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To compare long-term survival of Parkinson’s disease (PD) patients with deep brain stimulation (DBS) to matched controls, and examine whether DBS was associated with differences in injurious falls, long-term care, and home care.
Using administrative health data (Ontario, Canada), we examined DBS outcomes within a cohort of individuals diagnosed with PD between 1997 and 2012. Patients receiving DBS were matched with non-DBS controls by age, sex, PD diagnosis date, time with PD, and a propensity score. Survival between groups was compared using the log-rank test and marginal Cox proportional hazards regression. Cumulative incidence function curves and marginal subdistribution hazard models were used to assess effects of DBS on falls, long-term care admission, and home care use, with death as a competing risk.
There were 260 DBS recipients matched with 551 controls. Patients undergoing DBS did not experience a significant survival advantage compared to controls (log-rank test p = 0.50; HR: 0.89, 95% CI: 0.65–1.22). Among patients <65 years of age, DBS recipients had a significantly reduced risk of death (HR: 0.49, 95% CI: 0.28–0.84). Patients receiving DBS were more likely than controls to receive care for falls (HR: 1.56, 95% CI: 1.19–2.05) and home care (HR: 1.59, 95% CI: 1.32–1.90), while long-term care admission was similar between groups.
Receiving DBS may increase survival for younger PD patients who undergo DBS. Future studies should examine whether survival benefits may be attributed to effects on PD or the absence of comorbidities that influence mortality.
Research using single-word paradigms has established that forced language switching incurs processing costs for some bilinguals, yet, less research has addressed this phenomenon at the utterance level or considered real-world applications. The current study examined the impacts of forced language switching on spoken output and stress using a simulated virtual meeting. Twenty Spanish–English heritage bilinguals responded to general work-oriented questions in monolingual English (control) or language-switching (experimental) conditions. Responses were analyzed for mean length of utterance (MLU) and type-token-ratio (TTR). Multilevel modeling revealed an interaction effect of Condition (control vs. experimental) and question order on MLU, such that participants in the experimental condition produced significantly shorter utterances by the end of the task. Participants also had significantly lower lexical variation (TTR) overall in the experimental than the control condition. A 2 × 2 ANOVA revealed a significant effect of Condition and an interaction of Task (pre- vs. posttask) and Condition, such that participants in the control condition reported significantly lower stress after the activity. Results demonstrated the impact of a forced switching condition on production at the utterance level. Findings have implications for theory and scenarios in which heritage bilinguals are asked to use multiple languages in the workplace.
To examine whether sociodemographic characteristics and health care utilization are associated with receiving deep brain stimulation (DBS) surgery for Parkinson’s disease (PD) in Ontario, Canada.
Using health administrative data, we identified a cohort of individuals aged 40 years or older diagnosed with incident PD between 1995 and 2009. A case-control study was used to examine whether select factors were associated with DBS for PD. Patients were classified as cases if they underwent DBS surgery at any point 1-year after cohort entry until December 31, 2016. Conditional logistic regression modeling was used to estimate the adjusted odds of DBS surgery for sociodemographic and health care utilization indicators.
A total of 46,237 individuals with PD were identified, with 543 (1.2%) receiving DBS surgery. Individuals residing in northern Ontario were more likely than southern patients to receive DBS surgery [adjusted odds ratio (AOR) = 2.23, 95% confidence interval (CI) = 1.15–4.34]; however, regional variations were not observed after accounting for medication use among older adults (AOR = 1.04, 95% CI = 0.26–4.21). Patients living in neighborhoods with the highest concentration of visible minorities were less likely to receive DBS surgery compared to patients living in predominantly white neighborhoods (AOR = 0.27, 95% CI = 0.16–0.46). Regular neurologist care and use of multiple PD medications were positively associated with DBS surgery.
Variations in use of DBS may reflect differences in access to care, specialist referral pathways, health-seeking behavior, or need for DBS. Future studies are needed to understand drivers of potential disparities in DBS use.
One of the signs of severity of a Vascular Dementia (VD) is white matter lesion load, although white matter lesions also occur in Alzheimer´s Dementia. These lesions reduce some cognitive and executive functions of the brain, that also affect the ability to draw a clock in CDT.
Here we would like to examine if there is a relation beetween WML load and severity of errors in the clock drawing test.
Material and methods
Patients (n = 236) of a memory clinic were examined clinically, neuropsychologically and neuroradiologically and differentiated in the following diagnostic groups according to ICD-10: cognitively healthy persons (XD, n=65), VD (n=56) and Alzheimer´s Disease (AD, n=115).
A large number of neuropsychological tests were done, one of them was the CDT, which was rated with a specially developed 8-point scale developed in our hospital instead of the 6-point scale established by Shulman.
Rating of the WML load was done according to a special 48- point score, also developed in our house.
Comparison of groups was done using descriptive statistics and analysis of variance.
For all the three groups we found a statistically significant correlation between WML load and CDT score on the p< 0,05 level.
