Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Τρίτη 19 Απριλίου 2016

The predictive power of airborne gamma ray survey data on the locations of domestic radon hazards in Norway: A strong case for utilizing airborne data in large-scale radon potential mapping

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Publication date: Available online 19 April 2016
Source:Journal of Environmental Radioactivity
Author(s): M.A. Smethurst, R.J. Watson, V.C. Baranwal, A.L. Rudjord, I. Finne
It is estimated that exposure to radon in Norwegian dwellings is responsible for as many as 300 deaths a year due to lung cancer. To address this, the authorities in Norway have developed a national action plan that has the aim of reducing exposure to radon in Norway (Norwegian Ministries, 2010). The plan includes further investigation of the relationship between radon hazard and geological conditions, and development of map-based tools for assessing the large spatial variation in radon hazard levels across Norway. The main focus of the present contribution is to describe how we generate map predictions of radon potential (RP), a measure of radon hazard, from available airborne gamma ray spectrometry (AGRS) surveys in Norway, and what impact these map predictions can be expected to have on radon protection work including land-use planning and targeted surveying.We have compiled 11 contiguous AGRS surveys centred on the most populated part of Norway around Oslo to produce an equivalent uranium map measuring 180 km × 102 km that represents the relative concentrations of radon in the near surface of the ground with a spatial resolution in the 100 s of metres. We find that this map of radon in the ground offers a far more detailed and reliable picture of the distribution of radon in the sub-surface than can be deduced from the available digital geology maps.We tested the performances of digital geology and AGRS data as predictors of RP. We find that digital geology explains approximately 40% of the observed variance in ln RP nationally, while the AGRS data in the Oslo area split into 14 bands explains approximately 70% of the variance in the same parameter. We also notice that there are too few indoor data to characterise all geological settings in Norway which leaves areas in the geology-based RP map in the Oslo area, and elsewhere, unclassified. The AGRS RP map is derived from fewer classes, all characterised by more than 30 indoor measurements, and the corresponding RP map of the Oslo area has no unclassified parts. We used statistics of proportions to add 95% confidence limits to estimates of RP on our predictive maps, offering public health strategists an objective measure of uncertainty in the model. The geological and AGRS RP maps were further compared in terms of their performances in correctly classifying local areas known to be radon affected and less affected. Both maps were accurate in their predictions; however the AGRS map out-performed the geology map in its ability to offer confident predictions of RP for all of the local areas tested.We compared the AGRS RP map with the 2015 distribution of population in the Oslo area to determine the likely impact of radon contamination on the population. 11.4% of the population currently reside in the area classified as radon affected. 34% of ground floor living spaces in this affected area are expected to exceed the maximum limit of 200 Bq/m3, while 8.4% of similar spaces outside the affected area exceed this same limit, indicating that the map is very efficient at separating areas with quite different radon contamination profiles.The usefulness of the AGRS RP map in guiding new indoor radon surveys in the Oslo area was also examined. It is shown that indoor measuring programmes targeted on elevated RP areas could be as much as 6 times more efficient at identifying ground floor living spaces above the radon action level compared with surveys based on a random sampling strategy. Also, targeted measuring using the AGRS RP map as a guide makes it practical to search for the worst affected homes in the Oslo area: 10% of the incidences of very high radon contamination in ground floor living spaces (≥800 Bq/m3) are concentrated in just 1.2% of the populated part of the area.



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Labyrinthine concussion following gunshot injury: A case report

10.3109/14992027.2016.1166398<br/>Jamie M. Bogle

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Labyrinthine concussion following gunshot injury: A case report

10.3109/14992027.2016.1166398<br/>Jamie M. Bogle

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Labyrinthine concussion following gunshot injury: A case report

10.3109/14992027.2016.1166398<br/>Jamie M. Bogle

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Raman spectroscopy as a novel tool for monitoring biochemical changes and inter-donor variability in stored red blood cell units

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Analyst, 2016, Accepted Manuscript
DOI: 10.1039/C6AN00373G, Paper
Chad Garry Atkins, Kevin Buckley, Deborah Chen, H. Georg Schulze, Dana V. Devine, Michael W. Blades, Robin F. B. Turner
Individual units of donated red blood cells (RBCs) do not ordinarily undergo analytical testing prior to transfusion. This study establishes the utility of Raman spectroscopy for analyzing the biochemistry of...
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Self-Tracking for Health and the Quantified Self: Re-Articulating Autonomy, Solidarity, and Authenticity in an Age of Personalized Healthcare

Abstract

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two aims: first, to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research.



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Differences in Knowledge, Attitude, and Behavior towards HIV/AIDS and Sexually Transmitted Infections between Sexually Active Foreign and Chinese Medical Students

Although the prevalence of human immunodeficiency virus (HIV) decreased in the last decade worldwide, the number of deaths due to HIV/AIDS and communicable diseases including syphilis, hepatitis, and tuberculosis had dramatically increased in developing countries. Education and behavior are incredibly important factors to prevent these diseases' spread. This study highlights the range of differences in knowledge, attitude, and behavior of 434 sexually active medical students towards HIV/AIDS and sexually transmitted infections (STIs). Because the surveyed population constitutes the forefront of healthcare providers and was originated from different area of the world, this is the first time a study sought to investigate the behavioral attitude of this group of population irrespective of the three levels of their academic and professional knowledge. Several factors including sociodemographic characteristics, sexual behavior, HIV/AIDS, and STIs related patterns play a key role in medical student attitude and behavior towards people infected with HIV/AIDS and STIs. Our findings add consistent value in prior studies which aimed to stop new infections and also imply further investigations on the management of the studied infections by medical students. The present study arouses much interest among participants and provides evidence of reinforcing medical students' education on HIV/AIDS and STIs.

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Does Citrulline Have Protective Effects on Liver Injury in Septic Rats?

Citrulline (Cit) supplementation was proposed to serve as a therapeutic intervention to restore arginine (Arg) concentrations and improve related functions in sepsis. This study explored whether citrulline had positive effects on liver injury and cytokine release in the early stages of sepsis. The cecal ligation and puncture (CLP) model was utilized in our study. Rats were divided into four groups: normal, Cit, CLP, and CLP+Cit. The CLP group and CLP+Cit group were separated into 6-, 12-, and 24-hour groups, according to the time points of sacrifice after surgery. Intragastric administration of L-citrulline was applied to rats in Cit and CLP+Cit groups before surgery. Serum AST and ALT levels and levels of MDA, SOD, NO, and iNOS in the liver tissues were evaluated. Plasma concentrations of Cit and Arg were assessed using HPLC-MS/MS. Serum concentrations of cytokines and chemokines were calculated by Luminex. Results showed SOD activities of CLP+Cit groups were significantly higher than that of CLP groups, contrasting with the MDA and NO levels which were significantly lower in CLP+Cit groups than in CLP groups. In addition, plasma concentrations of TNF-α, IL-6, and IL-1β were significantly lower in the CLP+Cit 6-hour group than in the CLP 6-hour group.

