Fokus auf der Untersuchung des Einflusses biometrischer Faktoren auf das Ergebnis der nTMS Messung sprachrelevanter Areale neurochirurgischer Patienten

Objective: Navigated transcranial magnetic stimulation (nTMS) is a non-invasive mapping tool to locate functional areas of the brain, gaining importance as a preoperative diagnostic device. This is a summary of three studies, Schwarzer et al., Rosenstock et al. and Zdunczyk et al., whose aim it is to increase the accuracy and usability of nTMS in different neurosurgical patient groups. They intend to describe neurophysiological data gained through nTMS as a supportive measure for surgical planning to increase patient safety and improve outcome. Methods: All patients and healthy subjects were examined via bihemispheric nTMS. Schwarzer et al. ascertained a baseline picture naming performance and used repetitive nTMS (rnTMS) to induce speech disruptions to identify individual language areas in patients with language eloquent lesions. Nine biometric factors were analyzed for correlation with elevated error occurrence. Rosenstock et al. concentrated on the primary motor cortex of patients with motor-eloquent glioma and performed correlation analyses to test the association of nTMS-related variables and postoperative motor outcome. Zdunczyk et al. examined patients with degenerative cervical myelopathy (DCM) and healthy volunteers to see differences in neurophysiological nTMS data due to disease severity. Results: Schwarzer et al. showed a significant increase in error occurrence with increased severity of cognitive impairment (p8mm (p=0.014). New postoperative deficits could be seen in patients with pathological excitability of the motor cortex (resting motor threshold ratio 110%, p=0.031). Patients with DCM had a reduced corticospinal excitability estimated by the recruitment curve (p=0.022), and patients with mild symptoms showed an increased activation on non- primary motor areas (p<0.005). Patients with severe symptoms showed a higher cortical inhibition (p<0.05) and a reduced motor area (p<0.05). Conclusion: Most patients are eligible for rnTMS language mapping. A new protocol for language mapping is proposed for secure identification of patients eligible for reliable rnTMS in Schwarzer et al. Rosenstock et al. introduce a new risk stratification model, based on objective functional-anatomical and neurophysiological measures, which enables physicians to counsel patients about the risk of functional deterioration or the potential for recovery and supports surgical planning. Zdunczyk et al. propose a new concept for functional compensation for DCM on the cortical and spinal level: the corticospinal reserve capacity. nTMS is a viable diagnostic tool to characterize this and its parameters serve as valuable prognostic factors.Fragestellung: Navigierte transkranielle Magnetstimulation (nTMS) ist eine nicht-invasive Untersuchungsmethode, um kortikale Funktionsareale zu identifizieren, welche zunehmend an Bedeutung als präoperatives diagnostisches Mittel gewinnt. Dies ist eine Zusammenfassung dreier Studien, Schwarzer et al., Rosenstock et al. und Zdunczyk et al. Die Studien haben als Ziel, die Benutzerfreundlichkeit und Genauigkeit von nTMS für unterschiedliche neurochirurgische Patientengruppen zu verbessern. Neurophysiologische Parameter wurden mittels nTMS erhoben, um die operative Planung zu unterstützen und das individuelle Patientenrisiko korrekt einzuschätzen und zu verbessern. Methodik: Alle Patienten und Probanden wurden bihemisphärisch mittels nTMS untersucht. Schwarzer et al. erhoben vorher die individuelle Fähigkeit zur Objektbenennung (baseline) und nutzten repetitive nTMS (rnTMS), um Sprachunterbrechungen hervorzurufen und somit Kortexareale bei Patienten mit sprachrelevanten Hirnläsionen zu identifizieren. Neun biometrische Patienteneigenschaften wurden in ein Verhältnis mit der Fehleranfälligkeit gesetzt. Rosenstock et al. untersuchten den primär motorischen Kortex bei Gliompatienten und analysierten den Zusammenhang von nTMS-ermittelten Parametern mit dem postoperativen Patientenzustand. Zdunczyk et al. betrachteten Patienten mit degenerativer zervikaler Myelopathie (DCM), sowie gesunde Probanden und ermittelten die unterschiedlichen nTMS-Parameter in Abhängigkeit von der Symptomschwere. Ergebnisse: Die meisten biometrischen Faktoren zeigten keinen statistischen Zusammenhang mit dem Stimulationsergebnis bei Schwarzer et al. Je schwerer der Aphasiegrad und die kognitiven Einschränkungen waren, desto mehr Sprachfehler wurden in der rnTMS Untersuchung gemacht (je p8mm zwischen Tumor und kortikospinalem Trakt keine neuen permanenten postoperativen Defizite auftraten (p=0.014). Neue postoperative Defizite traten bei Patienten mit präoperativ pathologischer Kortexerregbarkeit (Ruhemotorschwellenverhältnis RMT 110%, p=0.031) auf. DCM Patienten wiesen eine reduzierte kortikospinale Erregbarkeit, gekennzeichnet durch ein Abflachen der recruitment curve, auf (p=0.022). Ein vergrößertes motorisch relevantes Kortexareal mit Aktivierung sekundärer Motorareale zeigte sich bei Patienten mit milder Symptomatik (p<0.005), während bei schwer betroffenen Patienten eine erhöhte kortikale Hemmung (CSP, p<0.05) und reduzierte motorische Kortexfläche auffiel (p<0.05). Schlussfolgerung: Schwarzer et al. stellen ein neues Prüfungsprotokoll für die Eignung von Patienten für ein reliables rnTMS Ergebnis vor, wobei die statistische Analyse ergab, dass die meisten Patienten für eine reliable rnTMS Sprachuntersuchung geeignet sind. Rosenstock et al. präsentieren ein neues Risikostratifikationsmodell für Patienten mit motorisch relevanten Gliomen, wodurch der Operateur anhand von funktionell-anatomischen und neurophysiologischen Parametern das individuelle Patientenrisiko für den postoperativen Verlauf einschätzen kann. Zdunczyk et al. beschreiben einen möglichen funktionellen Kompensationsmechanismus bei DCM Patienten auf kortikaler und spinaler Ebene: die kortikospinale Reservekapazität. Die durch nTMS ermittelten Parameter lassen damit objektivierbare prognostische Aussagen zu