Regarding the CDT score there was a highly significant correlation beetween XD/VD and XD/AD, but no correlation beetween VD/AD.
CDT seems to be an interesting tool in estimating wml load in dementias.
The lack of discriminatin beetween VD/AD could be perhaps overcome with an even finer scale.
Ischemic neuronal disintegration of the brain tissue is a main risk factor for the development of a vascular dementia (VD). Because of the complexity of cerebrovascular and other factors it is not possible to describe the whole variance of the incidence of VD merely by genetic polymorphisms, however they may explain a part of the complexity. Nevertheless there is hope to identify the contribution of genetic markers in VD.
Material and methods:
Data of clinically, neuropsychologically, neuroradiologically and genetically examined patients (n = 236) of a memory clinic were analysed upon the interrelation of clinical diagnosis according to ICD-10 and genetics, differentiated in the diagnostic groups: cognitively healthy persons (XD, n=65), VD (n=56) and Alzheimer´s Disease (AD, n=115).
Comparison of groups was done using descriptive statistics and analysis of variance.
The VD group (n=56) was genetically different compared to both groups, patients with Alzheimer disease (AD, n=115) and cognitively healthy persons (XD, n=65). For VD, there was a statistically significant correlation between some genetic markers and wmL load.
Regarding procentual frequency of the polymorphisms genetic pattern in patients with VD are different to XD but not to the AD group.
The wmL load is higher in VD and AD then in XD.
In general, the results are arguments against dichotomy and for the hypothesis of interaction between VD and AD in older age.
Psychiatric comorbidity is an important aspect of neurological disorders. It affects about 30-50% of neurologic patients but is frequently underrecognized.
Our objective was to determine the prevalence and severity of the symptoms of mental disorders in neurologic in-patients.
Between May and September 2014, all neurologic in-patients of a university neurologic center were asked to complete two self report questionnaires for assessing symptoms of mental disorders, namely the Beck Depression Inventory (BDI) and the Brief Symptom Inventory (BSI), which allow to assess a range of nine different psychiatric domains. We performed a multivariate covariance analysis in order to relate the type and frequency of symptoms of mental disorders with the neurological discharge diagnosis, while age, gender, and duration of in-patient treatment served as putative covariates.
Of all responders (n = 157), 51% stated to have suffered from psychological distress within the past seven days, and 43% indicated depressive symptoms (21% mild, 17% moderate, 5% severe). The mean global severity index GSI (M = 0.64, SD = 0.52) exceeded the 1 SD range of healthy persons but was lower than that of psychiatric in-patients known from the literature. Furthermore, our subanalysis revealed different patterns of symptoms of mental disorders between neurologic patients with degenerative, vascular, demyelinating or epileptic disoders.
Psychometric measurement is useful to characterize the burden of the symptoms of mental disorders and will be used to further develop the psychiatric liaison services.
Aberrant sensitivity to social reward may be an important contributor to abnormal social behavior that is a core feature of schizophrenia. The neuropeptide oxytocin impacts the salience of social information across species, but its effect on social reward in schizophrenia is unknown.
We used a competitive economic game and computational modeling to examine behavioral dynamics and oxytocin effects on sensitivity to social reward among 39 men with schizophrenia and 54 matched healthy controls. In a randomized, double-blind study, participants received one dose of oxytocin (40 IU) or placebo and completed a 35-trial Auction Game that quantifies preferences for monetary v. social reward. We analyzed bidding behavior using multilevel linear mixed models and reinforcement learning models.
Bidding was motivated by preferences for both monetary and social reward in both groups, but bidding dynamics differed: patients initially overbid less compared to controls, and across trials, controls decreased their bids while patients did not. Oxytocin administration was associated with sustained overbidding across trials, particularly in patients. This drug effect was driven by a stronger preference for winning the auction, regardless of monetary consequences. Learning rate and response variability did not differ between groups or drug condition, suggesting that differences in bidding derive primarily from differences in the subjective value of social rewards.
Our findings suggest that schizophrenia is associated with diminished motivation for social reward that may be increased by oxytocin administration.
This technical article discusses design and integration associated with distributed propulsion as a means of providing motive power with significantly reduced emissions and external noise for future aircraft concepts. The technical work reflects activities performed within a European Commission funded Framework 7 project entitled Distributed Propulsion and Ultra-high By-Pass Rotor Study at Aircraft Level, or, DisPURSAL. In this instance, the approach of distributed propulsion includes a Distributed Multiple-Fans Concept driven by a limited number of engine cores as well as one unique solution that integrates the fuselage with a single propulsor (dubbed Propulsive-Fuselage Concept) – both targeting entry-in-service year 2035+. Compared to a state-of-the-art, year 2000 reference aircraft, designs with tighter coupling between airframe aerodynamics and motive power system performance for medium-to-long-range operations indicated potentially a 40-45% reduction in CO2-emissions. An evolutionary, year 2035, conventional morphology gas-turbine aircraft was predicted to be –33% in CO2-emissions.
