Delimiting subterritories of the human subthalamic nucleus by means of microelectrode recordings and a Hidden Markov Model

Positive therapeutic response without adverse side effects to subthalamic nucleus deep brain stimulation (STN DBS) for Parkinson's disease (PD) depends to a large extent on electrode location within the STN. The sensorimotor region of the STN (seemingly the preferred location for STN DBS) lies dorsolaterally, in a region also marked by distinct beta (13–30 Hz) oscillations in the parkinsonian state. In this study, we present a real‐time method to accurately demarcate subterritories of the STN during surgery, based on microelectrode recordings (MERs) and a Hidden Markov Model (HMM). Fifty‐six MER trajectories were used, obtained from 21 PD patients who underwent bilateral STN DBS implantation surgery. Root mean square (RMS) and power spectral density (PSD) of the MERs were used to train and test an HMM in identifying the dorsolateral oscillatory region (DLOR) and nonoscillatory subterritories within the STN. The HMM demarcations were compared to the decisions of a human expert. The HMM identified STN‐entry, the ventral boundary of the DLOR, and STN‐exit with an error of ?0.09 ± 0.35, ?0.27 ± 0.58, and ?0.20 ± 0.33 mm, respectively (mean ± standard deviation), and with detection reliability (error < 1 mm) of 95, 86, and 91%, respectively. The HMM was successful despite a very coarse clustering method and was robust to parameter variation. Thus, using an HMM in conjunction with RMS and PSD measures of intraoperative MER can provide improved refinement of STN entry and exit in comparison with previously reported automatic methods, and introduces a novel (intra‐STN) detection of a distinct DLOR‐ventral boundary. © 2009 Movement Disorder Society     

The experiences and needs of individuals with disabilities exposed to chronic political violence

Purpose The main objective of this study was to understand, describe and map the experiences, challenges and needs of individuals with lifelong disabilities, who have been exposed to chronic politically violent events (terror, war or continuous missile attacks) in Israel. Method The study was conducted within the qualitative-constructivist paradigm. Three focus groups consisting of 18 individuals with lifelong disabilities were conducted; each focus group included a specific disability type (physical, visual and hearing impairment). Results The participants reported encountering environmental barriers, such as inaccessibly of the physical environment and information as well as dependency on others. These barriers limited the participants' functioning during emergency period and thus increased their level of distress. The participants also emphasized their physical, social and psychological needs. Conclusions The needs of individuals with disabilities in emergency situations can be met if they have a safe place to stay in, are with someone else, and plan every daily action in advance. It is also imperative to provide accessible services and information. Furthermore, it is recommended to develop training sessions for individuals with disabilities and for service providers regarding how to locate, communicate with and assist individuals with disabilities during security threat situations.

• Implications for Rehabilitation

• Successful coping of individuals with lifelong disabilities with chronic politically violent events depends on personal and organizational accommodations.

• Besides an accessible physical environment, the information provided should be available and accessible through mass media and assistive technologies.

• A comprehensive emergency service for various disabilities is needed.

• Service providers should be trained on how to locate, communicate with, and assist individuals with disabilities during security threat situations.

     

Disclosing Mental Illness During Dating: an Interpretative Phenomenological Analysis of the Partners’ Experience

International Journal of Mental Health and Addiction - The relatively little research on disclosure of mental illness has mainly presented the perspective of the individual who copes with a mental...     

Attitudes towards motherhood of women with physical versus psychiatric disabilities

Background

Women with disabilities may face social negative attitudes with regard to their being mothers. In addition, attitudes toward different disabilities form a hierarchy, with more positive attitudes being displayed toward persons with physical disabilities than toward persons with psychiatric disabilities.

Prevention of bacterial colonization on polyurethane in vitro by incorporated antibacterial agent

The presence of implanted biomaterials increases host susceptibility to infections. Once established, biomaterial-mediated infections are resistant to treatment and persist until the device is removed. The objective of this work was to study the prevention of bacterial-biofilm formation on polymeric implant (polyurethane) by controlled release of incorporated antibacterial agents (parabens). By embedding parabens in PU by the solvent-cast method, matrices with amorphous dispersions (or solid solutions) were obtained. Release rate modulation was achieved by using different MW parabens and by a rate-limiting membrane. Preliminary in vitro antibacterial studies of both methyl and propyl paraben matrices exhibited significant inhibition of Staphylococcus epidermidis biofilm formation. Propyl paraben matrices (15 and 20% w/w drug load) decreased the number of colony-forming units on PU surface to 2 x 10(4)/mL, in comparison to 6 x 10(5) on control polymers. This significant reduction was obtained without any effect on the number of viable bacteria in the suspension culture. This type of delivery system provides regional prophylactic activity by creating a high local concentration of antibacterial agent.     

Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints

Background: Preliminary evidence suggests that older people who seek medical help for subjective memory complaints (SMC) may be at risk for depression, poor quality of life (QoL), and functional limitations. This study aims to: (1) further investigate bio-psycho-social characteristics, participation in personally meaningful activities and QoL of help-seekers; and (2) examine the relationship of these characteristics to QoL, and explore the unique contribution of participation to QoL.

Methods: Cognitive, meta-cognitive, emotional, social, participation, and QoL measures were used to compare 51 help-seekers referred from geriatric clinics to 40 age-matched controls who did not seek help for memory problems.

Results: Help-seekers exhibited lower participation and QoL, had lower mean cognitive scores, reported more memory mistakes and negative memory-beliefs, more depression, worse self-efficacy, and less positive social interaction than non-help-seekers. Quality of life in help-seekers was significantly correlated with most variables. Participation contributed to the explained variance of QoL in help-seekers, beyond that accounted for by cognition and emotional status.

Discussion: Help-seekers with SMC exhibited a complex health condition that includes not only SMC, but also objective memory impairment, depression, functional restrictions, negative memory beliefs, low perception of memory abilities, reduced self-efficacy and insufficient social interactions, all associated with lower QoL. This multi-faceted condition should be considered in the treatment of help-seekers.

• Implications for Rehabilitation

• Older people who seek help for subjective memory complaints may be facing a larger problem involving bio-psycho-social factors, affecting participation in meaningful activities and quality of life.

• Quality of life may be improved via treatment of depression, functional restrictions, memory beliefs, self-efficacy, and positive social interactions.

• Participation in meaningful activities is an especially important target for improving health and quality of life in this population.

• Interventions for older adults seeking help for subjective memory complaints will benefit from adopting a bio-psycho-social rehabilitation perspective.

     

Psychophysiological whole‐brain network clustering based on connectivity dynamics analysis in naturalistic conditions

We introduce a novel method for delineating context‐dependent functional brain networks whose connectivity dynamics are synchronized with the occurrence of a specific psychophysiological process of interest. In this method of context‐related network dynamics analysis (CRNDA), a continuous psychophysiological index serves as a reference for clustering the whole‐brain into functional networks. We applied CRNDA to fMRI data recorded during the viewing of a sadness‐inducing film clip. The method reliably demarcated networks in which temporal patterns of connectivity related to the time series of reported emotional intensity. Our work successfully replicated the link between network connectivity and emotion rating in an independent sample group for seven of the networks. The demarcated networks have clear common functional denominators. Three of these networks overlap with distinct empathy‐related networks, previously identified in distinct sets of studies. The other networks are related to sensorimotor processing, language, attention, and working memory. The results indicate that CRNDA, a data‐driven method for network clustering that is sensitive to transient connectivity patterns, can productively and reliably demarcate networks that follow psychologically meaningful processes. Hum Brain Mapp 37:4654–4672, 2016. © 2016 Wiley Periodicals, Inc.