Decoding the Debate: A Comparative Study of Brain-Computer Interface and Neurofeedback.

Brain-Computer Interface (BCI) and Neurofeedback (NF) both rely on the technology to capture brain activity. However, the literature lacks a clear distinction between the two, with some scholars categorizing NF as a special case of BCI while others view BCI as a natural extension of NF, or classify them as fundamentally different entities. This ambiguity hinders the flow of information and expertise among scholars and can cause confusion. To address this issue, we conducted a study comparing BCI and NF from two perspectives: the background and context within which BCI and NF developed, and their system design. We utilized Functional Flow Block Diagram (FFBD) as a system modelling approach to visualize inputs, functions, and outputs to compare BCI and NF at a conceptual level. Our analysis revealed that while NF is a subset of the biofeedback method that requires data from the brain to be extracted and processed, the device performing these tasks is a BCI system by definition. Therefore, we conclude that NF should be considered a specific application of BCI technology. By clarifying the relationship between BCI and NF, we hope to facilitate better communication and collaboration among scholars in these fields.

RECURRENT SELF-LIMITED HYPERTHERMIA FOLLOWING ELECTROCONVULSIVE THERAPY.

Electroconvulsive therapy (ECT) is an effective and safe treatment for severe mental disorders, when it is implemented under an adequate surveillance. Its most frequently described side effects are anterograde amnesia, mania, post- ictal confusion, nausea, headache, myalgia, oral lacerations and dental injuries.

Relatos da pandemia: ser mulher e mãe em tempos de covid-19 / Pandemic reports: being a woman and mother in covid-19 times / Relatos de la pandemia: ser mujer y madre en tiempos del covid-19

Partindo da pergunta "Como tem sido ser mulher e mãe em tempos de pandemia?", o presente estudo convidou mulheres que são mães, em redes sociais virtuais, a partilhar um relato de suas experiências com a readaptação parental em função do distanciamento social causado pela pandemia de covid-19. O objetivo foi refletir sobre a experiência de ser mulher e mãe em tempos de covid-19 e distanciamento social, apontando algumas ressonâncias do cenário pandêmico na subjetividade dessas mulheres. O estudo teve como base o referencial psicanalítico, tanto na construção da pesquisa e análise dos relatos quanto na sua discussão. A análise dos cerca de 340 relatos coletados, os quais variaram de uma breve frase a longos parágrafos, apontou para uma série de questionamentos, pontos de análise e reflexões. A pandemia, e o decorrente distanciamento social, parece ter colocado uma lente de aumento sobre as angústias das mulheres que são mães, evidenciando sentimentos e sofrimentos sempre presentes. Destacaram-se, nos relatos, a sobrecarga das mulheres com as tarefas de cuidado dos filhos e da casa, a culpa, a solidão, a exaustão, e o sentimento de que não havia espaço nesse contexto para "ser mulher", sendo isso entendido especialmente a questões estéticas e de vaidade.(AU)

Starting from the question "How does it feel to be a woman and a mother in pandemic times?", this study invited women who are mothers, in virtual social networks, to share their experiences regarding parental adaptations due to social distancing caused by the COVID-19 pandemic. The objective was to reflect on the experience of being a woman and a mother in the context of COVID-19 and of social distancing, pointing out some resonances of the pandemic scenario in the subjectivity of these women. The study was based on the psychoanalytical framework, both in the construction of the research and analysis of the reports and in their discussion. The analysis of about 340 collected reports, which ranged from a brief sentence to long paragraphs, pointed to a series of questions, analysis topics, and reflections. The pandemic, and the resulting social distancing, seems to have placed a magnifying glass over the anguish of women who are mothers, showing ever-present feelings and suffering. The reports highlighted women's overload with child and house care tasks, the guilt, loneliness, exhaustion, and the feeling that there was no space in this context to "be a woman," and it extends to aesthetic and vanity related questions especially.(AU)

A partir de la pregunta "¿cómo te sientes siendo mujer y madre en tiempos de pandemia?", este estudio invitó por las redes sociales a mujeres que son madres a compartir un relato de sus experiencias sobre la readaptación parental en función del distanciamiento social causado por la pandemia del covid-19. Su objetivo fue reflexionar sobre la experiencia de ser mujer y madre en tiempos del covid-19 y el distanciamiento social, señalando algunas resonancias del escenario pandémico en la subjetividad de estas mujeres. Este estudio se basó en el marco psicoanalítico, tanto en la construcción de la investigación y análisis de los informes como en su discusión. El análisis de los casi 340 relatos, que variaron de una pequeña frase a largos párrafos, generó en las investigadoras una serie de cuestionamientos y reflexiones. La pandemia y el consecuente distanciamiento social parece haber agrandado las angustias de las mujeres que son madres, evidenciando sentimientos y sufrimientos siempre presentes. En los relatos destacan la sobrecarga de las mujeres con las tareas de cuidado de los hijos y del hogar, la culpa, la soledad, el cansancio, así como el sentimiento de que no hay espacio em este contexto para "ser mujer", relacionado principalmente a cuestiones estéticas y de vanidad.(AU)

Pellagra as a differential diagnosis in the confused patient on the acute medical unit.

