Τετάρτη, 14 Σεπτεμβρίου 2016

The N400 elicited by homonyms in puns: Two primes are not better than one

Abstract

To comprehend a pun involving a homonym (e.g., The prince with a bad tooth got a crown), both meanings of the homonym must be accessed and selected. Previous ERP studies have shown that the N400 reflects lexicosemantic processing, but none have directly investigated the N400 elicited by homonyms in the unique context of puns. Here, N400 priming effects showed that the dual context of puns (e.g., the primes prince and tooth) did not facilitate homonym processing in comparison to single dominant biasing (e.g., The prince with a bad leg got a crown) or subordinate biasing (e.g., The adult with a bad tooth got a crown) conditions. However, homonyms did elicit a less negative N400 (i.e., priming) in the pun condition in comparison to the neutral context condition (e.g., The adult with a bad leg got a crown). These findings are interpreted in terms of the dominant advantage and subordinate bias effect posited by the reordered access model of homonym processing, and in terms of N400 amplitude as an index of how consistently various sources of semantic featural information converge on one lexical item, even when two lexical items must be activated for comprehension.



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Don't startle me—Interference of startle probe presentations and intermittent ratings with fear acquisition

Abstract

Reproducibility is fundamental to science and a recent matter of discussion. We report challenges for conceptual replications when employing different readout measures to target the same theoretical construct, particularly those requiring probed reactions. This was addressed in a fear conditioning paradigm, a prototype of emotional learning, in three experimental groups (Ntotal = 57). We demonstrate that the inclusion of startle probes (95 dB burst of white noise) to elicit a startle reflex delays the acquisition of fear as reflected by skin conductance responses and intermittent fear ratings. The inclusion of fear ratings in turn did not significantly affect fear acquisition. Hence, subtle differences in experimental design, such as the inclusion of a single additional outcome measure, may substantially impact on study results and interpretations. Thus, small effects, as are common in between-group comparisons, may be particularly susceptible to this, which has strong implications for the replication of findings across studies employing slightly different experimental designs.



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Recollection is delayed under changed viewing conditions: A graded effect on the latency of the late posterior component

Abstract

Object recognition is a central human ability. In everyday life, the conditions under which objects have to be recognized are usually not perfect. Often, viewing conditions change in between two encounters with an object; typical are changes in illumination or in the object-observer distance. With such changes, object recognition sometimes feels slightly delayed. We examined this phenomenon empirically by measuring the latency of the well-established electrophysiological correlate of recollection, the late posterior component (LPC), in an object-recognition task. Although the cognitive processes underlying successful recognition are well examined, thus far the consequences of changed viewing conditions on the timing of these processes have not been investigated. The ERP technique is well suited for investigating this question, because it allows differentiating between processes contributing to recognition times (in particular, recollection from familiarity as indexed by the FN400 component) and measuring their time course with high temporal precision. In the present study, participants' task was to differentiate previously studied (old) objects from a set of new objects. Viewing conditions for old objects changed slightly, changed strongly, or remained identical between learning and test. We found that the latency of the LPC in response to an old object was delayed whenever viewing conditions changed. Moreover, this delay in LPC latency scaled with the size of the change. These effects were absent for the FN400. This is the first examination of effects of changes in viewing conditions on the latency of recollection and the first dissociation of FN400 and LPC latencies.



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'The Greatest' by Sia

The singer's latest music video is a tribute to the Orlando nightclub shooting victims.

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'The Greatest' by Sia

The singer's latest music video is a tribute to the Orlando nightclub shooting victims.

