Responses to the purr call in three areas of the guinea pig auditory cortex

Single electrodes were used to record from anaesthetized animals stimulated with a closed sound system. Neural responses to the purr call were very different in the dorsocaudal core field and in two long-latency belt areas, the ventrorostral belt and the dorsocaudal belt. Responses in the dorsocaudal core field were accurately timed to the start of the nine rhythmic pulses within the purr while the ventrorostral belt responses were more sustained and less temporally precise and most dorsocaudal belt units did not respond. These results are consistent with the separate processing of narrow-band tonal stimuli such as the purr by a ventrorostral pathway involving the primary auditory area and the ventrorostral belt but not by a dorsocaudal pathway from the dorsocaudal core field to the dorsocaudal belt area.     

Developing a method to identify medicines non-adherence in a community sample of adults with epilepsy

The aim is to propose a simple way of identifying patients at risk of antiepileptic drug (AED) non-adherence during epilepsy review (a scheduled consultation to review the patient and their condition). The use of a multi-modal approach to the problem of non-adherence is necessary because of the limitations of existing methods. A mixed methodology was developed in a nested study using a case record review to calculate the medicine possession ratio (MPR) from the AED medication records of a community sample, a literature review and a consensus panel to develop a questionnaire to address how people manage their epilepsy, particularly medicine management, and how to collect information about non-adherence through stated findings in keeping with non-adherent behavior. Results show that a medicine record can be used to estimate the MPR (<80% indicates non-adherence) and that an open and non-confrontational consultation style can be fostered by using key questions within the consultation to identify those at risk of non-adherence.     

Record-keeping in a state hospital: a modification of the Weed system.

The Weed problem-oriented medical record has been modified for use in a state psychiatric hospital that has a large proportion of long-term patients and uses an interdisciplinary team approach to treatment. Three new record forms were developed during a pilot study at the hospital: the processed-problem list, the problem card, and the unprocessed-problem list. The modified problem-oriented record system is being used in 28 wards providing both short- and long-term psychiatric care.     

Using quality improvement teams to improve documentation in records at a community mental health center

OBJECTIVE: A community mental health center sought a system for qualitative review of patients' records to improve the quality of documentation through the engagement of clinical staff in the review process. METHODS: The center developed a quality improvement system in which treatment team clinicians use a scored 30-item protocol to measure the quality of record documentation by peers. Questions address whether the record documents the full range of the psychiatric treatment process, including assessment and diagnosis, treatment planning, and provision of clinical services. Other questions address specific contractual or regulatory requirements, such as whether procedure codes are correct, and evaluate the physician's record of medication management. Each treatment team at the mental health center's six clinics has a quality improvement work group, composed of the team psychiatrist and at least one other team clinician. Each month the work group meets to review two randomly selected medical records from another treatment team at the same clinic and arrive at a consensus score. An administrative oversight team meets regularly with clinician-reviewers to foster uniform scoring of the protocol throughout the center. RESULTS: An analysis of the trend in protocol scores over a 21-month period suggests that the procedure improves the quality of the documentation in patients' records. CONCLUSIONS: A team-based quality review process appears to have a positive impact on the quality of medical record documentation. Improved documentation may improve continuity of care and improve the accuracy of record information used for other quality measurement systems.     

A simplified diagnostic approach to dizziness in children

The objective of the study was to validate the effectiveness of a questionnaire and computer-assisted algorithm in diagnosing children with dizziness or vertigo. Dizziness and vertigo are common complaints in children, causing an extensive, often unnecessary evaluation. A pediatric "dizziness questionnaire" was designed and a computer-assisted algorithm was developed to facilitate the diagnostic task. A retrospective medical record review was conducted on all children presenting to the clinic for dizziness or vertigo throughout a 2-year period. The information was used by one investigator to complete the questionnaire and by the other, the algorithm. The two diagnoses thus obtained were compared by the third investigator to the medical record diagnosis. Sixty-two records were reviewed. The final diagnoses were migraine (39%), benign paroxysmal vertigo (15%), vestibular neuronitis (14%), and anxiety (13%). In 57 patients (92%), the questionnaire-derived diagnosis was identical to the medical record diagnosis. In 52 patients (84%), the algorithm-derived diagnosis matched the medical record diagnosis. The questionnaire and computer-assisted algorithm are reliable diagnostic screening tools for children with dizziness or vertigo. When these tools combined provide a clear-cut diagnosis, no further evaluation is necessary.     

