Prediction of visceral leishmaniasis incidence using the Seasonal Autoregressive Integrated Moving Average model (SARIMA) in the state of Maranhão, Brazil / Previsão da incidência da leishmaniose visceral usando o modelo de média móvel integrado autorregressivo sazonal (SARIMA) no Maranhão, Brasil

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.

Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.

Prediction of visceral leishmaniasis incidence using the Seasonal Autoregressive Integrated Moving Average model (SARIMA) in the state of Maranhão, Brazil

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.

Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.

High-Throughput Deconvolution of Native Protein Mass Spectrometry Imaging Data Sets for Mass Domain Analysis.

Protein mass spectrometry imaging (MSI) with electrospray-based ambient ionization techniques, such as nanospray desorption electrospray ionization (nano-DESI), generates data sets in which each pixel corresponds to a mass spectrum populated by peaks corresponding to multiply charged protein ions. Importantly, the signal associated with each protein is split among multiple charge states. These peaks can be transformed into the mass domain by spectral deconvolution. When proteins are imaged under native/non-denaturing conditions to retain non-covalent interactions, deconvolution is particularly valuable in helping interpret the data. To improve the acquisition speed, signal-to-noise ratio, and sensitivity, native MSI is usually performed using mass resolving powers that do not provide isotopic resolution, and conventional algorithms for deconvolution of lower-resolution data are not suitable for these large data sets. UniDec was originally developed to enable rapid deconvolution of complex protein mass spectra. Here, we developed an updated feature set harnessing the high-throughput module, MetaUniDec, to deconvolve each pixel of native MSI data sets and transform m/z-domain image files to the mass domain. New tools enable the reading, processing, and output of open format .imzML files for downstream analysis. Transformation of data into the mass domain also provides greater accessibility, with mass information readily interpretable by users of established protein biology tools such as sodium dodecyl sulfate polyacrylamide gel electrophoresis.

Integrating electric field modeling and pre-tDCS behavioral performance to predict the individual tDCS effect on visual crowding.

Objective.Transcranial direct current stimulation (tDCS) has been broadly used to modulate brain activity with both bipolar and high-definition montages. However, tDCS effects can be highly variable. In this work, we investigated whether the variability in the tDCS effects could be predicted by integrating individualized electric field modeling and individual pre-tDCS behavioral performance.Approach.Here, we first compared the effects of bipolar tDCS and 4 × 1 high-definition tDCS (HD-tDCS) with respect to the alleviation of visual crowding, which is the inability to identify targets in the presence of nearby flankers and considered to be an essential bottleneck of object recognition and visual awareness. We instructed subjects to perform an orientation discrimination task with both isolated and crowded targets in the periphery and measured their orientation discrimination thresholds before and after receiving 20 min of bipolar tDCS, 4 × 1 HD-tDCS, or sham stimulation over the visual cortex. Individual anatomically realistic head models were constructed to simulate tDCS-induced electric field distributions and quantify tDCS focality. Finally, a multiple linear regression model that used pre-tDCS behavioral performance and tDCS focality as factors was used to predict post-tDCS behavioral performance.Main results.We found that HD-tDCS, but not bipolar tDCS, could significantly alleviate visual crowding. Moreover, the variability in the tDCS effect could be reliably predicted by subjects' pre-tDCS behavioral performance and tDCS focality. This prediction model also performed well when generalized to other two tDCS protocols with a different electrode size or a different stimulation intensity.Significance.Our study links the variability in the tDCS-induced electric field and the pre-tDCS behavioral performance in a visual crowding task to the variability in post-tDCS performance. It provides a new approach to predicting individual tDCS effects and highlights the importance of understanding the factors that determine tDCS effectiveness while developing more robust protocols.

Modulating Cortical Hemodynamic Activity in Parkinson's Disease Using Focal Transcranial Direct Current Stimulation: A Pilot Functional Near-infrared Spectroscopy Study.