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Slow gamma rhythms in CA3 are entrained by slow gamma activity in the dentate gyrus

In hippocampal area CA1, slow (~25-55 Hz) and fast (~60-100 Hz) gamma rhythms are coupled with different CA1 afferents. CA1 slow gamma is coupled to inputs from CA3, and CA1 fast gamma is coupled to inputs from the medial entorhinal cortex (Colgin et al. 2009). CA3 gives rise to highly divergent associational projections, and it is possible that reverberating activity in these connections generates slow gamma rhythms in the hippocampus. However, hippocampal gamma is maximal upstream of CA3, in the dentate gyrus (DG) region (Bragin et al. 1995a). Thus, it is possible that slow gamma in CA3 is driven by inputs from DG. Yet, few studies have examined slow and fast gamma rhythms in DG recordings. Here, we investigated slow and fast gamma rhythms in paired recordings from DG and CA3 in freely moving rats in order to determine whether slow and fast gamma rhythms in CA3 are entrained by DG. We found that slow gamma rhythms, as opposed to fast gamma rhythms, were particularly prominent in DG. We investigated directional causal influences between DG and CA3 using Granger causality analysis and found that DG slow gamma influences CA3 slow gamma. Moreover, DG place cell spikes were strongly phase-locked to CA3 slow gamma rhythms, suggesting that DG excitatory projections to CA3 may underlie this directional influence. These results indicate that slow gamma rhythms do not originate in CA3 but rather that slow gamma activity upstream in DG entrains slow gamma rhythms in CA3.



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Botulinum toxin injection causes hyperreflexia and increased muscle stiffness of the triceps surae muscle in the rat.

Botulinum toxin is used to diminish spasticity and reduce the risk of development of contractures. Here, we investigated changes in muscle stiffness caused by reflex activity or elastic muscle properties following botulinum toxin injection in the triceps surae muscle in rats. Forty-four rats received injection of botulinum toxin in the left triceps surae muscle. Control measurements were performed on the non-injected contralateral side in all rats. Acute experiments were performed 1, 2, 4 and 8 weeks following injection. The triceps surae muscle was dissected free, the Achilles tendon was cut and attached to a muscle puller. The resistance of the muscle to stretches of different amplitudes and velocities was systematically investigated. Reflex mediated torque was normalized to the maximal muscle force (Mmax) evoked by supramaximal stimulation of the tibial nerve. Botulinum toxin injection caused severe atrophy of the triceps surae muscle at all time points. The force generated by stretch reflex activity was also strongly diminished, but not to the same extent as Mmax at 2 and 4 weeks, signifying a relative reflex hyperexcitability. Passive muscle stiffness was unaltered at 1 week, but increased at 2, 4 and 8 weeks (p<0.01). These data demonstrate that botulinum toxin causes a relative increase in reflex stiffness, which is likely caused by compensatory neuroplastic changes. The stiffness of elastic elements in the muscles also increased. The data are not consistent with the ideas that botulinum toxin is an efficient antispastic medication or that it may prevent development of contractures.



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Activation of {beta} Noradrenergic Receptors Enhances Rhythmic Bursting in Mouse Olfactory Bulb External Tufted Cells

The main olfactory bulb (MOB) receives a rich noradrenergic innervation from the nucleus locus coeruleus. Despite the well documented role of norepinephrine and beta (β) adrenergic receptors in neonatal odor preference learning, identified cellular physiological actions of β receptors in the MOB have remained elusive. β receptors are expressed at relatively high levels in the MOB glomeruli, the location of external tufted (ET) cells that exert an excitatory drive on mitral and other cell types. The present study investigated the effects of β receptor activation on the excitability of ET cells using patch clamp electrophysiology in mature mouse MOB slices. Isoproterenol and selective β2, but not β1, receptor agonists were found to enhance two key intrinsic currents involved in ET burst initiation: persistent sodium (INaP) and hyperpolarization-activated inward (Ih) currents. Together, the positive modulation of these currents increased the frequency and strength of ET cell rhythmic bursting. Rodent sniff frequency and locus coeruleus neuronal firing increase in response to novel stimuli or environments. The increase in ET excitability by β receptor activation may better enable ET cell rhythmic bursting, and hence the glomerular network activity, to pace faster sniff rates during heightened norepinephrine release associated with arousal.



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High altitude-related hypertensive crisis and acute kidney injury in an asymptomatic healthy individual

High-altitude exposure causes a mild to moderate rise in systolic and diastolic blood pressure. This case report describes the first documented case of a hypertensive crisis at altitude, as well as the first r...

