Le TDA/H est caractérisé par des symptômes d’inattention pouvant inclure une hyperactivité et de l’impulsivité, suggérant un déficit du contrôle volontaire. Les mouvements oculomoteurs dépendent de structures cérébrales impliquées dans l’attention et le contrôle moteur, deux fonctions altérées dans le TDA/H. L’objectif de cette étude était d’évaluer l’effet du MPH sur les mouvements oculomoteurs de patients TDAH. Cinquante neuf patients TDA/H, naïfs de traitement (44 adultes ; 15 enfants) ont participé à l’étude. Des tâches de saccades et d’antisaccades ont été proposées à J1 (T1 et T2) aux patients non traités. Les mêmes tâches leur ont été proposées à J2 (T1 et T2), après une prise de MPH (10 mg per os). L’effet du traitement a été mesuré en comparant les performances à J1 et J2. L’effet test-retest a été mesuré en comparant les performances à T1 et T2. Les paramètres analysés étaient : le pourcentage d’anticipations et d’erreurs de direction ; la latence ; le gain (précision de la saccade sur la cible) ; la vitesse moyenne. Nous avons retrouvé un effet bénéfique du traitement sur le pourcentage d’anticipations (p < 0,009) ; sur le pourcentage d’erreurs de direction (p < 0,0002) ; sur les latences (p < 0,0008) et sur le gain (p < 0,01). Les performances des patients étaient significativement meilleures avec traitement que sans traitement de manière générale et en particulier dans les tâches d’antisaccades. Les dispersions individuelles étaient également moins importantes avec traitement que sans traitement (p < 0,0001). Aucun effet test-retest n’a été retrouvé. Le MPH modifie la programmation motrice et la réponse à l’inhibition des patients présentant un TDA/H. Le bénéfice du traitement peut s’observer grâce à des tâches de saccades réflexes ou des tâches plus cognitives telles que les antisaccades, dès la première prise de traitement. Ces résultats suggèrent que les mouvements oculomoteurs pourraient être un bon marqueur d’efficacité du MPH. Le MPH modifie la programmation motrice et la réponse à l’inhibition des patients présentant un TDA/H. Le bénéfice du traitement peut s’observer grâce à des tâches de saccades visuellement guidées ou des tâches plus cognitives telles que les antisaccades, dès la première prise de traitement. Ces résultats suggèrent que les mouvements oculomoteurs pourraient être un bon marqueur individuel d’efficacité du MPH.

Beds in Israel's private psychiatric hospitals, where the standard of care is markedly lower than in state-run facilities, are being closed down. Their patients - many hospitalized for years - are being re-assessed and those still needing inpatient care transferred to state hospitals. The aim is to give a better quality of life, conduct a thorough psychiatric reappraisal and offer the latest therapeutic options.

The merged Be'er Ya'akov-Ness Ziona- Israel Prisons Service Mental Health Center set up a multidisciplinary team to conduct a coordinated process of reappraisal, preparation, reorganization and admission for these patients and their families. We found in the patients complex self-management problems, a high level of dependency, severe neglect, a range of tendencies to violence, and mistrust of the staff. The family members revealed high levels of anxiety and fear. Given this situation, a nursing staffer was appointed to liaise with the families, be freely available for consultation and act as patient advocate.

In this presentation we describe the core principles for this multidisciplinary reassessment and re-placement process, which began by assessing the patients in their setting of origin. We report on the planning of new interventions incorporating the latest therapeutic advances, exceptional incidents, changing the profile of the psychogeriatric ward, etc. We offer the conclusions and recommendations drawn from this change process, undergone equally by patients, family members and staff, and report on its results, which for many of the patients led to a more open care-setting in the community and for some a return home.

We investigated a large multistate outbreak that occurred in the United States in 2015–2016. Epidemiologic, laboratory, and traceback studies were conducted to determine the source of the infections. We identified 907 case-patients from 40 states with illness onset dates ranging from July 3, 2015 to March 2, 2016. Sixty-three percent of case-patients reported consuming cucumbers in the week before illness onset. Ten illness sub-clusters linked to events or purchase locations were identified. All sub-clusters investigated received cucumbers from a single distributor which were sourced from a single grower in Mexico. Seventy-five cucumber samples were collected, 19 of which yielded the outbreak strain. Whole genome sequencing performed on 154 clinical isolates and 19 cucumber samples indicated that the sequenced isolates were closely related genetically to one another. This was the largest US foodborne disease outbreak in the last ten years and the third largest in the past 20 years. This was at least the fifth multistate outbreak caused by contaminated cucumbers since 2010. The outbreak is noteworthy because a recall was issued only 17 days after the outbreak was identified, which allowed for the removal of the contaminated cucumbers still available in commerce, unlike previous cucumber associated outbreaks. The rapid identification and response of multiple public health agencies resulted in preventing this from becoming an even larger outbreak.