Reduced thalamocortical facilitation of the motor cortex in PD leads to characteristic motor deficits such as bradykinesia. Recent research has highlighted improved motor function following tDCS, but a lack of neurophysiological evidence limits the progress of tDCS as an adjunctive therapy. Here, we tested the hypothesis that tDCS may modulate M1 hemodynamic activity in PD and healthy using functional near-infrared spectroscopy (fNIRS). In this randomized crossover experiment, fourteen PD and twelve healthy control participants attended three laboratory sessions and performed a regulated (3 Hz) right index finger tapping task before and after receiving tDCS. On each visit, participants received either anodal, cathodal, or sham tDCS applied over M1. Hemodynamic activity of M1 was quantified using fNIRS. Significant task related activity was observed in M1 and the inferior parietal lobe in PD and healthy (p < 0.05). PD additionally recruited the dorsal premotor cortex. During tDCS, while at rest, anodal and cathodal tDCS significantly increased the oxygenated hemoglobin concentration of M1 compared to sham (t62 = 4.09 and t62 = 4.25, respectively). Task related hemodynamic activity was unchanged following any tDCS intervention (p > 0.05). Task related hemodynamic activity of M1 is not modulated by tDCS in PD or healthy. During tDCS, both anodal and cathodal stimulation cause a significant increase of M1 oxygenation, the clinical significance of which remains to be clarified.

Cathodal high-definition transcranial direct current stimulation (HD-tDCS) of the left ventral prefrontal cortex (vPFC) interferes with conscious error correction.

Precise motor timing requires the ability to flexibly adapt one's own movements with respect to changes in the environment. Previous studies suggest that the correction of perceived as compared to non-perceived timing errors involves at least partially distinct brain networks. The dorsolateral prefrontal cortex (dPFC) has been linked to the correction of perceived timing errors and evidence for a contribution of the ventrolateral PFC (vPFC) specifically to the correction of non-perceived errors exists. The present study aimed at clarifying the functional contribution of the left vPFC for the correction of timing errors by adopting high-definition transcranial direct current stimulation (HD-tDCS). Twenty-one young healthy volunteers synchronized their right index finger taps with respect to an isochronous auditory pacing signal. Perceivable and non-perceivable step-changes of the metronome were interspersed, and error correction was analyzed by means of the phase-correction response (PCR). In subsequent sessions anodal and cathodal HD-tDCS was applied to the left vPFC to establish a brain-behavior relationship. Sham stimulation served as control condition. Synchronization accuracy as well as error correction were determined immediately prior to and after HD-tDCS. The analysis suggests a detrimental effect of cathodal HD-tDCS distinctively on error correction in trials with perceived timing errors. The data support the significance of the left vPFC for error correction in the temporal domain but contradicts the view of a role in the correction of non-perceived errors.

Nonstationary relationships among individuals' concurrent exposures to noise, air pollution and greenspace: A mobility-based study using GPS and mobile sensing data.

Individuals are often exposed to multiple environmental factors simultaneously. Understanding their joint effects is essential for developing effective public health policies. However, there has been a lack of research examining individuals' concurrent exposures to multiple environmental factors during people's daily mobility. To address this gap, this study investigated the relationships between and geographic patterns of individual exposures to air pollution (PM2.5), noise and greenspace using individual-level real-time GPS and mobile sensing data collected in outdoor environments. The findings indicate that the relationships between individual exposures to air pollution, noise and greenspace vary across different value ranges of exposures. The study also reveals that people's concurrent exposures to multiple environmental factors exhibit spatial nonstationary and strong clustering patterns. These results highlight the importance of considering spatial nonstationary and spatial heterogeneity of environmental exposures in understanding the relationships between multiple exposures in environmental health research.

Home-based transcranial alternating current stimulation (tACS) in Alzheimer's disease: rationale and study design.

