Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS

Background: It is currently unknown whether results from intraoperative test stimulation of two types of Deep Brain Stimulation (DBS), either during awake pallidal (GPi) or thalamic (Vim), are comparable to the results generated by chronic stimulation through the definitive lead.Objective: To determine whether side-effects-thresholds from intraoperative test stimulation are indicative of postoperative stimulation findings.Methods: Records of consecutive patients who received GPi or Vim were analyzed. Thresholds for the induction of either capsular or non-capsular side-effects were compared at matched depths and at group-level.Results: Records of fifty-two patients were analyzed (20 GPis, 75 Vims). The induction of side-effects was not significantly different between intraoperative and postoperative assessments at matched depths, although a large variability was observed (capsular: GPi DBS: p = 0.79; Vim DBS: p = 0.68); non-capsular: GPi DBS: p = 0.20; and Vim DBS: p = 0.35). Linear mixed-effect models revealed no differences between intraoperative and postoperative assessments, although the Vim had significantly lower thresholds (capsular side-effects p = 0.01, non-capsular side-effects p < 0.01). Unpaired survival analyses demonstrated lower intraoperative than postoperative thresholds for capsular side-effects in patients under GPi DBS (p = 0.01), while higher intraoperative thresholds for non-capsular side-effects in patients under Vim DBS (p = 0.01).Conclusion: There were no significant differences between intraoperative and postoperative assessments of GPi and Vim DBS, although thresholds cannot be directly extrapolated at an individual level due to high variability.

Annual Population Dynamics and Their Influencing Factors for an Endangered Submerged Macrophyte (Ottelia cordata)

Due to wetland loss, Ottelia cordata (O. cordata, Wallich) Dandy has been categorized as an endangered species on the List of Key Protected Wild Plants in China. Quantifying the relative importance of demographic (i.e., growth, survival, and reproduction) and habitat preference traits on the population dynamics (abundance) of O. cordata could guide how to develop the best recovery strategies of O. cordata, yet currently, there are no studies that investigate this. By monitoring monthly changes in O. cordata abundance and demographic traits (plant height, leaf area, flower sex ratio, and seed number) that were highly correlated with growth rate, photosynthetic rate, and water depth, we identified several relationships. Linear mixed-effect models and variance partition quantified the specific effects of four demographic traits and water depth on O. cordata abundance in three habitat types (paddyfield, stream, and spring). The linear mixed-effect models indicate that among the four demographic traits, height could be significantly positively correlated to abundance in all three habitat types. In contrast, other three traits (leaf area, sex ratio, and seed numbers) were non-significantly associated with abundance across each habitat. Height was determined by water depth, so water depth rather than photosynthetic rate and reproduction rate may promote the development and recovery of O. cordata populations. Variance partition results showed that water depth mediated the positive influence of growth rate on the abundance of O. cordata in the living habitats (paddyfield and spring). In contrast, water depth but not growth rate determined the abundance of O. cordata in the living habitat (stream). However, water depth had a significantly negative impact on the abundance of O. cordata in stream habitats, likely because all of the streams were shallow. Altogether, in the short term for avoiding the potential harm or even extinction of O. cordata, keeping appropriate water depth or transplanting O. cordata to spring should be an effective strategy because the water is not only deep enough but also clear in spring habitats. Additionally, water turbidity was shown to affect the density of O. cordata growth, wherein O. cordata was sparsely distributed when turbidity was high. Therefore, in the long run, to make the population gradually recovery, it will be necessary to restore the degraded wetland. This could be accomplished by reducing water pollution and removing sludge to reduce turbidity and increase hydrological connectivity.

The role of incubator classification on performance of incubators in Kenya.