A man in his 80s was admitted via the acute medical take after presenting with increased confusion and features of alcohol withdrawal. He had a several-month history of a worsening pruritic rash surrounding his neck, arms and legs in addition to new, profuse diarrhoea. In view of the background of known chronic alcoholism and the coexisting symptoms of rash, confusion and diarrhoea, pellagra was diagnosed via a multidisciplinary approach. Oral nicotinamide supplementation was commenced and his symptoms responded rapidly. The bias and challenge of reaching a unified diagnosis in the context of a multisystem condition are exemplified in this case report.

Confusion and Hallucination in a Geriatric Patient. Pitfalls of a Rare Differential: Case Report of an Anti-LGI1-Encephalitis.

Background: Confusion and hallucinations in geriatric patients are frequent symptoms and typically associated with delirium, late-life psychosis or dementia syndromes. A far rarer but well-established differential in patients with rapid cognitive deterioration, acute psychosis, abnormal movements and seizures is autoimmune encephalitis. Exemplified by our case we highlight clinical and economic problems arising in management of geriatric patients with cognitive decline and psychotic symptoms. Case Presentation: A 77-year-old female caucasian patient with an unremarkable medical history was hospitalized after a fall in association with diarrhea and hyponatremia. Upon adequate therapy, disorientation and troubled short-term memory persisted. Within a week the patient developed visual hallucinations. Basic blood and urine samples and imaging (cranial computed tomography and magnetic resonance imaging) were unremarkable. With progressive cognitive decline, amnestic impairment, word finding difficulty and general apathy, psychiatric and neurologic expertise was introduced. Advanced diagnostics did not resolve a final diagnosis; an electroencephalogram showed unspecific generalized slowing. Extended clinical observation revealed visual hallucinations and faciobrachial dystonic seizures. A treatment with anticonvulsants was initiated. Cerebrospinal fluid ultimately tested positive for voltage-gated potassium channel LGl1 (leucine-rich-inactivated-1) antibodies confirming diagnosis of autoimmune anti-LGI1 encephalitis. Immediate immunotherapy (high-dose glucocorticoids and administration of intravenous immunoglobulin G) led to a rapid improvement of the patient's condition. After immunotherapy was tapered, the patient had one relapse and completely recovered with reintroduction of glucocorticoids and initiation of therapy with rituximab. Conclusion: Rapidly progressive dementia in geriatric patients demands a structured and multidisciplinary diagnostic approach. Accurate management and financially supportable care is a major issue in rare diseases such as anti-LGI1-encephalitis. Education and awareness about autoimmune encephalitis of all physicians treating a geriatric population is important in order to involve expertise and establish treatment within reasonable time.

Mind the gap: Bromism secondary to internet-purchased supplements.

Bromism is an unusual syndrome characterized by a variety of nervous system impairments such as ataxia, confusion, and delusions. Contemporaneous cases are rare as therapeutic use of bromide-containing medications has declined, but bromides can still be obtained as unregulated dietary supplements. Bromism from dietary supplements is not well-described. We present a case of a 23-year-old male who was taking numerous supplements and developed bromism, characterized by ataxia, confusion, and persistent agitation. His laboratory evaluation revealed a large negative anion gap and a serum bromide level of 1200 mg/L (ref: 0-12 mg/L). He was treated with maintenance intravenous normal saline to promote excretion of the bromide ion and slowly returned to baseline over ten days. Bromism is an unusual but well-described constellation of neurologic impairments that presents insidiously and may be easily missed. The emergency physician should be aware of the dangers of bromide-containing dietary supplements and should educate patients taking these supplements of their risks.

Evaluating Olympic Pictograms Using Fuzzy TOPSIS-Focus on Judo, Taekwondo, Boxing, and Wrestling.

