsy, or whether patients were recently treated with levetiracetam or not. Collectively, these findings point out a neuronal subtype-specific distribution of the expression of the three SV2 genes, and the lower levels of both radioligand binding and expression further emphasize the significance of these proteins in this disease.

A Large Video Set of Natural Human Actions for Visual and Cognitive Neuroscience Studies and Its Validation with fMRI.

The investigation of the perception of others' actions and underlying neural mechanisms has been hampered by the lack of a comprehensive stimulus set covering the human behavioral repertoire. To fill this void, we present a video set showing 100 human actions recorded in natural settings, covering the human repertoire except for emotion-driven (e.g., sexual) actions and those involving implements (e.g., tools). We validated the set using fMRI and showed that observation of the 100 actions activated the well-established action observation network. We also quantified the videos' low-level visual features (luminance, optic flow, and edges). Thus, this comprehensive video set is a valuable resource for perceptual and neuronal studies.

Cost of Chronic Critically Ill Patients to the Healthcare System: A Single-center Experience from a Developing Country.

BACKGROUND: An increasing number of patients become chronic critically ill (CCI) and dependent on long-term therapies in the intensive care unit (ICU). Mortality and healthcare costs increase in these patients. In order to deal with this problem, the magnitude and risk factors for CCI must first be determined. Therefore, we aimed at evaluating the incidence cost and risk factors for CCI in our ICU. MATERIALS AND METHODS: This retrospective cohort study was compiled by recruiting patients admitted to our ICU between January 1, 2017, and December 31, 2018. Patients with an ICU stay of more than 21 days were defined as CCI. Patients who did not survive in the first 21 days were excluded from the study because it could be not known whether these patients would progress to CCI. During the study period, 1,166 patients were followed up, and 475 (40%) of them were excluded and 691 patients were included in the final analyses. RESULTS: During the study period, 691 patients were included in the study and 152 of them (22%) were CCI. Age, acute physiology and chronic health evaluation (APACHE)-2 score, length of stay, and daily costs were higher in patients with CCI. The cost for a patient with CCI is sixfold that of a patient without CCI. ICU mortality was 47% in patients without CCI and 54% in the CCI patients (p < 0.001). CONCLUSION: CCI affects an increasing number of patients and leads to increased mortality rates and cost. Prolonged duration in ICU may cause complications such as secondary infections, sepsis episodes, and acute renal injury. The treatment of these complications may lead to increased mortality and cost. HOW TO CITE THIS ARTICLE: Yildirim S, Durmaz Y, San Y, Taskiran I, Cinleti BA, Kirakli C. Cost of Chronic Critically Ill Patients to the Healthcare System: A Single-center Experience from a Developing Country. Indian J Crit Care Med 2021;25(5):519-523.

The unique role of parietal cortex in action observation: Functional organization for communicative and manipulative actions.

Action observation is supported by a network of regions in occipito-temporal, parietal, and premotor cortex in primates. Recent research suggests that the parietal node has regions dedicated to different action classes including manipulation, interpersonal interactions, skin displacement, locomotion, and climbing. The goals of the current study consist of: 1) extending this work with new classes of actions that are communicative and specific to humans, 2) investigating how parietal cortex differs from the occipito-temporal and premotor cortex in representing action classes. Human subjects underwent fMRI scanning while observing three action classes: indirect communication, direct communication, and manipulation, plus two types of control stimuli, static controls which were static frames from the video clips, and dynamic controls consisting of temporally-scrambled optic flow information. Using univariate analysis, MVPA, and representational similarity analysis, our study presents several novel findings. First, we provide further evidence for the anatomical segregation in parietal cortex of different action classes: We have found a new site that is specific for representing human-specific indirect communicative actions in cytoarchitectonic parietal area PFt. Second, we found that the discriminability between action classes was higher in parietal cortex than the other two levels suggesting the coding of action identity information at this level. Finally, our results advocate the use of the control stimuli not just for univariate analysis of complex action videos but also when using multivariate techniques.

