A Doença Enxerto Contra Hospedeiro Associada à Transfusão (DECH-AT) é uma reação transfusional rara, porém fatal, que ocorre devido à presença de células T no sangue doado e que pode ser prevenida por meio da irradiação do sangue do doador e de seus componentes antes da transfusão. Assim, o controle de qualidade associado à irradiação do sangue é necessário para se garantir a qualidade do produto transfundido. Neste trabalho é proposta a caracterização e a adaptação da resposta do dosímetro Fricke para uso na dosimetria da irradiação de sangue, mais especificamente o Fricke Xilenol Gel (FXG). Este é um dosímetro químico radiocrômico, que apresenta as vantagens de ser tecido equivalente e de permitir a inferência espacial da dose absorvida dentro da faixa de doses usados na prevenção DECH-AT. Dessa maneira, de modo a possibilitar a inferência de dose absorvida em todo o intervalo utilizado na prevenção da DECH-AT (25 a 50 Gy), o FXG foi caracterizado e adaptado para aplicações dosimétricas envolvendo a irradiação de sangue e derivados. Os resultados com o novo dosímetro apontaram adequabilidade para toda a faixa necessária de doses absorvidas, com sensibilidade e desvanecimento temporal satisfatórios para aplicações rotineiras. Além disso, pela metodologia proposta neste trabalho, foi possível determinar as distribuições espaciais das doses absorvidas com o dosímetro proposto de uma maneira rápida e simples, mostrando assim que este dosímetro apresenta características convenientes para o controle de qualidade para a dosimetria da irradiação de sangue e de hemocomponentes. / The Transfusion Associated Graft Versus Host Disease (TA-GVHD) is a rare transfusion reaction, however fatal, which develops due to the presence of donor T lymphocytes in the donated blood and that can be avoided by the irradiation of the donated blood blood and blood components prior to transfusion. Thus, the associated quality control of blood irradiation is necessary to guarantee the quality of the transfused product. In this work it is proposed the characterization and adaptation of the response of a Fricke dosimeter to be used for dosimetry of blood irradiation, more especiafically the Fricke Xylenol Gel (FXG). This is a radiochromic chemical dosimeter, which presents advantages to be tissue equivalent and allows the spatial absorbed dose inference. In this manner, in a way to possibilitate the absorbed dose inference in the full interval used for the prevention of the TA-GVHD (25 to 50 Gy) the FXG was characterized and adapted for dosimetry applications involving blood and blood components irradiation. The results with the new dosimeter showed adequability for the necessary absorbed doses, with satisfactory sensibility and time fading for routine applications. Furthermore, according to the methodology proposed in this work, it was possible to determine the spatial absorbed dose distributions with the new dosimeter in an fast and simple way, showing that this dosimeter presents convenient characteristics for dosimetry quality control of irradiated the blood and blood components.

A partir da leitura de Ernesto Guerra da Cal em Língua e Estilo de Eça de Queiroz, um estudo completo dos procedimentos estilísticos de Eça, há citação sobre a leitura e a influência queirosiana no \"Modernismo\" espanhol, passagem esta que nos desafiou à procura da real importância da recepção da obra do autor lusitano na Espanha; definindo esta pesquisa como seu objeto de estudo uma série de artigos que haviam sido publicados em castelhano, acerca dessa temática, a partir de 1883 a 1903. Veremos a leitura \"versus\" da obra de Eça de Queirós e a leitura \"com\" a obra de Eça de Queirós na Espanha, alcançando a Geração de 98; e as traduções queirosianas editadas em castelhano, entre 1882 e 1915. / The starting point for the present essay is Guerra da Cal, Língua e Estilo de Eça de Queirós, a complet reading of Eça de Queirós stylistics, in which there are various references to the influence the Portuguese author in the Spanish \"Modernismo\". Following such point of view, this study focusses on a series of articles published between 1883 and 1903.Thus, we analyse here the \"pros\" and \"cons\" of the reception of Eça de Queirós\' oeuvre in Spain, including the reactions of the \"Generación del 98\" and an overview of the translations of the Portuguese novelist into Spanish between the years 1882 to 1915.