BACKGROUND: Gamma (γ) brain oscillations are dysregulated in Alzheimer's disease (AD) and can be modulated using transcranial alternating stimulation (tACS). In the present paper, we describe the rationale and design of a study assessing safety, feasibility, clinical and biological efficacy, and predictors of outcome of a home-based intervention consisting of γ-tACS over the precuneus. METHODS: In a first phase, 60 AD patients will be randomized into two arms: ARM1, 8-week precuneus γ-tACS (frequency: 40 Hz, intensity: 2 mA, duration: 5 60-min sessions/week); and ARM2, 8-week sham tACS (same parameters as the real γ-tACS, with the current being discontinued 5 s after the beginning of the stimulation). In a second phase, all participants will receive 8-week γ-tACS (same parameters as the real γ-tACS in the first phase). The study outcomes will be collected at several timepoints throughout the study duration and include information on safety and feasibility, neuropsychological assessment, blood sampling, electroencephalography, transcranial magnetic stimulation neurotransmitter measures, and magnetic resonance imaging or amyloid positron emission tomography. RESULTS: We expect that this intervention is safe and feasible and results in the improvement of cognition, entrainment of gamma oscillations, increased functional connectivity, reduction of pathological burden, and increased cholinergic transmission. CONCLUSIONS: If our expected results are achieved, home-based interventions using γ-tACS, either alone or in combination with other therapies, may become a reality for treating AD. TRIAL REGISTRATION: PNRR-POC-2022-12376021.

Template MRI scans reliably approximate individual and group-level tES and TMS electric fields induced in motor and prefrontal circuits.

Background: Electric field (E-field) modeling is a valuable method of elucidating the cortical target engagement from transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES), but it is typically dependent on individual MRI scans. In this study, we systematically tested whether E-field models in template MNI-152 and Ernie scans can reliably approximate group-level E-fields induced in N = 195 individuals across 5 diagnoses (healthy, alcohol use disorder, tobacco use disorder, anxiety, depression). Methods: We computed 788 E-field models using the CHARM-SimNIBS 4.0.0 pipeline with 4 E-field models per participant (motor and prefrontal targets for TMS and tES). We additionally calculated permutation analyses to determine the point of stability of E-fields to assess whether the 152 brains represented in the MNI-152 template is sufficient. Results: Group-level E-fields did not significantly differ between the individual vs. MNI-152 template and Ernie scans for any stimulation modality or location (p > 0.05). However, TMS-induced E-field magnitudes significantly varied by diagnosis; individuals with generalized anxiety had significantly higher prefrontal and motor E-field magnitudes than healthy controls and those with alcohol use disorder and depression (p < 0.001). The point of stability for group-level E-field magnitudes ranged from 42 (motor tES) to 52 participants (prefrontal TMS). Conclusion: MNI-152 and Ernie models reliably estimate group-average TMS and tES-induced E-fields transdiagnostically. The MNI-152 template includes sufficient scans to control for interindividual anatomical differences (i.e., above the point of stability). Taken together, using the MNI-152 and Ernie brains to approximate group-level E-fields is a valid and reliable approach.

Transcranial magnetic stimulation and transcranial direct current stimulation affect explicit but not implicit emotion regulation: a meta-analysis.

Emotion regulation (ER) refers to the process through which people influence the occurrence, experience, and expression of emotions. It can be established in an explicit (voluntary) or implicit (automatic) way, both of which are essential for mental and physical well-being. Recent evidence has highlighted the potential of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) targeting the prefrontal cortex (PFC) to modulate ER. However, previous studies have only evaluated the effects of TMS and tDCS on explicit ER, leaving implicit ER relatively unexplored. In this review and meta-analysis, we systematically evaluated the effects of TMS and tDCS over the PFC on the two forms of ER, using both subjective and physiological response as outcome indicators. Twenty-seven studies were included in our study. Both subjective (Hedges' g = - 0.20) and physiological (Hedges' g = - 0.65) results indicated a significant effect of TMS and tDCS targeting PFC on down-regulation of explicit ER, but not implicit ER (Hedges' g = - 0.04). Moreover, moderation analysis indicated that the effect of TMS and tDCS on the down-regulating of subjective experience was moderated by several factors, including stimulation method, target area, target hemisphere, and stimulation timing. Specifically, our results showed that applying TMS or targeting the right PFC, particularly the right ventrolateral prefrontal cortex, or using offline TMS and tDCS produced a larger stimulation effect on ER. In summary, these findings suggest that TMS and tDCS has a positive effect on explicit, but not implicit ER. The distinct TMS and tDCS effect on the two forms of ER help deepen our understanding of TMS and tDCS use and provide valuable insights for the development of tailored TMS and tDCS protocols for explicit and implicit regulation.

