Preserved decision making ability in early multiple sclerosis

Background : The purpose of this study was to assess decision making in patients with multiple sclerosis (MS) at the earliest clinically detectable time point of the disease. Methods : Patients with definite MS (n = 109) or with clinically isolated syndrome (CIS, n = 56), a disease duration of 3 months to 5 years, and no or only minor neurological impairment (Expanded Disability Status Scale [EDSS] score 0-2.5) were compared to 50 healthy controls using the Iowa Gambling Task (IGT). Results : The performance of definite MS, CIS patients, and controls was comparable for the two main outcomes of the IGT (learning index: p = 0.7; total score: p = 0.6). The IGT learning index was influenced by the educational level and the co-occurrence of minor depression. CIS and MS patients developing a relapse during an observation period of 15 months dated from IGT testing demonstrated a lower learning index in the IGT than patients who had no exacerbation (p = 0.02). When controlling for age, gender and education, the difference between relapsing and non-relapsing patients was at the limit of significance (p = 0.06). Conclusion : Decision making in a task mimicking real life decisions is generally preserved in early MS patients as compared to controls. A possible consequence of MS relapsing activity in the impairment of decision making ability is also suspected in the early phase of M

Applicability of an orthogonal cutting slip-line field model for the microscale

Mechanical micromachining is a very flexible and widely exploited process, but its knowledge should still be improved since several incompletely explained phenomena affect the microscale chip removal. Several models have been developed to describe the machining process, but only some of them consider a rounded edge tool, which is a typical condition in micromachining. Among these models, the Waldorf’s slip-line field model for the macroscale allows to separately evaluate shearing and ploughing force components in orthogonal cutting conditions; therefore, it is suitable to predict cutting forces when a large ploughing action occurs, as in micromachining. This study aims at demonstrating how this model is suitable also for micromachining conditions. To achieve this goal, a clear and repeatable procedure has been developed for objectively validating its force prediction performance at low uncut chip thickness (less than 50 mm) and relatively higher cutting edge radius. The proposed procedure makes the model generally applicable after a suitable and nonextensive calibration campaign. This article shows how calibration experiments can be selected among the available cutting trial database based on the model force prediction capability. Final validation experiments have been used to show how the model is robust to a cutting speed variation even if the cutting speed is not among the model quantities. A suitable set-up, especially designed for microturning conditions, has been used to measure forces and chip thickness. Tests have been performed on 6082-T6 Aluminum alloy with different cutting speeds and different ratios between uncut chip thickness and cutting edge radius

Dorsolateral Prefrontal Transcranial Direct Current Stimulation Modulates Language Processing but Does Not Facilitate Overt Second Language Word Production.

Word retrieval in bilingual speakers partly depends on executive control systems in the left prefrontal cortex - including dorsolateral prefrontal cortex (DLPFC). We tested the hypothesis that DLPFC modulates word production of words specifically in a second language (L2) by measuring the effects of anodal transcranial direct current stimulation (anodal-tDCS) over the DLPFC on picture naming and word translation and on event-related potentials (ERPs) and their sources. Twenty-six bilingual participants with "unbalanced" proficiency in two languages were given 20 min of 1.5 mA anodal or sham tDCS (double-blind stimulation design, counterbalanced stimulation order, 1-week intersession delay). The participants then performed the following tasks: verbal and non-verbal fluency during anodal-tDCS stimulation and first and second language (L1 and L2) picture naming and translation [forward (L1 → L2) and backward (L2 → L1)] immediately after stimulation. The electroencephalogram (EEG) was recorded during picture naming and translation. On the behavioral level, anodal-tDCS had an influence on non-verbal fluency but neither on verbal fluency, nor on picture naming and translation. EEG measures revealed significant interactions between Language and Stimulation on picture naming around 380 ms post-stimulus onset and Translation direction and Stimulation on translation around 530 ms post-stimulus onset. These effects suggest that L2 phonological retrieval and phoneme encoding are spatially and temporally segregated in the brain. We conclude that anodal-tDCS stimulation has an effect at a neural level on phonological processes and, critically, that DLPFC-mediated activation is a constraint on language production specifically in L2

A pure case of Gerstmann syndrome with a subangular lesion

The four symptoms composing Gerstmann's syndrome were postulated to result from a common cognitive denominator (Grundstörung) by Gerstmann himself. He suggested that it is a disorder of the body schema restricted to the hand and fingers. The existence of a Grundstörung has since been contested. Here we suggest that a common psychoneurological factor does exist, but should be related to transformations of mental images rather than to the body schema. A patient (H.P.) was studied, who presented the four symptoms of Gerstmann's syndrome in the absence of any other neuropsychological disorders. MRI showed a focal ischaemic lesion, situated subcortically in the inferior part of the left angular gyrus and reaching the superior posterior region of T1. The cortical layers were spared and the lesion was seen to extend to the callosal fibres. On the basis of an extensive cognitive investigation, language, praxis, memory and intelligence disorders were excluded. The four remaining symptoms (finger agnosia, agraphia, right-left disorientation and dyscalculia) were investigated thoroughly with the aim of determining any characteristics that they might share. Detailed analyses of the tetrad showed that the impairment was consistently attributable to disorders of a spatial nature. Furthermore, cognitive tests necessitating mental rotation were equally shown to be impaired, confirming the essentially visuospatial origin of the disturbance. In the light of this report, the common cognitive denominator is hypothesized to be an impairment in mental manipulation of images and not in body schem

Frequency, characterisation and therapies of fatigue after stroke.

