Long-term changes in the small-world organization of brain networks after concussion.

There is a growing body of literature using functional MRI to study the acute and long-term effects of concussion on functional brain networks. To date, studies have largely focused on changes in pairwise connectivity strength between brain regions. Less is known about how concussion affects whole-brain network topology, particularly the "small-world" organization which facilitates efficient communication at both local and global scales. The present study addressed this knowledge gap by measuring local and global efficiency of 26 concussed athletes at acute injury, return to play (RTP) and one year post-RTP, along with a cohort of 167 athletic controls. On average, concussed athletes showed no alterations in local efficiency but had elevated global efficiency at acute injury, which had resolved by RTP. Athletes with atypically long recovery, however, had reduced global efficiency at 1 year post-RTP, suggesting long-term functional abnormalities for this subgroup. Analyses of nodal efficiency further indicated that global network changes were driven by high-efficiency visual and sensorimotor regions and low-efficiency frontal and subcortical regions. This study provides evidence that concussion causes subtle acute and long-term changes in the small-world organization of the brain, with effects that are related to the clinical profile of recovery.

Comparative usability of modern anaesthesia ventilators: a human factors study.

BACKGROUND: The anaesthesia ventilator represents the key equipment for intraoperative respiratory care. Improper operation of this device may threaten a patient's health. A self-explanatory interface facilitates handling and decreases the risk of operating errors. This study systematically evaluates the usability of user interfaces in four modern anaesthesia ventilators. METHODS: Twenty naïve operators were asked to execute 20 tasks on each of four different anaesthesia ventilators (Avance CS2™, GE Healthcare; Flow-i™, Maquet; and Perseus™ and Primus™, Dräger) in a randomized order. The success of task execution, frequency of requests for assistance, and processing times were recorded. During the tasks, the operators' visual focus was measured via eye-tracking. Additionally, subjective assessments of usability were evaluated by a standardized questionnaire. For comparison, six experienced operators undertook the same protocol. RESULTS: The overall rate of falsely executed tasks was low. Naïve operators requested assistance least when using the Perseus (26). Pooled processing times were shortest for the Perseus (222 s), followed by the Primus (223 s), the Avance (238 s), and the Flow-i (353 s). Task-specific processing times differed considerably between the devices. Eye-tracking analyses revealed associated interface issues that impeded the operators' performance. Operators rated usability best for the Perseus [mean (sd): 67 (17) arbitrary units] and worst for the Flow-i [50 (16) arbitrary units]. Results from experienced operators support these findings by trend. CONCLUSIONS: The usability of modern anaesthesia ventilators differs considerably. Interface issues of specific tasks impair the operator's efficiency. Eliminating the specific usability issues might improve the operator's performance and, as a consequence, the patient's safety.

Cognitive and Affective Aspects of Creative Option Generation in Everyday Life Situations.

Which factors influence a human being's ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article, we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48) generated options for action in 70 briefly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence -and linked these qualities to option generation fluency (speed and number of generated options), situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and, on the other hand, researchers working on the cognitive and clinical aspects of creativity.

FLOW CYTOMETRIC DETECTION OF SUBHAPLOID NUCLEI IN HUMAN SPERM AS A MEASURE OF DNA FRAGMENTATION AND APOPTOSIS.

The use of assisted reproductive technologies (ARTs) is increasing worldwide. In order to predict the rate of pregnancy after ART the DNA fragmentation index (DFI) of ejaculated spermatocytes may be a better marker than conventional semen quality parameters. Spermatocytes with fragmented DNA are associated with apoptotic stages and are characterized by a low DNA content. The subhaploid nuclei of DNA-damaged spermatocytes can be easily detected by flow cytometry. We here analyzed the percentage of subhaploid nuclei of semen samples from 163 patients aged 26 to 74 years who consulted one of the ten centres for reproductive medicine which routinely send sperm samples to our laboratory in order to determine special sperm parameters. The percentage of subhaploid nuclei indicating the DFI of spermatocytes did not correlate with age and sperm volume, but inversely correlated with sperm concentration and the percentage of motile spermatocytes. This is in concordance with previous studies which demonstrated that DNA damage of spermatozoa correlates with conventional semen quality parameters. Since DNA-damaged spermatocytes are associated with an impaired outcome of assisted conception technologies, this method could help to monitor sperm quality of subfertile men after measures to increase sperm quality and to improve selection criteria of cryopreserved sperm samples in assisted reproduction medicine.