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'The Greatest' by Sia

The singer's latest music video is a tribute to the Orlando nightclub shooting victims.

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'The Greatest' by Sia

The singer's latest music video is a tribute to the Orlando nightclub shooting victims.

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Assessment of Kinematics and Electromyography following Arthroscopic Single-Tendon Rotator Cuff Repair

The increasing demand for rotator cuff (RC) repair patients to return to work as soon as they are physically able has led to exploration of when this is feasible. Current guidelines from our orthopaedic surgery clinic recommend a return to work at 9 weeks post-operation. In order to more fully define capacity to return to work the current study was conducted using a unique series of quantitative tools. To date, no study has combined three-dimensional (3D) motion analysis with electromyography (EMG) assessment during activities of daily living (ADLs), which include desk tasks, and commonly prescribed rehabilitation exercise.

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Ultrasound-Guided Fasciotomy for Chronic Exertional Compartment Syndrome: A Cadaveric Investigation

Chronic exertional compartment syndrome (CECS) is a common cause of exertional leg pain. It is commonly treated with a surgical fasciotomy, which has a surgical complication rate of up to 16% and takes approximately 6-12 weeks to return to pre-procedure activity levels. Therefore, the development of a less invasive, effective outpatient intervention to treat CECS is desirable.

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Possibility and risk of medication vial coring in interventional spine procedures

When a needle is inserted into the stopper of a medication vial, small pieces of the stopper could be 'cored' inside the bore of the needle, consequently aspirated, and then injected into the body. Reported coring rates vary from 3.1% to 97%. This article reviews the literature surrounding this topic and covers: the rate of coring, its risk factors, and particle size, as well as prevention techniques to maximize safety during interventional procedures.

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Demonstration of Lesions Produced by Cooled Radiofrequency Neurotomy for Chronic Osteoarthritic Knee Pain: A Case Report

This is a case demonstrating radiographic evidence of lesions created following cooled radiofrequency (cRF) neurotomy of the knee. A 67-year-old man presents with chronic left knee osteoarthritis, pain, and disability. After failed trial of conservative treatments, the patient underwent diagnostic genicular nerve blocks, and subsequent cRF neurotomy, of the left knee. Shortly after cRF, magnetic resonance imaging (MRI) of the left knee was obtained. On MRI, lesions created by cRF ablation were identified.

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Intelligent humidification with the new HAMILTON-H900

After successful 510(k) clearance, Hamilton Medical presents the new active humidifier HAMILTON-H900 in the US. With improved ergonomics, ease of use, and facilitated handling, the HAMILTON-H900 makes humidification one less thing to worry about in critical care.

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New Norwegian AW101 All-Weather SAR Helicopter

Worlds most advanced SAR Helicopter, flying next year ? NAWSARH = Norwegian All Weather Searchs And Rescue Helicopter. The Norwegian coast-line and Arctic area is h u g e ... Ower trusty Sea-King`s is outdated, and both Super-Puma, Sikorsky S-92 and NH 90 seen as unfit for the job... ( Super-Puma 225 not legal to operate here ! Gearbox is useless, fan keeps faling off (same with the 725, AFAIK ...) AW 101 with top-spec. is what we will use. I hope it is GOOD! Anesthesiologist on the team, with the HEMS-Tec./Rescue swimmer to help, for optimal service. "Full Flight Simulator" is in the deal. The 330 Squadron is part of the National Air Ambulance Service. It carries out about 800 missions per year, or about ten percent of the total helicopter ambulance missions in Norway. The unit's helicopters are used when the ordinary helicopter ambulances (Eurocopter EC135, EC145, AW139) are unable to operate due to weather; missions in which a large cabin is needed due number of pt./Incubator e

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New Norwegian AW101 All-Weather SAR Helicopter

