166 research outputs found
Proactive inhibition is not modified by deep brain stimulation for Parkinson's disease: An electrical neuroimaging study.
In predictable contexts, motor inhibitory control can be deployed before the actual need for response suppression. The brain functional underpinnings of proactive inhibition, and notably the role of basal ganglia, are not entirely identified. We investigated the effects of deep brain stimulation of the subthalamic nucleus or internal globus pallidus on proactive inhibition in patients with Parkinson's disease. They completed a cued go/no-go proactive inhibition task ON and (unilateral) OFF stimulation while EEG was recorded. We found no behavioural effect of either subthalamic nucleus or internal globus pallidus deep brain stimulation on proactive inhibition, despite a general improvement of motor performance with subthalamic nucleus stimulation. In the non-operated and subthalamic nucleus group, we identified periods of topographic EEG modulation by the level of proactive inhibition. In the subthalamic nucleus group, source estimation analysis suggested the initial involvement of bilateral frontal and occipital areas, followed by a right lateralized fronto-basal network, and finally of right premotor and left parietal regions. Our results confirm the overall preservation of proactive inhibition capacities in both subthalamic nucleus and internal globus pallidus deep brain stimulation, and suggest a partly segregated network for proactive inhibition, with a preferential recruitment of the indirect pathway
Combined thalamic and subthalamic deep brain stimulation for tremor-dominant Parkinson's disease.
Deep brain stimulation (DBS) in the thalamic ventral intermediate (Vim) or the subthalamic nucleus (STN) reportedly improves medication-refractory Parkinson's disease (PD) tremor. However, little is known about the potential synergic effects of combined Vim and STN DBS. We describe a 79-year-old man with medication-refractory tremor-dominant PD. Bilateral Vim DBS electrode implantation produced insufficient improvement. Therefore, the patient underwent additional unilateral left-sided STN DBS. Whereas Vim or STN stimulation alone led to partial improvement, persisting tremor resolution occurred after simultaneous stimulation. The combination of both targets may have a synergic effect and is an alternative option in suitable cases
Associations of Statin Use with Deep Surgical Site Infections and Late Non-Infectious Revision Surgeries in Patients Undergoing Orthopedic Surgery: A Clinical Cohort Study
Statins have multiple preventive properties. We investigate if a chronic perioperative statin medication for cardiovascular indications reduces deep orthopedic surgical site infections (SSI), and other late non-infectious complications, in adult patients. We performed a single-center cohort of primary orthopedic interventions 2014-2019; with the exclusion of infection surgery and diabetic foot surgery. Group comparisons with Cox regression analyses; with and without propensity-score matching (nearest neighbor approach). We included 20,088 interventions in 20,088 different patients (median age 53 years, 49% females, 5% diabetes mellitus). Among them, 2,486 episodes (12%) revealed a pre-operative statin therapy (222 different brands and doses). After a median follow-up of 11 months, 1,414 episodes needed a surgical revision: 158 (0.8%) due to deep SSI and 1256 (6.3%) for non-infectious reasons. In multivariate Cox regression analyses, statin use was unrelated to both SSI (hazard ratio (HR) 0.9; 95% confidence interval (CI) 0.6-1.4) and non-infectious complications (HR 1.1, 95%CI 0.9-1.3). We equally lacked associations when we associated deep SSIS with statin use for the subgroups of implant-related surgery (HR 0.8, 95%CI 0.4-1.6) or orthroplasties (HR 0.8, 95%CI 0.3-2.6), separately. Likewise, propensity-score matched analyses on the variable “statin” equally failed to alter these outcomes. In our large cohort study with 20,088 orthopedic interventions, we found no protective association of a statin medication on deep SSI risks; or on other late non-infectious complications requiring revision surgery.