[Is bovine leishmaniasis spreading in Switzerland?]. / Breitet sich die bovine kutane Leishmaniose in der Schweiz aus?

The purpose of the present study was based upon the first diagnosed bovine cutaneous leishmaniasis in a cow in Switzerland in April 2009. We continued descriptively the search for other bovine cases in Switzerland. We carried out similar investigations in the original farm where the case had occurred, and in parallel also in the neighboring farm. Additionally, veterinary practitioners sent us an overall of 12 suspected cases of bovine leishmaniasis. Following diagnostic investigations, all cases were negative for Leishmania. The occurrence of this infection appears therefore to be a very rare event. Finally some differential diagnoses are discussed.

An autochthonous case of cutaneous bovine leishmaniasis in Switzerland.

The present case report describes a novel etiological agent of cutaneous leishmaniasis that appears for the first time in a cow. A similar agent had recently been described as causing autochthonous infections in horses of Germany and Switzerland. The infection in the cow was initially diagnosed upon clinical and immunohistological findings. Subsequent comparative sequence analysis of diagnostic PCR products from the internal transcribed spacer 1 (ITS1) of ssrRNA classified the respective isolate as neither Old World nor New World Leishmania species, but yielded complete identity of the analysed sequence with the above mentioned horse cases and 98% identity to Leishmania sp. siamensis, an organism recently identified in a visceral leishmaniasis patient from Thailand. The potential transmitting vectors for all these cases have not yet been identified. Future investigations will have to elucidate the veterinary-epidemiological relevance of this etiological agent, as well as biological parameters such as transmission mode and geographical origin and distribution.

Impact of socioeconomic status on the prevalence of dementia in an inner city memory disorders clinic.

BACKGROUND: Socioeconomic status (SES) has been identified as a possible risk factor for the development of dementia, with low SES shown to be associated with a higher prevalence of dementia, increased psychiatric comorbidity and worse baseline cognitive functioning. Few studies have actually looked at the impact of SES within a clinical population using multiple measures of SES and cognition. METHODS: Data on 217 patients seen in an Inner City Memory Disorders Clinic were analyzed with respect to demographic status, clinical status and SES. Correlations were then examined looking at the relationship of SES to clinical variables and neurocognitive status. Regression analysis was undertaken to examine the relative contribution of individual sociodemographic factors to a diagnosis of dementia. RESULTS: In general, there was wide variation in the sample examined with respect to most measures of SES. Approximately one third (36%) of the sample had a diagnosis of dementia, the mean age was 66.1 years and the mean Mini-mental State Examination score was relatively high (25.4). There was a strong association between age, individual annual income range, education, medical comorbidity and a diagnosis of dementia, with increased age and medical comorbidity being the strongest predictors. CONCLUSION: Increased age, low education, high medical comorbidity and low annual income are all associated with a diagnosis of dementia in an inner city setting. Age and medical comorbidity appear to be more strongly associated with a diagnosis of dementia than SES in an inner city setting.

Weakness of will, akrasia, and the neuropsychiatry of decision making: an interdisciplinary perspective.

This article focuses on both daily forms of weakness of will as discussed in the philosophical debate (usually referred to as akrasia) and psychopathological phenomena as impairments of decision making. We argue that both descriptions of dysfunctional decision making can be organized within a common theoretical framework that divides the decision making process in three different stages: option generation, option selection, and action initiation. We first discuss our theoretical framework (building on existing models of decision-making stages), focusing on option generation as an aspect that has been neglected by previous models. In the main body of this article, we review how both philosophy and neuropsychiatry have provided accounts of dysfunction in each decision-making stage, as well as where these accounts can be integrated. Also, the neural underpinnings of dysfunction in the three different stages are discussed. We conclude by discussing advantages and limitations of our integrative approach.

