Investigation from the cingulate cortex within idiopathic general epilepsy

Methylated flavonols form a special group with modulating biological activities in comparison with kaempferol and quercetin. The present study isolated ten compounds including two kaempferol methyl ethers 5-hydroxy-3,7,4'-trimethoxyflavone (1), 3-hydroxy-5,7,4'-trimethoxyflavone (6); four quercetin methyl ethers retusin (5-hydroxy-3,7,3',4'-tetramethoxyflavone) (4), 3,5-dihydroxy-7,3',4'-trimethoxyflavone (5), 3,4'-dihydroxy-5,7,3'-trimethoxyflavone (7), and 3,5,7,3',4'-pentamethoxyflavone (9); β-sitosterol (2); 5-hydroxy-1-(4'-hydroxyphenyl)eicosan-3-one (3); p-hydroquinone (8); and vanillic acid (10) from the rhizomes and fruit of Amomum koenigii J.F.Gmel. (Zingiberaceae). Their structures were determined by MS, NMR, and X-ray spectroscopic techniques. Among the methylated flavonols, 1, 4-7, and 9 were isolated for the first time from the rhizomes, while 1, 4, and 5 were isolated from the fruit. Compounds 2, 3, 7, 8, and 10 were reported for the first time from the species. Three main methylated flavonols 1, 4, and 5 were quantitatively analyzed in the rhizomes of A. koenigii by RP-HPLC-DAD; their contents were determined to be 1.81% (1), 1.38% (4), and 1.76% (5). The antimicrobial assay against Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, Aspergillus niger, Fusarium oxysporum, Candida albicans, and Saccharomyces cerevisiae and antioxidant DPPH scavenging test were performed for the isolated methylated flavonols. Copyright © 2020 Minh Giang Phan et al.Objectives Recent studies have suggested that vitamin K may exert significant effects on the central nervous system. The present study investigates the relationship between vitamin K plasmatic levels and cognitive functions in elderly patients on oral anticoagulant therapy (OAT). Design At the Thrombosis Centre of Haematology, "Sapienza" University of Rome, 85 patients on OAT, aged between 75 and 92, were randomly enrolled in the study. Patients were on OAT with vitamin K antagonists (VKAs). Vitamin K1 concentrations were determined using standardized High-Performance Liquid Chromatography (HPLC). Cognitive functions were assessed using the Milan Overall Dementia Assessment (MODA). Results MODA scores are positively correlated to vitamin K1 concentration. Patients with vitamin K1 below 0.100 μg/L and between 0.100 and 0.400 μg/L and between 0.100 and 0.400 μg/L and between 0.100 and 0.400 p 10 years) does not affect MODA scores. Education seems to exert a greater role on the cognitive status in comparison with aging. Conclusions The study shows a positive association between vitamin K1 concentration and cognitive status in elderly patients (≥75 years) on OAT. The relationship between vitamin K1 concentration and MODA scores is described by a linear model. Cognitive status is not influenced by the duration of OAT but by the years of education. Copyright © 2020 Ludovico Alisi et al.According to the action-specific theory of perception, a person's dynamic ability to act in the environment affects her/his spatial perception. Empirical evidence shows that the elderly perceive distances as farther compared with younger adults and that the harder the ground surface to walk, the farther the perceived distance. Such results suggest a general perceptual readaptation promoted by the aging process that is fine-tuned with the decline of the motor resources. However, it is still unknown whether the elderly space perception is affected by interindividual differences in their functional autonomy (FA) and whether the decline of motor resources affects spatial categorization only when distances are judged with reference to the observer's own body or also when they are judged with reference to the body of another agent present in the scene. To this aim, a sample of elderly adults with preserved cognitive functions but different levels of FA, measured through the Instrumental Activity of Daily Living (IADL) scale, were enrolled and tested on the extrapersonal space categorization task. Staurosporine Antineoplastic and Immunosuppressive Antibiotics inhibitor This task requires judging the position of a target as "Near" or "Far" with respect to different reference frames (RFs) centered on the observer's body (Self RF) or centered on external elements, like another body (Other RF) or an object (Object RF). Results indicated that the higher the level of FA, the wider the space categorized as "Near" when adopting as reference frame our own body or the body of another agent in the scene, but not a static object. In conclusion, the individual functional autonomy of elderly individuals, which is strongly influenced by motor resources and efficiency, modulates how the surrounding space is represented, but only when the distance judgment implies an agent body, thus providing new relevant data for recent embodied cognition models of aging. Copyright © 2020 Giorgia Committeri et al.Background Institutionalized older adults have increased gait and balance impairment compared with community-dwelling older adults. The use of the treadmill for the rehabilitation process has been studied in different groups, but not in the institutionalized elderly. Objectives The objective of this study was to assess the effects of a treadmill walking workout program on the postural balance of institutionalized older adults. Methods Postural balance was assessed by the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), gait speed, and Timed Up and Go Test (TUG) on 37 institutionalized older adults (23 in the intervention group and 14 in the control group). Training consisted of a 20-minute treadmill walking workout carried out twice a week for 10 weeks. Measurements were obtained before and after 10 weeks and with 1 month of follow-up for the intervention group. For the control group, the data were obtained before and after the training period. Results Significant improvement occurred in all motor function parameters (BBS p less then 0.01; gait speed p less then 0.01; gait speed p less then 0.01; gait speed p less then 0.01; gait speed. Conclusions The present results permit us to