The study sought to assess the importance of classifying incubators based on the programs offered for optimum performance. Client selection criteria were assessed through three constructs namely: models that fit program goals, uniqueness of ideas, and standard selection tool. A mixed cross-sectional and causal design was adopted and a census was carried out targeting all the 51 incubators. Primary data was collected with an incubator program as a grouping/ cluster variable yielding a multilevel data structure with incubator centres nested in programs. Linear mixed effect models were fitted using Stata to assess the study objective taking into account the fixed effects for the incubator centre level (level-1) and random effects for the program level (level-2). The uniqueness of ideas was found to have a significant fixed effect on performance at level one while at level two, the study found significant random intercepts of incubator centre performance across the programs. Models that match program goals and standard selection tools were also found to have significant random slopes as level two random covariates in the model. Based on the findings of significant random slopes, the study concluded that incubator classification is key for client selection criteria and enhances incubator performance.

The differences of poor SRH among municipalities in Iwate after the Great East Japan Earthquake

The health of communities has been observed to recover at differential rates in the wake of disasters. In the present study, the 5-year trends in poor self-rated health (SRH) in three municipalities of Iwate Prefecture following the 2011 Great East Japan Earthquake and Tsunami were compared. Annual surveys were conducted from 2011 to 2015 in three municipalities (Otsuchi, Rikuzentakata, and Yamada) that were heavily damaged by the tsunami. We tracked the prevalence of poor SRH in 10,052 participants (mean age, 61.0 years; 39.0% men). Trends in the prevalence of poor SRH were analyzed using generalized linear mixed effect models with control for covariates. Immediately after the disaster (2011), all three municipalities reported similar prevalences of poor SRH (around 15%). Among people under the age of 65 years, there was a gradual improvement in health for residents of Rikuzentakata and Yamada, but the prevalence of poor SRH remained persistently high in Otsuchi. Among people over the age of 65 years, the prevalence of poor SRH remained constant in Rikuzentakata and Yamada but increased over a 5-year follow-up period in Otsuchi. The delayed health recovery in Otsuchi may be due to the characteristics of the local health system. Examination of the variations in health recovery may provide clues about the sources of disaster resilience.

Pain and the Emotional Brain: Affective Rather than Cognitive Processes Drive the Cortical Encoding of Pain

The experience of pain has been dissociated into two interwoven aspects: a sensory-discriminative aspect assessed in ratings of pain intensity and an affective-motivational aspect assessed in ratings of unpleasantness. In a pain attenuation paradigm, participants were asked to evaluate applied cold pain. The majority of the trials showed a distinct rating: Some trials were rated higher for unpleasantness, others were rated higher for intensity. Using linear mixed effect models on single trials, we related the variable difference between unpleasantness and intensity ratings to functional MRI data. The direct comparison revealed a stronger relationship between cortical data and pain ratings for unpleasantness. No region showed a stronger effect for pain intensity. The present study underlines the importance of the emotional-affective aspects of pain-related cortical processes in the brain. These findings reflect the biological function of the pain system to prevent harm and to preserve the physical integrity of the body.

Role of temperature, influenza and other local characteristics in seasonality of mortality: a population-based time-series study in Japan

ObjectivesTo investigate the extent to which temperature and influenza explained seasonality of mortality in Japan and to examine the association of the seasonality with prefecture-specific characteristics.DesignWe conducted time-series analysis to estimate the seasonal amplitude before and after adjusting for temperature and/or influenza-like illness (ILI). Next, we applied linear mixed effect models to investigate the association of seasonal amplitudes with each indicator on prefecture-specific characteristics on climate, demographic and socioeconomic factors and adaptations.Setting47 prefectures in JapanParticipantsDeaths for all-cause, circulatory, and respiratory disease between 1999 and 2015.Outcome measuresPeak-to-trough ratio (PTR, a measure of seasonal amplitude).ResultsThe nationwide unadjusted-PTRs for all-cause, circulatory and respiratory mortality were 1.29 (95% CIs: 1.28 to 1.31), 1.55 (95% CI: 1.52 to 1.57) and 1.45 (95% CI: 1.43 to 1.48), respectively. These PTRs reduced substantially after adjusting for temperature but very little after a separate adjustment for ILI. Furthermore, seasonal amplitudes varied between prefectures. However, there was no strong evidence for the associations of PTR with the indicators on prefecture-specific characteristics.ConclusionsSeasonality of mortality is primarily driven by temperature in Japan. The spatial variation in seasonal amplitudes was not associated with prefecture-specific characteristics. Although further investigations are required to confirm our findings, this study can help us gain a better understanding of the mechanisms underlying seasonality of mortality.

