Efficacy of Functional Magnetic Stimulation in Neurogenic Bowel Dysfunction after Spinal Cord Injury

[[abstract]]Objective: The aims of this study were to assess the usefulness of functional magnetic stimulation in controlling neurogenic bowel dysfunction in spinal cord injured patients with supraconal and conal/caudal lesions, and to investigate the efficacy of this regimen with a 3-month follow-up. Design: A longitudinal, prospective before-after trial. Subjects: A total of 22 patients with chronic spinal cord injured and intractable neurogenic bowel dysfunction. They were divided into group 1 (supraconal lesion) and group 2 (conal/caudal lesion). Methods: The colonic transit time assessment and Knowles-Eccersley-Scott Symptom Questionnaire were carried out for each patient before they received a 3-week functional magnetic stimulation protocol and on the day following the treatment. Results and conclusion: Following functional magnetic stimulation, the mean colonic transit time for all patients decreased from 62.6 to 50.4 h (p < 0.001). The patients’ Knowles-Eccersley-Scott Symptom scores decreased from 24.5 to 19.2 points (p < 0.001). The colonic transit time decrement in both group 1 (p = 0.003) and group 2 (p = 0.043) showed significant differences, as did the Knowles-Eccersley-Scott Symptom score in both groups following stimulation and in the 3-month follow-up results (p < 0.01). The improvements in bowel function indicate that functional magnetic stimulation, featuring broad-spectrum application, can be incorporated successfully into other therapies as an optimal adjuvant treatment for neurogenic bowel dysfunction resulting from spinal cord injury.[[journaltype]]國外[[incitationindex]]SCI[[booktype]]紙本[[countrycodes]]SW

Fuzzy Integral with Particle Swarm Optimization for a Motor-Imagery-Based Brain-Computer Interface

© 2016 IEEE. A brain-computer interface (BCI) system using electroencephalography signals provides a convenient means of communication between the human brain and a computer. Motor imagery (MI), in which motor actions are mentally rehearsed without engaging in actual physical execution, has been widely used as a major BCI approach. One robust algorithm that can successfully cope with the individual differences in MI-related rhythmic patterns is to create diverse ensemble classifiers using the subband common spatial pattern (SBCSP) method. To aggregate outputs of ensemble members, this study uses fuzzy integral with particle swarm optimization (PSO), which can regulate subject-specific parameters for the assignment of optimal confidence levels for classifiers. The proposed system combining SBCSP, fuzzy integral, and PSO exhibits robust performance for offline single-trial classification of MI and real-time control of a robotic arm using MI. This paper represents the first attempt to utilize fuzzy fusion technique to attack the individual differences problem of MI applications in real-world noisy environments. The results of this study demonstrate the practical feasibility of implementing the proposed method for real-world applications

Single channel wireless EEG device for real-time fatigue level detection

© 2015 IEEE. Driver fatigue problem is one of the important factors of traffic accidents. Recent years, many research had investigated that using EEG signals can effectively detect driver's drowsiness level. However, real-time monitoring system is required to apply these fatigue level detection techniques in the practical application, especially in the real-road driving. Therefore, it required less channels, portable and wireless, real-time monitoring and processing techniques for developing the real-time monitoring system. In this study, we develop a single channel wireless EEG device which can real-time detect driver's fatigue level on the mobile device such as smart phone or tablet. The developed device is investigated to obtain a better and precise understanding of brain activities of mental fatigue under driving, which is of great benefit for devolvement of detection of driving fatigue system. This system consists of a Bluetooth-enabled one channel EEG, a regression model, and smartphone, which was a platform recording and transforming the raw EEG data to useful driving status. In the experiment, this was a sustained-attention driving task to implement in a virtual-reality (VR) driving simulator. To training model and develop the system, we were performed for 15 subjects to study Electroencephalography (EEG) brain dynamics by using a mobile and wireless EEG device. Based on the outstanding training results, the leave-one-subject-out cross validation test obtained 90% fatigue detection accuracy. These results indicate that the combination of a smartphone and wireless EEG device constitutes an effective and easy wearable solution for detecting and preventing driver fatigue in real driving environments

Neuroendocrine (Merkel cell) carcinoma of the retroperitoneum with no identifiable primary site