conclude that a treadmill walking program had positive effects on the postural balance of institutionalized older adults. Copyright © 2020 Natalia Moya Pereira et al.Liver volume and function after hepatectomies are directly correlated to postoperative complications and mortality. Consequently contemporary liver surgery has focused on reaching an adequate future liver remnant so as to diminish postoperative morbidity and mortality. Portal vein embolization has evolved and is the standard of care as a liver regenerative strategy in many surgery departments worldwide before major liver resections. Different embolic materials have been used for portal vein embolization including gelfoam, ethanol, polyvinyl-alcohol particles, calibrated microspheres, central vascular plugs, coils, n-butyl-cyanoacrylate glue, fibrin glue, polidocanol-foam, alcoholic prolamin solution, and ethylene vinyl alcohol copolymer, as sole occluders or in varied combinations. While to date there has been no prospective controlled trial comparing the efficacy of different embolic materials in portal vein embolization, retrospective data insinuates that the use of n-butyl-cyanoacrylate and absolute ethanol produces higher contralateral liver hypertrophies. In this review, we evaluated publications up to August 2019 to assess the technical and regenerative results of portal vein embolization accomplished with different embolic materials. Special attention was given to specific aspects, advantages, and drawbacks of each embolic agent used for portal vein embolization, its liver regenerative performance, and its influence on patient outcome. Copyright © 2020 Jose Hugo M. Luz et al.Limited, and underutilized, therapeutic options for acute stroke require new approaches to treatment. One such potential approach involves better understanding of innate immune response to brain injury such as acute focal cerebral ischemia. This includes understanding the temporal profile, and specificity, of Toll-like receptor 4 (TLR4) signaling in brain cell types, such as astrocytes, following focal cerebral ischemia. This study evaluated TLR4 signaling, and downstream mediators, in astrocytes, during acute and chronic phases post transient middle cerebral artery occlusion (MCAO). We also determined whether high mobility group box 1 (HMGB1), an endogenous TLR4 ligand, was sufficient to induce TLR4 signaling activation in astrocytes in vivo and in vitro. We injected HMGB1 into normal cortex, in vivo, and stimulated cultured astrocytes with HMGB1, in vitro, and determined TLR4, and downstream mediator, expression by immunohistochemistry. We found that expression of TLR4, and downstream mediators, such as inducible nitric oxide synthase (iNOS), occurs in penumbral astrocytes in acute and chronic phases after focal cerebral ischemia, but was undetectable in cortical astrocytes in the contralateral hemisphere. In addition, cortical injection of recombinant HMGB1 led to a trend towards an almost 2-fold increase in TLR4 expression in astrocytes surrounding the injection site. Consistent with these results, in vitro stimulation of the DI TNC1 astrocyte cell line, with recombinant HMGB1, led to increased TLR4 and iNOS message levels. These findings suggest that HMGB1, an endogenous TLR4 ligand, is an important physiological ligand for TLR4 signaling activation, in penumbral astrocytes, following acute and chronic ischemia and HMGB1 amplifies TLR4 signaling in astrocytes. Copyright © 2020 Bolanle M. Famakin et al.The aim of this study was to investigate action learning as an implementation method in a large-scale project with many participants in several autonomous and geographically spread groups. The focus of the implementation was the Model of Practical Skill Performance as a learning and supervision tool in the clinical education of nursing students. Nineteen action learning groups were established, and a total of 129 clinical supervisors and 13 facilitators were involved. To evaluate the implementation process, qualitative data were generated through three focus group interviews, questionnaires, and notes. Data illuminate clinical supervisors' perceptions of value, impact, and sustainability when they participate in an action learning group to become familiar with the Model of Practical Skill Performance. The deductive data analysis was guided by central concepts from action learning. Action learning proved to be an engaging and effective tool in the implementation where the main strength seemed to be the autonomous local group supporting collective reflections on actions. Clinical supervisors had the right competences to adopt a reflective process-oriented approach, which is the hallmark of action learning. This study shows the necessity of collaboration between stakeholders in practice, education, and management to implement large-scale projects in clinical practice. The findings imply that managers should choose participants on the basis of their motivation and their voluntary wish to participate and that nurses' immersion in the project over time aids implementation. Copyright © 2020 Irene Sommer et al.Nursing students must be able to initiate and perform effective cardiopulmonary resuscitation (CPR) when they start their career in nursing. Studies show that students' competency in CPR is deficient, indicating that better training is necessary during nursing education. This study reports on the differences in nursing students' competence in CPR before and after a longitudinal pedagogical intervention across the curriculum. Changes in the curriculum were relocation and added testing of CPR skills, inclusion of a course in defibrillation, a knowledge test as stimuli before simulation, and more simulation practice with deteriorating patients. This was a comparative study between two cohorts of students in the bachelor in nursing education. We measured knowledge and compression performance in the students' final year of education. Students in cohort 2, who received the pedagogical intervention, had a significant higher total knowledge score than students in cohort 1. Students' mean depth and number of correct compressions was similar.