Self-harm among inmates of the Berlin prison system

Introduction

Self-harming behavior in prisoners is a prevalent phenomenon, with international studies estimating a 4% prevalence rate. However, studies on self-injurious behavior in the German prison system are currently lacking. Therefore, our study aims to conduct an initial assessment.

Methods

The Criminological Service for the Berlin Prison System distributed questionnaires on incidents of self-harm to all Berlin prisons, except for juvenile detention centers. The questionnaires were supplemented with medical data, such as psychiatric diagnoses and medication.

Results

62 questionnaires were returned, which could be attributed to 52 inmates. Compared to the average population in the Berlin prison system, the study sample exhibited variations in age, gender distribution and nationality. 94% of the inmates received a psychiatric diagnosis. Two-thirds of the male inmates had substance use disorders, while 83% of the female inmates had emotionally unstable personality resp. borderline disorders. Prior to self-harm, 87% of the inmates were administered psychiatric medication.

Discussion

Our study found similarities between the study population and international studies in the distribution of certain characteristics. We assume that many of the postulated risk factors can also apply to Berlin prisoners. However, the study is limited by the small number of cases and the absence of a control group.

Prediction underlying comprehension of human motion: an analysis of Deaf signer and non-signer EEG in response to visual stimuli

Introduction

Sensory inference and top-down predictive processing, reflected in human neural activity, play a critical role in higher-order cognitive processes, such as language comprehension. However, the neurobiological bases of predictive processing in higher-order cognitive processes are not well-understood.

Methods

This study used electroencephalography (EEG) to track participants' cortical dynamics in response to Austrian Sign Language and reversed sign language videos, measuring neural coherence to optical flow in the visual signal. We then used machine learning to assess entropy-based relevance of specific frequencies and regions of interest to brain state classification accuracy.

Results

EEG features highly relevant for classification were distributed across language processing-related regions in Deaf signers (frontal cortex and left hemisphere), while in non-signers such features were concentrated in visual and spatial processing regions.

Discussion

The results highlight functional significance of predictive processing time windows for sign language comprehension and biological motion processing, and the role of long-term experience (learning) in minimizing prediction error.

Low-Frequency Entrainment to Visual Motion Underlies Sign Language Comprehension

When people listen to speech, neural activity tracks the entropy fluctuation in the acoustic envelope of the signal. This signal-based entrainment has been shown to be the basis of speech parsing and comprehension. In this electroencephalography (EEG) study, we compute sign language users’ cortical tracking of changes in visual dynamics of the communicative signal in the time-direct videos of sign language, and their time-reversed counterparts, and assess the relative contribution of response frequencies between.2 and 12.4 Hz to comprehension using a machine learning approach to brain state classification. Lower frequencies of EEG response (.2–4 Hz) yield 100% classification accuracy, while information about cortical tracking of the visual envelope in higher frequencies is less informative. This suggests that signers rely on lower visual frequency data, such as envelope of visual signal, for sign language comprehension. In the context of real-time language processing, given the speed of comprehension responses, this suggests that fluent signers employ a predictive processing heuristic based on sign language knowledge.

Age of sign language acquisition has lifelong effect on syntactic preferences in sign language users

Acquisition of natural language has been shown to fundamentally impact both one's ability to use the first language, and the ability to learn subsequent languages later in life. Sign languages offer a unique perspective on this issue, because Deaf signers receive access to signed input at varying ages. The majority acquires sign language in (early) childhood, but some learn sign language later - a situation that is drastically different from that of spoken language acquisition. To investigate the effect of age of sign language acquisition and its potential interplay with age in signers, we examined grammatical acceptability ratings and reaction time measures in a group of Deaf signers (age range: 28-58 years) with early (0-3 years) or later (4-7 years) acquisition of sign language in childhood. Behavioral responses to grammatical word order variations (subject-object-verb vs. object-subject-verb) were examined in sentences that included: 1) simple sentences, 2) topicalized sentences, and 3) sentences involving manual classifier constructions, uniquely characteristic of sign languages. Overall, older participants responded more slowly. Age of acquisition had subtle effects on acceptability ratings, whereby the direction of the effect depended on the specific linguistic structure.