Patients' concerns about and perceptions of electronic psychiatric records

This study assessed concerns about and perceptions of electronic psychiatric records in a university psychiatric adult outpatient clinic. Forty-one patients who refused to have their psychiatric records transferred to the electronic record system were compared with 39 patients who agreed to an electronic record. Regardless of whether or not they refused to have their information transferred to an electronic record, a majority of patients reported numerous concerns about electronic records, such as concerns about unauthorized access to their records by parties within the university health care system. Patients' concerns may affect patient disclosure and other help-seeking behavior and therefore must be addressed by clinicians and health care systems.     

Altered caudate nucleus field potentials following sustained stimulation to different substantia nigra regions

Evoked potential recording techniques were used as a physiological tool for electrode placement into the substantia nigra pars compacta (SNpc). It was found that when the recording electrodes were implanted at the level of the caudate nucleus (CN), typical patterns were obtained only when the stimulation electrode was located in the SNpc. When the stimulation electrode was fixed in the SNpc and four electrodes were simultaneously used to record depth profile from the caudate nucleus and the septum, the typical responses following stimulation were obtained only when electrodes were within the CN head. High frequency stimulation of the SNpc, which is known to alter dopamine content within the CN, caused a reversible diminution of responses in CN for 5-10 min. This observation was discussed in terms of terminal transmitter depletion.     

Psychiatric disorders prior to amyotrophic lateral sclerosis

It is recognized that neuropsychiatric conditions are overrepresented in amyotrophic lateral sclerosis (ALS) patient kindreds and psychiatric symptoms may precede the onset of motor symptoms. Using a hospital record linkage database, hospitalization with a diagnosis of schizophrenia, bipolar disorder, depression, or anxiety was significantly associated with a first diagnosis of ALS within the following year. This is likely to specifically reflect the clinicopathological overlap of ALS with frontotemporal dementia. A diagnosis of depression was significantly associated with a first record of ALS ≥5 years later, in keeping with growing evidence for major depressive disorder as an early marker of cerebral neurodegeneration. Ann Neurol 2016;80:935–938     

Understanding obstacles to the recognition of and response to dementia in different European countries: a modified focus group approach using multinational, multi-disciplinary expert groups

Experts from eight European countries (Belgium, France, The Netherlands, Ireland, Italy, Portugal, Spain and the United Kingdom) and the disciplines of clinical psychology, general practice, geriatric medicine, old age psychiatry, medical sociology, nursing and voluntary body organisation met in 2003 to explore obstacles to recognition of and response to dementia in general practice within Europe. A modified focus group methodology was used in this exploratory process. Groups were conducted over a two-day period, with five sessions lasting 1-1.5 hours each. An adapted nominal group method was used to record themes arising from the group discussion, and these themes were used in a grounded theory approach to generate explanations for delayed recognition of and response to dementia. The overarching theme that arose from the focus groups was movement, which had three different expressions. These were: population movement and its consequences for localities, services and professional experience; the journey of the person with dementia along the disease process; and the referral pathway to access services and support. Change is the core issue in dementia care, with multiple pathways of change that need to be understood at clinical and organisational levels. Practitioners and people with dementia are engaged in managing emotional, social and physical risks, making explicit risk management a potentially important component of dementia care. The boundary between generalist and specialist services is a particular problem, with great potential for dysfunctionality. Stigma and ageism are variably distributed phenomena both within and between countries.     

Federated Access to Heterogeneous Information Resources in the Neuroscience Information Framework (NIF)

The overarching goal of the NIF (Neuroscience Information Framework) project is to be a one-stop-shop for Neuroscience. This paper provides a technical overview of how the system is designed. The technical goal of the first version of the NIF system was to develop an information system that a neuroscientist can use to locate relevant information from a wide variety of information sources by simple keyword queries. Although the user would provide only keywords to retrieve information, the NIF system is designed to treat them as concepts whose meanings are interpreted by the system. Thus, a search for term should find a record containing synonyms of the term. The system is targeted to find information from web pages, publications, databases, web sites built upon databases, XML documents and any other modality in which such information may be published. We have designed a system to achieve this functionality. A central element in the system is an ontology called NIFSTD (for NIF Standard) constructed by amalgamating a number of known and newly developed ontologies. NIFSTD is used by our ontology management module, called OntoQuest to perform ontology-based search over data sources. The NIF architecture currently provides three different mechanisms for searching heterogeneous data sources including relational databases, web sites, XML documents and full text of publications. Version 1.0 of the NIF system is currently in beta test and may be accessed through .     