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Herpes Simplex Virus Type 1 and Type 2 Infection Increases Atherosclerosis Risk: Evidence Based on a Meta-Analysis

Objective. The aim of our study was to evaluate the relation of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) infection with the risk of atherosclerosis (AS). Methods. A systematic literature search was performed through three electronic databases. The pooled odds ratio (OR) and corresponding 95% confidence interval (CI) were used to assess the effect of HSV-1 and HSV-2 infection on AS risk. Results. 17 studies were available for meta-analysis of HSV-1 infection and AS risk and seven studies for meta-analysis of HSV-2 infection and AS risk. Subjects exposed to HSV-1 infection exhibited an increased risk of AS (OR = 1.77; 95% CI: 1.40–2.23; ). And consistent elevated AS risks for HSV-1 positive subjects were found in all subgroup analysis of disease type, region, male proportion, and age. HSV-2 positive subjects demonstrated significantly increased AS risk (OR = 1.37; 95% CI: 1.13–1.67; ). In subgroup analysis, elevated AS risks were only observed in myocardial ischemia group, male proportion >60% group, and age ≤60-year-old group. Conclusion. Our meta-analysis indicated that HSV-1 and HSV-2 infection could increase the risk of contracting AS.

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Identification and functional analysis of a novel mitochondria-localized 2-Cys peroxiredoxin, BbTPx-2, from Babesia bovis

Abstract

Cysteine-based peroxidases, known as peroxiredoxins (Prx) or thioredoxin peroxidases (TPx), are important antioxidant enzymes that prevent oxidative damage caused by reactive oxygen species (ROS). In this study, we identified a novel mitochondrial 2-Cys Prx, BbTPx-2, from a bovine Babesia parasite, B. bovis. BbTPx-2 complementary DNA (cDNA) encodes a polypeptide of 254 amino acid residues. This protein has a mitochondrial targeting peptide at the N-terminus and two conserved cysteine residues of the typical 2-Cys Prx. By using a thiol mixed-function oxidation assay, the antioxidant activity of recombinant BbTPx-2 was revealed, and its antioxidant activity was comparable to that of a cytosolic 2-Cys Prx from B. bovis, BbTPx-1. Notably, we confirmed that BbTPx-2 was expressed in the mitochondrion of B. bovis merozoites. Taken together, the results suggest that the mitochondrial BbTPx-2 is an antioxidative enzyme for scavenging ROS in B. bovis.



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Remote Sensing, Vol. 8, Pages 339: Estimating Stand Volume and Above-Ground Biomass of Urban Forests Using LiDAR

Assessing forest stand conditions in urban and peri-urban areas is essential to support ecosystem service planning and management, as most of the ecosystem services provided are a consequence of forest stand characteristics. However, collecting data for assessing forest stand conditions is time consuming and labor intensive. A plausible approach for addressing this issue is to establish a relationship between in situ measurements of stand characteristics and data from airborne laser scanning (LiDAR). In this study we assessed forest stand volume and above-ground biomass (AGB) in a broadleaved urban forest, using a combination of LiDAR-derived metrics, which takes the form of a forest allometric model. We tested various methods for extracting proxies of basal area (BA) and mean stand height (H) from the LiDAR point-cloud distribution and evaluated the performance of different models in estimating forest stand volume and AGB. The best predictors for both models were the scale parameters of the Weibull distribution of all returns (except the first) (proxy of BA) and the 95th percentile of the distribution of all first returns (proxy of H). The R2 were 0.81 (p < 0.01) for the stand volume model and 0.77 (p < 0.01) for the AGB model with a RMSE of 23.66 m3·ha−1 (23.3%) and 19.59 Mg·ha−1 (23.9%), respectively. We found that a combination of two LiDAR-derived variables (i.e., proxy of BA and proxy of H), which take the form of a forest allometric model, can be used to estimate stand volume and above-ground biomass in broadleaved urban forest areas. Our results can be compared to other studies conducted using LiDAR in broadleaved forests with similar methods.

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Techniques manuelles de drainage bronchique des adultes et adolescents : quel niveau de preuve ?

Publication date: Available online 13 April 2016
Source:Revue des Maladies Respiratoires
Author(s): Michel Cabillic, Pascal Gouilly, Gregory Reychler
IntroductionL'objectif de cette revue systématique de la littérature est de dégager le niveau de preuve des techniques de drainage bronchique manuelles les plus utilisées.MéthodeLa recherche bibliographique a été réalisée sur la période de 1995 à 2014 à partir des bases de données : Medline, PEDro, ScienceDirect, Cochrane Library, REEDOC et kinedoc. Les mots clés suivants ont été utilisés : « drainage de posture », « vibrations manuelles », « percussions thoraciques manuelles », « toux dirigée », « augmentation du flux expiratoire », « ELTGOL », « drainage autogène ».RésultatsDeux cent cinquante-six articles ont été recensés. Après élimination des doublons et lecture des titres et résumés, 63 articles ont été retenus dont 9 revues systématiques. Ce travail souligne l'insuffisance des données scientifiques valables et les difficultés pour pouvoir déterminer les niveaux de preuve des techniques de désencombrement manuel. Celles-ci ont été évaluées principalement avec des patients porteurs de pathologies sécrétrices (mucoviscidose, DDB, BPCO…). Il permet aussi de montrer les limites des critères d'évaluation permettant de mesurer la présence d'un encombrement et donc l'efficacité du désencombrement.ConclusionLe tableau synthétique classant les techniques de désencombrement bronchique en fonction de leur mécanisme physique, élaboré lors de la conférence de consensus de 1994, semble être un axe intéressant pour leur évaluation, permettant de regrouper les techniques ayant des mécanismes d'action identiques. Au vu des résultats de cette revue systématique, il apparaît que seul l'ELTGOL, le drainage autogène et l'ACBT reposent sur un niveau de preuve B. Toutes les autres techniques présentent un niveau de preuve inférieur.Niveau de preuve2.BackgroundThe aim of this systematic literature review was to grade the levels of evidence of the most widely used manual airway clearance techniques.MethodsA literature search was conducted over the period 1995–2014 from the Medline, PEDro, ScienceDirect, Cochrane Library, REEDOC and kinedoc databases, with the following keywords: "postural drainage", "manual vibrations", "manual chest percussion", "directed cough", "increased expiratory flow", "ELTGOL", "autogenic drainage" and "active cycle of breathing technique".ResultsTwo-hundred and fifty-six articles were identified. After removing duplicates and reading the titles and abstracts, 63 articles were selected, including 9 systematic reviews. This work highlights the lack of useful scientific data and the difficulty of determining levels of evidence for manual airway clearance techniques. Techniques were assessed principally with patients with sputum production (cystic fibrosis, DDB, COPD, etc.). It also shows the limited pertinence of outcome measures to quantify congestion and hence the efficacy of airway clearance techniques.ConclusionThe 1994 consensus conference summary table classifying airway clearance techniques according to physical mechanism provides an interesting tool for assessment, grouping together techniques having identical mechanisms of action. From the findings of the present systematic review, it appears that only ELTGOL, autogenic drainage and ACBT present levels of evidence "B". All other techniques have lower levels of evidence.Level of evidenceII.



