Outcome of Trauma Patients Admitted to Emergency Department Based on Full Outline of Unresponsiveness Score

oai:ojs.ajem.tums.ac.ir:article/1Introduction: Full Outline of Unresponsiveness (FOUR) score is one of the existing scoring scales, which has been used for evaluating the level of consciousness in recent years. Objective: The present study has been done with the aim of evaluating the ability to predict the outcome of patients with head trauma based on FOUR score on admission to emergency department (ED). Methods: In the present prospective cross-sectional study, head trauma patients with any changes in alertness level presenting to ED were evaluated. FOUR score measurement was done on admission and 6 hours after that. The studied outcomes in the current study included discharge without sequel, discharge with neurologic sequel, brain death or death during 1 month after admission of the patients. To evaluate the correlation between FOUR score and the studied outcomes, area under the receiver operating characteristic (ROC) curve was used. Results: In the end, 52 patients with the mean age of 32.67 ± 15.20 years were evaluated (84.6% male). Traffic accident with the frequency of 39 (75.0%) patients was the most common mechanism of trauma among the studied patients and finally, after 1 month follow up it was determined that 13 (25%) patients were discharged without sequel and 31 (59.6%) died. Area under the ROC curve for prediction of the final outcome of death using FOUR score on admission and after 6 hours were 0.889 (95% confidence interval: 0.800 - 0.977) and 0.974 (95% confidence interval: 0.938 – 1.000), respectively. Best cutoff points for FOUR score were the scores 8 and 9 on admission of the patients, and the score 5, six hours after admission. Conclusion: Based on the findings of this study, it seems that FOUR score is applicable for prediction of probable death outcome in patients with head trauma presenting to ED

Violation of rhythmic expectancies can elicit late frontal gamma activity nested in theta oscillations

International audienceRhythm processing involves building expectations according to the hierarchical temporal structure of auditory events. Although rhythm processing has been addressed in the context of predictive coding, the properties of the oscillatory response in different cortical areas are still not clear. We explored the oscillatory properties of the neural response to rhythmic incongruence and the cross-frequency coupling between multiple frequencies to further investigate the mechanisms underlying rhythm perception. We designed an experiment to investigate the neural response to rhythmic deviations in which the tone either arrived earlier than expected or the tone in the same metrical position was omitted. These two manipulations modulate the rhythmic structure differently, with the former creating a larger violation of the general structure of the musical stimulus than the latter. Both deviations resulted in an MMN response, whereas only the rhythmic deviant resulted in a subsequent P3a. Rhythmic deviants due to the early occurrence of a tone, but not omission deviants, seemed to elicit a late high gamma response (60-80 Hz) at the end of the P3a over the left frontal region, which, interestingly, correlated with the P3a amplitude over the same region and was also nested in theta oscillations. The timing of the elicited high-frequency gamma oscillations related to rhythmic deviation suggests that it might be related to the update of the predictive neural model, corresponding to the temporal structure of the events in higher-level cortical areas

Opposite effect of motivated forgetting on sleep spindles during stage 2 and slow wave sleep

International audienceMemories selectively benefit from sleep. In addition to the importance of the consolidation of relevant memories, the capacity to forget unwanted memories is also crucial. We investigated the effect of suppressing unwanted memories on electroencephalography activity of subsequent sleep using a motivated forgetting (MF) paradigm as compared with a control non-forgetting task. Subjects were randomly assigned to nap or no-nap groups. We used a modified version of the think/no-think paradigm with dominant number of no-think words cued to be forgotten and included only subjects capable of suppressing unwanted memories by performing an initial subject inclusion experiment. In both groups and conditions, the performance of the subjects in recalling the word pairs learned in the beginning of the day was evaluated in a final recall test. We found that both nap and no-nap groups recalled significantly less no-think words in the MF condition compared to the control condition. Moreover, for the nap group, in the MF compared to the control condition, spindle power and density increased during stage 2 (S2) whereas they decreased during slow wave sleep (SWS). Interestingly, recall performance of no-think words was negatively correlated with spindle power during S2 whereas it was positively correlated with spindle power during SWS. These results indicate that sleep spindles are sensitive to the previous MF experiences and suggest a differential role of sleep spindles during S2 and SWS in memory processing during sleep

Motivated forgetting increases the recall time of learnt items: Behavioral and event related potential evidence

International audienc

The Need for Mapping, Modeling, and Predicting Flood Hazard and Risk at the Global Scale

The socioeconomic impacts of flooding are huge. Between 1980 and 2013, flood losses exceeded $1 trillion globally, and resulted in approximately 220,000 fatalities. To reduce these negative impacts of floods, effective flood risk management is required. Reducing risk globally is at the heart of two recent international agreements: the Sendai Framework for Disaster Risk Reduction and the Warsaw International Mechanism for Loss and Damage Associated with Climate Change Impacts. Prerequisites for effective risk reduction are accurate methods to assess hazard and risk, based on a thorough understanding of underlying processes. Due to the paucity of local scale hazard and risk data in many regions, several global flood hazard and flood risk models have been developed in recent years. More and more, these global models are being used in practice by an ever‐increasing range of users and practitioners. In this chapter, we provide an overview of recent advances in global flood hazard and risk modeling. We then discuss applications of the models in high‐level advocacy in disaster risk management activities, international development organizations, the reinsurance industry, and flood forecasting and early warning. The chapter concludes with several remarks on limitations in global flood risk models and the way forward for the future.JRC.E.1-Disaster Risk Managemen