It is necessary to evaluate whether Olympic pictograms are designed accurately and are easy to understand, so that they fulfill their intended functions and roles. Olympic pictograms are used to facilitate smooth communication at this large sporting event. However, viewers often find it challenging to understand the actual sport represented by the pictogram. This study evaluates the ranking of comprehensibility of the pictograms for judo, taekwondo, boxing, and wrestling used in six games, from the 27th Sydney Olympics in 2000 to the 32nd Tokyo Olympics in 2021. The evaluation was done using the fuzzy technique for order of preference by similarity to ideal solution (TOPSIS) method, a multi-criteria decision-making methodology commonly used in economics and other fields. Data collection was conducted from 10 May to 30 June 2021 for 44 general public and seven experts. The results are as follows. First, the pictograms from the 2008 Beijing Olympics ranked first in three sports: taekwondo, boxing, and wrestling, but there were no pictograms that consistently ranked first or sixth in all sports. Second, the sensitivity analysis result shows the possibility that the ranking would be reversed if the weight of the evaluation factors were changed. This study is expected to contribute to developing pictograms that can adequately convey the appropriate information regarding Olympic sports in the future.

The Neural Correlates of Spatial Disorientation in Head Direction Cells.

While the brain has evolved robust mechanisms to counter spatial disorientation, their neural underpinnings remain unknown. To explore these underpinnings, we monitored the activity of anterodorsal thalamic head direction (HD) cells in rats while they underwent unidirectional or bidirectional rotation at different speeds and under different conditions (light vs dark, freely-moving vs head-fixed). Under conditions that promoted disorientation, HD cells did not become quiescent but continued to fire, although their firing was no longer direction specific. Peak firing rates, burst frequency, and directionality all decreased linearly with rotation speed, consistent with previous experiments where rats were inverted or climbed walls/ceilings in zero gravity. However, access to visual landmarks spared the stability of preferred firing directions (PFDs), indicating that visual landmarks provide a stabilizing signal to the HD system while vestibular input likely maintains direction-specific firing. In addition, we found evidence that the HD system underestimated angular velocity at the beginning of head-fixed rotations, consistent with the finding that humans often underestimate rotations. When head-fixed rotations in the dark were terminated HD cells fired in bursts that matched the frequency of rotation. This postrotational bursting shared several striking similarities with postrotational "nystagmus" in the vestibulo-ocular system, consistent with the interpretation that the HD system receives input from a vestibular velocity storage mechanism that works to reduce spatial disorientation following rotation. Thus, the brain overcomes spatial disorientation through multisensory integration of different motor-sensory inputs.

[Non-aphasic misnaming: a case report and literature review].

A 71-year-old, right-handed woman was admitted to our hospital due to a sudden difficulty with conversation. On admission, she was alert, but had a euphoric mood, disorientation, and a disturbance of recent memory. Her speech was fluent. Her repetition and auditory word cognition were excellent, but she had a slight difficulty with naming visual objects. She frequently showed word-finding difficulty and irrelevant paraphasia during free conversation and a word fluency task. Her irrelevant paraphasia was observed more frequently when she was asked to explain her outbreak of anger at the hospital, i.e., it was situation-dependent. She also had anosognosia. MRI showed an infarct in the territory of the left tuberothalamic artery. Single-photon emission computed tomography revealed low-uptake lesions in the left thalamus and orbital frontal, medial frontal, and medial temporal lobes. The patient was diagnosed with non-aphasic misnaming. The clinical characteristics of patients with non-aphasic misnaming in the literature were reviewed. All of the patients with non-aphasic misnaming had word-finding difficulty and irrelevant paraphasia. Additionally, they had either emotional disturbance or anosognosia.

Arteriovenous malformation as a cause for acute confusion and gastrointestinal bleeding in a primigravida pregnancy.

Acute confusion in pregnancy is generally uncommon, given the relatively young and healthy population obstetricians care for. We present an unusual and rare case of acute confusion in a term pregnancy with antecedent history of gastrointestinal (GI) bleeding. A primigravida with no medical history of note, was found to have a haemoglobin of 67 g/L at booking and was commenced on oral iron supplementation. In the third trimester, she presented with haematochezia and had several admissions, requiring 18 units of red blood cells during her pregnancy. At term, she was admitted with acute confusion and GI bleeding, and was subsequently delivered by caesarean section to facilitate ongoing investigation and management of her symptoms. She was diagnosed postnatally with an arteriovenous malformation in the jejunum which required interventional radiology and surgical management for symptom resolution. Her confusion was attributed to hyperammonaemic levels secondary to her high protein load.

