The Birthday Party Test (BPT): A new picture description test to support the assessment of simultanagnosia in patients with acquired brain injury.

There is broad consensus on the utility of complex pictures in the assessment of simultanagnosia in patients with acquired brain injury (ABI). To overcome various shortcomings of current instruments, we have developed the Birthday Party Test (BPT); a picture description test that contains a neutral scene, a balanced representation of events, and provides clear instructions and a scoring-aid. We have applied the BPT in a large group of patients with ABI (n = 502) and in an age-matched healthy control group (n = 194). Our results show that performance on the BPT was associated with a range of descriptive, neuropsychological and clinical characteristics and that poor test performance appeared to be more common in patients with etiologies that have an increased risk of bilateral damage. Furthermore, we assume a high correspondence between test performance on the BPT and the assessor's clinical judgment of likely having simultanagnosia in preliminary analyses. This study shows the potential usefulness of the BPT to support diagnostic decision making in simultanagnosia. The BPT is made freely available to facilitate its broad application in the clinical assessment of patients with visual impairment and to enable a further evaluation of its utility and validity in future studies.

[Intravascular migration of a contraceptive implant]. / Intravasculaire migratie van een hormoonimplantaat.

BACKGROUND: The Implanon NXT is a commonly used contraceptive. Incorrect localization of the implant can cause complications. CASE DESCRIPTION: A 41-year-old woman is seen in the gynaecology outpatient clinic with a request to remove a recently placed Implanon NXT because of worsening mood symptoms. The implant can't be found on physical and ultrasound examination. Duringsurgicalexplorationthe implant is not found at theinsertion site' By means of X-ray scanning the implant becomes visible around the humeral head. The implant appears to be located in the cephalic vein and is subsequently removed. CONCLUSION: In case of a referral due to because of worsening mood symptoms after an Implanon NXT exchange, it is possible that the implant is localized incorrectly. It is recommended to use additional imaging before performing surgical exploration. Furthermore, it is important to insert the Implanon NXT according to the supplied instructions to prevent this complication.

Screening of visual perceptual disorders following acquired brain injury: A Delphi study.

Impairments in visual perception are common after acquired brain injury (ABI) and adequate assessment is crucial for diagnosis and rehabilitation. However, there is no consensus yet on how to assess these disorders after ABI. The aim of the present study was to explore what measures are considered reasonable to be part of a test battery for the screening of a broad range of mid-level and higher-order visual perceptual disorders. A Delphi method was used to collect the opinions of 28 international multidisciplinary experts in visual perception in order to achieve consensus on the content of the test battery. Seventeen experts evaluated the test battery proposed in the third and final round of the Delphi process. Consensus was achieved (94%) on a battery of 11 distinctive tests with an expected administration time of 30 minutes. The current study provides an essential step in the development of a standardized and time-efficient test battery for the screening of mid-level and higher-order visual perceptual disorders. The composed battery may improve effectiveness of clinical assessment by providing insight into potential visual deficits in little time, thereby initiating further assessment. Future studies should focus on the validation of the suggested test battery and collect normative data.

Wood structural differences between northern and southern beech provenances growing at a moderate site.

Planting provenances originating from southern to northern locations has been discussed as a strategy to speed up species migration and mitigate negative effects of climate change on forest stability and productivity. Especially for drought-susceptible species such as European beech (Fagus sylvatica L.), the introduction of drought-tolerant provenances from the south could be an option. Yet, beech has been found to respond plastically to environmental conditions, suggesting that the climate on the plantation site might be more important for tree growth than the genetic predisposition of potentially drought-adapted provenances. In this study, we compared the radial growth, wood-anatomical traits and leaf phenology of four beech provenances originating from southern (Bulgaria, France) and northern locations (Sweden, the Netherlands) and planted in a provenance trial in the Netherlands. The distribution of precipitation largely differs between the sites of origin. The northern provenances experience a maximum and the southern provenances experience a minimum of rainfall in summer. We compared tree productivity and the anatomy of the water-conducting system for the period from 2000 to 2010, including the drought year 2003. In addition, tree mortality and the timing of leaf unfolding in spring were analysed for the years 2001, 2007 and 2012. Comparison of these traits in the four beech provenances indicates the influence of genetic predisposition and local environmental factors on the performance of these provenances under moderate site conditions. Variation in radial growth was controlled by environment, although the growth level slightly differed due to genetic background. The Bulgarian provenance had an efficient water-conducting system which was moreover unaffected by the drought in 2003, pointing to a high ability of this provenance to cope well with dry conditions. In addition, the Bulgarian provenance showed up as most productive in terms of height and radial growth. Altogether, we conclude that the similarity in ring-width variation among provenances points to environmental control of this trait, whereas the differences encountered in wood-anatomical traits between the well-performing Bulgarian provenance and the other three provenances, as well as the consistent differences in flushing pattern over 3 years under various environmental conditions, support the hypothesis of genetic control of these features.

Photon statistics of a laser with slow inversion.

We have measured the photon number probability distribution of a laser in which the inversion is not slaved to the field. For the experiments, we have used a Nd(3+):YVO(4) laser which has a sufficiently slow inversion to allow measurement of the photon fluctuations at a time scale much shorter than that of the relaxation oscillations. The photon distribution function becomes highly nonstandard (i.e., non-Poissonian) in such a laser; this is consistent with available theoretical work. We point out the relevance of our results for the case of the semiconductor microlaser.