Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005

Swift PGF, Skinner TC, de Beaufort CE, Cameron FJ, Åman J, Aanstoot H‐J, Castaño L, Chiarelli F, Daneman D, Danne T, Dorchy H, Hoey H, Kaprio EA, Kaufman F, Kocova M, Mortensen HB, Njølstad PR, Phillip M, Robertson KJ, Schoenle EJ, Urakami T, Vanelli M, Ackermann RW, Skovlund SE for the Hvidoere Study Group on Childhood Diabetes. Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005. Objective: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control. Methods: Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was measured centrally. Results: A total of 2062 adolescents completed questionnaires (age 14.4 ± 2.3 yr; diabetes duration 6.1 ± 3.5 yr). Mean HbA 1c = 8.2 ± 1.4% with significant differences between centres (F = 12.3; p < 0.001) range from 7.4 to 9.1%. There was a significant correlation between parent (r = 0.20) and adolescent (r = 0.21) reports of their perceived ideal HbA1c and their actual HbA1c result (p < 0.001), and a stronger association between parents' (r = 0.39) and adolescents' (r = 0.4) reports of the HbA1c they would be happy with and their actual HbA1c result. There were significant differences between centres on parent and adolescent reports of ideal and happy with HbA1c (8.1 < F > 17.4;p < 0.001). A lower target HbA1c and greater consistency between members of teams within centres were associated with lower centre HbA1c (F = 16.0; df = 15; p < 0.001). Conclusions: Clear and consistent setting of glycaemic targets by diabetes teams is strongly associated with HbA1c outcome in adolescents. Target setting appears to play a significant role in explaining the differences in metabolic outcomes between centres.     

Distinct neural processes in grapheme–colour synaesthetes and semantic controls

In synaesthetes, stimulation of one sensory pathway provokes a sensory experience (e.g. a colour concurrent) in a different sensory modality or sub‐modality. Results of synaesthetic Stroop and priming tests indicate that the perception of a colour concurrent interferes with the processing of a veridical colour in synaesthetes. We here examined the congruency between a stimulus’ colour and the colour concurrent both in grapheme–colour synaesthetes and in non‐synaesthetes trained on grapheme–colour associations. Electrophysiological (electroencephalogram) and behavioural measurements were collected during a priming task that included grapheme–grapheme and grapheme–colour patch pairs. To investigate covert bidirectional synaesthesia, an additional inverted colour patch–grapheme condition was included. Both groups of participants showed longer reaction time and more negative‐going N300 and N400 event‐related potential (ERP) components on incongruent trials. Whereas ERP effects in the non‐synaesthetes were largely confined to the late cognitive components N300, P300 and N400, the synaesthetes also showed congruency‐dependent modulation of the early sensory component N170. Our results suggest that early cognitive processes distinguish cross‐modal synaesthetic perceptions from acquired associations. The involvement of both early‐ and late‐stage cognitive components in bidirectional synaesthesia possibly indicates similar feature‐binding mechanisms during processing of opposite flow directions of information, namely grapheme–colour and colour–grapheme.     

Spatial cueing modulates the monitoring of correct responses

Efficient behavior requires actions to be monitored continuously. The monitoring of errors as reflected in the error negativity (Ne) has been claimed to be an important source for behavioral adaptation. The corresponding process of controlling correct responses is less evaluated. Recent studies on post-behavior negativities implicate a common response monitoring system for both behavioral outcomes. Specifically, it has been suggested that negative potentials following correct responses may be a correlate of response expectancy, evaluating congruences in the absence of behavioral errors. This notion was tested in a simple spatial cueing task. An inhibition of return (IOR) paradigm was utilized and the response-related ERP (Ne-like) was tested in a task with hardly any response errors. The results show that the Ne-like is sensitive to already very basic cue-target relations and the IOR effect.     

The production of leukaemia inhibitory factor by human endometrium: presence in uterine flushings and production by cells in culture

The concentration of leukaemia inhibitory factor (LIF) was measured in uterine flushings obtained from normal fertile women, from women with unexplained infertility and from women who suffered recurrent miscarriage. In normal fertile women, LIF was not detected in flushings obtained on days luteinizing hormone (LH)+0 to LH+6 of the cycle, but concentrations gradually increased from day LH+7 to a maximum at day LH+12. The amount of LIF in flushings obtained from women with unexplained infertility was significantly lower than in those from normal fertile women on day LH+10 (P < 0.05). The production of LIF by cultured human epithelial and stromal cells was also investigated. LIF was not detectable in the supernatants of cultured stromal cells. Basal LIF production by epithelial cells varied according to the stage in the cycle at which the biopsy was taken. Significantly more LIF was produced by epithelial cells from late proliferative and early secretory endometrium compared with amounts produced by cells from early proliferative (P < 0.001) and late secretory (P < 0.01) endometrium. High doses of progesterone and oestradiol caused a small decrease in epithelial cell LIF production: the combined effect of progesterone and oestradiol (P < 0.01) was greater than the effect of either steroid alone (P < 0.05). The results show, for the first time, the capability of human endometrium to produce LIF in vivo. The fact that maximum LIF concentrations are present at implantation and that decreased concentrations occur in women with unexplained infertility suggest the importance of this cytokine in embryo implantation.      

Cytokines and immuno-endocrine factors in recurrent miscarriage

Recurrent miscarriage remains an enigma. The main aetiologiesare endocrinological, immunological and unexplained. With thegrowth in molecular biology, it is now possible to look at theeffect of these aetiologies in more detail, allowing greaterunderstanding of the underlying pathogenesis. Keywords: cytokines/recurrent miscarriage     

Effects of rearranged vision on event-related lateralizations of the EEG during pointing

We used event-related lateralizations of the EEG (ERLs) and reversed vision to study visuomotor processing with conflicting proprioceptive and visual information during pointing. Reversed vision decreased arm-related lateralization, probably reflecting the simultaneous activity of left and right arm specific neurons: neurons in the hemisphere contralateral to the observed action were probably activated by visual feedback, neurons in the hemisphere contralateral to the response side by the somatomotor feedback. Lateralization related to the target in parietal cortex increased, indicating that visual to motor transformation in parietal cortex required additional time and resources with reversed vision. A short period of adaptation to an additional lateral displacement of the visual field increased arm-contralateral activity in parietal cortex during the movement. This is in agreement with the, which showed that adaptation to a lateral displacement of the visual field is reflected in increased parietal involvement during pointing.