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Haut Conseil de la Santé publique (HCSP). Avis relatif aux bénéfices–risques de la cigarette électronique ou e-cigarette étendus en population générale (22 février 2016)

Publication date: Available online 11 April 2016
Source:Revue des Maladies Respiratoires
Author(s): Haut Conseil de la santé publique




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SERS Monitoring the Dynamics of Local pH in Lysosome of Living Cells during Photothermal Therapy

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Analyst, 2016, Accepted Manuscript
DOI: 10.1039/C6AN00467A, Communication
Rongxing Luo, Yinhui Li, Qifeng Zhou, Jing Zheng, Dandan Ma, Pinting Tang, Sheng Yang, Zhihe Qing, Rong-Hua Yang
In this communication, we proposed a gold nanorods-based SERS nanotracker to monitor the local pH change during the photothermal therapy (PTT). The dynamic SERS analysis indicated that the local pH...
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The effect of thermal processing on the behaviour of peanut allergen peptide targets used in multiple reaction monitoring mass spectrometry experiments

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Analyst, 2016, Accepted Manuscript
DOI: 10.1039/C6AN00359A, Paper
Rebekah Louise Sayers, Phil E Johnson, Justin T Marsh, Perdita Barran, Helen Brown, Clare Mills
Mass spectrometry-based methods offer an alternative means of determining allergens in foods. Whilst targeted methods are likely to offer the most robust approach for detection and quantification, little is known...
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Updated guidelines (2015) for management and monitoring of adult and adolescent asthmatic patients (from 12 years and older) of the Société de Pneumologie de Langue Française (SPLF) (Full length text)

Publication date: Available online 14 April 2016
Source:Revue des Maladies Respiratoires
Author(s): C. Raherison, A. Bourdin, P. Bonniaud, G. Deslée, G. Garcia, C. Leroyer, C. Taillé, J. De Blic, J.-C. Dubus, I. Tillié-Leblond, P. Chanez




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Neurological disease of Şehzade Cihangir in the Ottoman history: spinal dysraphism



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Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

ABSTRACT Studies which have investigated muscular performance during the initial stages of Parkinson´s disease (PD) without L-dopa treatments were not found. Objective to assess whether muscular performance, work and power, of the trunk and lower limbs in L-dopa naïve patients in the early stages of PD was lower than those of healthy subjects and to compare muscular performance between the lower limbs. Method Ten subjects with PD, Hoehn and Yahr (HY) I-II, L-dopa naïve and 10 subjects in the control group were assessed with the isokinetic dynamometer. Results ANOVAs revealed that work and power measures of the trunk, hip, knee, and ankle muscular groups were lower in PD compared with the control group (p < 0.05). There were no significant differences in muscular performance between the lower limbs. Conclusion The results suggested the use of specific exercises, as rehabilitation strategies, to improve the ability to produce work and power with this population.


RESUMO Estudos que investigaram o desempenho muscular durante os estágios iniciais da doença de Parkinson (DP), sem tratamento com L-dopa não foram encontrados. Objetivo Avaliar se o desempenho muscular, por meio de medidas de trabalho e potência, do tronco e dos membros inferiores em pacientes sem o uso de L-dopa nas fases iniciais da DP é menor do que o de indivíduos saudáveis e comparar o desempenho muscular entre os membros inferiores. Método Dez indivíduos com DP, Hoehn and Yahr (HY) I-II, sem L-dopa e 10 indivíduos do grupo controle foram avaliados com o dinamômetro isocinético. Resultados Medidas de trabalho e potência muscular do tronco, quadril, joelho, tornozelo foram menores no PD em comparação com o grupo controle (p < 0,05) e não houve diferenças significativas no desempenho muscular entre os membros inferiores. Conclusão O uso de exercícios específicos, como estratégias de reabilitação, pode melhorar a capacidade de produzir trabalho e potência muscular nesta população.

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Phonological awareness and sinusoidal amplitude modulation in phonological dislexia

ABSTRACT Objective Dyslexia is the difficulty of children in learning to read and write as results of neurological deficiencies. The objective was to test the Phonological awareness (PA) and Sinusoidal amplitude modulation (SAM) threshold in children with Phonological dyslexia (PD). Methods We performed a case-control, analytic, cross sectional study. We studied 14 children with PD and 14 control children from 7 to 11 years of age, by means of PA measurement and by SAM test. The mean age of dyslexic children was 8.39 years and in the control group was 8.15. Results Children with PD exhibited inadequate skills in PA, and SAM. We found significant correlations between PA and SAM at 4 Hertz frequency, and calculated regression equations that predicts between one-fourth and one-third of variance of measurements. Conclusion Alterations in PA and SAM found can help to explain basis of deficient language processing exhibited by children with PD.


RESUMEN Objetivo La Dislexia es la dificultad en niños de aprender a leer y escribir como resultado de una deficiencia neurológica. Nuestro objetivo fue probar la Conciencia fonológica (CF) y la Modulación sinusoidal de la amplitud (MSA) en niños con Dislexia fonológica (DF). Métodos Realizamos un estudio analítico, transversal, de casos y controles. Estudiamos la CF y la MSA en 14 niños con DF y 14 controles de 7–11 años. La edad media de los niños con DF fue de 8.39 años y de los controles fue 8.15. Resultados Los niños con DF presentaron deficiencias en CF y en MSA. Encontramos correlaciones entre CF y MSA en la frecuencia de 4 Hertzios (Hz), calculamos ecuaciones de regresión que predijeron de un cuarto a un tercio de la varianza de las mediciones. Conclusión Las deficiencias en CF y en MSA pueden ayudar a comprender las alteraciones en el procesamiento del lenguaje presentadas por los niños con DF.

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Amyotrophic lateral sclerosis and motor neuron syndromes in Asia

While the past 2 decades have witnessed an increasing understanding of amyotrophic lateral sclerosis (ALS) arising from East Asia, particularly Japan, South Korea, Taiwan and China, knowledge of ALS throughout the whole of Asia remains limited. Asia represents >50% of the world population, making it host to the largest patient cohort of ALS. Furthermore, Asia represents a diverse population in terms of ethnic, social and cultural backgrounds. In this review, an overview is presented that covers what is currently known of ALS in Asia from basic epidemiology and genetic influences, through to disease characteristics including atypical phenotypes which manifest a predilection for Asians. With the recent establishment of the Pan-Asian Consortium for Treatment and Research in ALS to facilitate collaborations between clinicians and researchers across the region, it is anticipated that Asia and the Pacific will contribute to unravelling the uncertainties in ALS.