Hearing performance of individuals with minimal hearing loss in complex and realistic communication experiences. / Desempenho auditivo de indivíduos com perda auditiva mínima em experiências complexas e realistas de comunicação.

PURPOSE: To analyze hearing performance and expectations regarding the use of hearing aids (HA) by participants with minimal hearing loss. METHODS: This research is a primary, observational, longitudinal and prospective study. Two questionnaires, the Speech Spatial Qualities Questionnaire (SSQ) and the Expected Consequences of Hearing Aid Ownership (ECHO), were used, respectively, to verify hearing performance in complex listening situations and expectations regarding the use of HA. The convenience sample consisted of adults aged 53 to 72. RESULTS: SSQ showed that, for hearing performance, greater difficulties were observed in unfavorable situations such as speech and speech-in-noise, followed by greater ease in locating the sound source and in the quality and naturalness of the sound. ECHO showed that, for the expectations regarding the use of the HA, the variables with significant correlation values were age x general expectation with HA and age x HA's positive aspects. No statistically significant association existed between performance scores in complex listening situations and the analyzed variables. CONCLUSION: Minimal hearing loss can negatively influence everyday communicative situations, and the expectation of individuals with minimal hearing loss regarding the use of HA was shown to be high. In addition, the hearing performance of individuals in this study did not show correlations with the age, gender and education level of the sample.

OBJETIVO: Analisar o desempenho auditivo e expectativas quanto ao uso dos aparelhos de amplificação sonora individual (AASI) dos participantes com perda auditiva mínima. MÉTODO: Trata-se de uma pesquisa primária, observacional, longitudinal e prospectiva. Para isso, foram aplicados os questionários Speech Spatial Qualities Questionnaire e o Expected Consequences of Hearing Aid Ownership que buscam verificar o desempenho auditivo em situações complexas de escuta e a expectativa quanto ao uso de AASI, respectivamente. A amostra se deu por conveniência com indivíduos adultos de 53 a 72 anos. RESULTADOS: No desempenho auditivo, observaram-se maiores dificuldades em situações desfavoráveis como na fala e fala no ruído, seguidas por maior facilidade em localizar a fonte sonora, qualidade e naturalidade do som. Para as expectativas quanto ao uso do dispositivo de amplificação, as variáveis com valor de correlação significativa foram idade expectativa geral com o uso do AASI, e idade em relação aos seus aspectos positivos. Não houve associação estatisticamente significativa entre os scores de desempenho em situações complexas de escuta e as variáveis analisadas. CONCLUSÃO: A perda auditiva mínima pode influenciar negativamente em situações comunicativas cotidianas, como também, a expectativa dos indivíduos com perda auditiva mínima quanto ao uso do AASI mostrou-se elevada. Além disso, o desempenho auditivo nos indivíduos desse estudo não apresentou correlações com idade, gênero e escolaridade da amostra.

In-situ hearing threshold estimation using Gaussian process classification.

One in six Americans suffers from hearing loss. While treatment with amplification is possible for many, the acceptance rate of hearing aids is low. Poor device fitting is one of the reasons. The hearing aid fitting starts with a detailed hearing assessment by a trained audiologist in a sound-controlled environment, using standard equipment. The hearing aid is adjusted step-by-step, following well-described procedures based on the audiogram. However, for many patients in rural settings, considerable travel time to a hearing center discourages them from receiving a hearing test and treatment. We hypothesize that hearing assessment with the patient's hearing aid can reliably substitute the hearing test in the clinic. Over-the-counter hearing aids could be programmed from a distance and fine-tuned by the hearing aid wearer. This study shows that a patient-controlled hearing assessment via a hearing aid in a non-clinical setting is not statistically different from an audiologist-controlled hearing assessment in a clinical setting. The differences in hearing obtained with our device and the Gaussian Process are within 3 dB of the standard audiogram. At 250 Hz, the sound delivery with the hearing aid used in this study added an additional reduction of sound level, which was not compensated.