Comparison of the effects of bilateral and unilateral laparoscopic ovarian drilling on pregnancy rates in infertile patients with polycystic ovary syndrome.

AIM: This study aims to investigate the effects of unilateral and bilateral laparoscopic ovarian drilling (LOD) on pregnancy rates in patients with clomiphene citrate (CC) resistant infertile polycystic ovary syndrome. METHODS: This prospective cohort study included 75 patients who were admitted to the Department of Obstetrics and Gynecology of the Antalya Training and Research Hospital between July 2016 and December 2017 and underwent LOD operation. Among these patients, 37 underwent unilateral laparoscopic ovarian drilling (ULOD) and 38 underwent bilateral laparoscopic ovarian drilling (BLOD). The drilling procedure was carried out using the following equation: Number of punctures (np) = 60 J/cm3 /30 watt × 4 s by selecting the larger ovary in the patients who underwent ULOD and by taking the ovarian volume of each ovary in the BLOD group. RESULTS: During the 1-year follow-up, 20 of the ULOD patients (54.1%) and 13 of the BLOD patients (34.2%) were observed to be pregnant. Although a higher number of pregnancies were obtained in the ULOD group, no statistically significant difference was found between the two groups (P = 0.083). The pregnancies occurred more in the first 6 months during the postoperative follow-ups of the patients. A total of 14 (70%) of the 20 pregnancies in the ULOD group and 9 (69.2%) of the 13 pregnancies in the BLOD group occurred in the first 6 months. CONCLUSION: ULOD with respect to a larger ovarian volume should be preferred to BLOD for CC-resistant PCOS patients because of the high pregnancy rates and fewer potential side effects.

A parietal region processing numerosity of observed actions: An FMRI study.

When observing others' behavior, it is important to perceive not only the identity of the observed actions (OAs), but also the number of times they were performed. Given the mounting evidence implicating posterior parietal cortex in action observation, and in particular that of manipulative actions, the aim of this study was to identify the parietal region, if any, that contributes to the processing of observed manipulative action (OMA) numerosity, using the functional magnetic resonance imaging technique. Twenty-one right-handed healthy volunteers performed two discrimination tasks while in the scanner, responding to video stimuli in which an actor performed manipulative actions on colored target balls that appeared four times consecutively. The subjects discriminated between two small numerosities of either OMAs ("Action" condition) or colors of balls ("Ball" condition). A significant difference between the "Action" and "Ball" conditions was observed in occipito-temporal cortex and the putative human anterior intraparietal sulcus (phAIP) area as well as the third topographic map of numerosity-selective neurons at the post-central sulcus (NPC3) of the left parietal cortex. A further region of interest analysis of the group-average data showed that at the single voxel level the latter area, more than any other parietal or occipito-temporal numerosity map, favored numerosity of OAs. These results suggest that phAIP processes the identity of OMAs, while neighboring NPC3 likely processes the numerosity of the identified OAs.

Predictive processing account of action perception: Evidence from effective connectivity in the action observation network.

Visual perception of actions is supported by a network of brain regions in the occipito-temporal, parietal, and premotor cortex in the primate brain, known as the Action Observation Network (AON). Although there is a growing body of research that characterizes the functional properties of each node of this network, the communication and direction of information flow between the nodes is unclear. According to the predictive coding account of action perception (Kilner, Friston, & Frith, 2007a; 2007b), this network is not a purely feedforward system but has backward connections through which prediction error signals are communicated between the regions of the AON. In the present study, we investigated the effective connectivity of the AON in an experimental setting where the human subjects' predictions about the observed agent were violated, using fMRI and Dynamical Causal Modeling (DCM). We specifically examined the influence of the lowest and highest nodes in the AON hierarchy, pSTS and ventral premotor cortex, respectively, on the middle node, inferior parietal cortex during prediction violation. Our DCM results suggest that the influence on the inferior parietal node is through a feedback connection from ventral premotor cortex during perception of actions that violate people's predictions.