A boca é local de frequentes complicações relacionadas ao transplante de células tronco hematopoiéticas (TCTH) tais como xerostomia, disgeusia, disfagia, mucosite, infecções oportunistas e doença do enxerto contra hospedeiro (DECH). Sabe-se que estas complicações podem comprometer a qualidade de vida do paciente e interferir na morbidade pós-TCTH. O dentista é o profissional da saúde que deverá intervir no momento correto para tratar e minimizar esses efeitos secundários do TCTH. Para tanto é importante conhecermos o momento em que cada complicação ocorre para que a intervenção seja pronta e eficiente. O objetivo principal deste estudo foi identificar e quantificar as alterações bucais em indivíduos submetidos ao TCTH em cinco momentos consecutivos desde antes do início do condicionamento pré-TCTH até o dia 100 pós-TCTH. Como objetivos secundários buscamos investigar possíveis relações entre a severidade da mucosite oral e a manifestação da DECH com dados demograficos (sexo, idade), com o status de saude bucal (por meio dos índices IHO-S, CPOD, número de dentes cariados) e com a realização de adequação bucal pré-TCTH, e ainda, somente para a DECH, também foi investigada a possível relação entre esta doença com infecção sistêmica por citomegalovírus e com a manifestação de mucosite oral severa. Foram incluídos no estudo 27 indivíduos com doenças hematológicas do Serviço de Transplante de Medula Óssea do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), com idade 12 anos que receberam TCTH alogênico. Os indivíduos foram examinados em cinco momentos consecutivos. No primeiro momento, pré-TCTH, foi realizada a coleta de índices de saúde bucal e aplicação de questionário sobre o histórico de tratamentos odontológico prévios. Nos momentos de 10, 20, 60 e 100 dias pós-TCTH foram avaliadas as manifestações bucais presentes. A incidência de mucosite oral foi de 82,6% considerando todos os momentos avaliados. Mucosite oral severa, ou seja, graus 3 e 4 (OMS) foi observada em 57,9% dos pacientes avaliados nos momentos 2 e 3. Dez (37%) pacientes apresentaram GVHD em algum órgão, e destes, 8 (80%) apresentaram GVHD de boca. Infecção sistêmica por CMV foi diagnosticada em 6 (22,2%) pacientes. Concluímos que entre as queixas levantadas, dor bucal e disfagia foram as mais referidas. O período de maior incidência das complicações bucais foi nos segundo e terceiro momentos, ou seja, D+10 e D+20, representando deste forma, o período de maior morbidade do tratamento. Não houve associação entre a severidade de mucosite oral e idade, sexo, fonte de células, regime de condicionamento, número de dentes cariados, IHO-S, CPOD e preparo bucal pré-TCTH. Para a DECH a única relação encontrada foi para fonte de células, tendo sido observada menor chance de ocorrer DECH quando a fonte de células foi o sangue periférico. / The mouth is a well-known site of complications of the hematopoietic stem cell transplantation (HSCT) such as dry mouth, dysgeusia, dysphagia, mucositis, opportunistic infections and graft versus host disease (GVDH). It is known that these complications can compromise the patients quality of life and morbidity post-HSCT. The dentist is the health professional who should interfere at the right time to treat and minimize these side effects of HSCT. Thus, it is important to know the time at which each complication occurs to be dynamic and efficient. The main objective of this study was to identify and quantify the oral complications in patients treated with HSCT in five consecutive moments starting before conditioning chemotherapy until day 100 post-HSTC. As secondary objectives we seek to investigate possible relationships between the severity of oral mucositis and the manifestation of GVHD with demographic data (gender, age), with the oral health status (IHO-S, CPOD, number of decayed teeth) and dental treatment previously HSCT, and, only for GVHD, was also investigated the possible relationship between this disease with systemic cytomegalovirus infection and the manifestation of severe oral mucositis. It was included in the study 27 patients with hematologic diseases who were admitted in the Unit of Bone Marrow Transplantation, Hospital of Clinics, Faculty of Medicine, University of Sao Paulo (HC-FMUSP), 12 years old whom received allogeneic HSCT. The subjects were examined in five consecutive moments. At the first moment, before HSCT, the oral health índex evaluation and a questionnaire about history of previous dental treatments were performed. Besides that, 10, 20, 60 and 100 days after HSCT they were evaluated for oral manifestations. Oral mucositis incidence was 82,6% and 57,9% of these patients presented severe mucositis. Ten (37%) patients had GVHD in any organ, and of these, 8 (80%) had oral GVHD. Infection by CMV was diagnosed in 6 (22.2%) patients. We conclude that among the complaints raised, mouth pain and dysphagia were the most mentioned. The period of increased incidence of oral complications was the second and third times (D +10 and +20), representing the increased morbidity period. There was no association between the severity of oral mucositis and age, sex, cell source, conditioning regimen, number of decayed teeth, IHO-S, CPOD and dental treatment pre-HSCT. For GVHD the only relation found was with source of cells, in which, GVHD was less likely to occur when the source of cells was peripheral blood.