The effects of stimulating the cerebellum on social sequences: A tDCS-fMRI pilot study

Research on the involvement of the cerebellum in social behavior and its relationship with social mentalizing has just begun. Social mentalizing is the ability to attribute mental states such as desires, intentions, and beliefs to others. This ability involves the use of social action sequences which are believed to be stored in the cerebellum. In order to better understand the neurobiology of social mentalizing, we applied cerebellar transcranial direct current stimulation (tDCS) on 23 healthy participants in the MRI scanner, immediately followed by measuring their brain activity during a task that required to generate the correct sequence of social actions involving false (i.e., outdated) and true beliefs, social routines and non-social (control) events. The results revealed that stimulation decreased task performance along with decreased brain activation in mentalizing areas, including the temporoparietal junction and the precuneus. This decrease was strongest for true belief sequences compared to the other sequences. These findings support the functional impact of the cerebellum on the mentalizing network and belief mentalizing, contributing to the understanding of the role of the cerebellum in social sequences. (AU)

Stimulated brains and meditative minds: A systematic review on combining low intensity transcranial electrical stimulation and meditation in humans

Background: Low intensity transcranial electrical stimulation (tES) and meditation are two promising, yet variable, non-pharmacological interventions. Growing research is investigating combined effects of both techniques on one's cognitive, emotional, and physical health. Objective: This article reviews the current research that combines tES and meditation interventions in healthy and diseased participants. The review considers the intervention parameters and their effects in a well-organized manner. Method: A systematic search for clinical and experimental published studies was conducted in the PubMed, Cochrane, and transcranial direct current stimulation (tDCS) databases using common keywords for tES and for meditation techniques well defined by previous studies. Unpublished ongoing studies were identified with the ClinicalTrials.gov and DRKS.de clinical trial websites. Results: 20 published studies and 13 ongoing studies were included for qualitative analysis. 13 published articles studied patients with chronic pain, psychological disorders, cognitive impairment, and movement disorders. Anodal tDCS was the only tES technique while mindfulness meditation was the most common meditation type. Eight studies had a main group effect, with outcome improvement in the active combined intervention. However, most published studies showed improvements after at least one combined intervention with variable effects. Conclusion: Pairing anodal tDCS with meditation shows promising improvements of the physical, mental, and emotional aspects of daily life. Further studies are required to confirm the relevance of this combination in the clinic. (AU)

The effect of HD-tDCS on brain oscillations and frontal synchronicity during resting-state EEG in violent offenders with a substance dependence

Violence is a major problem in our society and therefore research into the neural underpinnings of aggression has grown exponentially. Although in the past decade the biological underpinnings of aggressive behavior have been examined, research on neural oscillations in violent offenders during resting-state electroencephalography (rsEEG) remains scarce. In this study we aimed to investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) on frontal theta, alpha and beta frequency power, asymmetrical frontal activity, and frontal synchronicity in violent offenders.Fifty male violent forensic patients diagnosed with a substance dependence were included in a double-blind sham-controlled randomized study. The patients received 20 minutes of HD-tDCS two times a day on five consecutive days. Before and after the intervention, the patients underwent a rsEEG task.Results showed no effect of HD-tDCS on the power in the different frequency bands. Also, no increase in asymmetrical activity was found. However, we found increased synchronicity in frontal regions in the alpha and beta frequency bands indicating enhanced connectivity in frontal brain regions as a result of the HD-tDCS-intervention.This study has enhanced our understanding of the neural underpinnings of aggression and violence, pointing to the importance of alpha and beta frequency bands and their connectivity in frontal brain regions. Although future studies should further investigate the complex neural underpinnings of aggression in different populations and using whole-brain connectivity, it can be suggested with caution, that HD-tDCS could be an innovative method to regain frontal synchronicity in neurorehabilitation. (AU)

