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as future neurorestorative or anti-cancer therapies.Objective Acute epidural hematoma (AEDH) is one of the deadliest lesions in patients after traumatic brain injury. AEDH with swirl sign progresses rapidly and requires timely surgical treatment. This study aims to investigate the risk factors for the occurrence of AEDH with swirl sign and its prognostic value. Methods Retrospective analysis was performed on 131 AEDH patients, who were divided into swirl sign group and non-swirl sign group based on the brain computed tomographic (CT) scan. Patient information, including gender, age, hypertension, mechanism of injury, Glasgow Coma Scale (GCS) score on admission, time from injury to CT scan, pupillary light reactivity on admission, midline shift, location of hematoma, hematoma volume on admission, oral anticoagulation, and Glasgow Outcome Scale (GOS) score at 3 months were collected. Univariate analysis was used to determine the risk factors for the occurrence of swirl sign. PD173212 The factors with P less then 0.05 were recruited into the multivariate logistic regresr power to predict the swirl sign. Conclusion GCS score on admission, pupillary light reactivity, and location of hematoma are risk factors for the occurrence of swirl sign, respectively. The combination of these three factors might be used to predict whether there is swirl sign in AEDH after traumatic brain injury. Furthermore, swirl sign can be used as an effective predictor of poor prognosis in patients.Parosmia is a distorted olfactory sensation in the presence of an odor. This olfactory disorder can affect the quality of life of most patients who experience it. Qualitative olfactory dysfunctions, such as parosmia and phantosmia, may be clinical conditions secondary to neurological diseases. The incidence of parosmia is underestimated, as well as its association with neurological diseases, due to poor self-reporting of patients and lack of objective methods for its measure. In this paper, we show selected clinical cases of parosmia associated with neurological disorders, such as traumatic brain injury and multiple sclerosis. These clinical cases show how the correct diagnosis of parosmia can represent the tip of the iceberg of important underlying neurological disorders and be a good prognostic indicator of their progression or recovery.Background Clinical trialists and clinicians have used a number of sleep quality measures to determine the outcomes of interventions to improve sleep and ameliorate the neurobehavioral consequences of sleep deprivation in critically ill patients, but findings have not always been consistent. To elucidate the source of these consistencies, an important consideration is responsiveness of existing sleep measures. The purpose of an evaluative measure is to describe a construct of interest in a specific population, and to measure the extent of change in the construct over time. This systematic literature review identified measures of sleep quality in critically ill adults hospitalized in the Intensive Care Unit (ICU), and assessed their measurement properties, strengths and weaknesses, clinical usefulness, and responsiveness. We also recommended modifications, including new technology, that may improve clinical usefulness and responsiveness of the measures in research and practice. Methods CINAHAL, PubMed/Medline,ommend future large, multi-site intervention studies that measure multiple dimensions of sleep, and provide additional evidence on instrument reliability, validity, feasibility and responsiveness. We also encourage testing new technologies to augment existing measures to improve their feasibility and accuracy.This study aimed to assess the efficacy and safety of self-designed Ningxin Anshen (NXAS) Formula for post-ischemic stroke insomnia of blood-deficient and liver-heat syndrome. Ninety patients were randomized into NXAS group, Placebo group and Zopiclone group. Patients in the NXAS group, Placebo group and Zopiclone group were treated with Ningxin Anshen Formula, placebo and zopiclone for 4 weeks, respectively. The scores of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and traditional Chinese Medicine (TCM) Syndromes of self-designed scale and the number of adverse events (AEs) were determined. Results showed that the overall effective rate in the NXAS group and Placebo group was 76.67 and 30.00%, respectively, showing significant difference (P 0.05). link2 Only one patient in the NXAS group developed gastrointestinal discomfort, which resolved without treatment discontinuation. In conclusion, self-designed NXAS Formula is effective and safe and has little adverse effect in treating post-stroke insomnia of blood-deficient and liver-heat syndrome.McArdle disease is a rare autosomal recessive disorder of muscle glycogen metabolism that presents with pain and fatigue during exercise. Stiff-Person Syndrome is an autoimmune-related neurologic process characterized by fluctuating muscle rigidity and spasm. Reported is a 41-year-old male who presented to the emergency department due to sudden-onset weakness and chest pain while moving his refrigerator at home. Cardiac workup was non-contributory, but a creatine kinase level > 6,000 warranted a muscle biopsy. The biopsy pathology report was misinterpreted to be diagnostic for McArdle disease given the clinical presentation. After 4 years of treatment without symptomatic improvement, a gradual transition of symptoms from pain alone to pain with stiffness was noted. A positive glutamic acid decarboxylase antibody test resulted in a change of diagnosis to Stiff-Person Syndrome. This is the first known case that highlights the similarities between these two rare and distinct disease processes, highlighting the necessity for thorough history taking, maintenance of a broad differential diagnosis, and knowledge of how best to interpret complex pathology