Visuospatial properties of ventral premotor cortex

In macaque ventral premotor cortex, we recorded the activity of neurons that responded to both visual and tactile stimuli. For these bimodal cells, the visual receptive field extended from the tactile receptive field into the adjacent space. Their tactile receptive fields were organized topographically, with the arms represented medially, the face represented in the middle, and the inside of the mouth represented laterally. For many neurons, both the visual and tactile responses were directionally selective, although many neurons also responded to stationary stimuli. In the awake monkeys, for 70% of bimodal neurons with a tactile response on the arm, the visual receptive field moved when the arm was moved. In contrast, for 0% the visual receptive field moved when the eye or head moved. Thus the visual receptive fields of most "arm + visual" cells were anchored to the arm, not to the eye or head. In the anesthetized monkey, the effect of arm position was similar. For 95% of bimodal neurons with a tactile response on the face, the visual receptive field moved as the head was rotated. In contrast, for 15% the visual receptive field moved with the eye and for 0% it moved with the arm. Thus the visual receptive fields of most "face + visual" cells were anchored to the head, not to the eye or arm. To construct a visual receptive field anchored to the arm, it is necessary to integrate the position of the arm, head, and eye. For arm + visual cells, the spontaneous activity, the magnitude of the visual response, and sometimes both were modulated by the position of the arm (37%), the head (75%), and the eye (58%). In contrast, to construct a visual receptive field that is anchored to the head, it is necessary to use the position of the eye, but not of the head or the arm. For face + visual cells, the spontaneous activity and/or response magnitude was modulated by the position of the eyes (88%), but not of the head or the arm (0%). Visual receptive fields anchored to the arm can encode stimulus location in "arm-centered" coordinates, and would be useful for guiding arm movements. Visual receptive fields anchored to the head can likewise encode stimuli in "head-centered" coordinates, useful for guiding head movements. Sixty-three percent of face + visual neurons responded during voluntary movements of the head. We suggest that "body-part-centered" coordinates provide a general solution to a problem of sensory-motor integration: sensory stimuli are located in a coordinate system anchored to a particular body part.     

Liability issues in managed care

The explosive growth in Managed Care Organizations as a mechanism for providing health care in the United States has generated an equal explosion in litigation and new legislation related to problems within this delivery system. Abuses have included the "gagging" of physicians from providing full disclosure of medical options for their patients, inappropriate denial of care, denial of specialty referral, false claims data, insurer insolvency, economic credentialling, deselection, financial disincentives to render care, and lack of appeal or grievance mechanisms. These issues and others have resulted in injuries to patients and damage to the patient/physician relationship. This article discusses some of the more dramatic litigated cases and endeavors to alert both physicians and patients to potential legal matters that should be considered before becoming involved within this structure.     

Development and validation of a geriatrics knowledge test for primary care residents

This study reports the development and preliminary validation of an instrument to measure geriatrics knowledge of primary care residents. A 23-item test was developed using questions selected from the American Geriatrics Society's Geriatrics Review Syllabus. Ninety-six internal medicine and family practice residents, 14 geriatrics fellows, and 11 geriatrics faculty members participated in the study. Findings support the reliability (Cronbach's alpha = 0.66) and validity (content and "known groups") of this short test. Predictive validity and sensitivity of the test to changes in knowledge will have to be further explored as residents progress through their training.     

A comparative psychophysiological analysis of anxiety disorders of a permanent and paroxysmal nature

Observation of patients with panic disorders (PD) and generalized anxious disturbances (GAD) by means of contingent negative variation (CNV) revealed that they significantly differ from healthy individuals. Anxiety, depression and autonomic dysfunction were more pronounced in such patients. Both high amplitude of early CNV component and alteration of its habituation were quite typical for patients with PA in contrast to GAD patients and healthy individuals. There were no differences in CNV indices between the healthy group and the patients with GAD. PA patients differed from GAD ones by smaller manifestation of depression, shorter duration of the disease, shorter time of reaction. The data obtained have demonstrated qualitative psychophysiologic differences between PA and GAD groups of patients. They were mostly pronounced in both amplitude of early CNV and alteration of its habituation. PA patients were characterized by an increase of excitability in brain cortex and by surplus orientation activity. The authors suppose that specific CNV pattern reflects neurodynamics of "paroxysmal brain".     

On inverse kinematics with inequality constraints: new insights into minimum jerk trajectory generation

The problem of inverse kinematics is revisited in the present paper. The paper is focusing on the problem of solving the inverse kinematics problem while minimizing the jerk of the joint trajectories. Even though the conventional inverse kinematics algorithms have been proven to be efficient in many applications, it has been proven that constraints on the accelerations or the jerk cannot be guaranteed, and even yields to divergence or makes the problem unsolvable. The proposed algorithm yields smooth velocity and acceleration trajectories, which are highly desired features for industrial robots. The algorithm uses the joint jerk as the control parameter instead of the classical use of the joint velocity as result constraints on the jerk function can be easily incorporated. To validate the proposed approach, we have conducted several simulations scenarios. The simulation results have revealed that the proposed method can efficiently solve the inverse kinematics problem while considering constraints on the joint acceleration and jerk.     

