emegency

BACKGROUND: The Coma Recovery Scale-Revised (CRS-R) has become a standard tool in assessing Disorders of consciousness (DoC) in adults. However, its measurement validity in pediatrics has only been ascertained in healthy cases. Increasing use of CRS-R in children with DoC imposes appropriate comparison against previously validated tools. The aims of the study were to describe the emergence to a conscious state (eMCS) in pediatric acquired brain injury (ABI); to explore the agreement between the CRS-R and Coma Near Coma Scale (CNCS) and to discuss the advantage of administering the CRS-R in pediatric age...

The pandemic COVID19 illness caused by SARS-CoV-2, which produces pneumonia and lower respiratory tract infections, is a serious public health concern, with frightening mutations causing over 4.5 million deaths globally. Whilst effective immunisation shows promise globally, several antiviral treatments are being clinically evaluated to fill the "therapeutic gap" in treating infected people. Understanding the entire repertoire of diverse host factors engaged by SARS-CoV-2 for entry and pathogenicity is required for long-lasting potential therapeutics or vaccines...

Helicobacter pyloris (H.pylori) a Gram-negative bacterium whose infection of the human stomach triggers a chronic gastritis that can evolve into a series of severe pathologies such as gastroduodenal ulcers and cancer. H.pylori infects more than 50% of world population. Its amazing diversity and variability are major contributors to this success by allowing the emegence of new alleles. The bacterium lacks SOS response, DNA mismatch repair system, has a huge repertoire of restriction-modification systems and is highly competent...

Flail chest is a common injury in blunt trauma which is usually treated with analgesia, oxygen, and other conservative measures. In more severe cases mechanical ventilation and surgical stabilization of rib fractures (SSRF) may be warranted. Penetrating injury to the heart or great vessels due to rib fractures however, is much less common. Here we present a 33 year old male that was admitted to the Emergency department (ED) after a horse riding accident, demonstrating severe shock. Emergency computerized tomography scan showed multiple bilateral displaced rib fractures, Left hemothorax and possibly a penetrating injury to the left side of the heart by one of the ribs...

INTRODUCTION: Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) are chronic diseases which can affect patients following a severe trauma. As these patients typically first present to the emergency department, it is critical for emergency physicians to remain updated on the use of ketamine or other anesthetic agents which may impede development or reduce symptoms which may impair normal functioning. The purpose of this clinical review was is to review the literature regarding how the use of peritraumatic ketamine could decrease the incidence of ASD and PTSD...

BACKGROUND: The COVID-19 pandemic is a public health challenge that puts health systems in a highly vulnerable situation. Nurses in critical care units (CCUs) and hospital emergency services (HESs) have provided care to patients with COVID-19 under pressure and uncertainty. OBJECTIVE: To identify needs related to safety, organisation, decision-making, communication and psycho-socio-emotional needs perceived by critical care and emergency nurses in the region of Madrid, Spain, during the acute phase of the epidemic crisis...

Communication through spoken language is a central human capacity, involving a wide range of complex computations that incrementally interpret each word into meaningful sentences. However, surprisingly little is known about the spatiotemporal properties of the complex neurobiological systems that support these dynamic predictive and integrative computations. Here, we focus on prediction, a core incremental processing operation guiding the interpretation of each upcoming word with respect to its preceding context...

Seed priming uses treatments to improve seed germination and thus potentially increase growth and yield. Low-cost, environmentally friendly, effective seed treatment remain to be optimized and tested for high-value specialty crop like watermelon (Citrullus lanatus) in multi-locations. This remains a particularly acute problem for triploids, which produce desirable seedless watermelons, but show low germination rates. In the present study, turmeric oil nanoemulsions (TNE) and silver nanoparticles (AgNPs) synthesized from agro-industrial byproducts were used as nanopriming agents for diploid (Riverside) and triploid (Maxima) watermelon seeds...

Transcranial direct current stimulation (tDCS) is a noninvasive method that delivers current through the scalp to enhance or suppress brain activity. The standard way of applying tDCS is by the use of two large rectangular sponge electrodes on the scalp. The resulting currents often stimulate a broad region of the brain distributed over brain networks. In order to address this issue, recently, multi-electrode transcranial direct current stimulation with optimized montages has been used to stimulate brain regions of interest (ROI) with improved trade-off between focality and intensity of the electrical current at the target brain region...

Modeling and experimental parameters influence the Electro- (EEG) and Magnetoencephalography (MEG) source analysis of the somatosensory P20/N20 component. In a sensitivity group study, we compare P20/N20 source analysis due to different stimulation type (Electric-Wrist [EW], Braille-Tactile [BT], or Pneumato-Tactile [PT]), measurement modality (combined EEG/MEG - EMEG, EEG, or MEG) and head model (standard or individually skull-conductivity calibrated including brain anisotropic conductivity). Considerable differences between pairs of stimulation types occurred (EW-BT: 8...