<p>Abstract</p> <p>Background</p> <p>Neuroendocrine carcinoma is an aggressive neoplasm that mainly affects elderly Caucasians and typically arises in sun-exposed areas of the skin. The disease is rather rare and only a relatively few cases present with no apparent primary lesion.</p> <p>Case presentation</p> <p>We report a case of an 81-year-old Caucasian male with neuroendocrine carcinoma, which initially presented as a large retroperitoneal mass. Pathological and immunohistochemical analysis of the transabdominal CT-guided biopsy specimen revealed tissue consistent with neuroendocrine carcinoma. The patient underwent exploratory laparotomy and the mass was successfully excised along with an associated mesenteric lymph node.</p> <p>Discussion</p> <p>There are currently two possible explanations for what occurred in our patient. First, the retroperitoneal mass could be a massively enlarged lymph node where precursor cells became neoplastic. This would be consistent with a presumptive diagnosis of primary nodal disease. Alternatively, an initial skin lesion could have spontaneously regressed and the retroperitoneal mass represents a single site of metastasis. Since Merkel cell precursors have never been identified within lymph nodes, the latter theory seems more befitting. Moreover, metastasis to the retroperitoneal lymph nodes has been reported as relatively common when compared to other sites such as liver, bone, brain and skin.</p> <p>Conclusion</p> <p>Wide local excision of the primary tumor is the surgical treatment of choice for localized disease. We propose that further studies are needed to elucidate the true efficacy of chemotherapy in conventional as well as unconventional patients with neuroendocrine carcinoma.</p

More than a piece of cake:Noun classifier processing in primary progressive aphasia

INTRODUCTION: Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown. METHODS: We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier. RESULTS: Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices. DISCUSSION: This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers. Highlights: Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.</p

Cancer risk in hospitalised psoriasis patients: a follow-up study in Sweden

We examined overall and specific cancer risks among Swedish subjects who had been hospitalised one or more times for psoriasis. A database was created by identifying such patients from the Swedish Hospital Discharge Register and linking them with the Cancer Registry. Follow-up of patients was carried out from the last hospitalisation through 2004. A total of 15 858 patients were hospitalised for psoriasis during 1965–2004, of whom 1408 developed cancer, giving an overall standardised incidence ratios (SIRs) of 1.33. A significant excess was noted for squamous cell skin cancer, and for cancers of the upper aerodigestive tract, oesophagus, stomach, liver, pancreas, lung, kidney and bladder as well as non-Hodgkin lymphoma. Many of these may reflect the effects of alcohol drinking and tobacco smoking. Patients with multiple hospitalisations showed high risk, particularly for oesophageal (SIR 6.97) and skin (SIR 4.76) cancers

Bullous pemphigoid and comorbidities: a case-control study in Portuguese patients

BACKGROUND: Although rare, bullous pemphigoid (BP) is the most common autoimmune blistering disease. Recent studies have shown that patients with bullous pemphigoid are more likely to have neurological and psychiatric diseases, particularly prior to the diagnosis of bullous pemphigoid. OBJECTIVE: The aims were: (i) to evaluate the demographic and clinical features of bullous pemphigoid from a database of patients at a Portuguese university hospital and (ii) to compare the prevalence of comorbid conditions before the diagnosis of bullous pemphigoid with a control group. METHODS: Seventy-seven patients with bullous pemphigoid were enrolled in the study. They were compared with 176 age- and gender-matched controls, which also had the same inpatient to outpatient ratio, but no history of bullous or cutaneous malignant disease. Univariate and multivariate analyses were used to calculate odds ratios for specific comorbid diseases. RESULTS: At least one neurologic diagnosis was present in 55.8% of BP patients compared with 20.5% controls (p<0.001). Comparing cases to controls, stroke was seen in 35.1 vs. 6.8%, OR 8.10 (3.80-17.25); dementia in 37.7 vs. 11.9%, OR 5.25 (2.71-10.16); and Parkinson's disease in 5.2 vs. 1.1%, OR 4.91 (0.88-27.44). Using multivariate analysis, all diseases except Parkinson's retained their association with BP. Patients under systemic treatment were eight times more likely to have complications than those treated with topical steroids (p< 0.017). CONCLUSIONS: The results of this study substantiate the association between BP and neurological diseases. In addition, they highlight the potential complications associated with the treatment of BP