Worlds most advanced SAR Helicopter, flying next year ? NAWSARH = Norwegian All Weather Searchs And Rescue Helicopter. The Norwegian coast-line and Arctic area is h u g e ... Ower trusty Sea-King`s is outdated, and both Super-Puma, Sikorsky S-92 and NH 90 seen as unfit for the job... ( Super-Puma 225 not legal to operate here ! Gearbox is useless, fan keeps faling off (same with the 725, AFAIK ...) AW 101 with top-spec. is what we will use. I hope it is GOOD! Anesthesiologist on the team, with the HEMS-Tec./Rescue swimmer to help, for optimal service. "Full Flight Simulator" is in the deal. The 330 Squadron is part of the National Air Ambulance Service. It carries out about 800 missions per year, or about ten percent of the total helicopter ambulance missions in Norway. The unit's helicopters are used when the ordinary helicopter ambulances (Eurocopter EC135, EC145, AW139) are unable to operate due to weather; missions in which a large cabin is needed due number of pt./Incubator e

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Va. EMT launches senior help-alert services

The device allows geriatric patients to notify EMS when an injury occurs and provides responders with additional information

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Contents

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10





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Alterations in transcallosal communication following concussion

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): Aimee J. Nelson




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An elegant new test of corticospinal tract function during surgery: More work to be done

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): Stan Skinner




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Editorial Board

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10





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Phenobarbital reduces EEG amplitude and propagation of neonatal seizures but does not alter performance of automated seizure detection

Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): Sean R. Mathieson, Vicki Livingstone, Evonne Low, Ronit Pressler, Janet M. Rennie, Geraldine B. Boylan
ObjectivePhenobarbital increases electroclinical uncoupling and our preliminary observations suggest it may also affect electrographic seizure morphology. This may alter the performance of a novel seizure detection algorithm (SDA) developed by our group.The objectives of this study were to compare the morphology of seizures before and after phenobarbital administration in neonates and to determine the effect of any changes on automated seizure detection rates.MethodsThe EEGs of 18 term neonates with seizures both pre- and post-phenobarbital (524 seizures) administration were studied. Ten features of seizures were manually quantified and summary measures for each neonate were statistically compared between pre- and post-phenobarbital seizures. SDA seizure detection rates were also compared.ResultsPost-phenobarbital seizures showed significantly lower amplitude (p<0.001) and involved fewer EEG channels at the peak of seizure (p<0.05). No other features or SDA detection rates showed a statistical difference.ConclusionThese findings show that phenobarbital reduces both the amplitude and propagation of seizures which may help to explain electroclinical uncoupling of seizures. The seizure detection rate of the algorithm was unaffected by these changes.SignificanceThe results suggest that users should not need to adjust the SDA sensitivity threshold after phenobarbital administration.



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Altered recovery from inhibitory repetitive transcranial magnetic stimulation (rTMS) in subjects with photosensitive epilepsy

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): Tommaso Bocci, Matteo Caleo, Laura Restani, Davide Barloscio, Simone Rossi, Ferdinando Sartucci
ObjectiveTo investigate functional changes underlying photosensitivity, we studied the response of the visual cortex to low-frequency, inhibitory repetitive transcranial magnetic stimulation (rTMS) in drug-free patients with photosensitive seizures and healthy volunteers.MethodsVisual evoked potentials (VEPs) triggered by grating stimuli of different contrasts were recorded in both hemispheres before and after transient functional inactivation of the occipital cortex of one side via low-frequency rTMS (0.5Hz for 20′). VEPs were recorded before (T0), immediately after (T1) and 45′ following the completion of rTMS (T2).ResultsBaseline amplitudes of the early VEP components (N1 and P1) were enhanced in photosensitive patients. At T1, rTMS produced an inhibitory effect on VEPs amplitudes at all contrasts in the targeted side and a concurrent facilitation of responses in the contralateral hemisphere. Compared with PSE subjects, VEP amplitudes remained persistently dampened in the stimulated hemisphere of controls (Holm–Sidak post-hoc method, p<0.05). In the contralateral hemisphere, we found a clear enhancement of VEP amplitude in photosensitive subjects but not controls at T2 (Holm–Sidak test, p<0.001).ConclusionsVisual responses recovered more quickly in the stimulated hemisphere, and disinhibition persisted in the contralateral side of photosensitive subjects.SignificanceThe rapid recovery of excitability and the persistent transcallosal disinhibition following perturbation of cortical activity may play a role in the pathophysiology of photosensitive epilepsy.