Efectividad de la tecnología robótica y la realidad virtual para la rehabilitación de la función motora en la parálisis cerebral. Revisión sistemática / Effectiveness of robotic technology and virtual reality for the rehabilitation of motor function in cerebral palsy. Systematic review

Introducción: La parálisis cerebral (PC) es una condición de salud secundaria a daños no progresivos que ocurren durante el desarrollo del cerebro en la etapa fetal o infantil. Evaluar la efectividad de la tecnología robótica y la realidad virtual de la función motora en pacientes con PC en comparación con estrategias convencionales de rehabilitación como fisioterapia, terapia ocupacional, intervención de neurodesarrollo y estimulación transcraneal. Se llevó a cabo una revisión de ensayos controlados aleatorizados de los últimos 5 años. Para la evaluación de la calidad metodológica de los estudios incluidos se utilizó la escala PEDro, con evaluación del nivel de evidencia y grado de recomendación según la clasificación de Oxford. Resultados: Diecisiete artículos cumplieron con los criterios de elegibilidad. La tecnología robótica y la realidad virtual demostraron ser efectivas para la mejora de la función motora, las habilidades manuales y las destrezas perceptivo-visuales de los pacientes con PC, en comparación con el uso de estrategias convencionales de rehabilitación.(AU)

Introduction: Cerebral palsy (CP) is a health condition secondary to non-progressive damage that occurs during brain development in the fetal or infant stage. To evaluate the effectiveness of robotic technology and virtual reality on motor function in patients with CP compared to conventional rehabilitation strategies such as physical therapy, occupational therapy, neurodevelopmental intervention, and transcranial stimulation. A review of randomized controlled trials of the last 5 years was carried out. For the evaluation of the methodological quality of the included studies, the PEDro scale was used, with evaluation of the level of evidence and degree of recommendation according to the Oxford classification. Results: Seventeen articles met the eligibility criteria. Robotic technology and virtual reality proved to be effective in improving motor function, manual skills, and visual–perceptual skills in patients with CP, compared to the use of conventional rehabilitation strategies.(AU)

Modulatory effects of transcranial direct current stimulation of right insula on compassion motivation

Background: Compassion motivation is associated with increased heart rate variability (HRV), reflecting a calm and self-soothing physiological state. Recent work, however, suggests that this association is dynamic for the specific components of compassion. Objectives: The present study adopted anodal transcranial direct current stimulation (tDCS) targeting the right insula to see whether this would modulate the sensitivity to suffering and the commitment to engage in helpful actions (i.e., the components of compassion motivation). Method: Ninety-seven healthy individuals underwent 15-min anodal or sham tDCS over the frontotemporal lobe, while watching a video inducing empathic sensitivity and performing a Redistribution Game. Tonic and phasic HRV, dispositional traits, and momentary affects were assessed. Results: Compared to sham condition, anodal stimulation favored significant i) HRV reductions during the video and HRV increases during the Redistribution Game; ii) decreases in self-reported levels of negative affect and increases in positive affect during task when the latter was preceded by the video, without influencing altruistic behavior. Conclusions: Anodal tDCS over the right insula may modulate the engagement phase of compassion by intensifying the psychophysiological sensitivity to signals of distress and protecting from being subjectively overwhelmed by it. (AU)

Audiological findings of family farmers exposed to pesticides. / Achados audiológicos de agricultores familiares paranaenses expostos a agrotóxicos.

