The supreme turbinate and the drainage of the posterior ethmoids: a computed tomographic study

Background: It is generally acknowledged that the posterior ethmoidal cells drain under the superior nasal turbinate (SorNT) or, rarely, under the supreme nasal turbinate (SmeNT), and the sphenoid ostium (SO) opens to the sphenoethmoidal recess. However, detailed relations between these structures are variable, complex and still not clear. There is no reliable data on the prevalence of SmeNT and drainage of the posterior ethmoidal cells under this structure. The aim of this study was to re-evaluate the anatomy of the aforementioned region. Materials and methods: Multiplanar and three-dimensional reconstruction analysis of 100 thin slice paranasal sinus computed tomography scans. Results: SmeNT was identified in 77 subjects (136 sides). It formed the ostium to the posterior ethmoidal cell adjacent to the skull base or orbit in 58 subjects (91 sides). This cell drained independently from the remaining posterior ethmoidal cells. The sphenoethmoidal (Onodi) cell drained to supreme meatus in 41 subjects (54 sides), and to superior meatus in 37 subjects (49 sides). SO was always located medial to the posteroinferior attachment of SmeNT, or SorNT (in absence of SmeNT). Conclusions: Patients with divergent drainage of the posterior ethmoids (with posterior ethmoidal cell draining to the supreme meatus) may require more extensive surgery to avoid persistence or recurrence of inflammatory disease. SmeNT is more common than thought, but due to its posterior and superior location to SorNT, it is rarely seen intraoperatively. If SmeNT is present, SO is always located medial to its posteroinferior attachment. (Folia Morphol 2018; 77, 1: 110–115

Training Forgetting of Negative Material in Depression

In this study, the authors investigated whether training participants to use cognitive strategies can aid forgetting in depression. Participants diagnosed with major depressive disorder (MDD) and never-depressed participants learned to associate neutral cue words with a positive or negative target word and were then instructed not to think about the negative targets when shown their cues. The authors compared 3 different conditions: an unaided condition, a positive-substitute condition, and a negative-substitute condition. In the substitute conditions, participants were instructed to use new targets to keep from thinking about the original targets. After the training phase, participants were instructed to recall all targets when presented with the cues. MDD participants, in contrast with control participants, did not exhibit forgetting of negative words in the unaided condition. In both the negative and positive substitute conditions, however, MDD participants showed successful forgetting of negative words and a clear practice effect. In contrast, negative substitute words did not aid forgetting by the control participants. These findings suggest that training depressed individuals to use cognitive strategies can increase forgetting of negative words

BDNF Genotype Modulates Resting Functional Connectivity in Children

A specific polymorphism of the brain-derived neurotrophic factor (BDNF) gene is associated with alterations in brain anatomy and memory; its relevance to the functional connectivity of brain networks, however, is unclear. Given that altered hippocampal function and structure has been found in adults who carry the methionine (met) allele of the BDNF gene and the molecular studies elucidating the role of BDNF in neurogenesis and synapse formation, we examined the association between BDNF gene variants and neural resting connectivity in children and adolescents. We observed a reduction in hippocampal and parahippocampal to cortical connectivity in met-allele carriers within both default-mode and executive networks. In contrast, we observed increased connectivity to amygdala, insula and striatal regions in met-carriers, within the paralimbic network. Because of the known association between the BDNF gene and neuropsychiatric disorder, this latter finding of greater connectivity in circuits important for emotion processing may indicate a new neural mechanism through which these gene-related psychiatric differences are manifest. Here we show that the BDNF gene, known to regulate synaptic plasticity and connectivity in the brain, affects functional connectivity at the neural systems level. In addition, we demonstrate that the spatial topography of multiple high-level resting state networks in healthy children and adolescents is similar to that observed in adults

Validation of polish version of the Basel extent of rationing of nursing care revised questionnaire