Post-stroke objective or subjective fatigue occurs in around 50% of patients and is frequent (30%) even after minor strokes. It can last more than one year after the event, and is characterised by a different quality from usual fatigue and good response to rest. Associated risk factors include age, single patients, female, disability, depression, attentional impairment and sometimes posterior strokes, but also inactivity, overweight, alcohol and sleep apnoea syndrome. There are few therapy studies, but treatment may include low-intensity training, cognitive therapy, treatment of associated depression, wakefulness-promoting agents like modafinil, correction of risk factors and adaptation of activities

A new neuropsychological instrument measuring effects of age and drugs on fitness to drive: development, reliability, and validity of MedDrive

Background: Current guidelines underline the limitations of existing instruments to assess fitness to drive and the poor adaptability of batteries of neuropsychological tests in primary care settings. Aims: To provide a free, reliable, transparent computer based instrument capable of detecting effects of age or drugs on visual processing and cognitive functions. Methods: Relying on systematic reviews of neuropsychological tests and driving performances, we conceived four new computed tasks measuring: visual processing (Task1), movement attention shift (Task2), executive response, alerting and orientation gain (Task3), and spatial memory (Task4). We then planned five studies to test MedDrive's reliability and validity. Study-1 defined instructions and learning functions collecting data from 105 senior drivers attending an automobile club course. Study-2 assessed concurrent validity for detecting minor cognitive impairment (MCI) against useful field of view (UFOV) on 120 new senior drivers. Study-3 collected data from 200 healthy drivers aged 20-90 to model age related normal cognitive decline. Study-4 measured MedDrive's reliability having 21 healthy volunteers repeat tests five times. Study-5 tested MedDrive's responsiveness to alcohol in a randomised, double-blinded, placebo, crossover, dose-response validation trial including 20 young healthy volunteers. Results: Instructions were well understood and accepted by all senior drivers. Measures of visual processing (Task1) showed better performances than the UFOV in detecting MCI (ROC 0.770 vs. 0.620; p=0.048). MedDrive was capable of explaining 43.4% of changes occurring with natural cognitive decline. In young healthy drivers, learning effects became negligible from the third session onwards for all tasks except for dual tasking (ICC=0.769). All measures except alerting and orientation gain were affected by blood alcohol concentrations. Finally, MedDrive was able to explain 29.3% of potential causes of swerving on the driving simulator. Discussion and conclusions: MedDrive reveals improved performances compared to existing computed neuropsychological tasks. It shows promising results both for clinical and research purposes

Machine Learning in Clinical Psychology and Psychotherapy Education: A Mixed Methods Pilot Survey of Postgraduate Students at a Swiss University

Background: There is increasing use of psychotherapy apps in mental health care.Objective: This mixed methods pilot study aimed to explore postgraduate clinical psychology students' familiarity and formal exposure to topics related to artificial intelligence and machine learning (AI/ML) during their studies.Methods: In April-June 2020, we conducted a mixed-methods online survey using a convenience sample of 120 clinical psychology students enrolled in a two-year Masters' program at a Swiss University.Results: In total 37 students responded (response rate: 37/120, 31%). Among respondents, 73% (n = 27) intended to enter a mental health profession, and 97% reported that they had heard of the term “machine learning.” Students estimated 0.52% of their program would be spent on AI/ML education. Around half (46%) reported that they intended to learn about AI/ML as it pertained to mental health care. On 5-point Likert scale, students “moderately agreed” (median = 4) that AI/M should be part of clinical psychology/psychotherapy education. Qualitative analysis of students' comments resulted in four major themes on the impact of AI/ML on mental healthcare: (1) Changes in the quality and understanding of psychotherapy care; (2) Impact on patient-therapist interactions; (3) Impact on the psychotherapy profession; (4) Data management and ethical issues.Conclusions: This pilot study found that postgraduate clinical psychology students held a wide range of opinions but had limited formal education on how AI/ML-enabled tools might impact psychotherapy. The survey raises questions about how curricula could be enhanced to educate clinical psychology/psychotherapy trainees about the scope of AI/ML in mental healthcare.</jats:p

The aerodynamics of the curled wake: a simplified model in view of flow control

When a wind turbine is yawed, the shape of the wake changes and a curled wake profile is generated. The curled wake has drawn a lot of interest because of its aerodynamic complexity and applicability to wind farm controls. The main mechanism for the creation of the curled wake has been identified in the literature as a collection of vortices that are shed from the rotor plane when the turbine is yawed. This work extends that idea by using aerodynamic concepts to develop a control-oriented model for the curled wake based on approximations to the Navier–Stokes equations. The model is tested and compared to time-averaged results from large-eddy simulations using actuator disk and line models. The model is able to capture the curling mechanism for a turbine under uniform inflow and in the case of a neutral atmospheric boundary layer. The model is then incorporated to the FLOw Redirection and Induction in Steady State (FLORIS) framework and provides good agreement with power predictions for cases with two and three turbines in a row.</p

Language Control and Lexical Competition in Bilinguals: An Event-Related fMRI Study

Language selection (or control) refers to the cognitive mechanism that controls which language to use at a given moment and context. It allows bilinguals to selectively communicate in one target language while minimizing the interferences from the nontarget language. Previous studies have suggested the participation in language control of different brain areas. However, the question remains whether the selection of one language among others relies on a language-specific neural module or general executive regions that also allow switching between different competing behavioral responses including the switching between various linguistic registers. In this functional magnetic resonance imaging study, we investigated the neural correlates of language selection processes in German-French bilingual subjects during picture naming in different monolingual and bilingual selection contexts. We show that naming in the first language in the bilingual context (compared with monolingual contexts) increased activation in the left caudate and anterior cingulate cortex. Furthermore, the activation of these areas is even more extended when the subjects are using a second weaker language. These findings show that language control processes engaged in contexts during which both languages must remain active recruit the left caudate and the anterior cingulate cortex (ACC) in a manner that can be distinguished from areas engaged in intralanguage task switchin