Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation

Transcutaneous spinal cord stimulation (TSCS) has demonstrated potential to beneficially modulate spinal cord motor and autonomic circuitry. We are interested in pairing cervical TSCS with other forms of nervous system stimulation to enhance synaptic plasticity in circuits serving hand function. We use a novel configuration for cervical TSCS in which the anode is placed anteriorly over ~C4–C5 and the cathode posteriorly over ~T2–T4. We measured the effects of single pulses of TSCS paired with single pulses of motor cortex or median nerve stimulation timed to arrive at the cervical spinal cord at varying intervals. In 13 participants with and 15 participants without chronic cervical spinal cord injury, we observed that subthreshold TSCS facilitates hand muscle responses to motor cortex stimulation, with a tendency toward greater facilitation when TSCS is timed to arrive at cervical synapses simultaneously or up to 10 milliseconds after cortical stimulus arrival. Single pulses of subthreshold TSCS had no effect on the amplitudes of median H-reflex responses or F-wave responses. These findings support a model in which TSCS paired with appropriately timed cortical stimulation has the potential to facilitate convergent transmission between descending motor circuits, segmental afferents, and spinal motor neurons serving the hand. Studies with larger numbers of participants and repetitively paired cortical and spinal stimulation are needed

The “Coherent Data Set”: Combining Patient Data and Imaging in a Comprehensive, Synthetic Health Record

The “Coherent Data Set” is a novel synthetic data set that leverages structured data from Synthea™ to create a longitudinal, “coherent” patient-level electronic health record (EHR). Comprised of synthetic patients, the Coherent Data Set is publicly available, reproducible using Synthea™, and free of the privacy risks that arise from using real patient data. The Coherent Data Set provides complex and representative health records that can be leveraged by health IT professionals without the risks associated with de-identified patient data. It includes familial genomes that were created through a simulation of the genetic reproduction process; magnetic resonance imaging (MRI) DICOM files created with a voxel-based computational model; clinical notes in the style of traditional subjective, objective, assessment, and plan notes; and physiological data that leverage existing System Biology Markup Language (SBML) models to capture non-linear changes in patient health metrics. HL7 Fast Healthcare Interoperability Resources (FHIR®) links the data together. The models can generate clinically logical health data, but ensuring clinical validity remains a challenge without comparable data to substantiate results. We believe this data set is the first of its kind and a novel contribution to practical health interoperability efforts

Risk of death in crashes on Ontario’s highways

<p>Abstract</p> <p>Background</p> <p>Motor vehicle collisions (MVCs) that result in one or more fatalities on the 400-series Highways represent a serious public health problem in Ontario, and were estimated to have cost $11 billion in 2004. To date, no studies have examined risk factors for fatal MVCs on Ontario’s 400 series highways.</p> <p>The investigate how demographic and environmental risk factors are associated with fatal MVCs on Ontario’s 400-Series Highways.</p> <p>Methods</p> <p>Data were provided from the Ontario Ministry of Transport database, and included driver demographics, vehicle information, environmental descriptors, structural descriptors, as well as collision information (date and time), and severity of the collision. Multivariate analysis was used to identify factors significantly associated with the odds of dying in a collision.</p> <p>Results</p> <p>There were 53,526 vehicles involved in collisions from 2001 to 2006 included in our analysis. Results from the multivariate analysis suggest that collisions with older age and male drivers were associated with an increased risk of involving a fatality. Highway 405 and an undivided 2-way design proved to be the most fatal structural configurations. Collisions in the summer, Fridays, between 12 am-4 am, and in drifting snow conditions during the wintertime were also shown to have a significantly increased risk of fatality.</p> <p>Conclusion</p> <p>Our results suggest that interventions to reduce deaths as a result of MVCs should focus on both driver-related and road-related modifications.</p

Common variants at five new loci associated with early-onset inflammatory bowel disease.

The inflammatory bowel diseases (IBD) Crohn's disease and ulcerative colitis are common causes of morbidity in children and young adults in the western world. Here we report the results of a genome-wide association study in early-onset IBD involving 3,426 affected individuals and 11,963 genetically matched controls recruited through international collaborations in Europe and North America, thereby extending the results from a previous study of 1,011 individuals with early-onset IBD. We have identified five new regions associated with early-onset IBD susceptibility, including 16p11 near the cytokine gene IL27 (rs8049439, P = 2.41 x 10(-9)), 22q12 (rs2412973, P = 1.55 x 10(-9)), 10q22 (rs1250550, P = 5.63 x 10(-9)), 2q37 (rs4676410, P = 3.64 x 10(-8)) and 19q13.11 (rs10500264, P = 4.26 x 10(-10)). Our scan also detected associations at 23 of 32 loci previously implicated in adult-onset Crohn's disease and at 8 of 17 loci implicated in adult-onset ulcerative colitis, highlighting the close pathogenetic relationship between early- and adult-onset IBD.Journal ArticleResearch Support, N.I.H. ExtramuralResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe