Impaired Sensorimotor Integration in Restless Legs Syndrome

Objective: Restless legs syndrome (RLS) is a complicated sensorimotor syndrome that may be linked to changes in sensorimotor integration. The mechanism of such changes is unclear. The aim of this study was to investigate sensorimotor integration in patients with RLS through transcranial magnetic stimulation-motor evoked potentials (TMS-MEPs) preceded by peripheral electric stimulation.Methods: Fourteen RLS patients and 12 healthy, age-matched controls were investigated. The clinical severity of RLS was evaluated based on the International Criteria of the International Restless Legs Syndrome Study Group (IRLSSG) severity scores. The tibial and median H-reflexes and the resting motor threshold (RMT) of the abductor pollicis brevis (APB) were tested in all 26 subjects. The RMT of the tibialis anterior (TA) was tested in 8 patients and 7 controls. All 26 subjects underwent measurement of unconditioned MEPs of the APB. Electric pulses were applied to the right median nerve, followed by TMS pulses over the left motor cortex at interstimulus intervals (ISIs) of 20, 25, 30, 50, 100, 150, and 200 ms. Unconditioned MEPs of the TA were measured in 8 patients and 7 controls. Electric pulses were applied to the right peroneal nerve, followed by TMS pulses over the left motor cortex at ISIs of 30, 35, 45, 60, 100, and 200 ms. The degree of modulation of MEPs by electric stimulation was expressed as the ratio of the conditioned MEP amplitude to the unconditioned MEP amplitude. Ratios <1 indicated inhibition, and ratios >1 indicated facilitation.Results: No significant differences in RMT or H-reflex latencies or amplitudes were found between RLS patients and controls. A significant increase in unconditioned MEP amplitudes of the TA was observed in patients compared to controls (p = 0.03). Long-latency afferent inhibition (LAI) of the median nerve in RLS patients was decreased significantly at ISIs of 150 (p = 0.000) and 200 ms (p = 0.004). Upon peroneal nerve stimulation, no significant difference was observed between the two groups at any ISI.Conclusions: Our results suggest increased motor cortical excitability of the legs and disturbed sensorimotor integration in RLS patients; this disturbance might originate at the cortical level

The Effect of Insomnia on Cortical Excitability in Patients With Generalized Anxiety Disorder

The high rate of comorbidity between insomnia and anxiety disorders have been confirmed by previous studies. However, the underlying neurobiological correlates of the relationship between insomnia and anxiety disorders are largely unknown. The aim of the present study was to investigate the effect of insomnia on cortical excitability in patients with generalized anxiety disorder (GAD) by examining the recovery functions of median nerve somatosensory evoked potentials (SEPs) in patients with GAD without insomnia and patients with GAD comorbid with insomnia. We studied the recovery functions of median nerve SEPs in 12 medication-naive patients with GAD without insomnia, 15 medication-naive patients with GAD comorbid with insomnia, and 15 age and sex matched healthy controls. SEPs in response to single stimulus and paired stimuli at interstimulus intervals (ISIs) of 20, 60, 100, and 150 ms were recorded. The recovery function of the P25 component showed significantly reduced suppression in patients with GAD without insomnia as compared to patients with GAD comorbid with insomnia and healthy controls. There were no significant differences in the recovery functions of median nerve SEPs between patients with GAD comorbid with insomnia and healthy controls. The present study suggested that the cortical excitability of right parietal cortex increased in patients with GAD without insomnia, and cortical excitability in patients with GAD comorbid with insomnia was modulated by insomnia. Our findings provide new insights into the underlying neurobiological correlates of the effects of insomnia on GAD, which could ultimately be used to inform clinical intervention

Clinical Features and Sleep Analysis of Chinese Patients with Fatal Familial Insomnia

This study aimed to examine clinical features, sleep, abnormal sleep-wake transition and non-sleep disturbances as well as lab tests in Chinese fatal familial insomnia (FFI) subjects. Patients with confirmed clinical and laboratory diagnosis of FFI have been retrospectively reviewed. The clinical features and the results of the complementary tests, including polysomnography (PSG), brain imaging and genetic analysis, were used. Two male and three female patients were recruited in this study. Three of the five patients had more comprehensive family medical records. The most typical clinical manifestations in all 5 patients were sleep disturbances, including insomnia, laryngeal stridor, sleep breath disturbance, and sleep-related involuntary movements. PSG of all these five cases showed reduction in total sleep time, sleep fragmentation, abnormal short non-rapid eye movement - rapid eye movement (REM) cycling, REM sleep reduction or loss, and REM sleep instruction in wakefulness. Patient 2's emission tomography scan demonstrated a reduction in glucose uptake in the left thalamus and bilateral inferior parietal lobe. In summary, Chinese FFI patients are typically characterized by organic sleep related symptoms, rapidly progressive dementia and sympathetic symptoms. We propose that structural damages in the thalamus and cortex are mostly responsible for clinical manifestations of FFI

