Palermo unawareness of deficits in alzheimer’s disease role of the cingulate ...Sara Palermo
Unawareness of deficits is a symptom of Alzheimer's disease that can be observed even in the early stages of the disease. The frontal hypoperfusion associated with reduced awareness of deficits has led to suggestions of the existence of a hypofunctioning prefrontal pathway involving the right dorsolateral prefrontal cortex, inferior parietal lobe, anterior cingulate gyri and limbic structures. Since this network plays an important role in response inhibition competence and patients with Alzheimer's disease who are unaware of their deficits exhibit impaired performance in response inhibition tasks, we predicted a relationship between unawareness of deficits and cingulate hypofunctionality. We tested this hypothesis in a sample of 29 patients with Alzheimer's disease (15 aware and 14 unaware of their disturbances), rating unawareness according to the Awareness of Deficit Questionnaire-Dementia scale. The cognitive domain was investigated by means of a wide battery including tests on executive functioning, memory and language. Neuropsychiatric aspects were investigated using batteries on behavioural mood changes, such as apathy and disinhibition. Cingulate functionality was assessed with functional magnetic resonance imaging, while patients performed a go/no-go task. In accordance with our hypotheses, unaware patients showed reduced task-sensitive activity in the right anterior cingulate area (Brodmann area 24) and in the rostral prefrontal cortex (Brodmann area 10). Unaware patients also showed reduced activity in the right post-central gyrus (Brodmann area 2), in the associative cortical areas such as the right parietotemporal-occipital junction (Brodmann area 39) and the left temporal gyrus (Brodmann areas 21 and 38), in the striatum and in the cerebellum. These findings suggest that the unawareness of deficits in early Alzheimer's disease is associated with reduced functional recruitment of the cingulofrontal and parietotemporal regions. Furthermore, in line with previous findings, we also found apathy and disinhibition to be prominent features of the first behavioural changes in unaware patients.
41st Semi-Annual SIAA Master Agency/Strategic Partner Business Meeting
April 7-9, 2016
Orlando World Center Marriott
SIAA Business Meetings are designed around creating relationship networking opportunities between our Strategic Partner Company attendees and our Master Agency Principals, Executives and Managers responsible for agency network development.
These meetings foster and reinforce the continuing commitment SIAA holds with its Strategic Partner Companies, Master Agencies and ultimately, its member agencies.
Learning Solutions and Your Product Launch: How a Curriculum Drives Success (...Bottom-Line Performance
Is your company ready to launch a new product? Your sales and support reps might not be. If the product is complex, your customers might not know how to use it, either.
This session shows how a curriculum of learning solutions can be used as part of a product launch to solve common business problems. It then connects the big picture goals of a product launch to practical curriculum design techniques that engage learners before, during and after a launch event. You’ll learn how to develop product launch training that drives learner retention… while avoiding common mistakes along the way.
Learning Objectives:
Understand how a blend of learning solutions can work together to reinforce product knowledge, selling skills and proficient usage of a product.
Identify what a curriculum can do to help learners build skills and knowledge around what they sell and support… and what a curriculum cannot do, like fix a bad message or a bad product.
Discover how to design a curriculum using a repeatable three-part framework that drives knowledge and skills retention.
Palermo unawareness of deficits in alzheimer’s disease role of the cingulate ...Sara Palermo
Unawareness of deficits is a symptom of Alzheimer's disease that can be observed even in the early stages of the disease. The frontal hypoperfusion associated with reduced awareness of deficits has led to suggestions of the existence of a hypofunctioning prefrontal pathway involving the right dorsolateral prefrontal cortex, inferior parietal lobe, anterior cingulate gyri and limbic structures. Since this network plays an important role in response inhibition competence and patients with Alzheimer's disease who are unaware of their deficits exhibit impaired performance in response inhibition tasks, we predicted a relationship between unawareness of deficits and cingulate hypofunctionality. We tested this hypothesis in a sample of 29 patients with Alzheimer's disease (15 aware and 14 unaware of their disturbances), rating unawareness according to the Awareness of Deficit Questionnaire-Dementia scale. The cognitive domain was investigated by means of a wide battery including tests on executive functioning, memory and language. Neuropsychiatric aspects were investigated using batteries on behavioural mood changes, such as apathy and disinhibition. Cingulate functionality was assessed with functional magnetic resonance imaging, while patients performed a go/no-go task. In accordance with our hypotheses, unaware patients showed reduced task-sensitive activity in the right anterior cingulate area (Brodmann area 24) and in the rostral prefrontal cortex (Brodmann area 10). Unaware patients also showed reduced activity in the right post-central gyrus (Brodmann area 2), in the associative cortical areas such as the right parietotemporal-occipital junction (Brodmann area 39) and the left temporal gyrus (Brodmann areas 21 and 38), in the striatum and in the cerebellum. These findings suggest that the unawareness of deficits in early Alzheimer's disease is associated with reduced functional recruitment of the cingulofrontal and parietotemporal regions. Furthermore, in line with previous findings, we also found apathy and disinhibition to be prominent features of the first behavioural changes in unaware patients.