Observation of polarized positrons from an undulator-based source.

An experiment (E166) at the Stanford Linear Accelerator Center has demonstrated a scheme in which a multi-GeV electron beam passed through a helical undulator to generate multi-MeV, circularly polarized photons which were then converted in a thin target to produce positrons (and electrons) with longitudinal polarization above 80% at 6 MeV. The results are in agreement with GEANT4 simulations that include the dominant polarization-dependent interactions of electrons, positrons, and photons in matter.

Muon decay: measurement of the transverse polarization of the decay positrons and its implications for the fermi coupling constant and time reversal invariance.

The two transverse polarization components P(T1) and P(T2) of the e(+) from the decay of polarized mu(+) have been measured as a function of the e(+) energy. Their energy averaged values are P(T1)=(6.3+/-7.7+/-3.4) x 10(-3) and P(T2)=(-3.7+/-7.7+/-3.4) x 10(-3). From the energy dependence of P(T1) and P(T2) the decay parameters eta,eta('') and alpha(')/A,beta(')/A are derived, respectively. Assuming only one additional coupling besides the dominant V-A interaction one gets improved limits on eta, beta(')/A, and the scalar coupling constant g(S)(RR): eta=(-2.1+/-7.0+/-1.0) x 10(-3), beta(')/A=(-1.3+/-3.5+/-0.6) x 10(-3), Re{g(S)(RR)}=(-4.2+/-14.0+/-2.0) x 10(-3), and Im{g(S)(RR)}=(5.2+/-14.0+/-2.4) x 10(-3).

Presynaptic regulation of neurotransmitter release in the cortex of aged rats with differential memory impairments.

Cluster analysis of water-maze reference-memory performances of 25-27-month-old (compared to 3-5-month-old) rats distinguished subpopulations of young adult rats (YOUNG), aged rats with no significant impairment (AU), aged rats with moderate impairment (AMI), and aged rats with severe impairment (ASI). In the frontoparietal cortex, we subsequently assessed the electrically evoked release of tritium in slices preloaded with [3H]choline, [3H]noradrenaline (NA), or [3H]serotonin (5-HT) and the effects of an agonist (oxotremorine, UK 14,304, and CP 93,129) of the respective autoreceptors. Cholinergic and monoaminergic markers were measured in homogenates. Overall, aged rats exhibited reduced accumulation of [3H]choline (-25%) and weaker evoked transmitter release (in % of accumulated tritium: -44%, -20%, and -34%, for [3H]acetylcholine, [3H]NA, and [3H]5-HT, respectively). In all rats, the inhibitory effects of the autoreceptor agonists on the evoked release of [3H] were comparable. Acetylcholinesterase (AChE), not choline acetyltransferase (ChAT), activity was reduced. The results suggest age-related modifications in the cholinergic, noradrenergic, and serotonergic innervation of the frontoparietal cortex, alterations of evoked transmitter release, but no interference with presynaptic autoinhibition of the release. Neither of these alterations seemed to account for the cognitive impairment assessed.

Contribution of visual and semantic proximity to identification performance in a viral encephalitis patient.

Identification deficits were investigated in F.S., a patient with herpes simplex viral encephalitis. F.S.'s confrontation naming abilities were assessed for multiple repetitions of 12 line drawings of artifacts. Six of the line drawings consisted of psychologically "close" objects (i.e., objects that share many visual and semantic features with other objects) and 6 were psychologically "disparate" objects (i.e., objects that share few, if any, visual and semantic features with other objects). F.S. correctly named all of the objects from the "disparate" category but only 47% of the objects from the "close" category. We also tested F.S. using novel, computer-generated shapes that were paired with artifact labels. We paired semantically close or disparate labels to shapes and F.S. attempted to learn these pairings. Overall, F.S.'s shape-label confusions were most detrimentally affected when we used labels that referred to objects that were visually close and semantically distinct. Results indicate that, at least for our patient, visual similarity contributed the most to his identification errors.

