Network analysis of prospective brain development in youth with benign epilepsy with centrotemporal spikes and its relationship to cognition.

Objective: Benign epilepsy with centrotemporal spikes (BECTS) is the most common childhood idiopathic localization-related epilepsy syndrome. BECTS presents normal routine magnetic resonance imaging (MRI); however, quantitative analytic techniques have captured subtle cortical and subcortical magnetic resonance anomalies. Network science, including graph theory (GT) analyses, facilitates understanding of brain covariance patterns, potentially informing in important ways how this common self-limiting epilepsy syndrome may impact normal patterns of brain and cognitive development.

Inroads Toward Robot-Assisted Internal Fixation of Bone Fractures Using a Bendable Medical Screw and the Curved Drilling Technique.

Internal fixation is a common orthopedic procedure in which a rigid screw is used to fix fragments of a fractured bone together and expedite the healing process. However, the rigidity of the screw, geometry of the fractured anatomy (e.g.

Dysregulated Glial Differentiation in Schizophrenia May Be Relieved by Suppression of SMAD4- and REST-Dependent Signaling.

Astrocytic differentiation is developmentally impaired in patients with childhood-onset schizophrenia (SCZ). To determine why, we used genetic gain- and loss-of-function studies to establish the contributions of differentially expressed transcriptional regulators to the defective differentiation of glial progenitor cells (GPCs) produced from SCZ patient-derived induced pluripotent cells (iPSCs). Negative regulators of the bone morphogenetic protein (BMP) pathway were upregulated in SCZ GPCs, including BAMBI, FST, and GREM1, whose overexpression retained SCZ GPCs at the progenitor stage.

NRF2/ARE pathway negatively regulates BACE1 expression and ameliorates cognitive deficits in mouse Alzheimer's models.

BACE1 is the rate-limiting enzyme for amyloid-β peptides (Aβ) generation, a key event in the pathogenesis of Alzheimer's disease (AD). By an unknown mechanism, levels of and a mRNA-stabilizing antisense RNA () are elevated in the brains of AD patients, implicating that dysregulation of expression plays an important role in AD pathogenesis. We found that nuclear factor erythroid-derived 2-related factor 2 (NRF2/NFE2L2) represses the expression of and through binding to antioxidant response elements (AREs) in their promoters of mouse and human.

Dissociating task acquisition from expression during learning reveals latent knowledge.

Performance on cognitive tasks during learning is used to measure knowledge, yet it remains controversial since such testing is susceptible to contextual factors. To what extent does performance during learning depend on the testing context, rather than underlying knowledge? We trained mice, rats and ferrets on a range of tasks to examine how testing context impacts the acquisition of knowledge versus its expression. We interleaved reinforced trials with probe trials in which we omitted reinforcement.

Intraoperative ultrasonography (ioUS) characteristics of focal cortical dysplasia (FCD) type II b.

Purpose: Focal cortical dysplasia (FCD) is one of the major causes of drug-resistant epilepsy. Surgery has proved to be the treatment of choice, however up to a third of patients experience only partial resection. Ill-defined borders and lesions embedded in eloquent areas are two of the main drawbacks of FCD surgery.

Thulium fiber laser ablation of kidney stones using an automated, vibrating fiber.

Our preliminary study investigates an automated, vibrating fiber optic tip for dusting of kidney stones during thulium fiber laser (TFL) lithotripsy. A (0.75-mm diameter and 5-mm length) magnetic bead was attached to the fiber jacket, centered 2 cm from distal fiber tip.

Plasma Levels of Soluble AβPPβ as a Biomarker for Alzheimer's Disease with Dementia.

Cost- and time-effective markers of Alzheimer's disease (AD), reliable and feasible at the population level are urgently needed. Soluble amyloid-β protein precursor β (sAβPPβ) in plasma has attracted scientific attention as a potential AD biomarker candidate. Here we report that plasma sAβPPβ levels in patients with AD dementia and typical for AD cerebrospinal fluid (CSF) biomarker profiles (N = 33) are significantly lower (p < 0.