An epidural intracranial pressure monitor for experimental use in the rat

We described the construction and use of a simple and reliable catheter system that can be used to monitor intracranial pressure (ICP) from the epidural space in rats in an experimental setting. The catheter system is easily fabricated in the laboratory from readily available materials. The monitor is fitted flush with the inner table through a burr hole in the temporal squama. A side port is used to fill the system with saline and to irrigate the system should be catheter become obstructed. The distal end of the catheter is fitted to a pressure transducer that is connected to a graphic display and recording system. This system was used to record ICP in 30 anaesthetized adult rats. Seven were subjected to baseline ICP recording only and 23 were subjected to baseline recordings followed by epidural balloon compression of the contralateral hemisphere. Baseline ICP varied between 0 and 8 mmHg and respiratory variation could be detected on the tracings for 24 rats (75%). ICP responded directly and sensitively to epidural balloon inflation in all 23 rats tested. In 5 rats that died during balloon inflation, the decrease in ICP after death followed closely the loss of arterial blood pressure. There was a close correlation of numerical values obtained in two rats in which ICP was recorded simultaneously from the epidural catheter and from a catheter in the subarachnoid space at the cisterna magna. In one rat in which ICP increased to more than 70 mmHg, the epidural catheter continued to record ICP accurately while the cisternal catheter became obstructed with herniated brain.(ABSTRACT TRUNCATED AT 250 WORDS)     

Using double-magnetic induction to measure head-unrestrained gaze shifts. I. Theory and validation

So far, the double-magnetic induction (DMI) method has been successfully applied to record eye movements from head-restrained humans, monkeys and cats. An advantage of the DMI method, compared to the more widely used scleral search coil technique, is the absence of vulnerable lead wires on the eye. A disadvantage, however, is that the relationship between the eye-in-head orientation and the secondary induction signal is highly non-linear and non-monotonic. This limits the effective measuring range to maximum eye orientations of about +/-30 degrees . Here, we analyze and test two extensions required to record the full eye-head orienting range, well exceeding 90 degrees from straight-ahead in all directions. (1) The use of mutually perpendicular magnetic fields allows for the disambiguation of the non-monotonic signal from the ring. (2) The application of an artificial neural network for offline calibration of the signals. The theoretical predictions are tested for horizontal rotations with a gimbal system. Our results show that the method is a promising alternative to the search coil technique.     

新一代卒中电子病历系统的建立与应用

在卒中患者的治疗过程中,患者临床信息、化验检查信息、病情转归信息及随访信息等数据对临床医生从事临床和科研工作极为重要。但是,由于卒中病历需要记载的医疗信息内容繁多,且通常以纸质形式存在,使得卒中病历相关信息在临床科研及教学等工作中无法得到充分利用。本研究将针对以上问题,重点阐述卒中电子病历系统的设计与功能。从而说明该系统符合卒中临床诊治信息承载功能,能够实现科学研究的电子病历系统。     

Facts, paradigms, and anomalies in the acceptance of energy psychology: A rejoinder to McCaslin's (2009) and Pignotti and Thyer's (2009) comments on Feinstein (2008a)

Allegations of selection bias and other departures from critical thinking in Feinstein (see record 2008-07317-008) found in the Pignotti and Thyer (see record 2009-08897-011), and the McCaslin (see record 2009-08897-010) commentaries, are addressed. Inaccuracies and bias in the reviewers' comments are also examined. The exchange is shown to reflect a paradigmatic clash within the professional community, with energy psychology having become a lightning rod for this controversy. While postulated "subtle energies" and "energy fields" are entangled in this debate, the most salient paradigm problem for energy psychology may simply be that accumulating reports of its speed and power have not been explained using established clinical models. (PsycINFO Database Record (c) 2010 APA, all rights reserved).     

Intra-subject reliability of parameters contributing to maps generated by transcranial magnetic stimulation in able-bodied adults.

OBJECTIVE: This study evaluated the reliability of several parameters contributing to topographic motor cortical maps of the extensor digitorum communis (EDC) within able-bodied participants, across 3 sessions and from both hemispheres with greater precision than previously reported. METHODS: Nine healthy right-handed males aged 44-75 years were studied at 3 separate sessions, spaced 7-14 days apart. Transcranial magnetic stimulation (TMS) was used to elicit motor evoked potentials (MEP) in the contralateral EDC. Closely spaced surface electrodes were used to record the MEPs. RESULTS: TMS-related parameters did not demonstrate a significant difference within participants across sessions and between hemispheres, with the exception of the hotspot distance, center of gravity distance, and normalized map volume. Hotspot and COG distances were determined from the Euclidean equation to calculate the distance in x,y coordinates traveled over sessions: one to two (distance A) and two to three (distance B). The hotspot distance, center of gravity distance and normalized map volume demonstrated a significant difference between right and left hemispheres, within participants. Adjusting for time and examining mean changes for hemispheres across sessions revealed that there was a 9-fold greater movement over sessions in the left hemisphere among these variables. CONCLUSIONS: TMS-related parameters are reliable within participants across 3 sessions. These data should be useful for planning and interpreting TMS studies using a healthy or patient population before and after an intervention.     