Observation of Scaling Violations in Scaled Momentum Distributions at HERA

Charged particle production has been measured in deep inelastic scattering (DIS) events over a large range of $x$ and $Q^2$ using the ZEUS detector. The evolution of the scaled momentum, $x_p$, with $Q^2,$ in the range 10 to 1280 $GeV^2$, has been investigated in the current fragmentation region of the Breit frame. The results show clear evidence, in a single experiment, for scaling violations in scaled momenta as a function of $Q^2$.Comment: 21 pages including 4 figures, to be published in Physics Letters B. Two references adde

Development and exploratory cluster-randomised opportunistic trial of a theory-based intervention to enhance physical activity among adolescents

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Changes in glass consumption in Pergamon (Turkey) from Hellenistic to late Byzantine and Islamic times

We present compositional data for nearly 100 glass samples from Pergamon, western Turkey, spanning 1500 years from the Hellenistic to Late Byzantine and Islamic periods. The data shows the use of already-known Roman glass groups during the first half of the time frame, for imported vessels as well as locally worked glass. No compositional change is seen related to the introduction of glass blowing for either of the glass groups in use during this time. During the first half of the 1st millennium AD, two previously little-known boron- and alumina-rich compositional groups emerge. These glass groups, thought to be regionally produced, dominate glass compositions in Pergamon during the mid-to late Byzantine and Islamic periods, indicating a major shift in glass supply and a fragmentation of the economy into more regional units. Plant-ash glass, from the 9th century AD replacing mineral natron glass in the Levant, plays only a minor role in Byzantine and Islamic Pergamon

Motivational, volitional and multiple goal predictors of walking in people with type 2 diabetes

Acknowledgment MN’s PhD scholarship was provided by Ministry of Health and Medical Education (Islamic Republic of Iran). This study was funded by the University of Aberdeen reference number: GP007RGC1618. FFS is funded by Fuse, the UK Clinical Research Collaboration Centre of Excellence for Translational Research in Public Health (grant number: MR/K02325X/1). The researchers gratefully acknowledge all the Type 2 diabetic patients and their household members who participated in the study for their contribution to this study; without them there would be no data. The researchers gratefully acknowledge the SDRN for providing the list of Type 2 diabetes and helping for sampling.Peer reviewedPublisher PD

BIRACIAL – BLACK? A SURVEY OF LANGUAGE USE AND LANGUAGE ATTITUDES IN POLAND AND GERMANY

The paper deals with the construction of race from the perspective of cognitive sociolinguistics. The focus is upon the perception of mixed-race people of black and white heritage in Poland and Germany compared to the USA, and its reflection in language use. The study clarifies in how far a socially marked perception of biracial people applies in these countries with very small population of black ancestry. Among other things, the first presidential campaign of Barack Obama is used to investigate the occurrence in both countries of mental colouring of biracial people. The paper also reflects the language debate on political correctness of the press language, sparked off by the presidential campaign and its media coverage. It presents claims and arguments by proponents of various solutions regarding referring to biracial people, and paradoxes showing up in the relationship between language use and ideological positions when the race issue is at stake

The radial plot in meta-analysis : approximations and applications

Fixed effects meta-analysis can be thought of as least squares analysis of the radial plot, the plot of standardized treatment effect against precision (reciprocal of the standard deviation) for the studies in a systematic review. For example, the least squares slope through the origin estimates the treatment effect, and a widely used test for publication bias is equivalent to testing the significance of the regression intercept. However, the usual theory assumes that the within-study variances are known, whereas in practice they are estimated. This leads to extra variability in the points of the radial plot which can lead to a marked distortion in inferences that are derived from these regression calculations. This is illustrated by a clinical trials example from the Cochrane database. We derive approximations to the sampling properties of the radial plot and suggest bias corrections to some of the commonly used methods of meta-analysis. A simulation study suggests that these bias corrections are effective in controlling levels of significance of tests and coverage of confidence intervals

Coping strategies as mediators within the relationship between emotion-regulation and perceived stress in teachers

The aim of the present study was to examine whether different coping strategies (focus on positive, support coping, active coping and evasive coping) mediate the relationship between emotion-regulation (i.e., emotion acceptance skills, emotion resilience skills and emotion regulation skills) and perceived stress in physical education (PE) teachers. The sample consisted of 457 PE pre-service teachers. Results show that evasive coping strategies partly negatively mediate the relationship between emotion resilience skills and emotion regulation and perceived stress. Therefore, emotion-regulation might protect against using evasive coping strategies, which have been found to be related to higher stress in previous studies.peer-reviewe