Intracranial Suppurative Complications of Sinusitis

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MRI-validation of SEP monitoring for ischemic events during microsurgical clipping of intracranial aneurysms

OBJECTIVE: During surgical clipping of intracranial aneurysms, reduction in SEP amplitude is thought to indicate cortical ischemia and subsequent neurological deficits. Since the sensitivity of SEP is questioned, we investigated SEP with respect to post-operative ischemia. METHODS: In 36 patients with 51 intracranial aneurysms, clinical evaluation and diffusion-weighted MRI (DWI) was performed before and within 24h after surgery. During surgery, time of temporary occlusion was recorded. MRI images were reviewed for signs of ischemia. RESULTS: For 43 clip applications (84%), we observed neither pathologic SEP events nor ischemia in MRI. In two cases where reduction lasted >10 min after clip release, SEP events correlated with ischemia in the MRI. Only one of the ischemic patients was symptomatic and developed a transient hemiparesis. CONCLUSIONS: While pathologic SEP events correlated with visible ischemia in MRI only in two cases with late SEP recovery, ischemia in MRI may have been transient or may not have reached detection threshold in the other cases, in agreement with the absence of permanent neurological deficits. SIGNIFICANCE: In complex aneurysm cases, where prolonged temporary occlusion is expected, SEP should be used to detect ischemia at a reversible stage to improve the safety of aneurysm clipping. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved

Finnish Multi-Story Timber-Framed Apartment Buildings: Tampere Residents’ Perspectives

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The Fine Line Between Persuasion and Digital Addiction

Digital addiction is becoming a prevalent societal concern and persuasive design techniques used in digital platforms might be accountable also for the development and maintenance of such problematic behavior. This paper theoretically analyses the relationship between persuasive system design principles and digital addiction in light of theories on behavioral and substance-based addictions. The findings suggest that some of the persuasive design principles, in specific contexts, may trigger and expedite digital addiction. The purpose of this paper is to open a discussion around the potential effects of persuasive technology on digital addiction and cater to this risk in the design processes and the persuasive design itself

A Planet at 5 AU Around 55 Cancri

We report precise Doppler shift measurements of 55 Cancri (G8V) obtained from 1989 to 2002 at Lick Observatory. The velocities reveal evidence for an outer planetary companion to 55 Cancri orbiting at 5.5 AU. The velocities also confirm a second, inner planet at 0.11 AU. The outer planet is the first extrasolar planet found that orbits near or beyond the orbit of Jupiter. It was drawn from a sample of ~50 stars observed with sufficient duration and quality to detect a giant planet at 5 AU, implying that such planets are not rare. The properties of this jupiter analog may be compared directly to those of the Jovian planets in our Solar System. Its eccentricity is modest, e=0.16, compared with e=0.05 for both Jupiter and Saturn. Its mass is at least 4.0 jupiter masses (M sin i). The two planets do not perturb each other significantly. Moreover, a third planet of sub-Jupiter mass could easily survive in between these two known planets. Indeed a third periodicity remains in the velocity measurements with P = 44.3 d and a semi-amplitude of 13 m/s. This periodicity is caused either by a third planet at a=0.24 AU or by inhomogeneities on the stellar surface that rotates with period 42 d. The planet interpretation is more likely, as the stellar surface is quiet, exhibiting log(R'_{HK}) = -5.0 and brightness variations less than 1 millimag, and any hypothetical surface inhomogeneity would have to persist in longitude for 14 yr. Even with all three planets, an additional planet of terrestrial--mass could orbit stably at ~1 AU. The star 55 Cancri is apparently a normal, middle-aged main sequence star with a mass of 0.95 solar masses, rich in heavy elements ([Fe/H] = +0.27). This high metallicity raises the issue of the relationship between its age, rotation, and chromosphere.Comment: 47 pages, 4 tables, 12 figures, uses AASTE

Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study

Recent studies suggest that delirium is associated with risk of dementia and also acceleration of decline in existing dementia. However, previous studies may have been confounded by incomplete ascertainment of cognitive status at baseline. Herein, we used a true population sample to determine if delirium is a risk factor for incident dementia and cognitive decline. We also examined the effect of delirium at the pathological level by determining associations between dementia and neuropathological markers of dementia in patients with and without a history of delirium. The Vantaa 85+ study examined 553 individuals (92% of those eligible) aged ≥85 years at baseline, 3, 5, 8 and 10 years. Brain autopsy was performed in 52%. Fixed and random-effects regression models were used to assess associations between (i) delirium and incident dementia and (ii) decline in Mini-Mental State Examination scores in the whole group. The relationship between dementia and common neuropathological markers (Alzheimer-type, infarcts and Lewy-body) was modelled, stratified by history of delirium. Delirium increased the risk of incident dementia (odds ratio 8.7, 95% confidence interval 2.1-35). Delirium was also associated with worsening dementia severity (odds ratio 3.1, 95% confidence interval 1.5-6.3) as well as deterioration in global function score (odds ratio 2.8, 95% confidence interval 1.4-5.5). In the whole study population, delirium was associated with loss of 1.0 more Mini-Mental State Examination points per year (95% confidence interval 0.11-1.89) than those with no history of delirium. In individuals with dementia and no history of delirium (n = 232), all pathologies were significantly associated with dementia. However, in individuals with delirium and dementia (n = 58), no relationship between dementia and these markers was found. For example, higher Braak stage was associated with dementia when no history of delirium (odds ratio 2.0, 95% confidence interval 1.1-3.5, P = 0.02), but in those with a history of delirium, there was no significant relationship (odds ratio 1.2, 95% confidence interval 0.2-6.7, P = 0.85). This trend for odds ratios to be closer to unity in the delirium and dementia group was observed for neuritic amyloid, apolipoprotein ε status, presence of infarcts, α-synucleinopathy and neuronal loss in substantia nigra. These findings are the first to demonstrate in a true population study that delirium is a strong risk factor for incident dementia and cognitive decline in the oldest-old. However, in this study, the relationship did not appear to be mediated by classical neuropathologies associated with dementia.Daniel H. J. Davis, Graciela Muniz Terrera, Hannah Keage, Terhi Rahkonen, Minna Oinas, Fiona E. Matthews ... et al

The structure of Organizational Virtual Social Networks

Organizational virtual social networks (OVSN) reshape social structures due to their ability to strengthen social ties, to change power relations and to enable new forms of cooperation. Research in Information and Communication Technologies (ICT) has led to various approaches that analyze the impact of OVSN on organizations in terms of structure and behavior. Our study aims to analyze important features related to the structure of OVSN. It also aims to strengthen a network approach to analyze organizational phenomena such as working groups and connected individuals, as well as the impact of online networks in organizations. This study was based on the lines of approach described by Oinas-Kukkonen et al. (2010) and on the research carried out by Bobsin & Hoppen (2012) to understand the process of structuring OVSN. Our main results are an OVSN structure consisting of actors and roles, interactions, operating elements and articulating goals. We also analyzed some structural elements of networks which may contribute to the development of a network based approach to study organizational phenomena

CAIDE Dementia Risk Score, Alzheimer and cerebrovascular pathology : a population-based autopsy study

Background. CAIDE Dementia Risk Score is a tool for estimating dementia risk in the general population. Its longitudinal associations with Alzheimer or vascular neuropathology in the oldest old are not known. Aim. To explore the relationship between CAIDE Dementia Risk Score at baseline and neuritic plaques, neurofibrillary tangles, cerebral infarcts and cerebral amyloid angiopathy (CAA) after up to 10-year follow-up in the Vantaa 85+ population. Methods. Study population included 149 participants aged 85 years, without dementia at baseline, and with available clinical and autopsy data. Methenamine silver staining was used for beta-amyloid and modified Bielschowsky method for neurofibrillary tangles and neuritic plaques. Macroscopic infarcts were identified from cerebral hemispheres, brain-stem and cerebellum slices. Standardized methods were used to determine microscopic infarcts, CAA and alpha-synuclein pathologies. The CAIDE Dementia Risk Score was calculated based on scores for age, sex, BMI, total cholesterol, systolic blood pressure, physical activity and APOE epsilon 4 carrier status (range 0-18 points). Results. A CAIDE Dementia Risk Score above 11 points was associated with more cerebral infarctions up to 10 years later: OR (95% CI) was 2.10 (1.06-4.16). No associations were found with other neuropathologies. Conclusion. In a population of elderly aged 85 years, higher CAIDE Dementia Risk Score was associated with increased risk of cerebral infarcts.Peer reviewe