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Intraoperative spinal cord monitoring using low intensity transcranial stimulation to remove post-activation depression of the H-reflex

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): Jennifer C. Andrews, Richard B. Stein, Kelvin E. Jones, Douglas M. Hedden, James K. Mahood, Marc J. Moreau, Eric M. Huang, François D. Roy
ObjectiveTo investigate whether low intensity transcranial electrical stimulation (TES) can be used to condition post-activation depression of the H-reflex and simultaneously monitor the integrity of spinal motor pathways during spinal deformity correction surgery.MethodsIn 20 pediatric patients undergoing corrective surgery for spinal deformity, post-activation depression of the medial gastrocnemius H-reflex was initiated by delivering two pulses 50–125ms apart, and the second H-reflex was conditioned by TES.ResultsLow intensity TES caused no visible shoulder or trunk movements during 19/20 procedures and the stimulation reduced post-activation depression of the H-reflex. The interaction was present in 20/20 patients and did not diminish throughout the surgical period. In one case, the conditioning effect was lost within minutes of the disappearance of the lower extremity motor evoked potentials.ConclusionPost-activation depression was used to detect the arrival of a subthreshold motor evoked potential at the lower motor neuron. The interaction produced minimal movement within the surgical field and remained stable throughout the surgical period.SignificanceThis is the first use of post-activation depression during intraoperative neurophysiological monitoring to directly assess the integrity of descending spinal motor pathways.



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Corrigendum to “Peripheral nerve tumors associated with Martin–Gruber anastomosis” [Clin. Neurophysiol. 126 (2015) 428–430]

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): C. Erra, D. Coraci, P. De Franco, G. Granata, L. Padua




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Evidence of alterations in transcallosal motor inhibition as a possible long-term consequence of concussions in sports: A transcranial magnetic stimulation study

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Publication date: October 2016
Source:Clinical Neurophysiology, Volume 127, Issue 10
Author(s): Travis W. Davidson, François Tremblay
ObjectiveGrowing evidence suggests that long-term structural and physiological alterations are present in the brain of previously concussed athletes. In this study, we sought to further explore the long-term consequences of concussions with transcranial magnetic stimulation (TMS) by examining excitability changes both within and between hemispheres.MethodsParticipants (32 young adults with and without a history of concussions (HxC)) first underwent testing to assess cognitive and motor performance using standardized tests. Then, the following TMS measures were derived bilaterally: (1) resting motor threshold and motor evoked potentials (MEP), (2) afferent-induced modulation, (3) contralateral silent period (cSP) and MEP facilitation, and, (4) ipsilateral silent period (iSP).ResultsMultivariate analyses of performance data revealed no major group differences. For TMS data, no "hemisphere" effects were detected for all measures. Group differences were detected only for iSP derived measures owing to alterations in the onset latency and duration of transcallosal inhibition in the HxC group.ConclusionsWhile no major asymmetries were found between hemispheres, participants in the HxC group showed evidence of impaired transcallosal inhibition.SignificanceResults provide one of the first piece of evidence pointing to alterations in transcallosal inhibition as a potential neurophysiological marker of long-term consequences of concussions in sports.