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Object engagement and manipulation in extremely preterm and full term infants at 6 months of age

Publication date: August 2016
Source:Research in Developmental Disabilities, Volume 55
Author(s): Mariagrazia Zuccarini, Alessandra Sansavini, Jana M. Iverson, Silvia Savini, Annalisa Guarini, Rosina Alessandroni, Giacomo Faldella, Tiziana Aureli
Delays in the motor domain have been frequently observed in preterm children, especially those born at an extremely low gestational age (ELGA;<28 weeks GA). However, early motor exploration has received relatively little attention despite its relevance for object knowledge and its impact on cognitive and language development. The present study aimed at comparing early object exploration in 20 ELGA and 20 full-term (FT) infants at 6 months of age during a 5-minute mother-infant play interaction. Object engagement (visual vs manual), visual object engagement (no act vs reach), manual object engagement (passive vs active), and active object manipulation (mouthing, transferring, banging, turn/rotating, shaking, fingering) were analyzed. Moreover, the Griffiths Mental Development Scales 0-2 years (1996) were administered to the infants. Relative to FT peers, ELGA infants spent more time in visual engagement, and less time in manual engagement, active manipulation, mouthing, and turning/rotating. Moreover, they had lower scores on general psychomotor development, eye & hand coordination, and performance abilities. Close relationships emerged between manual object engagement and psychomotor development. Clinical implications of these results in terms of early evaluation of action schemes in ELGA infants and the provision of intervention programs for supporting these abilities are discussed.



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Current Opinion and Use of Transcranial Doppler Ultrasonography in Traumatic Brain Injury in the Pediatric Intensive Care Unit

Journal of Neurotrauma , Vol. 0, No. 0.


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Current Opinion and Use of Transcranial Doppler Ultrasonography in Traumatic Brain Injury in the Pediatric Intensive Care Unit

Journal of Neurotrauma , Vol. 0, No. 0.


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Overcoming the obstacles of visualization in robotically assisted abdominal cerclage using indocyanine green

Abstract

Abdominal cerclage is found to have success rates of 85–95 % with lower incidence of preterm delivery and preterm premature rupture of membranes when compared to the vaginal approach. However, since it is more invasive, its use has been limited to selected cases. Robot-assisted abdominal cerclage is a relatively new minimally invasive technique that gives the opportunity for less invasive procedures when compared to the open technique and, when compared to conventional laparoscopy, has the advantages of 3D visualization and endowristed instrumentation. The distinctive feature of our case is the use of near infrared camera system, which is a relatively new modality in robotics and, to the best of our knowledge, this is the first report in the literature that indocyanine green dye was used to help to visualize vascular anatomy during a robotic cerclage procedure in a pregnant patient.



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Management and outcome of spontaneous cerebral venous sinus thrombosis in a 5-year consecutive single-institution cohort

Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with a variable presentation, ranging from headaches, to coma and death. Although the American Stroke Association has developed guidelines for the treatment of CVST, data are sparse on the outcome after treatment with anticoagulation, thrombolysis, and thrombectomy. In this retrospective review, we describe the 5-year UC Davis experience with spontaneous CVST. Forty-one patients (mean age 37.5±23.1, range 0–96 years; 29 female) were identified with CVST. The majority of cases involved the transverse sinus (75.6%), sigmoid sinus (58.5%), and superior sagittal sinus (29.3%). The most common form of treatment was anticoagulation or antiplatelet therapy (n=35), while six patients were managed by observation alone. The overall 1-year modified Rankin score (mRS) was 1.4±1.5. Male patients and patients with a poor admission mRS had a worse outcome. Outcome was unaffected by hypercoagulable state, number of dural sinuses involved, the presence of intracranial hemorrhage, or seizures. Two patients who underwent anticoagulation therapy also required endovascular thrombectomy; both patients had a 1-year mRS of ≤2. Two patients underwent direct open surgical canalization of the superior sagittal sinus with varying outcomes (mRS 2 vs mRS 6). In our series, the majority (92.9%) of patients with spontaneous dural sinus thrombosis had a favorable clinical outcome as defined by a mRS ≤2. Further prospective studies are needed to study the impact of anticoagulation on the clinical course of the disease.



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Brain Multimodality Monitoring: Updated Perspectives

Abstract

The challenges posed by acute brain injury (ABI) involve the management of the initial insult in addition to downstream inflammation, edema, and ischemia that can result in secondary brain injury (SBI). SBI is often subclinical, but can be detected through physiologic changes. These changes serve as a surrogate for tissue injury/cell death and are captured by parameters measured by various monitors that measure intracranial pressure (ICP), cerebral blood flow (CBF), brain tissue oxygenation (PbtO2), cerebral metabolism, and electrocortical activity. In the ideal setting, multimodality monitoring (MMM) integrates these neurological monitoring parameters with traditional hemodynamic monitoring and the physical exam, presenting the information needed to clinicians who can intervene before irreversible damage occurs. There are now consensus guidelines on the utilization of MMM, and there continue to be new advances and questions regarding its use. In this review, we examine these recommendations, recent evidence for MMM, and future directions for MMM.



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Successful Treatment of Bacillus cereus Bacteremia in a Patient with Propionic Acidemia

Bacillus cereus can cause serious, life-threatening, systemic infections in immunocompromised patients. The ability of microorganism to form biofilm on biomedical devices can be responsible for catheter-related bloodstream infections. Other manifestations of severe disease are meningitis, endocarditis, osteomyelitis, and surgical and traumatic wound infections. The most common feature in true bacteremia caused by Bacillus is the presence of an intravascular catheter. Herein, we report a case of catheter-related bacteremia caused by B. cereus in a patient with propionic acidemia.

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Nivolumab Doubles 1-Year OS Rates in Head and Neck Cancer - OncLive

images?q=tbn:ANd9GcQmszNBMuWHKiccus6smYA
OncLive

Nivolumab Doubles 1-Year OS Rates in Head and Neck Cancer
OncLive
Treatment with single-agent nivolumab (Opdivo) reduced the risk of death by 30% and double 1-year overall survival (OS) rates compared investigator's choice of therapy for patients with recurrent or metastatic head and neck squamous cell carcinoma ...
Nivolumab demonstrates efficacy in recurrent, metastatic SCCHNHealio

all 2 news articles »


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Labyrinthine concussion following gunshot injury: A case report

10.3109/14992027.2016.1166398<br/>Jamie M. Bogle

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AC/DC Singer Battles Sensorineural Hearing Loss

In an article posted to CNN.com on April 19, AC/DC lead singer Brian Johnson details his battle with sensorineural hearing loss after years of unprotected noise exposure from concert performances. In the article, he refers to his admission of hearing loss and ultimate decision to cease touring with the band as his "darkest day." Sadly, Johnson is only one in a long line of musicians, including Pete Townshend, Eric Clapton, Ted Nugent, Phil Collins, will.I.am, and many more, who suffer from tinnitus and/or hearing loss as a consequence of their profession.  



