Electrophysiological correlates of anticipatory task-switching processes

Recent studies show a differential switch-related positivity emerging before a switch trial and reflecting anticipatory task-set reconfiguration processes. In this study, the switch-related positivity was examined in a cued task-switching paradigm. Cue-stimulus and response-stimulus intervals were independently manipulated to dissociate between the effects of anticipatory preparation and passive dissipation of task-set interference. Reaction time switch cost declined with increasing cue-stimulus and response-stimulus intervals, suggesting a contribution from both active preparation and passive interference processes. In cue-related difference waveforms, a switch positivity peaked around 350-400 ms and is interpreted as reflecting differential activation of task-set reconfiguration. In stimulus-related difference waveforms, a switch-related negativity is believed to indicate the role of S-R priming and response interference in task-switching.     

Predictive factors of failure to control bleeding and 6-week mortality after variceal hemorrhage in liver cirrhosis – a tertiary referral center experience

IntroductionMortality from variceal bleeding remains high despite the therapeutic progress in severe cirrhosis. Understanding the predictive factors of failure to control bleeding (FTB) and mortality will lead to better future therapies. Comorbidities are thought to be important prognostic factors for variceal bleeding. The aim of the study was to assess the factors associated with FTB and with 42-day mortality and to evaluate the influence of comorbidities on these patients’ prognosis.Material and methodsWe prospectively included in the study all consecutive patients with cirrhosis and variceal bleeding presenting to the emergency room and we followed them up over 6 weeks. CirCom score and Charlson index were used for the assessment of comorbidities.ResultsOf the 138 patients included in the study, 27 (19.5%) were considered to have FTB. Child C class (74.07% vs. 32.43%, p < 0.001), Meld score (20.5 vs. 16.00, p = 0.004) and creatinine level (1.04 vs. 0.81, p = 0.01) were associated with FTB, but only Child class was independently associated with FTB in multivariate analysis (OR = 2.94, p = 0.006). Mortality at 42 days (21.7%) was influenced by the severity of the disease assessed through Child class (76.66% vs. 30.55% – Child C, p < 0.001) and MELD score (21.00 vs. 16.00, p < 0.001). Creatinine level (1.00 vs. 0.7, p = 0.02) and acute kidney injury (26.66% vs. 7.40%, p = 0.009) were also prognostic factors for the 6-week mortality. Comorbidities did not influence the mortality (CirCom > 1 (16.7% vs. 21.3%, p = 0.76) or Charlson index > 4 (36% vs. 47.2%, p = 0.41).ConclusionsThe severity of cirrhosis is an important prognostic factor for FTB and 42-day mortality. Identifying the factors associated with early mortality may help selecting patients needing more than conventional therapy.     

Glycemic control and the psychosocial benefits gained by patients with type 1 diabetes mellitus attending the diabetes camp

OBJECTIVE: The aim of this study was to evaluate the effectiveness of diabetes camp on glycemic control, knowledge, and psychosocial benefits among patients with type 1 diabetes (T1D). Glycemic control among patients with infrequent and frequent self-monitoring of blood glucose (SMBG) was also compared. METHODS: During a 5-day camp, 60 patients were taught diabetes self-management education (DSME). After camp, patients were divided into two groups based on frequency of SMBG (<3 versus 3-4 times/day) and were followed up until 6-month post-camp. Patients' HbA1c levels and knowledge were assessed at baseline, 3- and 6-month post-camp. Patients' impressions towards camp were assessed. RESULTS: In both SMBG groups, HbA1c levels decreased significantly at 3-month post-camp but did not sustain at 6-month monitoring. The patients with frequent SMBG had a lower mean HbA1c level. A significant improvement in knowledge was noted and sustained up to 6-month post-camp. The patients found diabetes camp of benefit and felt they could better cope with diabetes. CONCLUSIONS: Although the effect of the diabetes camp on glycemic control was short-lived, an improvement in knowledge and a better attitude towards having diabetes were seen among participants. PRACTICE IMPLICATIONS: The psychosocial benefits and knowledge gained by patients attending diabetes camp underline the importance of including a camp in a diabetes management plan. To improve patients' long-term glycemic control, a continuous education is required.     

The impact of vestibular status prior to cochlear implantation on postural control: A multiple case study

Objective: The goal of the present study was to investigate the impact of unilateral cochlear implantation on postural control in relation to the vestibular status before CI surgery.

Methods: We recruited 17 participants (four CI candidates and 13 hearing controls) and performed complete vestibular evaluation (cVEMP, oVEMP, vHIT) and postural evaluation using a force platform, prior and following unilateral cochlear implant surgery.

Results: Our study suggests that an increase in postural sway following cochlear implant was present only for the participants that received the implant in the ear with the better vestibular function. cVEMP and oVEMP measures in the implanted ear prior to unilateral cochlear implantation may help to predict postural control performance following surgery.

Discussion: A thorough evaluation of the vestibular function, as described in the present study, could not only be helpful to make a more accurate prognosis of the risks of fall following cochlear implantation, but also to provide proper vestibular rehabilitation for at-risk patients.