Keywords
statin medication, orthopedic surgery, surgical site infection, revision surgery, epidemiolog
Targeting accuracy of the subthalamic nucleus in DBS surgery: comparison between 3T MRI and microeltrode recording results
Comparison of DVB-T Passive Radar Simulated and Measured Bistatic RCS Values for a Pilatus PC-12 Aircraft
Passive radar is a technology that has huge potential for airspace monitoring, taking advantage of existing transmissions. However, to predict whether particular targets can be measured in a particular scenario, it is necessary to be able to model the received signal. In this paper, we present the results of a campaign in which a Pilatus PC-12 single-engine aircraft was measured with a passive radar system relying on DVB-T transmission from a single transmitter. We then present our work to simulate the bistatic RCS of the aircraft along its flight track, using both the method of moments and the shooting and bouncing ray solvers, assess the uncertainty in the simulations, and compare against the measurements. We find that our simulated RCS values are useful in predicting whether or not detection occurs. However, we see poor agreement between simulated and measured RCS values where measurements are available, which we attribute primarily to the difficulties in extracting RCS measurements from the data and to unmodeled transmission and received path effects
Mobility of charge carriers in self-assembled monolayers
We present a new approach to study charge transport within 2D layers of organic semi-conductors (OSCs) using atomic force microscopy (AFM)-based lithography applied to self-assembled monolayers (SAMs), fabricated from appropriate organothiols. The extent of lateral charge transport was investigated by insulating pre-defined patches within OSC-based SAMs with regions of insulating SAM made from large band gap alkanethiolates. The new method is demonstrated using a phenyl-linked anthracenethiolate (PAT), 4-(anthracene-2-ylethynyl)benzyl thiolate. I-V characteristics of differently shaped PAT-islands were measured using the AFM tip as a top electrode. We were able to determine a relationship between island size and electrical conductivity, and from this dependence, we could obtain information on the lateral charge transport and charge carrier mobility within the thin OSC layers. Our study demonstrates that AFM nanografting of appropriately functionalized OSC molecules provides a suitable method to determine intrinsic mobilities of charge carriers in OSC thin films. In particular, this method is rather insensitive with regard to influence of grain boundaries and other defects, which hamper the application of conventional methods for the determination of mobilities in macroscopic samples. © 2019 Fu et al
Axial symptoms predict mortality in patients with Parkinson disease and subthalamic stimulation.
OBJECTIVE
To characterize how disease progression is associated with mortality in a large cohort of patients with Parkinson disease (PD) with long-term follow-up after subthalamic nucleus deep brain stimulation (STN-DBS).
METHODS
Motor and cognitive disabilities were assessed before and 1, 2, 5, and 10 years after STN-DBS in 143 consecutive patients with PD. We measured motor symptoms "off" and "on" levodopa and STN-DBS and recorded causes of death. We used linear mixed models to characterize symptom progression, including interactions between treatment conditions and time to determine how treatments changed efficacy. We used joint models to link symptom progression to mortality.
RESULTS
Median observation time was 12 years after surgery, during which akinesia, rigidity, and axial symptoms worsened, with mean increases of 8.8 (SD 6.5), 1.8 (3.1), and 5.4 (4.1) points from year 1-10 after surgery ("on" dopamine/"on" STN-DBS), respectively. Responses to dopaminergic medication and STN-DBS were attenuated with time, but remained effective for all except axial symptoms, for which both treatments and their combination were predicted to be ineffective 20 years after surgery. Cognitive status significantly declined. Forty-one patients died, with a median time to death of 9 years after surgery. The current level of axial disability was the only symptom that significantly predicted death (hazard ratio 4.30 [SE 1.50] per unit of square-root transformed axial score).
CONCLUSIONS
We quantified long-term symptom progression and attenuation of dopaminergic medication and STN-DBS treatment efficacy in patients with PD and linked symptom progression to mortality. Axial disability significantly predicts individual risk of death after surgery, which may be useful for planning therapeutic strategies in PD
Boreal fire records in Northern Hemisphere ice cores: a review
Here, we review different attempts made since the early 1990s to reconstruct past forest fire activity using chemical signals recorded in ice cores extracted from the Greenland ice sheet and a few mid-northern latitude, high-elevation glaciers. We first examined the quality of various inorganic (ammonium, nitrate, potassium) and organic (black carbon, various organic carbon compounds including levoglucosan and numerous carboxylic acids) species proposed as fire proxies in ice, particularly in Greenland. We discuss limitations in their use during recent vs. pre-industrial times, atmospheric lifetimes, and the relative importance of other non-biomass-burning sources. Different high-resolution records from several Greenland drill sites and covering various timescales, including the last century and Holocene, are discussed. We explore the extent to which atmospheric transport can modulate the record of boreal fires from Canada as recorded in Greenland ice. Ammonium, organic fractions (black and organic carbon), and specific organic compounds such as formate and vanillic acid are found to be good proxies for tracing past boreal fires in Greenland ice. We show that use of other species – potassium, nitrate, and carboxylates (except formate) – is complicated by either post-depositional effects or existence of large non-biomass-burning sources. The quality of levoglucosan with respect to other proxies is not addressed here because of a lack of high-resolution profiles for this species, preventing a fair comparison. Several Greenland ice records of ammonium consistently indicate changing fire activity in Canada in response to past climatic conditions that occurred during the last millennium and since the last large climatic transition. Based on this review, we make recommendations for further study to increase reliability of the reconstructed history of forest fires occurring in a given region
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