We present the KMOS (K-band Multi-Object Spectrograph) Cluster and VIRIAL (VLT IRIFU Absorption Line) Guaranteed Time Observation (GTO) programs. KMOS provides 24 arms each feeding an integral field unit (14×14 spaxels of 0.2″ pixels) for IZ, YJ, H and K band near infrared (NIR) medium resolution spectroscopy (R ∼ 3500). Targets are selected from a 7.2′ diameter patrol field. Ultra-deep spectroscopy of ∼ 80 early-type cluster galaxies (∼ 20hr on source) and ∼ 200 (∼ 10hr on source) early-type field galaxies at 1 < z < 2 will dramatically improve the situation at z > 1 for which measurements of stellar velocity dispersions and absorption indices are limited to a few, often relatively young passively evolving galaxies (e.g. Bezanson 2013). In ESO Periods P92 and P93, 15 nights worth of data has been collected for KMOS-Clusters and 6 nights for VIRIAL: this will be supplemented with more data in upcoming semesters. All galaxies have multiband HST imaging including existing or upcoming WFC3 IR imaging, providing stellar mass maps and sizes. Combined with our dispersion measurements, this will allow us to examine the fundamental plane and the dynamical mass of a large sample of z > 1 galaxies for the first time, for both cluster and field galaxies.
We have investigated by x-ray diffraction defect structures in 6H-SiC after neutron irradiation with different fluences and followed by different annealing procedures. An interpretation along a model of Klimanek [1, 4–6] shows, that higher fluences lead to a stronger than linear reduction of the correlation length, whereas higher annealing temperatures correlate with a better recovery of the correlation length. In addition defects of 1st kind created by irradiation are reduced by annealing. We find that annealing changes the character of the defects and it accentuates a defect structure already present in the original samples.
Mg doped cubic GaN layers were studied by steady state and time resolved photoluminescence. The blue emission due to Mg doping can be decomposed in three bands. The decay curves and the spectral shift with time delays indicates donor-acceptor pair behaviour. This can be confirmed by excitation density dependent measurements. Furthermore temperature dependent analysis shows that the three emissions have one impurity in common. We propose that this is an acceptor level related to the Mg incorporation and the three deep donor levels are due to compensation effects.
GaN, its alloys, QWs and MQWs have gained an important place among shortwavelength optical emitters and high temperature electronic devices [1,2]. The performance of such devices is limited by the presence of native and impurity defects. The understanding of the optical properties of the basic material allows us to improve its quality and thus increase the performance of these materials.
Even in good quality undoped GaN samples, as assessed by the intense excitonic emission, the yellow band is present. This band has been attributed either to a shallow donor to deep double donor pair recombination , to a deep donor to a shallow acceptor  or to a shallow donor and a deep state . However, its origin is not yet clear. We present data on time resolved spectroscopy compared with steady state results. These results indicate that there is no difference in band shape between steady state and time resolved spectra at all temperatures. However, in some samples there is an increase in intensity of the yellow band. It is concluded that besides a fast emission, due to prompt excitation of the centre, an indirect path from a trap 13.7 meV below the shallow donor is responsible for the long component of the decay and the intensity increase. An emission with a lifetime of ca. 300 ms is also present with a maximum at 2.35 eV.
A near-field performance assessment (PA) was conducted for the Saltstone Disposal Facility (SDF) at the Savannah River Site in South Carolina. The analysis was conducted in four parts: general screening calculations, degradation calculations, and flow and transport through the fractured and nonfractured facility. Modeling approaches and example sensitivity analysis results from the simulations of the fractured facility are discussed. Design considerations that may not be apparent without addressing flow and transport through fractures and lessons learned during the process are also presented.
Liver samples from 10 Schistosoma mansoni-infected baboons all yielded eggs but neither their egg counts nor duration of infection (< 226 weeks) correlated with the slightly elevated liver collagen levels or minimal histological fibrosis observed. Approximately 10% of inert 9 and 15 μm diameter microspheres injected into the mesenterio veins of 2 baboons with acute, challenge S. mansoni infection reached their lungs (mainly 9 μm microspheres). Lung egg recoveries over 1000 were significantly less common among 175 baboons exposed once to S. monsoni infections than among 56 baboons exposed more than once. Among 221 S. mansoni-and S. haematobium-infected baboons, female worm, total tissue egg and lung egg recoveries were significantly correlated with each other but not with liver or (where available) spleen weights. Liver and spleen weights were strongly correlated with total body weight. Baboons did not develop significant liver fibrosis, even after prolonged schistosome infections. However, some liver ‘leakiness’ developed during acute primary and challenge infections, allowing small inert particles and eggs to pass to the lungs, but this ‘leakiness’ was not associated with resistance to challenge. In contrast to mice, such resistance in baboons cannot, therefore, be explained simply in terms of pathological changes due to previous infections.
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