Evolution from a locked to an open ward through therapeutically guided group meetings

This paper describes dramatic changes that took place during a two-and-a-half year period within a ward of chronic schizophrenic female patients (140) of a large mental hospital (7,500). Some of the significant problems, techniques used to cope with them, and clinical observations are described. The achievements were possible, the author believes, because resources within the staff and patients were organized by means of regularly scheduled group meetings. Through the process of identifying and accomplishing feasible group goals, the author believes large numbers of institutionalized patients can be helped in spite of limited availability of professional personnel.He wishes to express his appreciation to the staff and patients of Manteno State Hospital, particularly to the James sub-unit of Unit A for the opportunity to work with them and make this record if their accomplishments during the period July, 1963, through February, 1966.     

Two-dimensional photon counting imaging and spatiotemporal characterization of ultraweak photon emission from a rat's brain in vivo

The process of metabolic reactions within living cells leads to spontaneous ultraweak light emission. The development of a system for highly sensitive imaging and spatiotemporal analysis of ultraweak photon emission from a rat's brain is reported in this paper. The equipment used in this experiment consists of a two-dimensional photon-counting tube with a photocathode measuring 40 mm in diameter, a highly efficient lens system, and an electronic device to record time series of a photoelectron train with spatial information. The sensitivity and ability to extract spatiotemporal information from sequential data of a single photoelectron train were examined. The minimum detectable radiant flux density of the system was experimentally estimated to be 9.9 x 10(-17) W/cm2 with a 1-s observation time. Spontaneous photon emission was demonstrated from an exposed rat's cortex in vivo without adding any chemical agent or employing external excitation. An image of ultraweak photon emission was compared with one obtained after cardiac arrest. The intensity after cardiac arrest was depressed to approximately 60% of before that. The regional properties of time courses of emission intensity were also demonstrated, indicating the potential usefulness for spatiotemporal characterization of photon emission with mapping of physiological information such as oxidative stress. This technology constitutes a novel method, with the potential to extract pathophysiological information from the central nervous system.     

Microneurography in relation to intraneural topography: somatotopic organisation of median nerve fascicles in humans.

Microneurography was performed in median nerve sensory fascicles with concentric needle electrodes and with conventional tungsten microneedles. The latter electrodes preferentially recorded activity from the myelinated fibres in the whole fascicle. By contrast, due to its special design, a concentric needle can record activity selectively from even a small part of a fascicle. High amplitude signals in C fibres can be discriminated close to Schwann cells that envelope unmyelinated axons. Apart from being biased for activity in thin fibres, the concentric needles can also record signals from nearby myelinated fibres. The palmar receptive fields of such fibre groups were not congruent with the areas traditionally attributed to multiunit skin afferents in humans, namely the innervation zone(s) of one or two adjacent digital nerve(s). Instead, the multiunit fields often comprised small parts of a digital nerve innervation area, frequently only the pulp of a finger. Single units were always localised within previously screened multiunit areas. Contrary to some previously accepted tenets it is probable that single unit activity in myelinated fibres in these studies is recorded extra-axonally near to a node of Ranvier. The findings also suggest the presence of a somatotopy in human limb nerve fascicles, comparable to that previously established in the spinal cord and the somatosensory cortex.     

New sphenoidal electrode assembly to permit long-term monitoring of the patient's ictal or interictal EEG.

A new sphenoidal wire electrode is described which greatly increases the clinical and diagnostic usefulness of sphenoidal electrode recordings. These very fine wire electrodes are easy to insert; they are comfortable and acceptable to the patient. In contrast to sphenoidal needle electrodes they expose the patient to no risk should he have a seizure during recording. These electrodes also allow one to extend the recording time to several days, thus increasing the chances of recording a spontaneous seizure, for instance while the patient's EEG is being recorded with a telemetry system. The extended recording time also allows for continuous automatic sampling of the interictal EEG over a period of several days. The quality and the reliability of the EEG record are also enhanced. The new sphenoidal electrodes have been used on over 100 patients and are now being used routinely on suspected temporal lobe epileptics recorded with conventional techniques, while 50 of the patients have also been recorded with a cable-telemetry seizure monitoring system which has captured 65 spontaneous seizures.