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Object engagement and manipulation in extremely preterm and full term infants at 6 months of age

Publication date: August 2016
Source:Research in Developmental Disabilities, Volume 55
Author(s): Mariagrazia Zuccarini, Alessandra Sansavini, Jana M. Iverson, Silvia Savini, Annalisa Guarini, Rosina Alessandroni, Giacomo Faldella, Tiziana Aureli
Delays in the motor domain have been frequently observed in preterm children, especially those born at an extremely low gestational age (ELGA;<28 weeks GA). However, early motor exploration has received relatively little attention despite its relevance for object knowledge and its impact on cognitive and language development. The present study aimed at comparing early object exploration in 20 ELGA and 20 full-term (FT) infants at 6 months of age during a 5-minute mother-infant play interaction. Object engagement (visual vs manual), visual object engagement (no act vs reach), manual object engagement (passive vs active), and active object manipulation (mouthing, transferring, banging, turn/rotating, shaking, fingering) were analyzed. Moreover, the Griffiths Mental Development Scales 0-2 years (1996) were administered to the infants. Relative to FT peers, ELGA infants spent more time in visual engagement, and less time in manual engagement, active manipulation, mouthing, and turning/rotating. Moreover, they had lower scores on general psychomotor development, eye & hand coordination, and performance abilities. Close relationships emerged between manual object engagement and psychomotor development. Clinical implications of these results in terms of early evaluation of action schemes in ELGA infants and the provision of intervention programs for supporting these abilities are discussed.



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AC/DC Singer Battles Sensorineural Hearing Loss

In an article posted to CNN.com on April 19, AC/DC lead singer Brian Johnson details his battle with sensorineural hearing loss after years of unprotected noise exposure from concert performances. In the article, he refers to his admission of hearing loss and ultimate decision to cease touring with the band as his "darkest day." Sadly, Johnson is only one in a long line of musicians, including Pete Townshend, Eric Clapton, Ted Nugent, Phil Collins, will.I.am, and many more, who suffer from tinnitus and/or hearing loss as a consequence of their profession.  



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The Production of Complement Clauses in Children With Language Impairment.

The Production of Complement Clauses in Children With Language Impairment.

J Speech Lang Hear Res. 2016 Apr 18;:1-12

Authors: Steel G, Rose M, Eadie P

Abstract
Purpose: The purpose of this research was to provide a comprehensive description of complement-clause production in children with language impairment. Complement clauses were examined with respect to types of complement structure produced, verb use, and both semantic and syntactic accuracy.
Method: A group of 17 children with language impairment (mean age = 6;10 [years; months]) was compared with a group of 17 younger children with typical language development (mean age = 4;6). Examples of both nonfinite complements with different subjects and sentential complements involving a range of complement-taking verbs were collected using specially designed elicitation tasks.
Results: The children with language impairment were able to construct both types of complement clauses, had access to a range of verbs that are utilized within these constructions, and had knowledge of the grammatical constraints imposed by these verbs. However, they were more restricted in their production of sentential complements and produced significantly fewer semantically accurate complements (both finite and nonfinite) than the children with typical language development.
Conclusion: Children with language impairment evidenced deviant rather than merely delayed development in the area of complement-clause production. Complex sentences such as complement clauses need to be targeted in language intervention programs.

PMID: 27089061 [PubMed - as supplied by publisher]



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Infant-Directed Speech Is Consistent With Teaching.

Infant-Directed Speech Is Consistent With Teaching.

Psychol Rev. 2016 Apr 18;

Authors: Eaves BS, Feldman NH, Griffiths TL, Shafto P

Abstract
Infant-directed speech (IDS) has distinctive properties that differ from adult-directed speech (ADS). Why it has these properties-and whether they are intended to facilitate language learning-is a matter of contention. We argue that much of this disagreement stems from lack of a formal, guiding theory of how phonetic categories should best be taught to infantlike learners. In the absence of such a theory, researchers have relied on intuitions about learning to guide the argument. We use a formal theory of teaching, validated through experiments in other domains, as the basis for a detailed analysis of whether IDS is well designed for teaching phonetic categories. Using the theory, we generate ideal data for teaching phonetic categories in English. We qualitatively compare the simulated teaching data with human IDS, finding that the teaching data exhibit many features of IDS, including some that have been taken as evidence IDS is not for teaching. The simulated data reveal potential pitfalls for experimentalists exploring the role of IDS in language learning. Focusing on different formants and phoneme sets leads to different conclusions, and the benefit of the teaching data to learners is not apparent until a sufficient number of examples have been provided. Finally, we investigate transfer of IDS to learning ADS. The teaching data improve classification of ADS data but only for the learner they were generated to teach, not universally across all classes of learners. This research offers a theoretically grounded framework that empowers experimentalists to systematically evaluate whether IDS is for teaching. (PsycINFO Database Record

PMID: 27088361 [PubMed - as supplied by publisher]



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Differentiating School-Aged Children With and Without Language Impairment Using Tense and Grammaticality Measures From a Narrative Task.

Differentiating School-Aged Children With and Without Language Impairment Using Tense and Grammaticality Measures From a Narrative Task.

J Speech Lang Hear Res. 2016 Apr 18;:1-13

Authors: Guo LY, Schneider P

Abstract
Purpose: To determine the diagnostic accuracy of the finite verb morphology composite (FVMC), number of errors per C-unit (Errors/CU), and percent grammatical C-units (PGCUs) in differentiating school-aged children with language impairment (LI) and those with typical language development (TL).
Method: Participants were 61 six-year-olds (50 TL, 11 LI) and 67 eight-year-olds (50 TL, 17 LI). Narrative samples were collected using a story-generation format. FVMC, Errors/CU, and PGCUs were computed from the samples.
Results: All of the three measures showed acceptable to good diagnostic accuracy at age 6, but only PGCUs showed acceptable diagnostic accuracy at age 8 when sensitivity, specificity, and likelihood ratios were considered.
Conclusion: FVMC, Errors/CU, and PGCUs can all be used in combination with other tools to identify school-aged children with LI. However, FVMC and Errors/CU may be an appropriate diagnostic tool up to age 6. PGCUs, in contrast, may be a sensitive tool for identifying children with LI at least up to age 8 years.

PMID: 27088899 [PubMed - as supplied by publisher]



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Between-language repetition priming in antonym generation: evidence that translation-equivalent adjectives have shared conceptual representations across languages.

Between-language repetition priming in antonym generation: evidence that translation-equivalent adjectives have shared conceptual representations across languages.

Memory. 2016 Apr 18;:1-6

Authors: Taylor RS, Francis WS

Abstract
Previous literature has demonstrated conceptual repetition priming across languages in bilinguals. This between-language priming effect is taken as evidence that translation equivalents have shared conceptual representations across languages. However, the vast majority of this research has been conducted using only concrete nouns as stimuli. The present experiment examined conceptual repetition priming within and between languages in adjectives, a part of speech not previously investigated in studies of bilingual conceptual representation. The participants were 100 Spanish-English bilinguals who had regular exposure to both languages. At encoding, participants performed a shallow processing task and a deep-processing task on English and Spanish adjectives. At test, they performed an antonym-generation task in English, in which the target responses were either adjectives presented at encoding or control adjectives not previously presented. The measure of priming was the response time advantage for producing repeated adjectives relative to control adjectives. Significant repetition priming was observed both within and between languages under deep, but not shallow, encoding conditions. The results indicate that the conceptual representations of adjective translation equivalents are shared across languages.