Behavioural and cognitive mechanisms of Developmental Topographical Disorientation.

Individuals affected by Developmental Topographical Disorientation (DTD) get lost on a daily basis, even in the most familiar of surroundings such as their neighbourhood, the building where they have worked for many years, and, in extreme cases, even in their own homes. Individuals with DTD report a lifelong selective inability to orient despite otherwise well-preserved general cognitive functions, and the absence of any acquired brain injury or neurological condition, with general intelligence reported to be within the normal range. To date, the mechanisms underlying such a selective developmental condition remain unknown. Here, we report the findings of a 10-year-long study investigating the behavioural and cognitive mechanisms of DTD in a large sample of 1211 cases. We describe the demographics, heritability pattern, self-reported and objective spatial abilities, and some personality traits of individuals with DTD as compared to a sample of 1624 healthy controls; importantly, we test the specific hypothesis that the presence of DTD is significantly related to the inability of the individuals to form a mental representation of the spatial surroundings (i.e., a cognitive map). We found that individuals with DTD reported relatively greater levels of neuroticism and negative affect, and rated themselves more poorly on self-report measures of memory and imagery skills related to objects, faces, and places. While performing interactive tasks, as a group, the individuals with DTD performed slightly worse on a scene-based perspective-taking task, and, notably struggled to solve tasks that demand the generation and use of a cognitive map. These novel findings help define the phenotype of DTD, and lay the foundation for future studies of the neurological and genetic mechanisms of this lifelong condition.

Resuscitated sudden cardiac death due to severe hypokalemia caused by teff grain herbal tea: A case report.

Obesity is a common health problem and the prevalence is increasing worldwide. The improper and unregulated use of unconventional therapies, especially herbal treatment methods, has grown due to widespread availability. In our case, a 41-year-old male patient developed palpitation, confusion, loss of consciousness, and cardiac arrest while at home. An emergency medical team was called and chest compressions were performed by his wife until the medical team arrived. Ventricular fibrillation was detected on the monitor 5 minutes after the cardiac arrest occurred and the patient was defibrillated. A physical evaluation revealed hypotension and tachycardia. Electrocardiography (ECG) showed a fast idioventricular rhythm with capture and fusion beats and evident J waves in leads DII, DIII, and aVF. Brain magnetic resonance imaging and thoracic tomography revealed no pathology to explain his clinical condition and the coronary angiography results were not significant. The laboratory parameters included potassium (K): 2.23 mEq/L, ionized K (arterial blood): 2.43 mEq/L, sodium: 142 mEq/L, calcium: 9.3 mg/dL, creatinine: 1.6 mg/dL, pH: 7.29, cardiac troponin I: 0.12 (normal range: 0-0.11 ng/mL) and creatinine kinase mass: 8.3 (normal range: 0-3.23 ng/mL). After fluids and electrolyte replacement therapy were administered, the ECG results revealed narrow QRS complex atrial fibrillation followed by a normal sinus rhythm with a 490 ms corrected QT interval. The patient was extubated in follow-up. There were no risk factors for coronary artery disease, no history of drug or other substance use, and no exposure to excessive emotional or physical stress. The patient said that he had been consuming a large quantity of teff tea for 5 days to lose weight. He was discharged without any complications and has been asymptomatic in 9 months of follow-up. The inappropriate use of weight loss alternatives, especially herbal therapies such as teff tea, and the incidence of associated side effects are increasing due to wide availability and easy access. The general population should be warned about this issue.

Demographic characteristics and delayed neurological sequelae risk factors in carbon monoxide poisoning.

AIM: Carbon monoxide (CO) is a colorless, odorless gas and tasteless. CO poisoning (COP) is one of the most frequently encountered inhalation poisonings. The most common cause of morbidity in COP is delayed neurological sequelae (DNS). DNS is the occurrence of neuropsychiatric findings within 2-240 days after discharge of patients with COP and there are no definitive diagnostic criteria. The aim of our study is; to determine the risk factors and incidence of DNS. METHOD: Our study is a retrospective, observational study. Patients with the diagnosis of COP in the emergency department between 2015 and 2016 were included in the study. Patients age, gender, findings in the initial physical examination (PE) and neurological examination (NE), blood carboxyhemoglobin (COHb) level, relation between hyperbaric oxygen (HBO) treatment and DNS were assessed. RESULTS: Total of 72 patients were included in the study. Mean age was 33.43 ±â€¯20.89. It was determined that pathological findings in the initial NE are a significant predictive factor for DNS (Odds ratio 18.600, p:0.004). Significant relation between NE and HBO treatment was present (p:00.1). There was no statistically significant relationship between initial COHb level and receiving HBO treatment (p:0.9). Median COHb level of patients with DNS was 30 (min:10, max: 43), median COHb level of patients without DNS was 25 (min:10, max:44) and there was no statistically significant relationship between the two groups according to COHb levels (p:0.7). CONCLUSION: Pathological findings in the initial neurological examination had a predictive value for delayed neurological sequelae in patients with carbon monoxide poisoning.

