Predicting Clinical Outcome After Surgical Treatment in Patients With Carpal Tunnel Syndrome

Item does not contain fulltextPURPOSE: Carpal tunnel release (CTR) is typically offered to symptomatic patients with electrophysiological abnormalities when night orthoses no longer prevent waking with numbness and preferably before there is any static numbness, weakness, or atrophy. The ability to predict the amount of symptom relief after CTR could be beneficial for managing patient expectations and, therefore, improve treatment satisfaction. Therefore, the aim of this study was to identify predictors for symptom relief after CTR and to determine their contribution to symptom relief at 6 months after surgery. METHODS: A total of 1,049 patients who underwent CTR between 2011 and 2015 at 1 of 11 Xpert Clinics in the Netherlands were asked to complete online questionnaires at intake and 3 and 6 months after surgery. Patient demographics, comorbidities, and baseline scores were considered potential predictors for the amount of symptom relief on the Boston Carpal Tunnel Questionnaire (BCTQ) score, which was the primary outcome measure. RESULTS: A low score on the BCTQ at intake, a codiagnosis of a trigger finger, ulnar nerve neuropathy, trapeziometacarpal joint arthrosis, and instability or arthrosis of the wrist were associated with a smaller improvement in the BCTQ domains after a CTR at 6 months after surgery and accounted for 35% to 42% of the variance on the BCTQ domains in our multivariable regression models. CONCLUSIONS: In this study, we showed that clinical severity of carpal tunnel syndrome at intake is the most important factor in estimating symptom relief after surgical treatment. Furthermore, this study contributes to a more precise understanding of the capabilities of CTR in relieving symptoms for different subgroups of patients. Results of our study can be used to manage patient expectation on symptom relief from CTR. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II

ASH: An automatic pipeline to generate realistic and individualized chronic stroke volume conduction head models

Contains fulltext : 231559.pdf (Publisher’s version ) (Open Access)Objective. Large structural brain changes, such as chronic stroke lesions, alter the current pathways throughout the patients' head and therefore have to be taken into account when performing transcranial direct current stimulation simulations. Approach. We implement, test and distribute the first MATLAB pipeline that automatically generates realistic and individualized volume conduction head models of chronic stroke patients, by combining the already existing software SimNIBS, for the mesh generation, and LINDA, for the lesion identification. To highlight the impact of our pipeline, we investigated the sensitivity of the electric field distribution to the lesion location and lesion conductivity in 16 stroke patients' datasets. Main results. Our pipeline automatically generates 1 mm-resolution tetrahedral meshes including the lesion compartment in less than three hours. Moreover, for large lesions, we found a high sensitivity of the electric field distribution to the lesion conductivity value and location. Significance. This work facilitates optimizing electrode configurations with the goal to obtain more focal brain stimulations of the target volumes in rehabilitation for chronic stroke patients.9 p

ASH: an Automatic pipeline to generate realistic and individualized chronic Stroke volume conduction Head models

Item does not contain fulltextObjective: Large structural brain changes, such as chronic stroke lesions, alter the current pathways throughout the patients’ head and therefore have to be taken into account when performing transcranial direct current stimulation simulations. Approach: We implement, test and distribute the first MATLAB pipeline that automatically generates realistic and individualized volume conduction head models of chronic stroke patients, by combining the already existing software SimNIBS, for the mesh generation, and LINDA, for the lesion identification. To highlight the impact of our pipeline, we investigated the sensitivity of the electric field distribution to the lesion location and lesion conductivity in 16 stroke patients’ datasets. Main results: Our pipeline automatically generates 1 mm-resolution tetrahedral meshes, including the lesion compartment in less than three hours. Moreover, for large lesions, we found a high sensitivity of the electric field distribution to the lesion conductivity value and location. Significance: This work facilitates optimizing electrode configurations with the goal to obtain more focal brain stimulations of the target volumes in rehabilitation for chronic stroke patients.Ethical Statement: MRIs of 15 subjects were acquired under the approval of the Ethics Committee "CMO regio Arnhem-Nijmegen", (NL58437.091.17). All 15 individuals signed an informed consent for their scans to be shared.nul

Construction and reconstruction of brain circuits: normal and pathological axon guidance

Perception of our environment entirely depends on the close interaction between the central and peripheral nervous system. In order to communicate each other, both systems must develop in parallel and in coordination. During development, axonal projections from the central nervous system (CNS) as well as the peripheral nervous system (PNS) must extend over large distances to reach their appropriate target cells. To do so, they read and follow a series of axon guidance molecules. Interestingly, whilst these molecules play critical roles in guiding developing axons, they have also been shown to be critical in other major neurodevelopmental processes, such as the migration of cortical progenitors. Currently, a major hurdle for brain repair after injury or neurodegeneration is the absence of axonal regeneration in the mammalian CNS. By contrasts, PNS axons can regenerate. Many hypotheses have been put forward to explain this paradox but recent studies suggest that hacking neurodevelopmental mechanisms may be the key to promote CNS regeneration. Here, we provide a seminar report written by trainees attending the second Flagship school held in Alpbach, Austria in September 2018 organized by the International Society for Neurochemistry (ISN) together with the Journal of Neurochemistry (JCN). This advanced school has brought together leaders in the fields of neurodevelopment and regeneration in order to discuss major keystones and future challenges in these respective fields

Formação docente: reflexões sobre o estágio curricular

O presente artigo apresenta reflexões e discussões sobre a importância e o papel do estágio curricular na formação prática de alunos do curso de licenciatura em Ciências Biológicas. A partir da análise do estágio curricular dos acadêmicos do 7º e 9º período, foram identificados os aspectos favoráveis e desfavoráveis e formuladas sugestões que visam melhorar a qualidade do mesmo. A pesquisa acerca da realidade e dos problemas do estágio supervisionado foi realizada por meio de análise documental (diário de campo e narrativas) e questionários. Com auxílio da literatura especializada, conseguimos aprofundar a compreensão dos mecanismos de articulação entre teoria e prática no cotidiano escolar, o que poderá contribuir para a construção de um currículo mais coerente com a realidade da sala de aula da Educação Básica

HIT-COVID, a global database tracking public health interventions to COVID-19

The COVID-19 pandemic has sparked unprecedented public health and social measures (PHSM) by national and local governments, including border restrictions, school closures, mandatory facemask use and stay at home orders. Quantifying the effectiveness of these interventions in reducing disease transmission is key to rational policy making in response to the current and future pandemics. In order to estimate the effectiveness of these interventions, detailed descriptions of their timelines, scale and scope are needed. The Health Intervention Tracking for COVID-19 (HIT-COVID) is a curated and standardized global database that catalogues the implementation and relaxation of COVID-19 related PHSM. With a team of over 200 volunteer contributors, we assembled policy timelines for a range of key PHSM aimed at reducing COVID-19 risk for the national and first administrative levels (e.g. provinces and states) globally, including details such as the degree of implementation and targeted populations. We continue to maintain and adapt this database to the changing COVID-19 landscape so it can serve as a resource for researchers and policymakers alike