reports.Stroke-associated pneumonia is a major cause for poor outcomes in the post-acute phase after stroke. Several studies have suggested potential links between neglected oral health and pneumonia. Therefore, the aim of this prospective observational study was to investigate oral health and microbiota and incidence of pneumonia in patients consecutively admitted to a stroke unit with stroke-like symptoms. This study involved three investigation timepoints. The baseline investigation (within 24 h of admission) involved collection of demographic, neurological, and immunological data; dental examinations; and microbiological sampling (saliva and subgingival plaque). Further investigation timepoints at 48 or 120 h after baseline included collection of immunological data and microbiological sampling. Microbiological samples were analyzed by culture technique and by 16S rRNA amplicon sequencing. From the 99 patients included in this study, 57 were diagnosed with stroke and 42 were so-called stroke mimics. From 57 stroke patients, 8 (14%) developed pneumonia. Stroke-associated pneumonia was significantly associated with higher age, dysphagia, greater stroke severity, embolectomy, nasogastric tubes, and higher baseline C-reactive protein (CRP). There were trends toward higher incidence of pneumonia in patients with more missing teeth and worse oral hygiene. Microbiological analyses showed no relevant differences regarding microbial composition between the groups. However, there was a significant ecological shift over time in the pneumonia patients, probably due to antibiotic treatment. This prospective observational study investigating associations between neglected oral health and incidence of SAP encourages investigations in larger patient cohorts and implementation of oral hygiene programs in stroke units that may help reducing the incidence of stroke-associated pneumonia.[This corrects the article DOI 10.3389/fpsyg.2020.554127.].The embodiment approach has shown that motor neural networks are involved in the processing of action verbs. There is developmental evidence that embodied effects on verb processing are already present in early years. Yet, the ontogenetic origin of this motor reuse in action verbs remains unknown. This longitudinal study investigates the co-occurrence of manual verbs and actions during mother-child daily routines (free play, bathing, and dining) when children were 1 to 2 (Group 1) and 2 to 3 (Group 2) years old. Eight mother-child dyads were video-recorded in 3-month intervals across 12 months (27 recording hours), and the timing of verbs and manual actions (21,876 entries) were coded by independent observers. Results showed that the probability of matched verb-action co-occurrences were much higher (0.80 and 0.77) than that of random co-occurrences (0.13 and 0.15) for Group 1 and Group 2, respectively. The distributions of the verb-action temporal intervals in both groups were quite symmetrical and skewed with the peak corresponding to both 0.00 s synchronic intervals (8% of the cases) and the shortest +5 s interval (40% of the cases). Mother-led instances occurred in both groups whereas child-led instances were restricted to Group 2. Mothers pragmatically aligned their verbal productions, since they repeatedly used (74%) those verbs they shared with their children's repertoire (31%). In conclusion, the early multisensory communicative and manipulative scene affords grounding of verb meanings on the ongoing actions, facilitating verb-action pairing in the realm of social interactions, providing a new dimension to the prevailing solipsistic approach to embodiment.Pain and emotion are common subjective experiences that play vital roles in daily life. Pain has been clinically confirmed to increase depressive mood. link3 However, little is known about how pain modulates cognitive emotional judgment processing. A better understanding of this may help explain the effect of pain on the development of depressive moods. We recruited 30 adult participants to test their responses to pictures of scenes (Experiment 1) and faces (Experiment 2) that represented happy, neutral, and sad emotions, while experiencing painful (induced via topical capsaicin cream) and control (hand cream) treatments. Results showed that participants in the painful condition showed lower accuracy to emotional scene stimuli and longer reaction times to both emotional scene and face stimuli, relative to the control condition. In addition, the difference values of the reaction times between the painful and control conditions were larger for sad scenes than for happy or neutral scenes. These results suggest that pain alters attentional processing of emotional stimuli, especially with regards to sad scene stimuli, which may explain how painful stimuli affect the development of depressive moods.In everyday conversation, turns often follow each other immediately or overlap in time. It has been proposed that speakers achieve this tight temporal coordination between their turns by engaging in linguistic dual-tasking, i.e., by beginning to plan their utterance during the preceding turn. This raises the question of how speakers manage to co-ordinate speech planning and listening with each other. Experimental work addressing this issue has mostly concerned the capacity demands and interference arising when speakers retrieve some content words while listening to others. However, many contributions to conversations are not content words, but backchannels, such as "hm". Backchannels do not provide much conceptual content and are therefore easy to plan and respond to. To estimate how much they might facilitate speech planning in conversation, we determined their frequency in a Dutch and a German corpus of conversational speech. We found that 19% of the contributions in the Dutch corpus, and 16% of contributions in the German corpus were backchannels.

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