A doença do enxerto contra o hospedeiro (DECH) é uma das maiores causas de mortalidade e morbidade pós-transplante de células-tronco hematopoiéticas. A DECH, em sua manifestação crônica (DECHc), ainda não tem sua fisiopatologia totalmente esclarecida; entretanto, o envolvimento do sistema imunológico, por meio de respostas imunes inatas e adaptativas é bem estabelecido na literatura. A DECHc afeta múltiplos órgãos, incluindo as glândulas salivares, o que tem, como causa imediata, a xerostomia. Essas alterações são largamente desconhecidas e sub-relatadas. Assim, esse estudo indagou se o sintoma de xerostomia na DECHc é decorrente de alterações morfológicas e funcionais das glândulas salivares. Para responder essa pergunta analisamos de forma qualitativa e por meio da morfometria, espécimes de biopsias de glândulas salivares labiais de pacientes com DECHc e com sintoma de xerostomia. Foram utilizados como controles, espécimes de biopsias de glândulas salivares de pacientes diagnosticados com Síndrome de Sjögren (SSp) (que é um modelo clássico de xerostomia) e de pacientes com líquen plano oral (LPO) (cujas manifestações clínicas orais podem se assemelhar às da DECHc) e queixa de xerostomia. Também foram analisadas, por meio de ensaio multiplex, as citocinas relacionadas à resposta imune Th17 (importante via imunológica na patogenia da DECHc) na saliva de 21 pacientes de DECHc, 27 de SSp, 10 de LPO e 15 voluntários saudáveis. Os principais achados morfológicos nas glândulas salivares dos pacientes de DECHc foram a extensa fibrose, fibroplasia periductal, atrofia ductal e acinar; alterações vasculares representadas pela congestão e formação de trombos hialinos; e infiltrado inflamatório intersticial difuso de aspecto leve a moderado. As glândulas salivares de SSp, entretanto, apresentaram um infiltrado inflamatório na forma de focos de linfócitos ao redor dos ductos excretores de intensidade moderada a severa; os ductos excretores apresentaram-se atróficos, ectásicos, exibindo metaplasia oncocítica e fibroplasia periductal; as alterações vasculares, por sua vez, se apresentaram em maior proporção na forma de vasculite. No LPO as alterações teciduais foram menos intensas. Quando analisadas as concentrações das citocinas, na DECHc, foram encontradas maiores concentrações de IL-17A, IL-4, IL-17F e IL-10, em relação aos grupos controles, essas citocinas estão envolvidas em mecanismos prófibróticos, o que permitiu a correlação dessa expressão aos eventos escleróticos nas glândulas salivares dos pacientes de DECHc. Entre elas, a IL-17F apresentou uma tendência de aumento em relação a proporção da área de fibrose nas glândulas salivares destes pacientes. A CD40L, que também esteve presente em maior concentração nos pacientes de DECHc, é uma molécula de ligação capaz de amplificar a resposta imunológica no mecanismo de rejeição do enxerto no hospedeiro, além de regular o mecanismo de apoptose e ativar o endotélio para a formação de trombos. As citocinas IL-31, IL-23 e IL-22, também apresentaram relevância na saliva dos pacientes de DECHc, sendo participantes do mecanismo das alterações liquenóides no LPO. Através das análises comparativas foi possível correlacionar a presença de citocinas envolvidas na resposta Th17 com as alterações glandulares e consequente xerostomia nos pacientes de DECHc. / The graft versus host disease (GVHD) is one of the biggest causes of mortality and morbidity after hematopoietic stem cells transplantation. The pathophysiology in the chronical manifestation of the disease (cGVHD), is not entirely elucidated, however the involvement of the immunological system, by means of the innate and adaptive responses are depicted in the literature concerning the disease development. The cGVHD affects multiple organs, including the salivary glands, leading to xerostomia. These alterations are under reported and mostly unknown. Therefore, this study investigated if the symptom of xerostomia in cGVHD is triggered by functional e morphological changes in minor salivary glands. To answer this inquiry specimens of biopsied labial salivary glands from patients of cGVHD and xerostomia were analyzed qualitatively and through morphometry. Specimens of biopsied salivary glands from patients with Sjögren\'s Syndrome (SS) (which is