Development of simple, valid and reliable instruments to determine nursing care rationing is a subject of ongoing research. One such instrument, which is gaining popularity worldwide and has significant research applicability, is the Basel Extent of Rationing of Nursing Care (BERNCA) and its revised version, the BERNCA-R. The aim of this study was to translate and adapt the BERNCA-R into a Polish-language version and to assess its reliability and validity in evaluating the level of implicit rationing of nursing care in Poland. Standard methodological requirements were followed during translation and cultural adaptation of the English version of the BERNCA-R questionnaire into Polish. The cross-sectional validation study was conducted between May and September 2017, which included 175 nurses undergoing specialisation and qualification courses at the European Postgraduate Education Centre in Wrocław, Poland. Cronbach’s alpha and inter-item correlations were used to analyse the internal consistency of the Polish BERNCA-R questionnaire. The mean total BERNCA-R score was 1.9 points (SD = 0.74) on a scale of 0-4. Cronbach’s alpha for the unidimensional scale was 0.96. The mean inter-item correlation was 0.4 (range 0.1-0.84), which indicates high internal consistency. A single-factor solution demonstrated stable loadings above 0.5 for almost all items of the Polish BERNCA-R questionnaire. The study using the Polish BERNCA-R questionnaire demonstrated that the instrument is valid and reliable for use in investigating care rationing in groups of Polish nurses

Viscoelastic response of contractile filament bundles

The actin cytoskeleton of adherent tissue cells often condenses into filament bundles contracted by myosin motors, so-called stress fibers, which play a crucial role in the mechanical interaction of cells with their environment. Stress fibers are usually attached to their environment at the endpoints, but possibly also along their whole length. We introduce a theoretical model for such contractile filament bundles which combines passive viscoelasticity with active contractility. The model equations are solved analytically for two different types of boundary conditions. A free boundary corresponds to stress fiber contraction dynamics after laser surgery and results in good agreement with experimental data. Imposing cyclic varying boundary forces allows us to calculate the complex modulus of a single stress fiber.Comment: Revtex with 24 pages, 7 Postscript figures included, accepted for publication in Phys. Rev.

COMPARISON OF FOUR-AND FIVE-OPTION MULTIPLE-CHOICE QUESTIONS IN NURSING ENTRANCE TESTS

Abstract Introduction: Most multiple-choice tests comprise questions with four options per item. However, a number of academic teachers believe that a larger number of options per question shall increase the scope of variability of test results. An increase in discrimination capability is particularly important with reference to selective examinations. In 2011 and 2013, Nursing Entrance Test at Medical University of Warsaw (MUW) comprised 5-option items tests, which was an exception from 4-option items tests used in 2009-2010 and 2012. Aim of study: Assessment of the impact of change of the number of options in multiple-choice questions (MCQs) on the quality of Nursing Entrance Exams for an MA programme at MUW between 2009-2013. Materials and Methods: A total of 250 multiple-choice exam questions, including 150 four-option items (2009-2010 and 2012) and 100 five-option items (2011 and 2013). In order to compare the quality of particular exams, the level of easiness, substitute differentiation power, and Pearson's linear correlation coefficient were established for each pool of questions. The comparison comprised the scope of variability of the results (coefficient of variation, scope of results, and quartile range) as well as the average easiness and capacity of differentiating particular questions in consecutive versions of the exam. A one-way analysis of ANOVA variance and post-hoc RIR Tukey honestly significant difference test were used. Results: In 2011 and 2013, when the 5-option items tests were introduced, the difficulty of the exam expressed as the mean score amounted to 24.3 and 25.7 points, respectively. These values are comparable to the results achieved in 2010 (25.6), but they are clearly different from those obtained in 2009 (30.2) and 2012 (31.5). Similar differences were observed in comparison of coefficients of variation that were similar in 2010, 2011, and 2013 (17.1, 17.9 and 18.4%, respectively) and significantly different from those obtained in 2009 and 2012 (14.3 and 14.1%, respectively). Moreover, a greater symmetry (skewness ≈ 0) in frequency distribution of test scores was observed in the case of 5-option items tests compared to 4-option items tests. The reliability of the exam was variable, Cronbach's α coefficient ranged between 0.429 and 0.559. No statistically significant differences were found in discrimination capability of the exams performed in the form of 4-or 5-option items tests (ANOVA test, P> 0.05). It was also demonstrated that the 2011 exam (5 options) was significantly more difficult than that of 2012 (4 options) (ANOVA test (P = 0.0025) and post-hoc RIR Tukey honestly significant difference test (P< 0.01)). Conclusions: The introduction of an additional option item to the test questions did not significantly improve the qualitative parameters of the Nursing Entrance Exams at MUW. Significant increase in selective capacity of the exam and reliability of assessment was not observed. It is recommended to use 4-option items tests and to develop a good test content outline for future editions of the exam

