Transcranial Magnetic Stimulation of the Supplementary Motor Area in the Treatment of Obsessive-Compulsive Disorder: A Multi-Site Study

Recently, strategies beyond pharmacological and psychological treatments have been developed for the management of obsessive-compulsive disorder (OCD). Specifically, repetitive transcranial magnetic stimulation (rTMS) has been employed as an adjunctive treatment in cases of treatment-refractory OCD. Here, we investigate six weeks of low frequency rTMS, applied bilaterally and simultaneously over the sensory motor area, in OCD patients in a randomized, double-blind placebo-controlled clinical trial. Twenty-two participants were randomly enrolled into the treatment (ACTIVE = 10) or placebo (SHAM = 12) groups. At each of seven visits (baseline; day 1 and weeks 2, 4, and 6 of treatment; and two and six weeks after treatment) the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was administered. At the end of the six weeks of rTMS, patients in the ACTIVE group showed a clinically significant decrease in Y-BOCS scores compared to both the baseline and the SHAM group. This effect was maintained six weeks following the end of rTMS treatment. Therefore, in this sample, rTMS appeared to significantly improve the OCD symptoms of the treated patients beyond the treatment window. More studies need to be conducted to determine the generalizability of these findings and to define the duration of rTMS’ clinical effect on the Y-BOCS. Clinical Trial Registration Number (NCT) at www.clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT00616486","term_id":"NCT00616486"}}NCT00616486.     

Modelling and Characterisation of the Texture Development in the Fusion Zone of An Austenitic Weld

The relation between texture and microstructure and the macroscopic solidification direction has been investigated for an austenitic 316L stainless steel weld. The fusion zone has been characterised by EBSD. Texture development has been simulated by thermal Finite Element Analysis coupled with a simple model of preferential <100>‐oriented solidification following the solidification direction. The thermal part is validated by means of thermocouple measurements at several locations on the specimen. The predicted texture is in very good agreement with the measured one.     

Wrapping Effect and Wrapping Function

We study the wrapping effect associated with validated interval methods for numerical solution of the initial value problem for ordinary differential equations by introducing a new concept of wrapping function. The wrapping function is proved to be the limit of the enclosures of the solution produced by methods of certain type. There is no wrapping effect if and only if the wrapping function equals the optimal interval enclosure of the solution.     

Cytokine patterns in patients after major vascular surgery, hemorrhagic shock, and severe blunt trauma. Relation with subsequent adult respiratory distress syndrome and multiple organ failure

OBJECTIVE: This study investigates the course of serum cytokine levels in patients with multiple trauma, patients with a ruptured abdominal aortic aneurysm (AAA), and patients undergoing elective AAA repair and the relationship of these cytokines to the development of adult respiratory distress syndrome (ARDS) and multiple organ failure (MOF). SUMMARY BACKGROUND DATA: Severe tissue trauma, hemorrhagic shock, and ischemia-reperfusion injury are pathophysiologic mechanisms that may result in an excessive uncontrolled activation of inflammatory cells and mediators. This inflammatory response is thought to play a key role in the development of (remote) cell and organ dysfunction, which is the basis of ARDS and MOF. METHODS: The study concerns 28 patients with multiple trauma, 20 patients admitted in shock because of a ruptured AAA, and 18 patients undergoing elective AAA repair. Arterial blood was serially sampled from admission (or at the start of elective operation) to day 13 in the intensive care unit, and the serum concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1 beta, and IL-6 were determined. RESULTS: Twenty-two patients died, 15 within 48 hours and 7 after several weeks, as a result of ARDS/MOF. At hospital admission and after 6 hours, these nonsurvivors had significantly higher plasma TNF-alpha and IL-1 beta levels than did the survivors. At the same measuring points, TNF-alpha and IL-1 beta were significantly more elevated in patients with ruptured AAA than in traumatized patients. However, IL-6 was significantly higher in the traumatized patients. In 10 patients, ARDS/MOF developed, and 41 had an uncomplicated course in this respect. Those with ARDS/MOF exhibited significantly different cytokine patterns in the early postinjury phase. TNF-alpha and IL-1 beta levels were higher mainly on the first day of admission; IL-6 concentrations were significantly elevated in patients with ARDS/MOF from the second day onward. The latter cytokine showed a good correlation with the daily MOF score during the whole 2-week observation period. CONCLUSIONS: In the early postinjury phase, higher concentrations of these cytokines are associated, not only with an increased mortality rate, but also with an increased risk for subsequent ARDS and MOF. These data therefore support the concept that these syndromes are caused by an overwhelming autodestructive inflammatory response.     

Electrochemical study of rat brain acetylcholinesterase inhibition by chlorofos: Kinetic aspects and analytical applications

An electrochemical sensor was applied for investigating the immobilized rat brain acetylcholinesterase inhibition by chlorofos. Two alternative routes were explored as response-generating reactions: (i) direct electrochemical oxidation of thiocholine produced upon acetylthiocholine enzymatic hydrolysis and (ii) reduction of the produced thiocholine with hexacyanoferrate (III), followed by hexacyanoferrate (II) electrochemical detection. The advantages of the direct way are simplicity and higher sensitivity compared to the indirect one, which however avoids the interferences because of the lower potential applied.Enzyme inhibition was identified as competitive, the increasing from 1.31 to 1.43 mmol L⁻¹ with chlorofos concentration in the range 0.2-1.0 mmol L⁻¹ and the maximal rate of the enzyme reaction remaining constant (I_max = 579.30 ± 5.71 μA) in the presence of chlorofos. The inhibition constant was calculated using the Dixon method (K_I = 10.07 mmol L⁻¹).The suppression of the acetylcholinesterase activity by the inhibitor, expressed as current decrease at a constant substrate concentration, was exploited for chlorofos quantification optimized by the design of experiments methodology. Optimal response was obtained for an acetylthiocholine concentration of 0.2 mmol L⁻¹, at 26 °C and pH 7.     

Fatigue crack growth in TRIP steel under positive R-ratios

Load-controlled fatigue tests are conducted for four positive R values on a low-alloy TRIP steel for two different heat treatments: an optimal treatment leading to a multiphase microstructure containing retained austenite, ferrite, bainite and martensite, and a non-optimal treatment leading to a ferritic–martensitic dual-phase microstructure. A significantly increased resistance to fatigue crack growth is found for the optimal case with respect to the non-optimal case. The amount of crack closure is found to be larger in case of the non-optimally treated (ferritic–martensitic) steel. Close to the crack tip, an increased hardness suggests martensite formation. An EBSD technique is used to quantify the volume of retained austenite ahead of the crack tip, within the plastic zone. It is found that martensite formation only occurs within the monotonic plastic zone during fatigue. By evaluation of the retained austenite fraction during straining in static tensile tests, the plastic strain levels within the plastic zone are assessed. Additionally, the effect of martensite formation on fracture toughness is estimated.