Transitive gesture production in apraxia: visual and nonvisual sensory contributions.

The production of transitive limb gestures is optimized when the appropriate tool can be physically manipulated. Little research has addressed the independent contributions of visual and nonvisual sources of sensory information to this phenomenon. In this study, 12 control, 37 LHD, and 50 RHD stroke patients performed transitive limb gestures to pantomime (to verbal command with the object visible) and object manipulation. Performance was more accurate in the object manipulation condition, suggesting that haptic and kinesthetic cues are important for transitive gesture production. Various patterns of performance were observed in the stroke groups, indicating that selective damage to the haptic/kinesthetic processing system is possible and common following unilateral stroke.

Echocardiography of the normal bovine heart: technique and ultrasonographic appearance.

Fifty-one clinically healthy cows were examined ultrasonographically from the third and fourth intercostal spaces on both sides of the thorax. A 3.0 MHz transducer was used and the heart was examined in the caudal long, caudal short and cranial long axes on the right side, and in the caudal and cranial long axes on the left side. In each position the optimal transducer orientation and the images of the structures were recorded. In the caudal long axis view of the heart on the right (transducer positioned at the fourth intercostal space), all four chambers were visible with the transducer positioned 8 to 10 cm dorsal to the level of the olecranon. The left ventricular outflow tract, consisting of the aortic valve and ascending aorta, were visible in the same position with the transducer rotated 10 to 40 degrees clockwise. In the caudal short axis view of the heart on the right, the left and right ventricles were visible in cross-section with the transducer held at right angles to the ribs in the fourth intercostal space, 3 to 6 cm dorsal to the olecranon and tipped slightly dorsally. In the cranial long axis view of the heart on the right, the right ventricular outflow tract, consisting of the pulmonary valve and pulmonary artery, was visible in the third intercostal space, 8 to 10 cm dorsal to the olecranon with the transducer angled craniodorsally and rotated 10 to 20 degrees clockwise. In the caudal long axis view of the heart on the left, the left and right ventricles and the left ventricular outflow tract were visible with the transducer placed in the fourth intercostal space. In the cranial long axis view on the left, the right ventricular outflow tract was visible.

[Determination of heart dimensions in cattle via 2-D-mode echocardiography]. / Bestimmung der Herzdimensionen beim Rind mit Hilfe der 2-D-Mode-Echokardiographie.

The goal of this study was to determine via echocardiography the size of the left and right cardiac ventricles and the width of the interventricular septum and the left free ventricular wall in 51 healthy cows. The heart regions were examined in standing cows using a 3.0 Mhz sector transducer in 2-D-Mode. The dimensions of the heart were measured in the caudal long and short axes on the right side and in the caudal and cranial long axes on the left. The diameter of the ventricles was determined in a plane immediately beneath the mitral or tricuspid valves and that of the aorta and pulmonary artery in a plane immediately above the aortic and pulmonary valves, respectively. At the end of the study, all of the cows were slaughtered, the hearts were removed and the same parameters were determined using a tape measure. Results of in vivo and in vitro measurements were compared. In the right caudal long axis, the diameters of the left ventricle during both diastole (x +/- s = 7.0 +/- 0.73 cm) and systole (4.5 +/- 0.69 cm) were larger than those of the right ventricle during diastole (4.1 +/- 1.02 cm) and systole (3.6 +/- 0.98 cm). The diameter of the ventricles during diastole was larger than that during systole. Analogous results were obtained in both other axes. The diameter of the right ventricle during systole was larger when measured in the right caudal long axis (3.6 +/- 0.98 cm) than in the right caudal short axis (3.2 +/- 1.15 cm). This was also true for measurements obtained during diastole. The interventricular septum and the left ventricular wall were thicker during systole than during diastole. The diameter of the pulmonary artery was larger during diastole (5.6 +/- 0.82 cm) than systole (5.2 +/- 0.84 cm). The diameter of the aorta was smaller than that of the pulmonary artery and did not change significantly during diastole (4.9 +/- 0.92 cm) and systole (4.8 +/- 0.80 cm). The diameters of both ventricles measured at post mortem were smaller than those measured in vivo during diastole and larger than those measured during systole. There were no significant differences between the measurements performed twice, three days apart, in 11 of the cows.