41st Semi-Annual SIAA Master Agency/Strategic Partner Business Meeting
April 7-9, 2016
Orlando World Center Marriott
SIAA Business Meetings are designed around creating relationship networking opportunities between our Strategic Partner Company attendees and our Master Agency Principals, Executives and Managers responsible for agency network development.
These meetings foster and reinforce the continuing commitment SIAA holds with its Strategic Partner Companies, Master Agencies and ultimately, its member agencies.
Learning Solutions and Your Product Launch: How a Curriculum Drives Success (...Bottom-Line Performance
Is your company ready to launch a new product? Your sales and support reps might not be. If the product is complex, your customers might not know how to use it, either.
This session shows how a curriculum of learning solutions can be used as part of a product launch to solve common business problems. It then connects the big picture goals of a product launch to practical curriculum design techniques that engage learners before, during and after a launch event. You’ll learn how to develop product launch training that drives learner retention… while avoiding common mistakes along the way.
Learning Objectives:
Understand how a blend of learning solutions can work together to reinforce product knowledge, selling skills and proficient usage of a product.
Identify what a curriculum can do to help learners build skills and knowledge around what they sell and support… and what a curriculum cannot do, like fix a bad message or a bad product.
Discover how to design a curriculum using a repeatable three-part framework that drives knowledge and skills retention.
Global Consulting Executive Search recently completed a study about the motivations of consultants,
former consultants and prospective consultants. We were interested in what makes highly-educated
business people join the field, remain in it, leave it and sometimes, return to the profession.
Our findings confirmed a number of motivations considered common knowledge in the field, as well as
some trends that we did not expect. Expected results include:
1. Variety of work is the most significant attractor to consultants.
2. Travel is the most significant downside of the profession.
3. Pressure to sell stands alongside travel as the most significant negative among consultants and
former consultants.
Presentation given at JTEL2012 (Joint European Summer school on Technology Enhanced Learning)
Event URL: http://www.prolearn-academy.org/Events/summer-school-2012
My contact email: caislas@gmail.com
Global Consulting Executive Search recently completed a study about the motivations of consultants,
former consultants and prospective consultants. We were interested in what makes highly-educated
business people join the field, remain in it, leave it and sometimes, return to the profession.
Our findings confirmed a number of motivations considered common knowledge in the field, as well as
some trends that we did not expect. Expected results include:
1. Variety of work is the most significant attractor to consultants.
2. Travel is the most significant downside of the profession.
3. Pressure to sell stands alongside travel as the most significant negative among consultants and
former consultants.
Presentation given at JTEL2012 (Joint European Summer school on Technology Enhanced Learning)
Event URL: http://www.prolearn-academy.org/Events/summer-school-2012
My contact email: caislas@gmail.com
Take home message
Acute pain is a symptom, tell us that there is something wrong in our body.
Chronic pain is a disease entity and that must be treated differently to acute pain.
Since chronic pain is biopsychosocial phenomenon it must be treated by multidisciplinary team with multidisiplinary approach.
Pain and Opioids: damage and danger, mechanism and meaningMark Sullivan
In this presentation, I argue that pain exists more to protect than to inform, so survival implications affect pain processing. The salience and valence of pain are continually adjusted to promote survival. For humans, physical survival depends on social survival, so our brains have evolved to make both physical and social injury painful, with our endogenous opioid system modulating both forms of pain to promote both forms of survival.
Physiology of Pain, Characteristic of pain, Basic consideration of nervous system, Pain receptor, Mechanism of pain causation, Theories of pain, Pathways of pain, Pain Receptors
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
2. Pain
Pain is the cortical output of highest priority.
Moseley, 2003
1- Pain is an output of the brain that is produced whenever the brain concludes that
body tissues is in danger and action is required.
2- Pain is a multisystem output that is produced when an individual-specific cortical
pain neuromatrix is activated.