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Hyaluronan metabolism in overloaded temporomandibular joint

Abstract

The present study aimed to examine hyaluronan (HA) metabolism in relation to the onset and progression of temporomandibular joint osteoarthritis (TMJ-OA) induced by mechanical overloading. Two-month-old and 6-month-old C57BL/6N mice were divided into experimental and untreated control groups (n = 5/group). A sliding plate was attached to the maxillary incisors of the experimental mice for 10 days to overload the condylar cartilage in TMJ. In experimental group, profound cartilage degradation was detected in hematoxylin-eosin, Safranin-O-Fast Green stained sections. It was also shown that the cartilage degradation was greater in older mice in both the control and the experimental groups. The number of HABP positive cells was decreased by mechanical overloading and with age. The reduction of HA expression was correlated with the progression of cartilage degradation induced by mechanical overloading. The absolute quantification of the mRNA expression related to HA synthesis and HA degradation was also performed in each group. The mRNA expression levels of HA synthase (HAS) 2 and 3 were lower in the experimental group compared with the control group in the younger mice. In contrast, the mRNA expression levels of the HA degradation gene, HYAL2 and KIAA1199, were higher in the experimental group compared with the control group in the older mice. Thus, mechanical overload differently affected the balance of HA degradation and HA synthesis in the older and younger mice, respectively. In conclusion, mechanical overloading affects HA metabolism and it might initiate or amplify the condylar cartilage degradation.

This article is protected by copyright. All rights reserved.



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Factors related to taste sensitivity in elderly: cross-sectional findings from SONIC Study

Abstract

The sense of taste is important, as it allows for assessment of nutritional value, as well as safety and quality of foods, with several factors suggested to be associated with taste sensitivity. However, comprehensive variables regarding taste and related factors have not been utilized in previous studies for assessments of sensitivity. In the present study, we performed cross-sectional analyses of taste sensitivity and related factors in geriatric individuals who participated in the SONIC Study. We analyzed 2 groups divided by age, 69 to 71 years (young-old, n=687) and 79 to 81 years (old-old, n=621), and performed a general health assessment, an oral examination, and determination of taste sensitivity. Contributing variables were selected by univariate analysis, then subjected to multivariate logistic regression analysis. In both groups, females showed significantly better sensitivity for bitter and sour tastes. Additionally, higher cognitive scores for subjects with a fine taste for salty were commonly seen in both groups, while smoking, drinking, hypertension, number of teeth, stimulated salivary flow salt intake, and years of education were also shown to be associated with taste sensitivity. We found gender and cognitive status to be major factors affecting taste sensitivity in geriatric individuals.

This article is protected by copyright. All rights reserved.



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Treatment of obstructive sleep apnea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Abstract

Background

Obstructive sleep apnea (OSA) is an increasing problem worldwide. Yet, a large number of patients may remain undiagnosed. Dentists could suspect OSA but little is known about their knowledge and attitudes towards the topic.

Methods

An email questionnaire was sent to dentists working in Helsinki Health Centre, Helsinki, Finland (n=226). It consisted of demographic data, items on dentists' overall knowledge of OSA and factors associated with it, and their possibilities and willingness to take part in the recognition and treatment of OSA patients.

Results

Altogether, 70.9% (n=134) of dentists eligible for the study completed the questionnaire. Of them, 79.1% (n=106) were general practitioners and 20.9% (n=28) dentists with specialty training. Continuous positive airway pressure (CPAP) (99.3%) and weight control (99.3%) were both generally acknowledged as effective methods to treat OSA. Regarding the efficacy of other treatment modalities, significant differences were found between general practitioners' and specialists' opinions. For example, mandibular advancement devices (MAD) were less often reported by general practitioners (69.8%) than specialists (89.3%) (p<0.05). The possible risk factors, signs and symptoms, and consequences of OSA were overall well recognized regardless the years in dental profession but specialists saw more often that nocturnal sweating (p<0.01) and snoring (p<0.05) may signify OSA.

Conclusion

Dentists could play an important role in suspecting OSA but they may need more education to cope with that.

This article is protected by copyright. All rights reserved.