PMID: 27088515 [PubMed - as supplied by publisher]



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Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

ABSTRACT Studies which have investigated muscular performance during the initial stages of Parkinson´s disease (PD) without L-dopa treatments were not found. Objective to assess whether muscular performance, work and power, of the trunk and lower limbs in L-dopa naïve patients in the early stages of PD was lower than those of healthy subjects and to compare muscular performance between the lower limbs. Method Ten subjects with PD, Hoehn and Yahr (HY) I-II, L-dopa naïve and 10 subjects in the control group were assessed with the isokinetic dynamometer. Results ANOVAs revealed that work and power measures of the trunk, hip, knee, and ankle muscular groups were lower in PD compared with the control group (p < 0.05). There were no significant differences in muscular performance between the lower limbs. Conclusion The results suggested the use of specific exercises, as rehabilitation strategies, to improve the ability to produce work and power with this population.


RESUMO Estudos que investigaram o desempenho muscular durante os estágios iniciais da doença de Parkinson (DP), sem tratamento com L-dopa não foram encontrados. Objetivo Avaliar se o desempenho muscular, por meio de medidas de trabalho e potência, do tronco e dos membros inferiores em pacientes sem o uso de L-dopa nas fases iniciais da DP é menor do que o de indivíduos saudáveis e comparar o desempenho muscular entre os membros inferiores. Método Dez indivíduos com DP, Hoehn and Yahr (HY) I-II, sem L-dopa e 10 indivíduos do grupo controle foram avaliados com o dinamômetro isocinético. Resultados Medidas de trabalho e potência muscular do tronco, quadril, joelho, tornozelo foram menores no PD em comparação com o grupo controle (p < 0,05) e não houve diferenças significativas no desempenho muscular entre os membros inferiores. Conclusão O uso de exercícios específicos, como estratégias de reabilitação, pode melhorar a capacidade de produzir trabalho e potência muscular nesta população.

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Phonological awareness and sinusoidal amplitude modulation in phonological dislexia

ABSTRACT Objective Dyslexia is the difficulty of children in learning to read and write as results of neurological deficiencies. The objective was to test the Phonological awareness (PA) and Sinusoidal amplitude modulation (SAM) threshold in children with Phonological dyslexia (PD). Methods We performed a case-control, analytic, cross sectional study. We studied 14 children with PD and 14 control children from 7 to 11 years of age, by means of PA measurement and by SAM test. The mean age of dyslexic children was 8.39 years and in the control group was 8.15. Results Children with PD exhibited inadequate skills in PA, and SAM. We found significant correlations between PA and SAM at 4 Hertz frequency, and calculated regression equations that predicts between one-fourth and one-third of variance of measurements. Conclusion Alterations in PA and SAM found can help to explain basis of deficient language processing exhibited by children with PD.


RESUMEN Objetivo La Dislexia es la dificultad en niños de aprender a leer y escribir como resultado de una deficiencia neurológica. Nuestro objetivo fue probar la Conciencia fonológica (CF) y la Modulación sinusoidal de la amplitud (MSA) en niños con Dislexia fonológica (DF). Métodos Realizamos un estudio analítico, transversal, de casos y controles. Estudiamos la CF y la MSA en 14 niños con DF y 14 controles de 7–11 años. La edad media de los niños con DF fue de 8.39 años y de los controles fue 8.15. Resultados Los niños con DF presentaron deficiencias en CF y en MSA. Encontramos correlaciones entre CF y MSA en la frecuencia de 4 Hertzios (Hz), calculamos ecuaciones de regresión que predijeron de un cuarto a un tercio de la varianza de las mediciones. Conclusión Las deficiencias en CF y en MSA pueden ayudar a comprender las alteraciones en el procesamiento del lenguaje presentadas por los niños con DF.

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Early event-related potentials to emotional faces differ for adults with autism spectrum disorder and by serotonin transporter genotype

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Susan Faja, Geraldine Dawson, Elizabeth Aylward, Ellen M. Wijsman, Sara Jane Webb
ObjectiveTo test differences in neural sensitivity to facial expressions, including expressions with open versus closed mouths, exhibited by (1) adults with autism spectrum disorder (ASD) compared to neurotypical adults, and by (2) short versus long serotonin transporter allele (SLC6A4) carriers.MethodsEvent related potentials (ERPs) to happy, fearful, and neutral expressions were collected from neurotypical adults (n=25) and adults with ASD (n=27)–of whom 32 had short and 13 had homozygous long SLC6A4 alleles.ResultsIn the neurotypical group, we confirmed that the N170, VPP and EPN, but not the P1, were influenced by emotional expressions, and determined the EPN was the earliest component modulated by open mouth. Compared to the neurotypical group, individuals with ASD exhibited differences in EPN amplitude in response to open versus closed mouths and in hemispheric distribution. Across groups, short serotonin transporter allele carriers had reduced P1 amplitude compared to long allele carriers.ConclusionsIndividuals with ASD exhibited a different pattern of neural response when encoding and recognizing facial expressions at the EPN component. Across groups, SLC6A4 allele type modulated early sensory attention at the P1.SignificanceThese results provide insight into the nature of early responses to emotional information according to genetic variation and clinical condition.



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ERP C250 shows the elderly (cognitively normal Alzheimers disease) store more stimuli in short-term memory than Young Adults do

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Robert M. Chapman, Margaret N. Gardner, Mark Mapstone, Rafael Klorman, Anton P. Porsteinsson, Haley M. Dupree, Inga M. Antonsdottir, Lily Kamalyan
ObjectiveTo determine how aging and dementia affect the brain's initial storing of task-relevant and irrelevant information in short-term memory.MethodsWe used brain Event-Related Potentials (ERPs) to measure short-term memory storage (ERP component C250) in 36 Young Adults, 36 Normal Elderly, and 36 early-stage AD subjects. Participants performed the Number–Letter task, a cognitive paradigm requiring memory storage of a first relevant stimulus to compare it with a second stimulus.ResultsIn Young Adults, C250 was more positive for the first task-relevant stimulus compared to all other stimuli. C250 in Normal Elderly and AD subjects was roughly the same to relevant and irrelevant stimuli in Intratrial Parts 1–3 but not 4. The AD group had lower C250 to relevant stimuli in part 1.ConclusionsBoth normal aging and dementia cause less differentiation of relevant from irrelevant information in initial storage. There was a large aging effect involving differences in the pattern of C250 responses of the Young Adult versus the Normal Elderly/AD groups. Also, a potential dementia effect was obtained.SignificanceC250 is a candidate tool for measuring short-term memory performance on a biological level, as well as a potential marker for memory changes due to normal aging and dementia.



