La Ferrassie 1: New perspectives on a “classic” Neandertal

Publication date: April 2018
Source:Journal of Human Evolution, Volume 117
Author(s): Asier Gómez-Olivencia, Rolf Quam, Nohemi Sala, Morgane Bardey, James C. Ohman, Antoine Balzeau
The La Ferrassie 1 (LF1) skeleton, discovered over a century ago, is one of the most important Neandertal individuals both for its completeness and due to the role it has played historically in the interpretation of Neandertal anatomy and lifeways. Here we present new skeletal remains from this individual, which include a complete right middle ear ossicular chain (malleus, incus, and stapes), three vertebral fragments, and two costal remains. Additionally, the study of the skeleton has allowed us to identify new pathological lesions, including a congenital variant in the atlas, a greenstick fracture of the left clavicle, and a lesion in a mid-thoracic rib of unknown etiology. In addition, we have quantified the amount of vertebral pathology, which is greater than previously appreciated. We have complemented the paleopathological analysis with a taphonomic analysis to identify any potential perimortem fractures. The taphonomic analysis indicates that no surface alteration is present in the LF1 skeleton and that the breakage pattern is that of bone that has lost collagen, which would be consistent with the intentional burial of this individual proposed by previous researchers. In this study, we used CT and microCT scans in order to discover new skeletal elements to better characterize the pathological lesions and to quantify the fracture orientation of those bones in which the current plaster reconstruction did not allow its direct visualization, which underlines the broad potential of imaging technologies in paleoanthropological research. A century after its discovery, LF1 is still providing new insights into Neandertal anatomy and behavior.



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Aberrant resting-state functional brain networks in dyslexia: Symbolic mutual information analysis of neuromagnetic signals

Publication date: Available online 21 February 2018
Source:International Journal of Psychophysiology
Author(s): Stavros I. Dimitriadis, Panagiotis G. Simos, Jack Μ. Fletcher, Andrew C. Papanicolaou
Neuroimaging studies have identified a variety of structural and functional connectivity abnormalities in students experiencing reading difficulties. The present study adopted a novel approach to assess the dynamics of resting-state neuromagnetic recordings in the form of symbolic sequences (i.e., repeated patterns of neuromagnetic fluctuations within and/or between sensors).Participants were 25 students experiencing severe reading difficulties (RD) and 27 age-matched non-impaired readers (NI) aged 7–14 years. Sensor-level data were first represented as symbolic sequences in eight conventional frequency bands. Next, dominant types of sensor-to-sensor interactions in the form of intra and cross-frequency coupling were computed and subjected to graph modeling to assess group differences in global network characteristics.As a group RD students displayed predominantly within-frequency interactions between neighboring sensors which may reflect reduced overall global network efficiency and cost-efficiency of information transfer. In contrast, sensor networks among NI students featured a higher proportion of cross-frequency interactions. Brain-reading achievement associations highlighted the role of left hemisphere temporo-parietal functional networks, at rest, for reading acquisition and ability.



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Smartphone technology: a reliable and valid measure of knee movement in knee replacement

Knee range of motion (ROM) following a knee arthroplasty is an important clinical outcome that directly relates to the patient's physical function. Smartphone technology has led to the creation of applications that can measure ROM. The aim was to determine the concurrent reliability and validity of the photo-based application 'Dr Goniometer' (DrG) compared with a universal goniometer performed by a clinician. A smartphone camera was used to take photographs of the knee in full flexion and full extension, and the images were sent by participants to a study phone. Participants then rated the ease of participation. To assess validity, the patient's knee was measured by a clinician using a goniometer. To examine reliability, four clinicians assessed each image using DrG on four separate occasions spaced 1 week apart. A total of 60 images of knee ROM for 30 unicondylar or total knee arthroplasty were assessed. The goniometer and DrG showed strong correlations for flexion (r=0.94) and extension (r=0.90). DrG showed good intrarater reliability and excellent inter-rater reliability for flexion (intraclass correlation coefficient=0.990 and 0.990) and good reliability for extension (intraclass correlation coefficient=0.897 and 0.899). All participants found the process easy. DrG was proven to be a valid and reliable tool in measuring knee ROM following arthroplasty. Smartphone technology, in conjunction with patient-reported outcomes, offers an accurate and practical way to remotely monitor patients. Benefit may be found in differentiating those who need face-to-face clinical consult to those who do not. Correspondence to Hannah Castle, BAppSc (Physiotherapy), Hollywood Private Hospital, Monash Avenue, Nedlands, WA 6009, Australia Tel: +61 9346 6869; fax: +61 9389 8470; e-mail: castleh@ramsayhealth.com.au Received January 11, 2018 Accepted January 28, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Ultrasound-guided bilateral superficial cervical block and preemptive single-dose oral tizanidine for post-thyroidectomy pain: a randomized-controlled double-blind study

Abstract

Purposes

The postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery.