Classification of visual comprehension based on EEG data using sparse optimal scoring

OBJECTIVE

Understanding and differentiating brain states is an important task in the field of cognitive neuroscience with applications in health diagnostics (such as detecting neurotypical development vs. Autism Spectrum or coma/vegetative state vs. locked-in state). Electroencephalography (EEG) analysis is a particularly useful tool for this task as EEG data can detect millisecond-level changes in brain activity across a range of frequencies in a non-invasive and relatively inexpensive fashion. The goal of this study is to apply machine learning methods to EEG data in order to classify visual language comprehension across multiple participants.

APPROACH

26-channel EEG was recorded for 24 Deaf participants while they watched videos of sign language sentences played in time-direct and time-reverse formats to simulate interpretable vs. uninterpretable sign language, respectively. Sparse Optimal Scoring (SOS) was applied to EEG data in order to classify which type of video a participant was watching, time-direct or time-reversed. The use of SOS also served to reduce the dimensionality of the features to improve model interpretability.

MAIN RESULTS

The analysis of frequency-domain EEG data resulted in an average out-of-sample classification accuracy of 98.89%, which was far superior to the time-domain analysis. This high classification accuracy suggests this model can accurately identify common neural responses to visual linguistic stimuli.

SIGNIFICANCE

The significance of this work is in determining necessary and sufficient neural features for classifying the high-level neural process of visual language comprehension across multiple participants.

Psycholinguistic mechanisms of classifier processing in sign language

Nonsigners viewing sign language are sometimes able to guess the meaning of signs by relying on the overt connection between form and meaning, or iconicity (cf. Ortega, Özyürek, & Peeters, 2020; Strickland et al., 2015). One word class in sign languages that appears to be highly iconic is classifiers: verb-like signs that can refer to location change or handling. Classifier use and meaning are governed by linguistic rules, yet in comparison with lexical verb signs, classifiers are highly variable in their morpho-phonology (variety of potential handshapes and motion direction within the sign). These open-class linguistic items in sign languages prompt a question about the mechanisms of their processing: Are they part of a gestural-semiotic system (processed like the gestures of nonsigners), or are they processed as linguistic verbs? To examine the psychological mechanisms of classifier comprehension, we recorded the electroencephalogram (EEG) activity of signers who watched videos of signed sentences with classifiers. We manipulated the sentence word order of the stimuli (subject-object-verb [SOV] vs. object-subject-verb [OSV]), contrasting the two conditions, which, according to different processing hypotheses, should incur increased processing costs for OSV orders. As previously reported for lexical signs, we observed an N400 effect for OSV compared with SOV, reflecting increased cognitive load for linguistic processing. These findings support the hypothesis that classifiers are a linguistic part of speech in sign language, extending the current understanding of processing mechanisms at the interface of linguistic form and meaning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychosis in German prisoners: Comparison of the clinical appearance of psychotic disorder of an imprisoned population with a not detained community group

Surveys confirm risk factors for the incarceration of patients with psychosis including homelessness and comorbidity. There is also agreement that severe psychosis can lead to violence. Data describing prisoners with psychosis in Germany are scarce. We aimed to compare patients with psychosis in a prison hospital and patients with psychosis in a community hospital. Demographic data were collected, as well as comorbidity in the form of substance dependence and a psychiatric assessment using the German version of the 18-item Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). In the prison hospital group more patients were homeless (17 versus 2%) and non-German (36 versus 4%). There were also more patients with substance dependence or abuse in the prison hospital group. The total scores of BPRS and PANSS were lower in the prison hospital group (BPRS, 43.8 versus 51.2; PANSS, 71.5 versus 83.7). We assume that social disintegration for mentally disturbed offenders prior to incarceration hindered effective treatment. To avoid further social disintegration and possible further deterioration of mental health status of released offenders, which may lead to reoffending after imprisonment, discharge management after release from prison should be improved.