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The relevance of attention in schizophrenia P50 paired stimulus studies

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Anna Dalecki, Amity E. Green, Stuart J. Johnstone, Rodney J. Croft
ObjectiveP50 suppression refers to the P50 ERP amplitude-reduction to the second (S2) relative to the first (S1) of identical brief auditory stimuli (SOA=500ms). Its reduction in schizophrenia is argued to represent impaired inhibitory input (II) mechanisms. Enhancing attention enhances II functionality (reducing S2P50 amplitude and increasing P50 difference) in healthy subjects. We determined whether the effect of attention on P50 suppression differs between schizophrenia patients (SCZ) and controls (CON) and thus is a confound in P50 schizophrenia research.MethodsWe manipulated the direction of attention (attention, non-attention) in 21 SCZ and 18 CON in the P50 suppression task.ResultsDirecting attention towards stimulus pairs (versus non-attention) increased P50 suppression (P50 difference). This effect differed between groups, with attention increasing S1P50, reducing S2P50 and increasing P50 suppression (P50 difference and reducing P50 ratio) in CON only. No group differences were found for P50 difference or ratio.ConclusionsAttention is a confound in schizophrenia P50 research and thus should be carefully controlled. When attention was controlled, P50 group differences were not found.SignificanceThe SCZ–CON P50 difference reported in the literature may be related to uncontrolled attention (and not impaired P50 suppression per se).



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Freezing of gait is associated with increased saccade latency and variability in Parkinsons disease

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Samuel T. Nemanich, Gammon M. Earhart
ObjectiveFreezing of gait (FOG) is a locomotor disturbance in Parkinson disease (PD) related to impaired motor automaticity. In this study, we investigated the impact of freezing on automaticity in the oculomotor system using an anti-saccade paradigm.MethodsSubjects with PD with (PD–FOG, n=13) and without (PD–NON, n=13) FOG, and healthy age-matched controls (CTRL, n=12) completed automatic pro-saccades and non-automatic anti-saccades. Primary outcomes were saccade latency, velocity, and gain.ResultsPD–FOG (pro-saccade latency=271ms, anti-saccade latency=412ms) were slower to execute both types of saccades compared to PD–NON (253ms, 330ms) and CTRL (246ms, 327ms). Saccade velocity and gain variability was also increased in PD–FOG.ConclusionsSaccade performance was affected in PD–FOG for both types of saccades, indicating differences in automaticity and control in the oculomotor system related to freezing.SignificanceThese results and others show that FOG impacts non-gait motor functions, suggesting global motor impairment in PD–FOG.



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Transcranial direct current stimulation (tDCS) over primary motor cortex leg area promotes dynamic balance task performance

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Elisabeth Kaminski, Christopher J. Steele, Maike Hoff, Christopher Gundlach, Viola Rjosk, Bernhard Sehm, Arno Villringer, Patrick Ragert
ObjectiveThe aim of the study was to investigate the effects of facilitatory anodal tDCS (a-tDCS) applied over the leg area of the primary motor cortex on learning a complex whole-body dynamic balancing task (DBT). We hypothesized that a-tDCS during DBT enhances learning performance compared to sham tDCS (s-tDCS).MethodsIn a randomized, parallel design, we applied either a-tDCS (n=13) or s-tDCS (n=13) in a total of 26 young subjects while they perform the DBT. Task performance and error rates were compared between groups. Additionally, we investigated the effect of tDCS on the relationship between performance and kinematic variables capturing different aspects of task execution.ResultsA-tDCS over M1 leg area promotes balance performance in a DBT relative to s-tDCS, indicated by higher performance and smaller error scores. Furthermore, a-tDCS seems to mediate the relationship between DBT performance and the kinematic variable velocity.ConclusionsOur findings provide novel evidence for the ability of tDCS to improve dynamic balance learning, a fact, particularly important in the context of treating balance and gait disorders.SignificanceTDCS facilitates dynamic balance performance by strengthening the inverse relationship of performance and velocity, thus making tDCS one potential technique to improve walking ability or help to prevent falls in patients in the future.



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Do quiet standing centre of pressure measures within specific frequencies differ based on ability to recover balance in individuals with stroke?

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Alison Schinkel-Ivy, Jonathan C. Singer, Elizabeth L. Inness, Avril Mansfield
ObjectiveTo determine whether quiet standing measures at specific frequency levels (representative of reactive control) differed between individuals with stroke based on their ability to recover balance (Failed or Successful Responses to external perturbations).MethodsIndividuals with stroke completed a clinical assessment, including 30 s of quiet standing and lean-and-release postural perturbations, at admission to in-patient rehabilitation. Quiet standing centre of pressure (COP) signals were calculated and discrete wavelet decomposition was performed. Net COP amplitude, between-limb synchronization, and ratios of individual-limb COP were determined for each frequency level of interest, and for the non-decomposed signal (all frequency levels). Outcome measures were compared between individuals who exhibited Failed and Successful Responses during (a) unconstrained and (b) encouraged-use lean-and-release trials.ResultsIndividuals with Failed Responses during the unconstrained lean-and-release trials displayed greater net COP amplitude than those with Successful Responses, specifically within a frequency range of 0.40–3.20Hz.ConclusionsReduced ability to recover balance among individuals with stroke may be reflected in impaired reactive control of quiet standing.SignificanceThese results provide insight into the mechanism by which reactive control of quiet standing is impaired in individuals with stroke, and may inform assessment and rehabilitation strategies for post-stroke reactive balance control.



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Threshold tracking transcranial magnetic stimulation: Effects of age and gender on motor cortical function

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Kazumoto Shibuya, Susanna B. Park, Nimeshan Geevasinga, William Huynh, Neil G. Simon, Parvathi Menon, James Howells, Steve Vucic, Matthew C. Kiernan
ObjectiveRecently, the utility of threshold tracking paired-pulse transcranial magnetic stimulation (TTTMS), to measure changes in cortical excitabilitability, has been established for diagnostic purposes across a range of neurological diseases. However, the impact of healthy aging on the GABA-ergic intracortical inhibitory system remains unclear. To improve the clinical applicability, TTTMS was performed across an age spectrum.MethodsTTTMS, single-pulse TMS and nerve conduction studies (NCS) were performed in 113 healthy subjects aged between 20 and 83years (57 male and 56 female).ResultsProlonged motor evoked potential (MEP) latency, increased central motor conduction time, decreased compound muscle action potential (CMAP) amplitude, prolonged F-wave latency and decreased neurophysiological index (NI), calculated from CMAP amplitude, latency and F-wave frequency, were observed as subjects aged. In contrast, short interval intracortical inhibition (SICI) and facilitation did not change. Compared to females, males exhibited a reduced SICI and NI along with longer MEP, CMAP with prolonged F-wave latencies. Multivariate analyses revealed similar results.ConclusionUtilizing clinically applicable TTTMS protocols, findings suggest that GABA mediated intracortical inhibition may be greater in females but does not significantly change with age.SignificanceThese findings may better inform the interpretation of diagnostic TTTMS studies in the clinical setting.