Spoken word recognition in context is remarkably fast and accurate, with recognition times of around 200ms, typically well before the end of the word. The neurocomputational mechanisms underlying these contextual effects are still poorly understood. This study combines source-localised electro- and magnetoencephalographic (EMEG) measures of real-time brain activity with multivariate Representational Similarity Analysis (RSA) to determine directly the timing and computational content of the processes evoked as spoken words are heard in context, and to evaluate the respective roles of bottom-up and predictive processing mechanisms in the integration of sensory and contextual constraints...

In human visual processing, information from the visual field passes through numerous transformations before perceptual attributes such as colour are derived. The sequence of transforms involved in constructing perceptions of colour can be approximated by colour appearance models such as the CIE (2002) colour appearance model, abbreviated as CIECAM02. In this study, we test the plausibility of CIECAM02 as a model of colour processing by looking for evidence of its cortical entrainment. The CIECAM02 model predicts that colour is split in to two opposing chromatic components, red-green and cyan-yellow (termed CIECAM02-a and CIECAM02-b respectively), and an achromatic component (termed CIECAM02-A)...

There is widespread interest in the relationship between the neurobiological systems supporting human cognition and emerging computational systems capable of emulating these capacities. Human speech comprehension, poorly understood as a neurobiological process, is an important case in point. Automatic Speech Recognition (ASR) systems with near-human levels of performance are now available, which provide a computationally explicit solution for the recognition of words in continuous speech. This research aims to bridge the gap between speech recognition processes in humans and machines, using novel multivariate techniques to compare incremental 'machine states', generated as the ASR analysis progresses over time, to the incremental 'brain states', measured using combined electro- and magneto-encephalography (EMEG), generated as the same inputs are heard by human listeners...

In recent years, the use of source analysis based on electroencephalography (EEG) and magnetoencephalography (MEG) has gained considerable attention in presurgical epilepsy diagnosis. However, in many cases the source analysis alone is not used to tailor surgery unless the findings are confirmed by lesions, such as, e.g., cortical malformations in MRI. For many patients, the histology of tissue resected from MRI negative epilepsy shows small lesions, which indicates the need for more sensitive MR sequences...

Acoustic signals pass through numerous transforms in the auditory system before perceptual attributes such as loudness and pitch are derived. However, relatively little is known as to exactly when these transformations happen, and where, cortically or sub-cortically, they occur. In an effort to examine this, we investigated the latencies and locations of cortical entrainment to two transforms predicted by a model of loudness perception for time-varying sounds: the transforms were instantaneous loudness and short-term loudness, where the latter is hypothesized to be derived from the former and therefore should occur later in time...

IMPORTANCE: Neonatal and infant lumbar puncture is a commonly performed procedure in emergency departments, yet traumatic and unsuccessful lumbar punctures occur 30% to 50% of the time. Dehydration may be a risk factor for unsuccessful lumbar punctures, but to our knowledge, no studies have investigated the use of intravenous (IV) fluid bolus prior to lumbar puncture. OBJECTIVE: To investigate the association of IV fluid bolus administration with the sonographic measure of the neonatal and infant lumbar subarachnoid space...

We investigated two important means for improving source reconstruction in presurgical epilepsy diagnosis. The first investigation is about the optimal choice of the number of epileptic spikes in averaging to (1) sufficiently reduce the noise bias for an accurate determination of the center of gravity of the epileptic activity and (2) still get an estimation of the extent of the irritative zone. The second study focuses on the differences in single modality EEG (80-electrodes) or MEG (275-gradiometers) and especially on the benefits of combined EEG/MEG (EMEG) source analysis...

A primary objective for cognitive neuroscience is to identify how features of the sensory environment are encoded in neural activity. Current auditory models of loudness perception can be used to make detailed predictions about the neural activity of the cortex as an individual listens to speech. We used two such models (loudness-sones and loudness-phons), varying in their psychophysiological realism, to predict the instantaneous loudness contours produced by 480 isolated words. These two sets of 480 contours were used to search for electrophysiological evidence of loudness processing in whole-brain recordings of electro- and magneto-encephalographic (EMEG) activity, recorded while subjects listened to the words...

A wide variety of evidence, from neurophysiology, neuroanatomy, and imaging studies in humans and animals, suggests that human auditory cortex is in part tonotopically organized. Here we present a new means of resolving this spatial organization using a combination of non-invasive observables (EEG, MEG, and MRI), model-based estimates of spectrotemporal patterns of neural activation, and multivariate pattern analysis. The method exploits both the fine-grained temporal patterning of auditory cortical responses and the millisecond scale temporal resolution of EEG and MEG...

A variety of chronic pathologies often come along with the aging process and are experienced by many patients in late adulthood. EMS providers must be aware of the various challenges of transporting the geriatric population. And although an emphasis is often placed on the physical and medical issues associated with this population, it's also imperative to look at the whole picture to help prevent issues before they become an emegent problem. This includes being vigilant for elder abuse and neglect, as well as potential home hazards-including fall potentials and maintaining colder home temperatures-and dangerous cost-cutting measures, such as sharing medications...