Methods

Sixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C, n = 20) received BSCPB with 0.9% saline plus oral placebo. The superficial cervical group (Group SC, n = 20) received BSCPB with 0.25% bupivacaine plus oral placebo. The superficial cervical and tizanidine group (Group SC + T, n = 20) received BSCPB with 0.25% bupivacaine plus tizanidine 6 mg capsule. Surgical site pain scores, opioid consumption, rescue analgesia, posterior neck pain, headache, and opioid-related side effects were assessed for the first 24 h.

Results

Compared with Group C, rest and swallowing pain scores in Group SC and Group SC + T were statistically lower at all postoperative time points (p < 0.05). Fentanyl consumption was lower in Group SC and Group SC + T than in Group C at time periods 0–4 and 4–8 h (p < 0.05). Fentanyl consumption was lower in Group SC + T than in Group SC at 0–4 h (p = 0.006). Total fentanyl consumption was higher in Group C than in the other groups (p < 0.001). Postoperative cervical pain and occipital headache were significantly lower in Group SC + T than in the other groups (p < 0.05).

Conclusions

Ultrasound-guided BSCPB with or without preemptive oral tizanidine was effective at reducing postoperative pain and opioid consumption in patients undergoing total thyroidectomy. Addition of preemptive oral tizanidine to BSCPB reduced the early postoperative opioid consumption, posterior neck pain, and occipital headache.

Clinical trials registry

The study was registered with a clinical trials registry (ClinicalTrials.gov. identifier NCT02725359).

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Impact of clinical factors and UGT1A9 and CYP2B6 genotype on inter-individual differences in propofol pharmacokinetics

Abstract

Purpose

Propofol is one of the most widely used fast-acting intravenously administered anesthetics. However, although large inter-individual differences in dose requirements and recovery time have been observed, there are few previous studies in which the association between several potential covariates, including genetic factors such as the UGT1A9 and CYP2B6 genotypes, and propofol pharmacokinetics was simultaneously examined. This study aimed to identify factors determining propofol pharmacokinetics.

Methods

Eighty-three patients were enrolled, and their blood samples were collected 1, 5, 10, and 15 min after administering a single intravenous bolus of propofol at a dose of 2.0 ml/kg to measure propofol plasma concentration. Area under the time–plasma concentration curve from zero up to the last measurable time point (AUC_15min) was determined from the concentration data. The inter-individual variability of the propofol pharmacokinetics was evaluated by investigating relationships between AUC_15min and genotype of UGT1A9 and CYP2B6; clinical factors, such as age, sex, body mass index (BMI), and preoperative hematological examination; and hemodynamic variables measured by a pulse dye densitogram analyzer. The Spearman rank correlation coefficient and the Mann–Whitney U test were used for the statistical analysis of continuous and categorical values, respectively. Subsequently, clinical factors that had p values of < 0.05 in the univariate analysis were examined in a multivariate analysis using multiple linear regression analysis.

Results

Age, BMI, indocyanine green disappearance ratio (K-ICG), hepatic blood flow (HBF), preoperative hemoglobin level, and sex were correlated with AUC_15min (p < 0.05) in univariate analysis. Multivariate analysis performed to adjust for age, BMI, K-ICG, HBF, preoperative hemoglobin level, and sex revealed only BMI as an independent factor associated with AUC_15min.

Conclusions

This study demonstrated that BMI influences propofol pharmacokinetics after its administration as a single intravenous injection, while UGT1A9 and CYP2B6 SNPs, other clinical factors, and hemodynamic variables do not. These results suggest that BMI is an independent factor associated with propofol pharmacokinetics in several potential covariates.

Clinical trials registration number

University Hospital Medical Information Network (UMIN000022948).

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Symmetry of cortical planning for initiating stepping in sub-acute stroke

Publication date: April 2018
Source:Clinical Neurophysiology, Volume 129, Issue 4
Author(s): Sue Peters, Tanya D. Ivanova, Bimal Lakhani, Lara A. Boyd, W. Richard Staines, Todd C. Handy, S. Jayne Garland
ObjectiveThis study examined motor planning for stepping when the paretic leg was either stepping or standing (to step with the non-paretic leg), to understand whether difficulty with balance and walking post-stroke could be attributed to poor motor planning.MethodsIndividuals with stroke performed self-initiated stepping. Amplitude and duration of the movement-related cortical potential (MRCP) was measured from Cz. Electromyography (EMG) of biceps femoris (BF) and rectus femoris (RF) were collected.ResultsThere were no differences between legs in stepping speed, MRCP or EMG parameters. The MRCPs when stepping with the paretic leg and the non-paretic leg were correlated. When the paretic leg was stepping, the MRCP amplitude correlated with MRCP duration, indicating a longer planning time was accompanied by higher cognitive effort. Slow steppers had larger MRCP amplitudes stepping with the paretic leg and longer MRCP durations stepping with the non-paretic leg.ConclusionsMRCP measures suggest that motor planning for initiating stepping are similar regardless of which limb is stepping. Individuals who stepped slowly had greater MRCP amplitudes and durations for planning.SignificanceIndividuals who step slowly may require more time and effort to plan a movement, which may compromise their safety in the community.



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Comparison between Corticosteroid and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial

No abstract available

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