Moseley, 2003
Pain the defender, not the ofender Sicuteri, 1992
3. Pain
1. Pain does not provide a measure of the state of the tissues
2. Pain is modulated by many factors: somatic, psychological and social
3. Relationship between pain and the state of the tissues is less predictable
as pain persist
4. Conscious correlate of the implicit perception that tissue is in danger.
Moseley, 2007
5. Changes in the Nervous System
· Peripheral and central changes
· Sensitization:
Nonassociative learning. Repeated or extended application of a stimulus leads
to an increase response. Flor, 2012
LTP (memory mechanisms) Ji, 2003
·Disinhibition (impresicion) - Increase in RF
· Adaptative or maladaptative Woolf CJ, 2004
6. Assessment
Subjective examination
Sensory examination
Motor examination
Autonomic examination
MAKE THE FEATURES FIT
“Without identification of the mechanisms, the optimum treatment strategy
for the patient´s pain cannot be selected”
Woolf & Mannion, 1999,
26. Changes in peripersonal space
• Peripersonal space in CRPS
Moseley 2009
• Peripersonal space in Knee
Osteoarthrosis Pain
Stanton, 2012
• Assessment: recognise, TOJ
27. Motor Control
Para ver e sta pelícu la, d ebe
disponer de QuickTime™ y de
un descompresor mpeg4.
28. Treatment motor cortical changes
• Graded Motor Imagery
• Laterality
• Imagery
• Mirror Therapy
• Correction of somatosensation?
32. Is it possible that the physical examination, with its exhaustive and often
repetitive provocation of specific joints, with specific mobilisations, which
require the patient to carefully attend to and discriminate the location, quality
and intensity of the percept works via similar mechanisms to discrimination
training?
Is it possible that learning precise and sometimes subtle motor skills, which
require the patient to attend carefully to specific body parts and to discrimi-
nate the contraction of one muscle from the contraction of its immediate
neighbour, has a similar effect?
Moseley 2008
33. Moseley GL. A pain neuromatrix approach to patients with chronic pain. Man Ther.
Moseley GL. Reconceptualising Pain. Physical Therapy Reviews. 2007 Aug 25;3(12):169-78.
Flor H. New developments in the understanding and management of persistent pain. Current opinion in psychiatry. 2012 Jan 6.
Ji R-R, Kohno T, Moore KA, Woolf CJ. Central sensitization and LTP: do pain and memory share similar mechanisms? Trends Neurosci. 2003 Dec
1;26(12):696-705.
Woolf CJ. Pain: Moving from Symptom Control toward Mechanism-Specific Pharmacologic Management. 2004 Mar 16:1-11.
Banic B, Petersen-Felix S, Andersen OK, Radanov BP, Villiger PM, Arendt-Nielsen L, et al. Evidence for spinal cord hypersensitivity in chronic pain after
whiplash injury and in fibromyalgia. Pain. 2004 Jan 1;107(1-2):7-15.
Marinus J, Moseley GL, Birklein F, Baron R, Maihöfner C, Kingery WS, et al. Clinical features and pathophysiology of complex regional pain syndrome.
Lancet Neurol. 2011 Jul 1;10(7):637-48.
Moseley GL. I can't find it! Distorted body image and tactile dysfunction in patients with chronic back pain. Pain. 2008 Nov 15;140(1):239-43.
Moseley GL, Wiech K. The effect of tactile discrimination training is enhanced when patients watch the reflected image of their unaffected limb during
training. Pain. 2009 Aug 1;144(3):314-9.
Moseley GL, Zalucki NM, Wiech K. Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain. Pain. 2008 Jul 31;137(3):600-8.
Maihöfner C, Handwerker HO, Neundörfer B, Birklein F. Patterns of cortical reorganization in complex regional pain syndrome. Neurology. 2003 Dec
23;61(12):1707-15.
Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002 Jul 1;1(3):182-9
Koelbaek Johansen M, Graven-Nielsen T, Schou Olesen A, Arendt-Nielsen L. Generalised muscular hyperalgesia in chronic whiplash syndrome. Pain.
1999 Nov 1;83(2):229-34.
Moseley GL, Gallace A, Spence C. Space-based, but not arm-based, shift in tactile processing in complex regional pain syndrome and its relationship to
cooling of the affected limb. Brain. 2009 Nov 1;132(Pt 11):3142-51.
Stanton TR, Lin C-WC, Smeets RJEM, Taylor D, Law R, Lorimer Moseley G. Spatially defined disruption of motor imagery performance in people with
osteoarthritis. Rheumatology (Oxford). 2012 Aug 1;51(8):1455-64
Moseley GL. Pain, brain imaging and physiotherapy--opportunity is knocking. Man Ther. 2008 Dec 1;13(6):475-7