Prosedur penyelesaian pembiayaan bermasalah pada akad mudharabah dalam rangka meminimalisir resiko di BMT Amanah Usaha Mulia Magelang

Permasalah kehidupan perekonomian yang sulit, membuat masyarakat berinisiatif untuk membuka usaha sendiri. Mereka membutuhkan suatu bantuan berupa dana untuk memperlancar usahanya, maka BMT Amanah Usaha Mulia Magelang ikut untuk mengembangkan produknya yaitu pembiayaan mudharabah sesuai perkembangan dunia perbankan dalam target peningkatan keuntungan dan menyejahterakan masyarakat. Dengan diberikanya pembiayaan tersebut, terkadang muncul adanya pembiayaan bermasalah dikarenakan ada beberapa faktor diantaranya ketidakmampuan anggota untuk membayar tepat waktu atau jatuh tempo pembayaran diakibatkan karena usaha anggota yang kurang lancar dan lain sebagaianya. Tugas Akhir ini berjudul “ Prosedur Penyelesaian Pembiayaan Bermasalah pada Akad Mudharabah Dalam Rangka Meminimalisir Risiko” Berdasarkan judul tersebut dapat diambil rumusan masalah yaitu apa penyebab terjadinya pembiayaan bermasalah pada BMT Amanah Usaha Mulia Magelang dan bagaimana prosedur penyelesaian pembiayaaan bermasalah pada akad mudharabah di BMT Amanah Usaha Mulia Magelang. Penelitian ini merupakan penelitian lapangan dimana sumber data yang digunakan berasal dari data primer dan sekunder yang diperoleh melalui metode wawancara dengan manajer, bagian pembiayaan dan dokumentasi. Metode yang digunakan dalam penelitian ini adalah deskriptif kualitatif yang bertujuan untuk menggambarkan secara sistematis dan akurat mengenai objek penelitian. Berdasarkan hasil penelitian dapat disimpulkan bahwa penyebab terjadinya pembiayaan bermasalah yaitu faktor internal meliputi kurang telitinya petugas BMT dalam menganalisi data calon anggota, kurang disiplinya dalam penagihan dan eksternal meliputi karakter anggota yang kurang baik, usahanya bangkrut dan terjadinya bencana alam yang tidak terduga. Adapun prosesdur yang digunakan BMT Amanah Usaha Mulia dalam menyelesaian pembiayaan bermasalah pada akad mudharabah dengan cara kekeluargaan atau musyawarah dengan anggota, penjadwalan kembali (rescheduling), persyaratan kembali (reconditioning), pengambilan jaminan (eksekusi), dan write off final. Di BMT Amanah Usaha Mulia dalam penyelesaian pembiayaan bermasalah jarang menngunakan jalur hukum, tetapi sering menggunakan cara kekeluargaan yang dianggap lebih efektif dan eksekusi jaminan apabila anggota tersebut sudah mengalami macet atau bermasalah

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Ammonia Volatilization Reduced by Combined Application of Biogas Slurry and Chemical Fertilizer in Maize–Wheat Rotation System in North China Plain

Digestate and biogas slurry (BS) are the byproduct of biogas engineering that could be used for elevating plant growth. However, the consequent emissions of ammonia from BS are considered a severe threat to the atmosphere. Herein, we conducted two consecutive field experiments with wheat–maize rotations to find out the optimum ratio of BS to combine with chemical fertilizer (CF) to reduce ammonia volatilization (AV) while keeping the stable crop yield. In maize season, 226.5 kg N/ha of CF was applied. In wheat season, 226.5 kg N/ha was applied at different ratios (100%, 80%, and 50%) between BS and CF. Our results found that the maximum yield of 6250 kg/ha was produced by CF, and this yield could be obtained through a combined application of 38% BS mixed with CF. Highest AV produced of 16.08 kg/ha by CF. BS treatments significantly reduced the emission from 18% to 32% in comparison to CF. The combined application of BS-CF produced the highest yield due to essential nutrients coming from both BS-CF. Subsequently, it reduced the AV depending on fertilizer type and fertilizer rate. An optimal ratio of 38% BS was recommended to produce the highest yield and lowest ammonia emissions. The application of BS together with different ratios of CF could be an alternative agricultural strategy to obtain desired crop yield and reduce AV in North China Plain (NCP)

Transcutaneous Vagus Nerve Stimulation Could Improve the Effective Rate on the Quality of Sleep in the Treatment of Primary Insomnia: A Randomized Control Trial