Applicability of two violence risk assessment tools in a psychiatric prison hospital population

The risk of violent behavior is known to be higher for patients who suffer from a severe mental disorder. However, specific prediction tools for clinical work in prison psychiatry are lacking. In this single-center study, two violence risk assessment tools (Forensic Psychiatry and Violence Tool, "FoVOx," and Mental Illness and Violence Tool, "OxMIV") were applied to a prison hospital population with a primary psychotic or bipolar disorder and subsequently compared. The required information on all items of both tools was obtained retrospectively for a total of 339 patients by evaluation of available patient files. We obtained the median and inter-quartile range for both FoVOx and OxMIV, and their rank correlation coefficient along with 95% confidence intervals (CIs)-for the full cohort, as well as for cohort subgroups. The two risk assessment tools were strongly positively correlated (Spearman correlation = 0.83; 95% CI = 0.80-0.86). Such a high correlation was independent of nationality, country of origin, type of detention, schizophrenia-spectrum disorder, previous violent crime and alcohol use disorder, where correlations were above 0.8. A lower correlation was seen with patients who were 30 years old or more, married, with affective disorder and with self-harm behavior, and also in patients without aggressive behavior and without drug use disorder. Both risk assessment tools are applicable as an adjunct to clinical decision making in prison psychiatry.

Age of acquisition effects differ across linguistic domains in sign language: EEG evidence

One of the key questions in the study of human language acquisition is the extent to which the development of neural processing networks for different components of language are modulated by exposure to linguistic stimuli. Sign languages offer a unique perspective on this issue, because prelingually Deaf children who receive access to complex linguistic input later in life provide a window into brain maturation in the absence of language, and subsequent neuroplasticity of neurolinguistic networks during late language learning. While the duration of sensitive periods of acquisition of linguistic subsystems (sound, vocabulary, and syntactic structure) is well established on the basis of L2 acquisition in spoken language, for sign languages, the relative timelines for development of neural processing networks for linguistic sub-domains are unknown. We examined neural responses of a group of Deaf signers who received access to signed input at varying ages to three linguistic phenomena at the levels of classifier signs, syntactic structure, and information structure. The amplitude of the N400 response to the marked word order condition negatively correlated with the age of acquisition for syntax and information structure, indicating increased cognitive load in these conditions. Additionally, the combination of behavioral and neural data suggested that late learners preferentially relied on classifiers over word order for meaning extraction. This suggests that late acquisition of sign language significantly increases cognitive load during analysis of syntax and information structure, but not word-level meaning.

Prevalence of Opioid Dependence and Opioid Agonist Treatment in the Berlin Custodial Setting: A Cross-Sectional Study

BACKGROUND

Among people living in detention, substance use is highly prevalent, including opioid dependence. Opioid agonist treatment (OAT) has been established as an evidence-based, first-line treatment for opioid dependence. Despite high prevalence of opioid dependence, conclusive data regarding its prevalence and the OAT practice in German prisons is scarce; rather, the existing data widely diverges concerning the rates of people in detention receiving OAT.

MATERIALS AND METHODS

We conducted a cross-sectional survey of all detention facilities in Berlin. On the date of data collection, a full census of the routine records was completed based on the medical documentation system. For each opioid dependent individual, we extracted sociodemographic data (i.e., age, sex, and non-/German nationality, whether people experienced language-related communication barriers), information about OAT, comorbidities (HIV, hepatitis C, schizophrenia), and the detention center, as well as the anticipated imprisonment duration and sentence type. The data was first analyzed descriptively and secondly in an evaluative-analytical manner by analyzing factors that influence the access to OAT of people living in detention.

RESULTS

Among the 4,038 people in detention in the Berlin custodial setting under investigation, we identified a 16% prevalence of opioid dependence. Of the opioid-dependent individuals, 42% received OAT; 31% were treated with methadone, 55% were treated with levomethadone, and 14% were treated with buprenorphine. Access to OAT seemed mainly dependent upon initial receipt of OAT at the time of imprisonment, detention duration, the prisons in which individuals were detained, German nationality, and sex. The overall prevalence of HIV was 4-8%, hepatitis C was 31-42%, and schizophrenia was 5%.