a classic model of xerostomia) and from patients with oral lichen planus (OLP) (whose clinical oral manifestations resemble the cGVHD lesions) were used as controls. Also, the cytokines related to the immunological response Th17 (important immune pathway in cGVHD pathophysiology) in the saliva of 21 cGVHD patients, 27 of SS, 10 patients of OLP and 165 healthy individuals were analyzed using the multiplex assay. The major morphological findings revealed on the salivary glands of cGVHD patients were the extensive fibrosis, periductal fibrosis, ductal and acinar atrophy. Congestion and hyaline thrombi formation were the most important vascular changes shown among these specimens. A diffuse interstitial inflammatory infiltrate was observed, with varied intensity. The SS salivary glands, however, portrayed a focal inflammatory infiltrate, with moderate to severe intensity around the excretory ducts. These ducts exhibited atrophy, ectasia, periductal fibrosis and oncocytic metaplasia. The main vascular change presented in these patients was the manifestation of vasculitis. The salivary glands from the OLP patients showed a lesser amount of alterations. The multiplex assay revealed a higher concentration of the cytokines IL-17A, IL-4, IL-17F and IL-10 in the cGVHD samples, when compared to the other groups. These cytokines are involved within the promotion of fibrosis, which endorsed the association of these secretions with the salivary glands sclerotic mechanisms. The secretion of CD40L was higher in cGVHD samples; this membrane protein is capable of amplifying the immunological response in graft rejection, besides the capacity to regulate apoptosis and activate the endothelium in thrombi formation. The cytokines IL-31, IL-23 and IL-22, also presented a higher concentration in cGHVD patients\' saliva, these secretions are actively involved in the mechanisms of lichenoid lesions in OLP, corroborating the perceived morphological changes. The comparative analysis of the morphological and salivary changes in cGVHD confirmed the correlation of Th17 immunological response within the minor salivary glands injuries and consequent xerostomia in these patients.

A roller coaster manufacturer became aware that improperly heat treated track couplings were sent to a construction site for assembly. Concerns were that suspect couplings might not meet the engineering specifications and could be vulnerable to sudden failure. A testing company in Oak Ridge, TN that specializes in in-situ and laboratory mechanical testing was contacted by the manufacturer for help in this endeavor. The construction company elected to enlist a local testing firm to perform field tests on the components instead of the company in Oak Ridge. The test methods used are incapable of providing quantitative results that could be measured to the engineering specifications, making it unlikely to identify anything but the worst material conditions. This study is an example that the need for accurate analysis is very important. The manufacturer reported that 60 couplings were replaced, but it is presently unknown how many should have been replaced.

The top endorsed athletes in the world are most likely the ones who have the biggest impact on their sport. These athletes are usually among the best in their sport or they might have something special that creates a strong relationship between the athlete and his or her fans. It is possible to say that this relationship combined with their skills on and off of the fields, courts, or arenas is what makes these athletes special. Big companies all over the world feel attracted to these athletes and, as a result, they spend millions of dollars every year in order to make these athletes the face of their companies. This research investigates the relationship between the monetary values of the top 50 most endorsed athletes in the world and their behaviors. Companies spend millions of dollars every year on endorsement deals, so it is important that they pick the right athlete to represent them. Furthermore, the athletes that are being endorsed need to know if there is a possibility of gaining or losing endorsements based upon their behaviors. The methodology in this research utilizes Analysis of Variance to investigate this relationship.