(1) Background: The purpose of this study was to investigate the efficacy and safety of transcutaneous vagus nerve stimulation (t-VNS) in the treatment of primary insomnia. (2) Methods: This is a single center, randomized, double-blind study. A total of 30 patients diagnosed with primary insomnia were randomly divided into two groups to receive 20 Hz t-VNS in either the auricular concha area (treatment group) or periauricular area (control group), twice a day for 20 min during a one-month study period. The effective rate of treatment, defined as a ≥50% reduction of the Pittsburgh Sleep Index Scale (PSQI) after treatment, was compared between the two groups as the primary outcome. Response rate (defined as ≥10% change in the PSQI score), and changes in the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) scores were also assessed. (3) Results: After one month of treatment, the PSQI score of the treatment group decreased significantly (p = 0.001). The effective rate of the treatment group (73% vs. 27%, p = 0.027) was significantly higher than that of the control group. No statistical differences in changes of HAMA and HAMD scores were detected between the two groups. There were no complications in all patients. (4) Conclusion: T-VNS appeared to be a safe and effective treatment for primary insomnia

EEG Biofeedback Decreases Theta and Beta Power While Increasing Alpha Power in Insomniacs: An Open-Label Study

Insomnia, often associated with anxiety and depression, is a prevalent sleep disorder. Biofeedback (BFB) treatment can help patients gain voluntary control over physiological events such as by utilizing electroencephalography (EEG) and electromyography (EMG) power. Previous studies have rarely predicted biofeedback efficacy by measuring the changes in relative EEG power; therefore, we investigated the clinical efficacy of biofeedback for insomnia and its potential neural mechanisms. We administered biofeedback to 82 patients with insomnia, of whom 68 completed 10 sessions and 14 completed 20 sessions. The average age of the participants was 49.38 ± 12.78 years, with 26 men and 56 women. Each biofeedback session consisted of 5 min of EMG and 30 min of EEG feedback, with 2 min of data recorded before and after the session. Sessions were conducted every other day, and four scale measures were taken before the first, fifth, and tenth sessions and after the twentieth session. After 20 sessions of biofeedback treatment, scores on the Pittsburgh Sleep Quality Index (PSQI) were significantly reduced compared with those before treatment (−5.5 ± 1.43,t = −3.85, p = 0.006), and scores on the Beck Depression Inventory (BDI-II) (−7.15 ± 2.43, t = −2.94, p = 0.012) and the State-Trait Anxiety Inventory (STAI) (STAI-S: −12.36 ± 3.40, t = −3.63, p = 0.003; and STAI-T: −9.86 ± 2.38, t = −4.41, p = 0.001) were significantly lower after treatment than before treatment. Beta and theta power were significantly reduced after treatment, compared with before treatment (F = 6.25, p = 0.014; and F = 11.91, p = 0.001). Alpha power was increased after treatment, compared with before treatment, but the difference was not prominently significant (p > 0.05). EMG activity was significantly decreased after treatment, compared with before treatment (F = 2.11, p = 0.015). Our findings suggest that BFB treatment based on alpha power and prefrontal EMG relieves insomnia as well as anxiety and depression and may be associated with increased alpha power, decreased beta and theta power, and decreased EMG power

Chiral Photonic Crystalline Microcapsules with Strict Monodispersity, Ultrahigh Thermal Stability, and Reversible Response

Tunable photonic crystals (TPCs) reflecting selected wavelengths of visible light and responding to external stimuli are widely applied to fabricate smart optical devices. Chiral nematic liquid crystals (CNLCs) possessing response to temperature, electric field, and magnetic field are considered as one-dimensional TPCs. The encapsulation of CNLCs provides responsive photonic devices with stand-alone macroscopic structure and excellent processability. However, when CNLCs as cores are wrapped by polymeric shells to form core–shell structured microcapsules, the polydispersity of microcapsule size, the irregular spatial geometry, and the low thermal stability inevitably result in a deterioration of the optical performance and limited application at high temperatures. Herein, a combination of microfluidic emulsification and interfacial polymerization is employed to fabricate polymer wrapped photonic crystalline microcapsules (PWPCMs). The sizes and reflected colors of PWPCMs can be simultaneously controlled by adjusting the flow rates in the microfluidic chips. PWPCMs possess strictly monodispersed sizes with coefficients of variation less than 1%. The free-standing PWPCMs have high thermal stability. The deformation temperature of PWPCMs is as high as 210 °C. The colored PWPCMs also exhibit a reversible thermochromic property between the chiral nematic phase and the isotropic phase. The highly stable and tunable PWPCMs provide new opportunities for a wide range of photonic applications, including smart optical window, tunable microlasers, responsive microsensors, and various photonic devices