CONCLUSIONS

The prevalence of opioid dependence and access to OAT remains a major health issue in the custodial setting. OAT implementation must be especially intensified among male, non-German, opioid-dependent individuals with a short detention period. Treatment itself must be diversified regarding the substances used for OAT, and institutional treatment differences suggest the need for a consistent treatment approach and the standardized implementation of treatment guidelines within local prison's standard operating procedures. Testing for infectious diseases should be intensified among opioid-dependent people living in detention to address scarcely known infection statuses and high infection rates.

The Impact of Transitional Movements and Non-Manual Markings on the Disambiguation of Locally Ambiguous Argument Structures in Austrian Sign Language (ÖGS)

Previous studies of Austrian Sign Language (ÖGS) word-order variations have demonstrated the human processing system's tendency to interpret a sentence-initial (case-) ambiguous argument as the subject of the clause ("subject preference"). The electroencephalogram study motivating the current report revealed earlier reanalysis effects for object-subject compared to subject-object sentences, in particular, before the start of the movement of the agreement marking sign. The effects were bound to time points prior to when both arguments were referenced in space and/or the transitional hand movement prior to producing the disambiguating sign. Due to the temporal proximity of these time points, it was not clear which visual cues led to disambiguation; that is, whether non-manual markings (body/shoulder/head shift towards the subject position) or the transitional hand movement resolved ambiguity. The present gating study further supports that disambiguation in ÖGS is triggered by cues occurring before the movement of the disambiguating sign. Further, the present study also confirms the presence of the subject preference in ÖGS, showing again that signers and speakers draw on similar strategies during language processing independent of language modality. Although the ultimate role of the visual cues leading to disambiguation (i.e., non-manual markings and transitional movements) requires further investigation, the present study shows that they contribute crucial information about argument structure during online processing. This finding provides strong support for granting these cues some degree of linguistic status (at least in ÖGS).

Global distribution of earthworm diversity

Soil organisms, including earthworms, are a key component of terrestrial ecosystems. However, little is known about their diversity, their distribution, and the threats affecting them. We compiled a global dataset of sampled earthworm communities from 6928 sites in 57 countries as a basis for predicting patterns in earthworm diversity, abundance, and biomass. We found that local species richness and abundance typically peaked at higher latitudes, displaying patterns opposite to those observed in aboveground organisms. However, high species dissimilarity across tropical locations may cause diversity across the entirety of the tropics to be higher than elsewhere. Climate variables were found to be more important in shaping earthworm communities than soil properties or habitat cover. These findings suggest that climate change may have serious implications for earthworm communities and for the functions they provide.

High-Definition Zoom Mode, a High-Resolution X-Ray Microscope for Neurointerventional Treatment Procedures: A Blinded-Rater Clinical-Utility Study

BACKGROUND AND PURPOSE

Quality of visualization of treatment devices during critical stages of endovascular interventions, can directly impact their safety and efficacy. Our aim was to compare the visualization of neurointerventional procedures and treatment devices using a 194-μm pixel flat panel detector mode and a 76-μm pixel complementary metal oxide semiconductor detector mode (high definition) of a new-generation x-ray detector system using a blinded-rater study.

MATERIALS AND METHODS

Deployment of flow-diversion devices for the treatment of internal carotid artery aneurysms was performed under flat panel detector and high-definition-mode image guidance in a neurointerventional phantom simulating patient cranium and tissue attenuation, embedded with 3D-printed intracranial vascular models, each with an aneurysm in the ICA segment. Image-sequence pairs of device deployments for each detector mode, under similar exposure and FOV conditions, were evaluated by 2 blinded experienced neurointerventionalists who independently selected their preferred image on the basis of visualization of anatomic features, image noise, and treatment device. They rated their selection as either similar, better, much better, or substantially better than the other choice. Inter- and intrarater agreement was calculated and categorized as poor, moderate, and good.

RESULTS

Both raters demonstrating good inter- and intrarater agreement selected high-definition-mode images with a frequency of at least 95% each and, on average, rated the high-definition images as much better than flat panel detector images with a frequency of 73% from a total of 60 image pairs.

CONCLUSIONS

Due to their higher resolution, high-definition-mode images are sharper and visually preferred compared with the flat panel detector images. The improved imaging provided by the high-definition mode can potentially provide an advantage during neurointerventional procedures.