Updates in Pediatric Pancreatology: Proceedings of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Frontiers in Pediatric Pancreatology Symposium.

The Pancreas Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition aims to promote awareness of pediatric pancreatic diseases, support clinical and basic science research in the field, educate pediatric gastroenterologists, and advocate on behalf of pediatric patients with pancreatic disorders. At the 2017 Annual North American Society for Pediatric Gastroenterology, Hepatology and Nutrition meeting, the Pancreas Committee held a full day symposium on pediatric pancreatic diseases, entitled, "Frontiers in Pediatric Pancreatology." The symposium served as a timely and novel academic meeting that brought together individuals with a vested interest in the care of children with pancreatic disorders.

On the Use of a Continuum Manipulator and a Bendable Medical Screw for Minimally Invasive Interventions in Orthopedic Surgery.

Accurate placement and stable fixation are the main goals of internal fixation of bone fractures using the traditional medical screws. These goals are necessary to expedite and avoid improper fracture healing due to misalignment of the bone fragments. However, the rigidity of the screw, geometry of the fractured anatomy (e.

High power holmium:YAG versus thulium fiber laser treatment of kidney stones in dusting mode: ablation rate and fragment size studies.

Objectives: The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative to the gold standard Holmium:YAG laser for lithotripsy. Recent advances in both Holmium and TFL technology allow operation at similar laser parameters for direct comparison. The use of a "dusting" mode with low pulse energy (0.

Recent advances in infrared laser lithotripsy [Invited].

The flashlamp-pumped, solid-state, pulsed, mid-infrared, holmium:YAG laser (λ = 2120 nm) has been the clinical gold standard laser for lithotripsy for over the past two decades. However, while the holmium laser is the dominant laser technology in ureteroscopy because it efficiently ablates all urinary stone types, this mature laser technology has several fundamental limitations. Alternative, mid-IR laser technologies, including a thulium fiber laser (λ = 1908 and 1940 nm), a thulium:YAG laser (λ = 2010 nm), and an erbium:YAG laser (λ = 2940 nm) have also been explored for lithotripsy.

Neural Interactions Underlying Visuomotor Associations in the Human Brain.

Rapid and flexible learning during behavioral choices is critical to our daily endeavors and constitutes a hallmark of dynamic reasoning. An important paradigm to examine flexible behavior involves learning new arbitrary associations mapping visual inputs to motor outputs. We conjectured that visuomotor rules are instantiated by translating visual signals into actions through dynamic interactions between visual, frontal and motor cortex.

Advanced Ultrasound Imaging in Glioma Surgery: Beyond Gray-Scale B-mode.

Glioma surgery is aimed at obtaining maximal safe tumor resection while preserving or improving patient's neurological status. For this reason, there is growing interest for intra-operative imaging in neuro-oncological surgery. Intra-operative ultrasound (ioUS) provides the surgeon with real-time, anatomical and functional information.

Intraoperative Strain Elastosonography in Brain Tumor Surgery.

Background: Sonoelastography is an ultrasound imaging technique able to assess mechanical properties of tissues. Strain elastography (SE) is a qualitative sonoelastographic modality with a wide range of clinical applications, but its use in brain tumor surgery has been so far very limited.

Objective: To describe the first large-scale implementation of SE in oncological neurosurgery for lesions discrimination and characterization.

Peripheral Vertigo.

This article summarizes the systematic assessment of the dizzy patient who presents with peripheral vertigo. It demonstrates the steps and tests necessary using the Triage-Timing-Trigger-Test (Triage + TiTraTe) method to accurately diagnose the underlying most probable cause while ruling out life-threatening causes. Using video support and just-in-time infographics, it demonstrates the Dix-Hallpike, Semont, Epley, and HINTS maneuvers.