The fund market has grown substantially during the past decades and the majority of Swedish citizens are invested in funds directly or through pension savings. There is mixed evidence on the performance of Swedish equity funds depending on the method employed and the time period studied. In this study, we set out to estimate abnormal performance using acknowledged methods during a time-period that is both longer and more recent than previous studies. Our sample is survivorship-free and consists of 150 mutual equity funds during January 1993 to December 2011. We use a four-factor model to estimate abnormal performance compared to an index and additional risk factors. We find that the average performance is neutral net of costs and that funds outperform with 1.7 percent before costs, the difference is approximately the average management fee. Over time, we find that the average abnormal performance and the share of funds that have significant outperformance have decreased while the share of significant underperformance has increased. Since the study of fund performance started in the 1960's the twin questions has been; does funds outperform the market and is this a result of pure chance or are managers skilled? Since we observe funds with significant positive and negative abnormal performance, we want to know if the results can attributed to luck or skill. We employ the latest technique, a bootstrap simulation, to test for skill or luck. This is the first study to employ the bootstrap to distinguish skill from luck in sample of Swedish funds. By ranking funds on performance after costs, we find that the performance of the majority of funds can be attributed to skill or "bad skill". The evidence is strongest in the top 95th percentile and above, and from the bottom 50th percentile and below.

Dendritic cells (DCs), a hematopoietic cell type belonging to the sub-group of cells called antigen presenting cells (APCs), inhabit a central role in innate and adaptive immunity. Although the DC family is very heterogeneous, all members share unique features. Most importantly, DCs can stimulate an immune response. This is due to the cells’ ability to capture and process antigens and to maturate in the presence of danger signals presented by pathogens. Maturation in turn results in the migration of DCs from the tissue they reside in to the draining lymph nodes, as well as in the subsequent presentation of the acquired antigens to T cells. In the skin, which is one of the most immunogeneic organs, DCs are present in sizable numbers in both the epidermis and the dermis. This study focused on two types of DCs: epidermal Langerhans cells (LCs) and dermal DCs (DDCs). While much is understood about LCs, far less is known about the role that DDCs play in skin immunity. Therefore one purpose of this study was to characterize DDCs and to compare their phenotype and functions to that of LCs. This study used two different methods to characterize human skin resident immune cells with regard to their number and distribution. First, a stable analytical immunohistochemistry-based method was developed and applied to a substantial number of healthy skin donors. This enabled a quantitative analysis of skin DC types and skin resident T cells at different anatomical locations in situ. A novel method to count dermal cell populations in situ was developed that resulted in the first published quantification of APCs, DDCs, as well as T cells in human dermis. Second, the traditional form of the emigration assay, which selectively enriches vital cells capable of ex vivo emigration from the skin, was upgraded toward a stable analytical method to separate epidermal LCs from DDCs. In this way, both skin DC types became accessible in sufficient numbers to allow for a comparison of phenotypes and functions in vitro. The resulting phenotypic observations clearly showed that both, LCs and DDCs are not fully mature after their emigration ex vivo and that both can be transformed into a phenotypically more mature state by treating them with inflammatory cytokines. What’s more, LCs are also functionally in an immature state after their emigration. They efficiently took up antigen, showed a low capacity to trans-migrate in response to chemokines, and demonstrated a low capacity to stimulate allogeneic T cells in a mixed leukocyte reaction (MLR). For the first time this study observed all these main APC functions not only for LCs but additionally for DDCs. As these observations were made in relation to LCs of the same donor, it could be concluded that DDCs are functionally more mature than LCs after emigration. DDCs showed a lower antigen uptake capacity than LCs but were superior in terms of their migratory and stimulatory capacity. However, treatment with cytokines could skew LC functions toward functional capacities observed for DDCs, i.e., it decreased LCs’ Ag uptake and increased their migratory and stimulatory capacity, whereas the cytokine treatment did not alter DDCs’ functional capacities. After improving immuno-histochemistry and the emigration assay using healthy skin samples, these newly developed techniques were