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H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter 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Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk

OBJECTIVE

We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals.

RESEARCH DESIGN AND METHODS

We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables.

RESULTS

Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002).

CONCLUSIONS

The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.

Initial investigations of a special high-definition (Hi-Def) zoom capability in a new detector system for neuro-interventional procedures

Real-time visualization of fine details ranging to 100 um or less in neuro-vascular imaging guided interventions is important. A separate high-resolution detector mounted on a standard flat panel detector (FPD) was previously reported. This device had to be rotated mechanically into position over the FPD for high resolution imaging. Now, the new detector reported here has a high definition (Hi-Def) zoom capability along with the FPD built into one unified housing. The new detector enables rapid switching, by the operator between Hi-Def and FPD modes. Standard physical metrics comparing the new Hi-Def modes with those of the FPD are reported, demonstrating improved imaging resolution and noise capability at patient doses similar to those used for the FPD. Semi-quantitative subjective studies involving qualitative clinician feedback on images of interventional devices such as a Pipeline Embolization Device (PED) acquired in both Hi-Def and FPD modes are presented. The PED is deployed in a patient specific 3D printed neuro-vascular phantom embedded inside realistic bone and with tissue attenuating material. Field-of-view (FOV), exposure and magnification were kept constant for FPD and Hi-Def modes. Static image comparisons of the same view of the PED within the phantom were rated by expert interventionalists who chose from the following ratings: Similar, Better, or Superior. Generally, the Hi-Def zoomed images were much preferred over the FPD, indicating the potential to improve endovascular procedures and hence outcomes using such a Hi-Def feature.

Spectroscopy with a CdTe-based photon-counting imaging detector (PCD) having charge sharing correction capability

The spectroscopic capabilities of a newly upgraded version of a prototype imaging photon counting detector (PCD) was investigated. The XCounter Actaeon has four acquisition modes in which signal processing is varied including one mode having a charge sharing correction so that neighboring pixels that share a detected event will not be erroneously counted twice, hence it is designated the Anti-Coincidence Circuit On or ACC On mode. Since this CdTe-based direct conversion PCD has 100 μm pixels, such charge sharing may frequently occur for typical medical x-ray energies. Each pixel of this PCD has two scalers and two energy discriminators that enable counting without instrumentation noise of events above each threshold level; hence, a spectrum can be obtained by sequentially moving the thresholds of both discriminators. It became evident from the spectra for the various acquisition modes that only those obtained with the charge sharing correction enabled, compared favorably with theoretically predicted spectra. After verifying the energy calibration using the mono-energetic emissions from an Am-241 source, spectra at various kVps from a standard medical x-ray generator were obtained. The spectra generated by ACC On mode for 70 kVp and 110 kVp were the closest match to the theoretical spectra generated by SpekCal. For dual energy applications, ACC On mode with charge sharing correction circuitry would be the best choice among various acquisition modes. Also investigated was the dual energy imaging capability of the Actaeon PCD with ACC On mode to separate Aluminum and Iodine while imaging an artery stenosis phantom.

Gantry rotational motion-induced blur in cone-beam computed tomography

As neuro-endovascular image-guided interventions (EIGIs) make use of higher resolution detectors, gantry rotational motion-induced blur becomes more noticeable in acquired projections as well as reconstructed images by reducing the visibility of vascular and device features whose visualization could be critical in the treatment of vascular pathology. Motion-induced blur in projections views is a function of an object's position in the field-of-view (FOV), gantry rotational speed, and frame capture or exposure time. In this work different frame rates were used to investigate the effects of blurring from individual projections on the reconstructed image. To test the effects of these parameters on reconstructed images, a regular pattern phantom of small objects was simulated and projection views were generated at various different frame rates for a given simulated rotational velocity. The reconstruction was made using a linear interpolation of filtered backprojections. Images reconstructed from lower frame rates showed significant blurring in the azimuthal direction, increasingly worse towards the periphery of the image. However, those reconstructed from higher frame rates showed significantly less blur throughout the entire FOV. While lower frame rates could be used with slower gantry speeds this would increase the risk of voluntary or involuntary patient motion contributing to blur over the entire FOV. A high frame rate used with high gantry speeds could reliable provide images without gantry-motion blur while reducing the risk of patient-motion blur. Frame rates exceeding 2000 fps available with photon counting detectors such as the X-counter Actaeon¹ are available.

Evaluation of a new photon-counting imaging detector (PCD) with various acquisition modes

The prospect of improved low noise, high speed, and dual-energy imaging that may be associated with the use of photon-counting imaging detectors (PCD) has motivated this evaluation of a newly upgraded version of a prototype PCD. The XCounter Actaeon was evaluated in its four acquisition modes each based upon varying signal processing firmware including a mode with charge sharing correction that enables neighboring pixels that share the energy from one incident x-ray photon detection to be counted only once at the proper summed energy in the pixel with the largest charge deposition. Since this PCD is a CdTe-based direct detector with 100 μm pixels, such charge sharing for typical medical x-ray energy photons may occur frequently and must be corrected to achieve more accurate counts. This charge sharing correction is achieved with an Anti-Coincidence Circuit (ACC) which prevents double pixel counting from one event as well as prevents counting from either event if they are below a preset threshold. Various physical parameters of the PCD were evaluated including linearity, sensitivity, pulse pile-up effects, dark noise, spatial resolution, noise power spectrum, and detective quantum efficiency.

The effects of antimuscarinic treatment on the cognition of spinal cord injured individuals with neurogenic lower urinary tract dysfunction: a prospective controlled before-and-after study

STUDY DESIGN

Prospective controlled before-and-after study.

OBJECTIVES

To investigate the effects of antimuscarinic treatment of neurogenic lower urinary tract dysfunction on the cognition of individuals with spinal cord injury (SCI) during the early post-acute phase.

SETTING

Single SCI rehabilitation center.

METHODS

Patients with acute traumatic SCI admitted for primary rehabilitation from 2011 to 2015 were screened for study enrollment. Study participants underwent baseline neuropsychological assessments prior to their first urodynamic evaluation (6-8 weeks after SCI). Individuals suffering from neurogenic detrusor overactivity received antimuscarinic treatment, and those not requiring antimuscarinic treatment constituted the control group. The neuropsychological follow-up assessment was carried out 3 months after the baseline assessment. The effects of group and time on the neuropsychological parameters were investigated.

RESULTS

The data of 29 individuals were evaluated (control group 19, antimuscarinic group 10). The group had a significant (P≤0.033) effect on immediate recall, attention ability and perseveration. In the control group, individuals performed significantly (P≤0.05) better in immediate recall both at baseline (percentile rank 40, 95% CI 21-86 versus 17, 95% CI 4-74) and follow-up (percentile rank 40, 95% CI 27-74 versus 16, 95% CI 2-74). The time had a significant (P≤0.04) effect on attention ability, processing speed, word fluency and visuospatial performance. The individuals in both groups performed better at the follow-up compared to the baseline assessment.

CONCLUSION

Even though, we did not observe cognitive deterioration in the investigated, cognitively intact SCI individuals during the first 3 treatment months, the concerns regarding deleterious effects of antimuscarinics on cognition remain.

Cast aluminium single crystals cross the threshold from bulk to size-dependent stochastic plasticity

Metals are known to exhibit mechanical behaviour at the nanoscale different to bulk samples. This transition typically initiates at the micrometre scale, yet existing techniques to produce micrometre-sized samples often introduce artefacts that can influence deformation mechanisms. Here, we demonstrate the casting of micrometre-scale aluminium single-crystal wires by infiltration of a salt mould. Samples have millimetre lengths, smooth surfaces, a range of crystallographic orientations, and a diameter D as small as 6 μm. The wires deform in bursts, at a stress that increases with decreasing D. Bursts greater than 200 nm account for roughly 50% of wire deformation and have exponentially distributed intensities. Dislocation dynamics simulations show that single-arm sources that produce large displacement bursts halted by stochastic cross-slip and lock formation explain microcast wire behaviour. This microcasting technique may be extended to several other metals or alloys and offers the possibility of exploring mechanical behaviour spanning the micrometre scale.