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Non-invasive cortical modulation of experimental pain in migraine

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): M. Uglem, P.M. Omland, M. Engstrøm, G.B. Gravdahl, M. Linde, K. Hagen, T. Sand
ObjectiveTo test the hypothesis that secondary somatosensory cortex (S2) is involved in the migraine pathogenesis, by exploring the effect of navigated repetitive transcranial magnetic stimulation (rTMS) to S2 on thermal perception and pain.MethodsIn this blinded sham-controlled case-control study of 26 interictal migraineurs and 31 controls, we measured thermal detection and pain thresholds on the hand and forehead, and pain ratings to heat stimulation on the forearm and temple, after real and sham 10Hz rTMS.ResultsrTMS increased cold and heat pain thresholds in controls as compared to interictal migraineurs (p<0.026). rTMS decreased forehead and arm pain ratings (p<0.005) and increased hand cool detection thresholds (p<0.005) in both interictal migraineurs and controls.ConclusionsThe effects of rTMS to S2 on thermal pain measures differed significantly between migraine and control subjects, although the effects were generally low in magnitude and not present in pain ratings. However, the lack of cold and heat pain threshold increase in migraineurs may reflect a hypofunction of inhibitory pain modulation mechanisms.SignificanceThe expected rTMS-induced cold and heat hypoalgesia was not found among migraineurs, possibly a reflection of reduced intracortical inhibition.



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Electroencephalogram signatures of ketamine anesthesia-induced unconsciousness

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Oluwaseun Akeju, Andrew H. Song, Allison E. Hamilos, Kara J. Pavone, Francisco J. Flores, Emery N. Brown, Patrick L. Purdon
ObjectivesKetamine is an N-methyl-d-aspartate (NMDA) receptor antagonist commonly administered as a general anesthetic. However, neural circuit mechanisms to explain ketamine anesthesia-induced unconsciousness in humans are yet to be clearly defined. Disruption of frontal–parietal network connectivity has been proposed as a mechanism to explain this brain state. However, this mechanism was recently demonstrated at subanesthetic doses of ketamine in awake-patients. Therefore, we investigated whether there is an electroencephalogram (EEG) signature specific for ketamine anesthesia-induced unconsciousness.MethodsWe retrospectively studied the EEG in 12 patients who received ketamine for the induction of general anesthesia. We analyzed the EEG dynamics using power spectral and coherence methods.ResultsFollowing the administration of a bolus dose of ketamine to induce unconsciousness, we observed a "gamma burst" EEG pattern that consisted of alternating slow-delta (0.1–4Hz) and gamma (∼27–40Hz) oscillations. This pattern was also associated with increased theta oscillations (∼4–8Hz) and decreased alpha/beta oscillations (∼10–24Hz).ConclusionsKetamine anesthesia-induced unconsciousness is associated with a gamma burst EEG pattern.SignificanceThe EEG signature of ketamine anesthesia-induced unconsciousness may offer new insights into NMDA circuit mechanisms for unconsciousness.



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Maintenance of cutaneomuscular neuronal excitability after leg-cycling predicts lower limb muscle strength after incomplete spinal cord injury

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Stefano Piazza, Julio Gómez-Soriano, Elisabeth Bravo-Esteban, Diego Torricelli, Gerardo Avila-Martin, Iriana Galan-Arriero, José Luis Pons, Julian Taylor
ObjectiveControlled leg-cycling modulates H-reflex activity after spinal cord injury (SCI). Preserved cutaneomuscular reflex activity is also essential for recovery of residual motor function after SCI. Here the effect of a single leg-cycling session was assessed on cutaneomuscular-conditioned H-reflex excitability in relation to residual lower limb muscle function after incomplete SCI (iSCI).MethodsModulation of Soleus H-reflex activity was evaluated following ipsilateral plantar electrical stimulation applied at 25–100ms inter-stimulus intervals (ISI's), before and after leg-cycling in ten healthy individuals and nine subjects with iSCI.ResultsLeg-cycling in healthy subjects increased cutaneomuscular-conditioned H-reflex excitability between 25 and 75ms ISI (p<0.001), compared to a small loss of excitability at 75ms ISI after iSCI (p<0.05). In addition, change in cutaneomuscular-conditioned H-reflex excitability at 50ms and 75ms ISI in subjects with iSCI after leg-cycling predicted lower ankle joint hypertonia and higher Triceps Surae muscle strength, respectively.ConclusionLeg-cycling modulates cutaneomuscular-conditioned spinal neuronal excitability in healthy subjects and individuals with iSCI, and is related to residual lower limb muscle function.SignificanceCutaneomuscular-conditioned H reflex modulation could be used as a surrogate biomarker of both central neuroplasticity and lower limb muscle function, and could benchmark lower-limb rehabilitation programs in subjects with iSCI.



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Cortical correlates of susceptibility to upper limb freezing in Parkinson’s disease

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Marlieke Scholten, Rathinaswamy B. Govindan, Christoph Braun, Bastiaan R. Bloem, Christian Plewnia, Rejko Krüger, Alireza Gharabaghi, Daniel Weiss
ObjectiveFreezing behavior is an unmet symptom in Parkinson's disease (PD), which reflects its complex pathophysiology. Freezing behavior can emerge when attentional capacity is reduced, i.e. under dual task interference. In this study, we characterized the cortical network signatures underlying the susceptibility to freezing during continuous finger tapping.MethodsFourteen PD patients with STN-DBS and thirteen age- and gender-matched healthy controls performed continuous tapping with the index finger as single motor task and during dual tasking. Synchronized EEG and mechanogram of the finger tapping were recorded. Subsequently, we analyzed cortical activity and cortico-cortical phase synchronization. We correlated these spectral measures with the biomechanically confirmed numbers of freezing episodes during finger tapping.ResultsDuring dual tasking compared to the single motor task, PD patients showed an increase of cortico-cortical phase synchronization over the left prefrontal area from 13 to 30Hz. This correlated with increased occurrence of freezing episodes. Interestingly, PD patients lacked the increase of prefrontal cortico-cortical synchronization from 4 to 7Hz during dual tasking as observed in healthy controls.ConclusionDual task interference led to an increase of left prefrontal beta band synchronization (13–30Hz) in PD and this increment predicted the number of freezing episodes. This increment may underscore the relevance of prefrontal executive dysfunction in freezing susceptibility.SignificanceThese findings enhance our understanding of the pathological network mechanisms behind increased susceptibility to freezing behavior.



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Freezing of gait is associated with increased saccade latency and variability in Parkinson’s disease

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Publication date: June 2016
Source:Clinical Neurophysiology, Volume 127, Issue 6
Author(s): Samuel T. Nemanich, Gammon M. Earhart
ObjectiveFreezing of gait (FOG) is a locomotor disturbance in Parkinson disease (PD) related to impaired motor automaticity. In this study, we investigated the impact of freezing on automaticity in the oculomotor system using an anti-saccade paradigm.MethodsSubjects with PD with (PD–FOG, n=13) and without (PD–NON, n=13) FOG, and healthy age-matched controls (CTRL, n=12) completed automatic pro-saccades and non-automatic anti-saccades. Primary outcomes were saccade latency, velocity, and gain.ResultsPD–FOG (pro-saccade latency=271ms, anti-saccade latency=412ms) were slower to execute both types of saccades compared to PD–NON (253ms, 330ms) and CTRL (246ms, 327ms). Saccade velocity and gain variability was also increased in PD–FOG.ConclusionsSaccade performance was affected in PD–FOG for both types of saccades, indicating differences in automaticity and control in the oculomotor system related to freezing.SignificanceThese results and others show that FOG impacts non-gait motor functions, suggesting global motor impairment in PD–FOG.



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