implemented in clinical trials to observe the number, distribution and migratory capacity of skin DCs and T cells in patients undergoing allogeneic hematopoietic cell transplantation (aHSCT). Such a study is of importance because the turnover of DCs and T cells is closely associated with the occurrence of acute graft-versus-host disease (aGvHD), the major cause of morbidity and mortality after aHSCT. Due to the study design used, this study concisely demonstrate that at the onset of aGvHD, different DC types accumulate along with effector T cells in skin lesions of aGvHD but not in uninvolved skin of the same patient. These results suggest that in addition to donor T cells LCs and DDCs play a role during the early phase of cutaneous aGvHD directly within the site of inflammation. The view of many authors that DC depletion in the transplant recipient, especially in target organs, is a promising approach for aGvHD prophylaxis and therapy is further underscored by these results. One targeting strategy to inhibit GvHD by eliminating recipient DCs may be the use of DC specific monoclonal antibodies. Alemtuzumab (anti-CD52) is a monoclonal antibody and has proven effective in preventing aGvHD after aHSCT. It may, despite depleting donor T cells, also work by targeting recipient DCs. To determine whether the last mechanism of action is significant, a second clinical study investigated the effects of intravenous alemtuzumab on DCs by comparing the number of these cells in skin and blood of patients before and after a 4-week course of alemtuzumab treatment. The result was that although skin DCs weakly express the target antigen CD52 the number of these cells was not consistently reduced by alemtuzumab. In contrast, circulating blood DCs have a stronger CD52 expression and were significantly reduced by the treatment. In conclusion, this work provides new insights into the phenotypical and functional characteristics of human skin DCs, as well as into the fate of these cell types during aHSCT. The investigation of the APC system during aGvHD as carried out here will help to understand the process of aGvHD in more detail. All these efforts may hopefully support the development of new approaches for therapy and prevention of this major limitation of aHSCT and may help to improve this only curative therapy for several life-threatening diseases.

<p>In recent years, two estimators have been proposed to correct the bias exhibited by the leastsquares (LS) estimator of the lagged dependent variable (LDV) coefficient in dynamic regression models when the sample is finite. They have been termed as &lsquo / mean-unbiased&rsquo / and &lsquo / medianunbiased&rsquo / estimators. Relative to other similar procedures in the literature, the two locationbased estimators have the advantage that they offer an exact and uniform methodology for LS estimation of the LDV coefficient in a first order autoregressive model with or without exogenous regressors i.e. ARX(1).</p> <p><br /> However, no attempt has been made to accurately establish and/or compare the statistical properties among these estimators, or relative to those of the LS estimator when the LDV coefficient is restricted to realistic values. Neither has there been an attempt to&nbsp / compare their performance in terms of their mean squared error (MSE) when various forms of the exogenous regressors are considered. Furthermore, only implicit confidence intervals have been given for the &lsquo / medianunbiased&rsquo / estimator. Explicit confidence bounds that are directly usable for inference are not available for either estimator. In this study a new estimator of the LDV coefficient is proposed / the &lsquo / most-probably-unbiased&rsquo / estimator. Its performance properties vis-a-vis the existing estimators are determined and compared when the parameter space of the LDV coefficient is restricted. In addition, the following new results are established: (1) an explicit computable form for the density of the LS estimator is derived for the first time and an efficient method for its numerical evaluation is proposed / (2) the exact bias, mean, median and mode of the distribution of the LS estimator are determined in three specifications of the ARX(1) model / (3) the exact variance and MSE of LS estimator is determined / (4) the standard error associated with the determination of same quantities when simulation rather than numerical integration method is used are established and the methods are compared in terms of computational time and effort / (5) an exact method of evaluating the density of the three estimators is described / (6) their exact bias, mean, variance and MSE are determined and analysed / and finally, (7) a method of obtaining the explicit exact confidence intervals from the distribution functions of the estimators is proposed.</p> <p><br /> The discussion and results show that the estimators are still biased in the usual sense: &lsquo / in expectation&rsquo / . However the bias is substantially reduced compared to that of the LS estimator. The findings are important in the specification of time-series regression models, point and interval estimation, decision theory, and simulation.</p>