COMPARISON OF FOUR-AND FIVE-OPTION MULTIPLE-CHOICE QUESTIONS IN NURSING ENTRANCE TESTS

Abstract Introduction: Most multiple-choice tests comprise questions with four options per item. However, a number of academic teachers believe that a larger number of options per question shall increase the scope of variability of test results. An increase in discrimination capability is particularly important with reference to selective examinations. In 2011 and 2013, Nursing Entrance Test at Medical University of Warsaw (MUW) comprised 5-option items tests, which was an exception from 4-option items tests used in 2009-2010 and 2012. Aim of study: Assessment of the impact of change of the number of options in multiple-choice questions (MCQs) on the quality of Nursing Entrance Exams for an MA programme at MUW between 2009-2013. Materials and Methods: A total of 250 multiple-choice exam questions, including 150 four-option items (2009-2010 and 2012) and 100 five-option items (2011 and 2013). In order to compare the quality of particular exams, the level of easiness, substitute differentiation power, and Pearson's linear correlation coefficient were established for each pool of questions. The comparison comprised the scope of variability of the results (coefficient of variation, scope of results, and quartile range) as well as the average easiness and capacity of differentiating particular questions in consecutive versions of the exam. A one-way analysis of ANOVA variance and post-hoc RIR Tukey honestly significant difference test were used. Results: In 2011 and 2013, when the 5-option items tests were introduced, the difficulty of the exam expressed as the mean score amounted to 24.3 and 25.7 points, respectively. These values are comparable to the results achieved in 2010 (25.6), but they are clearly different from those obtained in 2009 (30.2) and 2012 (31.5). Similar differences were observed in comparison of coefficients of variation that were similar in 2010, 2011, and 2013 (17.1, 17.9 and 18.4%, respectively) and significantly different from those obtained in 2009 and 2012 (14.3 and 14.1%, respectively). Moreover, a greater symmetry (skewness ≈ 0) in frequency distribution of test scores was observed in the case of 5-option items tests compared to 4-option items tests. The reliability of the exam was variable, Cronbach's α coefficient ranged between 0.429 and 0.559. No statistically significant differences were found in discrimination capability of the exams performed in the form of 4-or 5-option items tests (ANOVA test, P> 0.05). It was also demonstrated that the 2011 exam (5 options) was significantly more difficult than that of 2012 (4 options) (ANOVA test (P = 0.0025) and post-hoc RIR Tukey honestly significant difference test (P< 0.01)). Conclusions: The introduction of an additional option item to the test questions did not significantly improve the qualitative parameters of the Nursing Entrance Exams at MUW. Significant increase in selective capacity of the exam and reliability of assessment was not observed. It is recommended to use 4-option items tests and to develop a good test content outline for future editions of the exam

Structural abnormality of the corticospinal tract in major depressive disorder

BACKGROUND: Scientists are beginning to document abnormalities in white matter connectivity in major depressive disorder (MDD). Recent developments in diffusion-weighted image analyses, including tractography clustering methods, may yield improved characterization of these white matter abnormalities in MDD. In this study, we acquired diffusion-weighted imaging data from MDD participants and matched healthy controls. We analyzed these data using two tractography clustering methods: automated fiber quantification (AFQ) and the maximum density path (MDP) procedure. We used AFQ to compare fractional anisotropy (FA; an index of water diffusion) in these two groups across major white matter tracts. Subsequently, we used the MDP procedure to compare FA differences in fiber paths related to the abnormalities in major fiber tracts that were identified using AFQ. RESULTS: FA was higher in the bilateral corticospinal tracts (CSTs) in MDD (p’s < 0.002). Secondary analyses using the MDP procedure detected primarily increases in FA in the CST-related fiber paths of the bilateral posterior limbs of the internal capsule, right superior corona radiata, and the left external capsule. CONCLUSIONS: This is the first study to implicate the CST and several related fiber pathways in MDD. These findings suggest important new hypotheses regarding the role of CST abnormalities in MDD, including in relation to explicating CST-related abnormalities to depressive symptoms and RDoC domains and constructs