Hydrogen‐Assisted Growth of Ultrathin Te Flakes with Giant Gate‐Dependent Photoresponse

Tellurium (Te), as an elementary material, has attracted intense attention due to its potentially novel properties. However, it is still a great challenge to realize high‐quality 2D Te due to its helical chain structure. Here, ultrathin Te flakes (5 nm) are synthesized via hydrogen‐assisted chemical vapor deposition method. The density functional theory calculations and experiments confirm the growth mechanism, which can be ascribed to the formation of volatile intermediates increasing vapor pressure of the source and promoting the reaction. Impressively, the Te flake‐based transistor shows high on/off ratio ≈10⁴, ultralow off‐state current ≈8 × 10^?13 A, as well as a negligible hysteresis due to reducing thermally activated defects at 80 K. Moreover, Te‐flake‐based phototransistor demonstrates giant gate‐dependent photoresponse: when gate voltage varies from ?70 to 70 V, I_on/I_off is increased by ≈40‐fold. The hydrogen‐assisted strategy may provide a new approach for synthesizing other high quality 2D elementary materials.     

Effect of block composition on the morphology and transport properties of sulfonated fluoroblock copolymer blend membranes

This study focuses on the relationship between the transport properties and the morphological changes of ionic block copolymer blend membranes, as a function of the fluoroblock chemical composition and loading. Poly(styrene‐b‐isobutylene‐b‐styrene) was sulfonated and blended with three different fluoropolymers: Poly(styrene)‐b‐poly(2,3,4,5,6‐pentafluorostyrene)‐b‐poly(2,2,3,4,4,4‐hexafluorobutyl methacrylate) [PS‐b‐PFS‐b‐PHFBMA], a difluoroblock copolymer composed of PS‐b‐PHFBMA and a homopolymer composed of PHFBMA. Equilibrium and transport properties (e.g., ion exchange capacity, water uptake, water content, proton conductivity, and methanol permeability), were shown to be significantly influenced by the chemical nature of the fluoroblock copolymer, the fluoropolymer content, and their resulting morphology. Proton conductivity and methanol permeability were very sensitive to the incorporation of PHFBMA. Polymer blends composed of sulfonated poly(styrene‐b‐isobutylene‐b‐styrene) (SIBS SO₃H) and PHFBMA above 9 wt% showed interconnected ionic domains that have a shorter correlation length and high water content, which results in improved transport properties for direct methanol fuel cell (DMFC) applications. POLYM. ENG. SCI., 57:1262–1272, 2017. © 2017 Society of Plastics Engineers     

Endothelial cell damage by temporary arterial occlusion with surgical clips. Study of the clip site by scanning and transmission electron microscopy

The effects of temporary vascular occlusion with surgical clips on the underlying endothelial lining were studied with scanning (SEM) and transmission (TEM) electron microscopy. Twenty-five rabbits were anesthetized and both common carotid arteries exposed. A Heifetz clip was used to occlude the right carotid artery for 5, 15, and 30 minutes, and 2 hours in five animals each. The clips were removed and the vessels immediately perfused with glutaraldehyde. In five remaining animals, the right carotid arteries were occluded for 30 minutes followed by removal of the clip and resumption of blood flow for 30 minutes prior to fixation. Combined SEM and TEM examination of the endothelium of compressed segments revealed "craters" and "balloons", blebs and vacuoles, swollen mitochondria, dilated granular endoplasmic reticulum, and subendothelial edema. There were also areas of endothelial cell flattening, discontinuity, and desquamation exposing the subendothelial tissues. Following restoration of flow, platelets and fibrin were found adherent to altered endothelial cells and to exposed subendothelial tissues. Endothelial craters and balloons were also found distal and, significantly less frequently, proximal to the site of occlusion. It is suggested that antiplatelet aggregating agents may prove beneficial for the prevention of thrombus formation at the site of the clip as well as craters and balloons distal to the clip following procedures requiring temporary vascular occlusion.     

Loss of renal tissue in the elderly

Eighty-eight kidneys obtained at necropsy from normotensive subjects aged over 50 years were examined histologically and by post-mortem pyelography and angiography. Moderate or severe scarring was present in 50%. Its distribution and the absence of calyceal deformity make pyelonephritic scarrig unlikely. Its extent was related to the severity of change in the renal vessels, but not to age. On pyelograms, scarring was difficult to distinguish from fetal lobation. Kidneys with the most severe histological changes in the vessels tended to show the most marked angiographic distortion, though in general the two techniques examine different parts of the renal vascular bed. Total renal area and "cortical" area, measured from the angiograms, were not significantly correlated with age, thouth both tended to be smaller in older subjects. These dimensions, particularly cortical area, were significantly correlated with vascular changes, being smallest when vessels were most markedly affected. Results suggest that the loss of renal tissue which occurs in the elderly, particularly selective loss of cortex, is more closely related to events in the renal vasculature than to age itself.     

Primary repair of colorectal injuries in childhood

A retrospective survey of 44 children with colorectal perforating injuries secondary to shrapnel and high velocity bullets is presented. Seven patients had the injury limited to the colon or rectum. All patients were operated upon within 7 hr from the their colonic wounds and 20 underwent a colostomy. Five of the patients repaired primarily had their injuries to the left side of the colon or rectum. None of the patients undergoing primary repair suffered from an anastomotic leak. The mortality rate after primary repair was 16.6% and after colostomy 10%. The mortality was significantly different in the group of patients who had additional injuries where a colostomy procedure was associated with a lower mortality rate (11% versus 21%). Shock on admission and during operation affected survival adversely in all patients. The average hospital stay of survivors was 24 days with "primary repair" and 36 days with "colostomy."