Applications of Focused Ultrasound in Cerebrovascular Diseases and Brain Tumors.

Oncology and cerebrovascular disease constitute two of the most common diseases afflicting the central nervous system. Standard of treatment of these pathologies is based on multidisciplinary approaches encompassing combination of interventional procedures such as open and endovascular surgeries, drugs (chemotherapies, anti-coagulants, anti-platelet therapies, thrombolytics), and radiation therapies. In this context, therapeutic ultrasound could represent a novel diagnostic/therapeutic in the armamentarium of the surgeon to treat these diseases.

Tuning Pharmacokinetics to Improve Tumor Accumulation of a Prostate-Specific Membrane Antigen-Targeted Phototheranostic Agent.

We describe a simple and effective bioconjugation strategy to extend the plasma circulation of a low molecular weight targeted phototheranostic agent, which achieves high tumor accumulation (9.74 ± 2.26%ID/g) and high tumor-to-background ratio (10:1).

Clinical Significance of Extracellular Vesicles in Plasma from Glioblastoma Patients.

Purpose: Glioblastoma (GBM) is the most common primary brain tumor. The identification of blood biomarkers reflecting the tumor status represents a major unmet need for optimal clinical management of patients with GBM. Their high number in body fluids, their stability, and the presence of many tumor-associated proteins and RNAs make extracellular vesicles potentially optimal biomarkers.

Progressive dissociation of cortical and subcortical network development in children with new-onset juvenile myoclonic epilepsy.

Objective: Structural and functional magnetic resonance imaging (MRI) studies have consistently documented cortical and subcortical abnormalities in patients with juvenile myoclonic epilepsy (JME). However, little is known about how these structural abnormalities emerge from the time of epilepsy onset and how network interactions between and within cortical and subcortical regions may diverge in youth with JME compared to typically developing children.

Methods: We examined prospective covariations of volumetric differences derived from high-resolution structural MRI during the first 2 years of epilepsy diagnosis in a group of youth with JME (n = 21) compared to healthy controls (n = 22).

Filling the gap between the OR and virtual simulation: a European study on a basic neurosurgical procedure.

Background: Currently available simulators are supposed to allow young neurosurgeons to hone their technical skills in a safe environment, without causing any unnecessary harm to their patients caused by their inexperience. For this training method to be largely accepted in neurosurgery, it is necessary to prove simulation efficacy by means of large-scale clinical validation studies.

Methods: We correlated and analysed the performance at a simulator and the actual operative skills of different neurosurgeons (construct validity).

Quantitative Monitoring Wound Healing Status Through Three-dimensional Imaging on Mobile Platforms.

There are approximately 6.5 million patients in the U.S.

Ectopic expression of aPKC-mediated phosphorylation in p300 modulates hippocampal neurogenesis, CREB binding and fear memory differently with age.

Epigenetic modifications have become an emerging interface that links extrinsic signals to alterations of gene expression that determine cell identity and function. However, direct signaling that regulates epigenetic modifications is unknown. Our previous work demonstrated that phosphorylation of CBP at Ser 436 by atypical protein kinase C (aPKC) regulates age-dependent hippocampal neurogenesis and memory.

PDK4 Deficiency Suppresses Hepatic Glucagon Signaling by Decreasing cAMP Levels.

In fasting or diabetes, gluconeogenic genes are transcriptionally activated by glucagon stimulation of the cAMP-protein kinase A (PKA)-CREB signaling pathway. Previous work showed pyruvate dehydrogenase kinase (PDK) inhibition in skeletal muscle increases pyruvate oxidation, which limits the availability of gluconeogenic substrates in the liver. However, this study found upregulation of hepatic PDK4 promoted glucagon-mediated expression of gluconeogenic genes, whereas knockdown or inhibition of hepatic PDK4 caused the opposite effect on gluconeogenic gene expression and decreased hepatic glucose production.

Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note.

The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins.