Learning and retention of computer-related vocabulary in memory-impaired patients: method of vanishing cues

Several investigators have suggested that microcomputers might serve as useful external aids for memory-impaired patients. However, knowledge of basic computer vocabulary may be necessary for patients to use and benefit from a microcomputer. The present paper describes a procedure, the method of vanishing cues, which facilitated the acquisition of computer-related vocabulary in four memory-impaired patients. The method involves the systematic reduction of letter fragments of to-be-learned words across trials. Although learning was slow and strongly dependent on first-letter cues, all patients acquired a substantial amount of the vocabulary and eventually were able to produce the target words in the absence of fragment cues. Further, they retained the vocabulary over a 6-week interval and showed some transfer of the knowledge they had acquired. These findings suggest that memory-impaired patients may eventually be able to use a microcomputer as a prosthetic device.     

Novelty and Familiarity Activations in PET Studies of Memory Encoding and Retrieval

Nine young right-handed men viewed colored pictures of people,scenes, and landscapes. Then, 24 hr later while undergoing PETscanning, they viewed previously studied (OLD) pictures in onetype of scan, and previously not seen (NEW) pictures in another.The OLD-NEW subtraction of PET images indicates familiarity,and the NEW-OLD indicates novelty. Familiarity activations,signalling aspects of retrieval, were observed in the left andright frontal areas, and posterior regions bilaterally. Noveltyactivations were in the right limbic regions, and bilaterallyin temporal and parietal regions, including area 37. These latteractivations were located similarly to novelty activations inprevious PET studies using visual words and auditory sentences,suggesting the existence of brain regions specializing in transmodalnovelty assessment The effects of novelty are seen both be haviorallyand in replicable patterns of cortical and subcortical activation.We propose a "novelty/encoding hypothesis": (1) novelty assessmentrepresents an early stage of long-term memory encoding; (2)elaborate, meaning-based encoding processes operate on the incoming information to the extent of its novelty, and therefore(3) the probability of long-term storage of information vanesdirectly with the novelty of the information.     

General and specific brain regions involved in encoding and retrieval of events: what, where, and when.

Remembering an event involves not only what happened, but also where and when it occurred. We measured regional cerebral blood flow by positron emission tomography during initial encoding and subsequent retrieval of item, location, and time information. Multivariate image analysis showed that left frontal brain regions were always activated during encoding, and right superior frontal regions were always activated at retrieval. Pairwise image subtraction analyses revealed information-specific activations at (i) encoding, item information in left hippocampal, location information in right parietal, and time information in left fusiform regions; and (ii) retrieval, item in right inferior frontal and temporal, location in left frontal, and time in anterior cingulate cortices. These results point to the existence of general encoding and retrieval networks of episodic memory whose operations are augmented by unique brain areas recruited for processing specific aspects of remembered events.     

Ficolin-2 recognizes DNA and participates in the clearance of dying host cells

Ficolin-2 is a serum opsonin, which has been shown to be a pattern recognition molecule in the lectin complement activation pathway. Because innate immune mechanisms are involved in maintaining tissue homeostasis we hypothesized that Ficolin-2 also participate in the clearance of dying host cells. We found that Ficolin-2 binds to late apoptotic cells, as well as to apoptotic bodies and necrotic cells, but not to early apoptotic cells. We demonstrated that Ficolin-2 binds DNA in a calcium dependent manner and that DNA inhibits the binding to late apoptotic and necrotic cells, suggesting that DNA on permeable dying cells is a plausible ligand. Reconstituting serum deficient of Ficolin-2, C1q and mannose-binding lectin with Ficolin-2 augmented deposition of complement C4 on necrotic cells. Opsonization leads to an enhanced attachment/uptake of necrotic cells by macrophages. In conclusion dying host cells expose ligands with the capacity of binding Ficolin-2, which in turn leads to increased attachment and engulfment. Binding of Ficolin-2 to DNA points at nucleic acid exposed by permeable late apoptotic and necrotic cells as one of the ligands for Ficolin-2. Ficolin-2 may therefore be a scavenger molecule participating in the removal of host cells and maintenance of tissue homeostasis.     

Memory encoding and retrieval on the ascending and descending limbs of the blood alcohol concentration curve

Rationale Little is known about acute effects of alcohol on memory encoding and retrieval on different limbs (ascending and descending) of the blood alcohol concentration (BAC) curve. Objectives This extensive experiment was designed to examine alcohol's effects on memory encoding and retrieval throughout a protracted drinking episode. Methods In a 9-h session, male participants consumed either alcohol (1 ml/kg) or placebo (n=32/32) over a period of 90 min and learned various materials in different memory tasks before, during, and after consuming the drinks, while their BAC levels were monitored. A week later, in a similar session, they were tested on learned materials before, during, and after drinking. Mood was assessed throughout both sessions. Results Alcohol impaired recall of words more than recognition, and cued recall most severely. Perceptual priming and picture recognition were not affected by alcohol. Alcohol impaired encoding in cued recall, recognition of completed word fragments, and free recall regardless of limb, but impaired retrieval in word recognition only during the ascending BAC. Alcohol increased negative mood on the descending limb during the first session, and on the ascending limb during the second session. Conclusions Under naturalistic drinking conditions, alcohol's effects on memory depend on task, memory process, and limb of the BAC curve. The differential effects of alcohol on retrieval during the ascending and descending limbs demonstrate the importance of examining the differential effects on the two limbs.     

Reimbursement strategies for botulinum toxin type A in Austria

In the last two decades, botulinum toxin A (BtxA) has become the treatment of choice for spasmodic torticollis, blepharospasm and hemifacial spasm. Since 1999 Dysport and Botox are approved in Austria for the treatment of these indications. BtxA is applied in the hospital (out- and in-patient clinics) and by specialists (especially neurologists) in private practices. Complete reimbursement of the costs by the health insurance is provided only if the treatment has taken place in the specialist's private practice. The costs of BtxA application in the hospital are partially covered by the so called "LKF points" (Austrian system for reimbursement of costs in the hospital) or by the flat rate fee for out-patients. Approval for other indications for BtxA is expected in the next years, therefore appropriate cost reimbursement for BtxA is of immense importance. Different reimbursement systems are discussed in the following article. It seems useful to adopt approved procedures in special situations, such as reimbursement for the ambulatory application of chemotherapy and Betainterferon in Austria. The appropriate reimbursement system has to consider the indication and documentation of Btx-treatments as well as the qualification of the Btx-user.     

Computer learning by memory-impaired patients: acquisition and retention of complex knowledge

Several investigators have shown that memory-impaired patients are capable of learning relatively simple information in both the laboratory and everyday life. The present research explored whether patients with memory disorders could also acquire complex knowledge--the domain-specific knowledge needed for operating and interacting with a microcomputer. The results indicated that patients with memory disorders of varying severity could learn to manipulate information on the computer screen, to write, edit and execute simple computer programs, and to perform disk storage and retrieval operations. The learning process, however, was slow relative to controls and the knowledge acquired appeared to be qualitatively different. Theoretical and practical implications of these findings are discussed.     

Using national electronic health care registries for comparing the risk of psychiatric re-hospitalisation in six European countries: Opportunities and limitations

Psychiatric re-hospitalisation rates have been of longstanding interest as health care quality metric for planners and policy makers, but are criticized for not being comparable across hospitals and countries due to measurement unclarities. The objectives of the present study were to explore the interoperability of national electronic routine health care registries of six European countries (Austria, Finland, Italy, Norway, Romania, Slovenia) and, by using variables found to be comparable, to calculate and compare re-hospitalisation rates and the associated risk factors. A “Methods Toolkit” was developed for exploring the interoperability of registry data and protocol led pilot studies were carried out. Problems encountered in this process are described. Using restricted but comparable data sets, up to twofold differences in psychiatric re-hospitalisation rates were found between countries for both a 30- and 365-day follow-up period. Cumulative incidence curves revealed noteworthy additional differences. Health system characteristics are discussed as potential causes for the differences. Multi-level logistic regression analyses showed that younger age and a diagnosis of schizophrenia/mania/bipolar disorder consistently increased the probability of psychiatric re-hospitalisation across countries. It is concluded that the advantage of having large unselected study populations of national electronic health care registries needs to be balanced against the considerable efforts to examine the interoperability of databases in cross-country comparisons.