Task demands and limb apraxia in stroke.

The present study was designed to examine the frequency and severity of apraxia in patients with left- or right-hemisphere stroke in both pantomime and imitation conditions and to compare the frequency of apraxia in each stroke group across the three patterns of apraxia described in Roy's model (Roy, 1996). Ninety-nine stroke patients and 15 age-matched healthy adults performed eight transitive gestures to pantomime and to imitation. Gestural performance was quantified as accuracy on five performance dimensions; a composite score, an arithmetic combination of the five performance dimensions, was used as an index of the overall accuracy. Analyses revealed a comparable proportion of patients in each stroke group were classified as apraxic in the imitation condition, but a higher proportion of left stroke patients were apraxic in the pantomime condition. The severity of apraxia in each stroke group and the performance dimensions affected were, however, comparable. Analyses of the patterns of apraxia (pantomime alone, imitation alone or apraxia in both conditions) revealed a higher frequency of apraxia in both stroke groups for the pattern reflecting apraxia in both conditions, indicating that a disruption at the movement execution stage of gesture performance was most common.

Alcohol affects processing of ignored stimuli in a negative priming paradigm.

OBJECTIVE: This research examined the effect of alcohol on negative priming, which is considered to reflect a basic process of selective attention. METHOD: Male social drinkers (N = 28) performed a color naming reaction time (RT) task that measured negative priming. After a baseline test on the task, they received either 0.56 g/kg of alcohol or a placebo; they then performed the task twice. RESULTS: In accord with the hypotheses, alcohol suppressed negative priming during the ascending limb but not during the descending limb of the blood alcohol curve. No suppression of negative priming was evident under placebo. CONCLUSIONS: The suppression of this process by alcohol may represent a basic mechanism by which the drug reduces the ability to efficiently allocate attention and leads to impaired performance on various attention-based tasks (e.g., divided attention and vigilance tasks).

Superior single dimension relative to "exclusive or" categorization performance by a patient with category-specific visual agnosia: empirical data and an ALCOVE simulation.

ELM, a patient with category-specific visual agnosia, was tested on a single-dimension categorization problem, and the "exclusive or" (XOR) categorization problem. Stimuli were computer-generated shapes in which exemplars within a shape set shared values across two visual dimensions (curvature and thickness). In single-dimension categorization only curvature was relevant, and ELM performed as well as normal participants. In the XOR problem, categorization depended on being able to extract from memory values on curvature AND thickness for each exemplar, and ELM was significantly impaired on this task. A computer simulation using ALCOVE (Kruschke, 1992) reproduced ELM's behavior by changing a single (specificity) parameter related to how easily proximate objects within a multidimensional shape space could be disambiguated.

Musical instrument naming impairments: the crucial exception to the living/nonliving dichotomy in category-specific agnosia.

In category-specific agnosia (CSA) patients typically have more trouble naming animals, fruits, and vegetables than tools, furniture, and articles of clothing. A crucial exception to this living vs nonliving rule involves the category of musical instruments. Patients with problems naming living objects often repeatedly fail to name musical instruments. In CSA it is crucial to equate living and nonliving object lists on object name frequency, complexity, and familiarity. The present study shows, however, that even the most rigorously controlled object lists can lead to erroneous conclusions if nonliving stimuli contain an overrepresentation of musical instruments. Naming capabilities of a herpes encephalitis patient were assessed using matched lists of living and nonliving objects and showed no indication of category-specific deficits. When exemplars were separated into biological objects, musical instruments and man-made artifacts, strong category-specificity emerged: artifact naming was flawless whereas musical instrument and biological object naming were both severely impaired. It is concluded that CSA is a veridical phenomenon but that our understanding of CSA is limited by adhering to the spurious living/nonliving distinction.