Objectives: A growing body of research suggests that regular participation in long-term exercise is associated with enhanced cognitive function. However, less is known about the beneficial effects of acute exercise on semantic memory. This study investigated brain activation during a semantic memory task after a single session of exercise in healthy older adults using functional magnetic resonance imaging (fMRI). Methods: Using a within-subjects counterbalanced design, 26 participants (ages, 55–85 years) underwent two experimental visits on separate days. During each visit, participants engaged in 30 min of rest or stationary cycling exercise immediately before performing a Famous and Non-Famous name discrimination task during fMRI scanning. Results: Acute exercise was associated with significantly greater semantic memory activation (Famous>Non-Famous) in the middle frontal, inferior temporal, middle temporal, and fusiform gyri. A planned comparison additionally showed significantly greater activation in the bilateral hippocampus after exercise compared to rest. These effects were confined to correct trials, and as expected, there were no differences between conditions in response time or accuracy. Conclusions: Greater brain activation following a single session of exercise suggests that exercise may increase neural processes underlying semantic memory activation in healthy older adults. These effects were localized to the known semantic memory network, and thus do not appear to reflect a general or widespread increase in brain blood flow. Coupled with our prior exercise training effects on semantic memory-related activation, these data suggest the acute increase in neural activation after exercise may provide a stimulus for adaptation over repeated exercise sessions. (JINS, 2019, 25, 557–568)

Foodborne non-typhoidal salmonellosis causes approximately 1 million illnesses annually in the USA. In April 2015, we investigated a multistate outbreak of 65 Salmonella Paratyphi B variant L(+) tartrate(+) infections associated with frozen raw tuna imported from Indonesia, which was consumed raw in sushi. Forty-six (92%) of 50 case-patients interviewed ate sushi during the week before illness onset, and 44 (98%) of 45 who specified ate sushi containing raw tuna. Two outbreak strains were isolated from the samples of frozen raw tuna. Traceback identified a single importer as a common source of tuna consumed by case-patients; this importer issued three voluntary recalls of tuna sourced from one Indonesian processor. Four Salmonella Weltevreden infections were also linked to this outbreak. Whole-genome sequencing was useful in establishing a link between Salmonella isolated from ill people and tuna. This outbreak highlights the continuing foodborne illness risk associated with raw seafood consumption, the importance of processing seafood in a manner that minimises contamination with pathogenic microorganisms and the continuing need to ensure imported foods are safe to eat. People at higher risk for foodborne illness should not consume undercooked animal products, such as raw seafood.

Background: Planning for neurology training necessitated a reflection on the experience of graduates. We explored practice characteristics, and training experience of recent graduates. Methods: Graduates from 2010-2014 completed a survey. Results: Response rate was 37% of 211. 56% were female. 91% were adult neurologists. 65% practiced in an outpatient setting. 63% worked in academics. 85% completed subspecialty training (median 1 year). 36% work 3 days a week or less. 82% took general call (median 1 night weekly). Role preparation was considered very good or excellent for most; however poor or fair ratings were 17% in advocacy and 8% in leadership. Training feedback was at least “good” for 87%. Burnout a few times a week or more was noted by 5% (6% during residency, particularly PGY1 and 5). 64% felt overly burdened by paperwork. Although most felt training was adequate, it was poor or fair at preparing for practice management (85%) and personal balance (55%). Most conditions were under-observed in training environment. Many noted a need for more independent practice development and community neurology. Conclusions: Although our training was found to be very good, some identified needs included advocacy training, and more training in general neurology in the longitudinal outpatient/community settings.

Cortical atrophy is a biomarker of Alzheimer’s disease (AD) that correlates with clinical symptoms. This study examined changes in cortical thickness from before to after an exercise intervention in mild cognitive impairment (MCI) and healthy elders. Thirty physically inactive older adults (14 MCI, 16 healthy controls) underwent MRI before and after participating in a 12-week moderate intensity walking intervention. Participants were between the ages of 61 and 88. Change in cardiorespiratory fitness was assessed using residualized scores of the peak rate of oxygen consumption (V̇O2peak) from pre- to post-intervention. Structural magnetic resonance images were processed using FreeSurfer v5.1.0. V̇O2peak increased an average of 8.49%, which was comparable between MCI and healthy elders. Overall, cortical thickness was stable except for a significant decrease in the right fusiform gyrus in both groups. However, improvement in cardiorespiratory fitness due to the intervention (V̇O2peak) was positively correlated with cortical thickness change in the bilateral insula, precentral gyri, precuneus, posterior cingulate, and inferior and superior frontal cortices. Moreover, MCI participants exhibited stronger positive correlations compared to healthy elders in the left insula and superior temporal gyrus. A 12-week moderate intensity walking intervention led to significantly improved fitness in both MCI and healthy elders. Improved V̇O2peak was associated with widespread increased cortical thickness, which was similar between MCI and healthy elders. Thus, regular exercise may be an especially beneficial intervention to counteract cortical atrophy in all risk groups, and may provide protection against future cognitive decline in both healthy elders and MCI. (JINS, 2015, 21, 757–767)

The flow inside a constant-width wind-tunnel contraction is simulated by solving the Reynolds-Averaged Navier-Stokes equations with an eddy-viscosity turbulence model. The results show the presence of longitudinal vortices near the sidewalls centreline. This confirms a former hypothesis involving the generation of skew-induced longitudinal vorticity within the sidewalls boundary layers. Detailed analysis reveals that the flow structure is influenced by viscous effects in the boundary layers and streamline curvature in the potential flow. Three-dimensional boundary-layer profiles on the contraction sidewall are analysed in the framework of the streamline co-ordinate system and its associated hodographic diagram. The resulting profiles help understand the generation of secondary flows and the associated longitudinal vorticity.