Perceptual rivalry refers to visual phenomena that are characterised by alternations between different percepts, despite an unchanging sensory input. Two common types of perceptual rivalry are (i) reversible figures — two-dimensional stable images that when viewed, are perceived to switch between different interpretations, and (ii) binocular rivalry — the alternations in image dominance resulting from the presentation of conflicting stimuli, one to each eye. Several investigators have suggested that these rivalling phenomena are mediated by similar neural mechanisms. Such a view, however, has not only been inadequately substantiated, but has also yet to be assessed in the context of a directly testable neurophysiological model. Miller and Pettigrew have proposed a novel, high-level interhemispheric switch (IHS) explanatory model of binocular rivalry. This model conceptualises the perceptual alternations as being mediated by alternations between one hemisphere’s selected image and the other hemisphere’s selected (rival) image. To assess their hypothesis, caloric vestibular stimulation (CVS) was used. CVS is a simple, inexpensive, and non-invasive brain stimulation technique that unilaterally activates high-level attentional areas. In accordance with the IHS model, CVS was found to significantly affect predominance (the duration that one image is perceived relative to the other, within a given viewing period) during conventional binocular rivalry with horizontal/vertical gratings and with orthogonal oblique gratings. The present thesis therefore aims, through the use of CVS, to extend this IHS model of binocular rivalry to reversible-figure alternations and propose a general IHS model of perceptual rivalry. Chapter 1 provides a detailed literature review of the field within the context of comparing both perceptual rivalries. In Chapter 2, investigations are presented on two different reversible figures — the perspective-reversing Necker cube and the figure–ground reversing Rubin’s vase–faces illusion. In these experiments, CVS was found to significantly change observers’ predominance compared to their baseline predominance. These results demonstrate that interhemispheric switching also mediates the alternations of these visual phenomena, in addition to binocular rivalry, thereby extending the IHS model to one of perceptual rivalry in general. Moreover, the findings are interpreted in a cognitive neuroscience context, including a novel proposal of a forebrain framework for the IHS model. Chapter 3 presents CVS experiments that address the issue of percept–to–hemisphere selection and the reproducibility of CVS effects, following Miller’s initial work on two types of conventional binocular rivalry. In planned analyses, significant predominance changes were not found in horizontal/vertical rivalry, oblique rivalry and Necker-cube rivalry. In post-hoc analyses that accounted for study-design differences between Miller’s original experiments and the present experiment, CVS was again not shown to induce significant predominance changes in any of the rivalry types. Assessment of directional predominance changes following CVS appeared to suggest an arbitrary selection of percept–to–hemisphere in all rivalry types, although no firm conclusions could be drawn from the obtained data on this issue. Nevertheless, the experiments further extend upon Miller’s earlier work by examining the inter- and intra-individual reproducibility of CVS-induced effects on predominance. Such reproducibility was found to be low and potential reasons for this are discussed. The experiments in Chapter 4 examine a type of binocular rivalry in which dichoptic presentation of Díaz-Caneja stimuli yields rivalry among four different stable images: half-field rivalry between the images presented to the eyes, and coherence rivalry in which aspects of each eye’s presented image are perceptually regrouped into rivalling coherent images. Each of these rivalries was found to occur for about half the given viewing time. Furthermore, CVS significantly shifted the predominance of perceived coherent images (coherence rivalry) but not half-field images (eye rivalry). This finding suggests that coherence rivalry (like conventional rivalry according to previous experiments) is mediated by interhemispheric switching at a high level, while eye rivalry is mediated by intrahemispheric mechanisms, most likely at a low level. In addition, it is proposed that Díaz-Caneja stimuli induce ‘meta-rivalry’ whereby these discrete high- and low-level competitive processes themselves rival for visual consciousness. The current thesis thus presents a novel meta-rivalry model of multistable binocular rivalry. It also presents the first direct evidence that interhemispheric switching mediates reversible-figure alternations, thereby supporting a generalised IHS model of perceptual rivalry. It is argued that both models provide a parsimonious exploratory framework within which specific predictions can be made and readily tested. Finally, the findings of all experiments in the current thesis are summarised.