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Pattern of drug usage among medical students in Tumkur, Karnataka

2016-09-14T07-54-46Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Rajesh B, Dharani Devangi R, Waseem Anjum.
Background: Scheduled drugs are also purchased without prescriptions, which is a cause for concern. Educational status is an important determinant of self-medication. Student drug use surveys provide an essential source of information about the prevalence and frequency of drug use, associated harms, socio-demographic correlates, and identification of high-risk groups in a youth population. Self-medication is more common among medical students because of easy access to drug information and drugs. Aims and Objective: The present study was undertaken to identify the patterns of self-medication among medical students. Materials and Methods: The study was carried out among medical students studying in the Shridevi Institute of Medical Sciences and Research Hospital, Tumkur, by questionnaire-based interview. Results: Among 267 students interviewed, 66.8% took self-medications, 24.6% followed the prescriptions. The number of students using self-medications was significantly higher (P

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Tutorial in medical education: A review of contextual modifications

2016-09-14T07-54-46Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Tripti K Srivastava, Lalitbhushan S Waghmare.
Tutorial has embodied a major teachinglearning strategy in basic science of medical education and is widely researched for its effectiveness in learning outcomes. It is a class or short series of classes in which one or more instructors provide intensive instruction on a subject to a small group. Medical students, during tutorials, are trained to develop and test their ideas, clarify concepts taught in lectures, define new problems, seek solutions, cultivate problem-solving skills, and indulge in self-learning. Literature identifies certain important issues with respect to challenges and limitations of conventional tutorial method. Constraints such as lack of structural uniformity, financial and resource limitations for teaching in small groups, and short supply of dependable peer tutors are a few recognized challenges. Available bodies of research also suggest need-based modifications to overcome the operational difficulties without compromising the integrity of tutorial. The proposed alterations can be of consequence in developing professional competencies such as interpersonal and self-directed learning skills. It is apparent that different tutorial formats may be optimal in different fields and levels of study and hence should be piloted as per the local need and relevance.


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A comparative study of gender difference in reaction time in response to exam stress among first-year medical students

2016-09-14T07-54-46Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Surendra S Wadikar, Parikshit A Muley, Pranjali P Muley.
Background: Different studies conducted worldwide among medical students have reported the prevalence of stress ranging from 27% to 73%. Exam stress acts as an acute stressor which affects cognitive functions. It is found that the exam stress elicits elevated activity in the hypothalamic-pituitary-adrenal axis and increased release of cortisol. Aims and Objective: The study was planned to investigate gender difference in perceptions of exam stress and reactions to it among first-year medical students. Choice reaction time (CRT) was used to evaluate the cognitive performance of students during stress-free and stress (exam) conditions. Materials and Methods: The study was conducted on 60 healthy first year MBBS students (30 boys and 30 girls) between the age group of 18 and 20 years. Digital reaction time was used. Randomly occurring visual and auditory CRT tasks were presented to students. First set of readings was taken during stress-free period, and the second and third sets were taken 20 min before first and second terminal practical examination, respectively. Results: The readings were analyzed by unpaired Students t-test. Results showed that visual and auditory reaction times were increased in both boys and girls with statistically significant difference between boys and girls in stress (exam) condition, but no difference during stress-free condition. Conclusion: The observation shows that girls tend to perceive more stress than boys which might affect the cognitive functions more, as slower reaction time was observed in girls than boys when they were exposed to stress.


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Study of prescribing patterns of hypolipidemic agents in a tertiary care teaching hospital in North India