Metabolic encephalopathy caused by nitrous oxide ('laughing gas') induced hyperammonaemia.

A 26-year-old man presented at the emergency department with confusion and decreased consciousness after several days of vomiting. In the preceding 6 months, he had used a 2-litre tank of nitrous oxide (N2O) weekly. His metabolic encephalopathy was caused by hyperammonaemia which probably resulted from interference of N2O-induced vitamin B12 deficiency with ammonia degradation. A catabolic state might have contributed to the hyperammonaemia in this case. After treatment with vitamin B12 and lactulose, both his consciousness and hyperammonaemia improved. He reported no residual complaints after 3 months of follow-up. Since N2O is increasingly used as a recreational drug, we recommend considering hyperammonaemia as a cause of metabolic encephalopathy in cases of N2O use and altered mental status.

Auditory Verbal Working Memory Load Effects on a Simulator-Induced Spatial Disorientation Event.

INTRODUCTION: Working memory is an essential executive function for flying an aircraft and its limitations may jeopardize flight safety. This function is particularly critical when pilots have to struggle with spatial disorientation (SD) cues. This research aimed to assess the combined effect of the auditory N-back task (NBT) and simulator-induced SD cues on pilots' flight performance.METHODS: Using an SD simulator, 39 male military pilots (control N = 20; age M = 31.6; SD = 8.22, experimental N = 19; age M = 26.9; SD = 8.67) were exposed to 12 flight sequences, where 6 contained an SD conflict-3 with vestibular illusions and 3 with visual illusions. Additionally, the pilots from the experimental group were asked to perform an auditory NBT involving sound stimuli (the sequential letter memory task) as they performed during oriented and disoriented flight conditions.RESULTS: Pilots' flight performance from the NBT group were significantly worse than the control group in the approach and landing profiles involving visual illusions (for both nonconflict and conflict flight), and in the profile involving the false horizon illusion (only for the conflict flight). No increase in a pilot's susceptibility to SD was observed with any other profiles.DISCUSSION: The current study provides support that pilots' cognitive workload can negatively impact flight performance. Pilots are not always aware of altered flight parameters, which may indicate that they have lost spatial orientation, mainly as a result of visual illusion. If problems occur in maintaining proper flight parameters, pilots should direct all available mental resources to regain their orientation and withdraw from any other parallel tasks.Lewkowicz R, Strózak P, Balaj B, Francuz P. Auditory verbal working memory load effects on a simulator-induced spatial disorientation event. Aerosp Med Hum Perform. 2019; 90(6):531-539.

[Hypothalamic intravascular B-cell lymphoma in an immunocompetent patient]. / Linfoma B intravascular hipotalamico en una paciente inmunocompetente.

TITLE: Linfoma B intravascular hipotalamico en una paciente inmunocompetente.

Body Weight and Mood State Modifications in Mixed Martial Arts: An Exploratory Pilot.

Brandt, R, Bevilacqua, GG, Coimbra, DR, Pombo, LC, Miarka, B, and Lane, AM. Body weight and mood state modifications in mixed martial arts: An exploratory pilot. J Strength Cond Res 32(9): 2548-2554, 2018-Mixed martial arts (MMA) fighters typically use rapid weight loss (RWL) as a strategy to make competition weight. The aim of the present study was to compare body weight and mood changes in professional male MMA athletes who used strategies to rapidly lose weight (n = 9) and with MMA athletes who did not (n = 3). Body mass and mood states of anger, confusion, depression, fatigue, tension, and vigor and total mood disturbance were assessed (a) 30 days before competition, (b) at the official weigh-in 1 day before competition, (c) 10 minutes before competition, and (d) 10 minutes postcompetition. Results indicated that RWL associated with reporting higher confusion and greater total mood disturbance at each assessment point. Rapid weight loss also associated with high anger at the official weigh-in. However, in performance, RWL did not have deleterious effects on performance. The RWL group also reported greater total mood disturbance at all assessment points with a moderate difference effect size. Research supports the notion that RWL associates with potentially dysfunctional mood states.