PURPOSE: To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. METHODS: Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. RESULTS: Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. CONCLUSION: There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

OBJETIVO: Analisar as possíveis diferenças na audição de agricultores e suas famílias em comparação com população não exposta aos agrotóxicos. MÉTODO: Estudo transversal, com 70 participantes (grupo pesquisa), com média de idade de 39,7 anos, de ambos os sexos, proprietários de pequenos estabelecimentos agrícolas vinculados a agricultura familiar e tempo de exposição médio aos agrotóxicos de 23,7 anos. Um grupo controle com 71 participantes de ambos os sexos, sem exposição a ruído e agentes químicos, com idade média de 39,5 anos, foi incluído para a comparação dos resultados. Na etapa 1, ambos os grupos foram submetidos a audiometria convencional e de altas frequências e imitanciometria. Na etapa 2, somente os normoouvintes foram submetidos as emissões otoacústicas evocadas e efeito de supressão das emissões otoacústicas transientes. RESULTADOS: Observou-se diferenças significativas entre os grupos para audiometria tonal convencional e de altas frequências, e no reflexo acústico. As frequências mais afetadas na audiometria tonal convencional foram 3 a 6kHz e na audiometria de altas frequências foram as frequências de 9.000 e 11.200 Hz. Nas emissões otoacusticas transientes, observou-se no efeito de supressão piores resultados no grupo de pesquisa. CONCLUSÃO: Conclui-se que houve diferenças na audição dos agricultores familiares em comparação com o grupo controle. Os limiares auditivos convencionais estão relacionados em função do grupo, idade e gênero. O trabalho na agricultura está associado com o comprometimento na região basal da cóclea, à ausência de reflexo acústico, à redução da relação sinal/ruído das emissões otoacústicas transientes e à disfunção do sistema auditivo eferente olivococlear.

Prevalence of voice handicap among nurses in intensive care units due to occupational noise during pandemic.

Background: Healthcare workers have been identified as being at risk of occupational voice disorders. Among them, nurses working in intensive care units (ICUs) are particularly vulnerable due to the risk factors that are associated with their exposure to high levels of noise. Thus, this study aimed to determine the prevalence of voice disorders among ICU nurses. Methods: A questionnaire was administered to 100 ICU nurses from four hospitals in China. The questionnaire assessed vocal-related symptoms, perceived voice handicap, frequently heard noise sources, and the quality of communications. Results: Results indicate that the most frequently reported voice symptoms were 'voice tiredness' and 'voiceless'. Nurses working more than 50 h per week experienced voice symptoms more frequently than nurses working for 40-50 h per week. The median value of the perceived voice handicap score (VHI-30) was 23, indicating mild voice handicap, while 24% of the nurses reported severe voice handicap. Longer working hours and working at patient wards were significantly associated with higher VHI-30 scores. The nurses also reported that the quality of verbal communication with patients and colleagues and voice problems worsened during the COVID-19 pandemic. Conclusion: More than 20% of nurses reported severe voice handicap, however, voice handicap among ICU nurses did not appear universally to all nurses. Further research is necessary to identify the risk factors associated with voice disorders and the mechanism behind such heterogeneity among ICU nurses.

Predicting speech-in-speech recognition: Short-term audibility and spatial separation.

Quantifying the factors that predict variability in speech-in-speech recognition represents a fundamental challenge in auditory science. Stimulus factors associated with energetic and informational masking (IM) modulate variability in speech-in-speech recognition, but energetic effects can be difficult to estimate in spectro-temporally dynamic speech maskers. The current experiment characterized the effects of short-term audibility and differences in target and masker location (or perceived location) on the horizontal plane for sentence recognition in two-talker speech. Thirty young adults with normal hearing (NH) participated. Speech reception thresholds and keyword recognition at a fixed signal-to-noise ratio (SNR) were measured in each spatial condition. Short-term audibility for each keyword was quantified using a glimpsing model. Results revealed that speech-in-speech recognition depended on the proportion of audible glimpses available in the target + masker keyword stimulus in each spatial condition, even across stimuli presented at a fixed global SNR. Short-term audibility requirements were greater for colocated than spatially separated speech-in-speech recognition, and keyword recognition improved more rapidly as a function of increases in target audibility with spatial separation. Results indicate that spatial cues enhance glimpsing efficiency in competing speech for young adults with NH and provide a quantitative framework for estimating IM for speech-in-speech recognition in different spatial configurations.