2016-09-14T07-54-46Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Seema Gupta, Rajesh Kumar, Dharminder Kumar, Sanjeev Bhat, Dinesh Kumar, Nusrat Kareem Bhat, Surbhi Mahajan.
Background: Lipid-lowering agents are now the cornerstone of treatment used to reduce the risk of coronary events. Since there is wide variation in selection and use of these drugs, drug utilization studies help to evaluate and analyze drug therapy from time to time. This in turn can guide physicians prescribing practices and help in minimizing adverse drug reactions. Aims and Objectives: To evaluate the prescribing pattern of hypolipidemic drugs in a tertiary care teaching hospital in Jammu. Materials and Methods: An observational study was carried out in patients attending the departments of cardiology and general medicine for 6 months. Prescription of the patients who were prescribed at least one hypolipidemic drug as monotherapy or in combination was evaluated. Hypolipidemic and other classes of drugs prescribed and the World Health Organization prescribing indicators were analyzed. Monthly cost of the hypolipidemic drugs prescribed was also determined. Results: Nearly, two-third (63.7%) patients with increased plasma lipids and 36.2% patients in spite of having normal lipid profile were prescribed hypolipidemic drugs as well. Hypertension with comorbid conditions (39.63%) was the most common diseases, for which hypolipidemic drugs were prescribed. The average number of drugs per prescription was 6.21 ± 1.6. Atorvastatin was the most common hypolipidemic drug prescribed as monotherapy (59.16%), whereas atorvastatin with ramipril was the most common drugs prescribed as combination therapy (14.69%). Conclusion: This study depicts the widespread use of statins in various disease conditions, both as primary and secondary preventive measures. Such studies should be done to educate the physicians on good prescribing practices and on rational use of hypolipidemic drugs.


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Validation of the optimal site in the neck region for detecting swallowing sounds

Summary

Background

Recently, the swallowing sound has been used to detect swallowing events non-invasively. A previous study, using an accelerometer, showed that the site over the lateral border of the trachea immediately inferior to the cricoid cartilage was the optimal site for detecting swallowing sounds. However, the optimal site for detection of the swallowing sound using a microphone remains undetermined.

Objective

To validate the optimal site in the neck region for detecting swallowing sounds.

Methods

Fourteen healthy subjects (mean age, 27.6 ± 2.2 years; seven male and seven female) participated in this study. Twenty condenser microphones were attached to 20 sites on the left neck surface to detect swallowing sounds. Participants were instructed to swallow five different stimuli three times as follows: Resting saliva, 1 and 5 mL of Japanese tea, and 1 and 5mL of yoghurt. Mean relative peak intensity was used to indicate the magnitude of the swallowing sound. Sound spectrograms were used to illustrate differences in the properties of swallowing sounds.

Results

Mean relative peak intensity number was highest in sites at the inferior border of the mandible just above the sternocleidomastoid muscle (site 11), and sites over the lateral border of the trachea immediately inferior to the cricoid cartilage (site 8). Comparison of spectrograms showed a greater density distribution of higher frequency components at site 11 compared with site 8.

Conclusion

These results indicate that the inferior border of the mandible just above the sternocleidomastoid muscle is the optimal site for the detection of swallowing sounds.

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REV ambulance group to have six brands and exclusive "green" idling technology on display at EMS world Expo oct. 5-7

WHAT: The REV Ambulance Group, the leading manufacturer of vehicles for fire and emergency responders, will have six of their brands on display at North America's largest EMS conference and trade show. REV Ambulance Group is one of the world's largest and best-positioned independent suppliers of Type I, II and III emergency vehicles to hospitals, critical care providers, plants, airports ...

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A novel mutation in PIGW causes glycosylphosphatidylinositol deficiency without hyperphosphatasia

In recent years, many mutations have been identified that affect the biosynthesis of the glycosylphosphatidylinositol anchor, a biomolecule that attaches surface molecules to cell membranes. Here, we present two second-degree cousins with unexplained patterns of seizures. Next-generation sequencing identified the homozygous c.460A>G; p.(R154G) PIGW mutation in both patients. Transfection of the mutated allele into Pigw-defective CHO cells indicated impaired enzymatic activity of the mutated PIGW product. Alkaline phosphatase did not exceed the upper normal range and flow cytometry of CD16, CD24, and CD66c on granulocytes showed subtle changes of the cellular expression of the glycosylphosphatidylinositol-anchored proteins. The patients' phenotype is therefore remarkably different from the phenotype of the only other described individual with PIGW mutations. Patients might therefore be missed when relying on traditional flow cytometry of glycosylphosphatidylinositol-anchored proteins only and we suggest that glycosylphosphatidylinositol-deficiency should be considered even with patients not showing the typical clinical phenotypes. © 2016 Wiley Periodicals, Inc.



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