Elites Do Not Deplete – No Effect of Prior Mental Exertion on Subsequent Shooting Performance in Elite Shooters

In order to perform at the highest level, elite shooters have to remain focused during the whole course of a tournament, which regularly lasts multiple hours. Investing self-control over extended time periods is often associated with lower levels of perceived self-control strength (i.e., the subjective estimation of how much mental effort one is capable of investing in a given task) and impaired performance in several sports-related domains. However, previous findings on the effects of prior self-control efforts on shooting performance have been mixed, as elite shooters seem to be less affected by preceding self-control demanding tasks than sub-elite athletes. Therefore, the aim of the present study was to investigate the effects of self-control on shooting performance in elite shooters. Hence, we randomly assigned elite shooters to an experimental (n = 12) or a control condition (n = 11) and asked them to perform a series of 40 shots at baseline (T1) and again after a task which either did or did not require self-control (T2). Additionally, we continuously measured the shooters’ level of perceived self-control strength. We assumed that in elite athletes, shooting accuracy as well as the perceived level of self-control strength would not be significantly affected over time from T1 to T2 in both conditions. In line with our assumptions, Bayesian linear mixed effect models revealed that shooting performance remained relatively stable in both conditions over time and the conditions also did not differ significantly in their perceived levels of self-control strength. Contrary to resource-based theories of self-control, these results speak against the idea of a limited self-control resource as previous acts of self-control did not impair subsequent shooting performance in elite athletes.

Abstract P214: Ideal Cardiovascular Health And Progression Of Extra-coronary Calcification In The Multi-ethnic Study Of Atherosclerosis

Background: Ideal cardiovascular health (CVH) is associated with a lower incidence of cardiovascular disease (CVD). Extra-coronary calcification (ECC) – measured at the aortic valve (AVC), mitral annulus (MAC), ascending thoracic aorta (ATAC) and descending thoracic aortic (DTAC) – is an indicator of systemic atherosclerosis. However, the association between ideal CVH and ECC is unknown. This study examined whether favorable CVH was associated with a lower risk of ECC. Methods: We analyzed data from 6,504 men and women aged 45-84 years from MESA, a multi-ethnic cohort free of CVD at baseline. Extra-coronary calcification [AVC, MAC, ATAC and DTAC] was measured by non-contrast cardiac CT scan at baseline and after an average of 2.4 years. Prevalent and incident ECC were defined as an Agatston score >0. Each CVH metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) was scored 0-2 points, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. The maximum CVH score attainable ranged from 0-14 points (inadequate score: 0-8; average: 9-10; optimal: 11-14). We used Poisson regression and linear mixed-effect models to examine the association between CVH and ECC adjusted for age, sex, race/ethnicity, education, income, health insurance and study site. Results: The mean (SD) age of participants was 62 (10) years, 53% were women, 39% White, 12% Chinese American, 26% Black and 22% Hispanic. Optimal and average CVH scores were associated with a lower prevalence and incidence of ECC as well as lower ECC extent at baseline compared to inadequate scores (Table). In addition, optimal and average CVH scores were associated with less ECC progression at 2 years although the associations were only significant for MAC and DTAC. Conclusion: In this multi-ethnic cohort, favorable CVH was associated with a lower risk of developing extra-coronary atherosclerosis. These findings underscore the importance of primordial prevention as an intervention to reduce the burden of CVD.