Probing the orientation specificity of excitatory and inhibitory circuitries in the primary motor cortex with multi-channel TMS.

Objective: Electric-field orientation is crucial for optimizing neuronal excitation in transcranial magnetic stimulation (TMS). Yet, the stimulus orientation effects on short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) are poorly understood due to technical challenges in manipulating the TMS-induced stimulus orientation within milliseconds. We aimed to assess the orientation sensitivity of SICI and ICF paradigms and identify optimal orientations for motor evoked potential (MEP) facilitation and suppression.

Clinical sensemaking: Advancing a conceptual learning model of clinical reasoning.

Context: Much remains unanswered regarding how clinical reasoning is learned in the clinical environment. This study attempts to unravel how novice medical students learn to reason, by examining how they make sense of the clinical patient encounter.

Method: The current study was part of a greater research project employing constructivist grounded theory (CGT) to develop a learning model of clinical reasoning.

Epstein-Barr Virus in the Cerebrospinal Fluid and Blood Compartments of Patients With Multiple Sclerosis and Controls.

Background And Objectives: Epstein-Barr virus (EBV) infection is a major risk factor of multiple sclerosis (MS). We examined the presence of EBV DNA in the CSF and blood of patients with MS and controls. We analyzed whether EBV DNA is more common in the CSF of patients with MS than in controls and estimated the proportions of EBV-positive B cells in the CSF and blood.

Cultured lymphocytes' mitochondrial genome integrity is not altered by cladribine.

Cladribine tablets are a treatment for multiple sclerosis with effects on lymphocytes, yet its mode of action has not been fully established. Here, we analyzed the effects of cladribine on mitochondrial DNA integrity in lymphocytes. We treated cultured human T-cell lines (CCRF-CEM and Jurkat) with varying concentrations of cladribine to mimic the slow cell depletion observed in treated patients.

DELMEP: a deep learning algorithm for automated annotation of motor evoked potential latencies.

The analysis of motor evoked potentials (MEPs) generated by transcranial magnetic stimulation (TMS) is crucial in research and clinical medical practice. MEPs are characterized by their latency and the treatment of a single patient may require the characterization of thousands of MEPs. Given the difficulty of developing reliable and accurate algorithms, currently the assessment of MEPs is performed with visual inspection and manual annotation by a medical expert; making it a time-consuming, inaccurate, and error-prone process.

Advanced Pipeline for Designing Multi-Locus TMS Coils With Current Density Constraints.

Objective: This work aims for a method to design manufacturable windings for transcranial magnetic stimulation (TMS) coils with fine control over the induced electric field (E-field) distributions. Such TMS coils are required for multi-locus TMS (mTMS).

Methods: We introduce a new mTMS coil design workflow with increased flexibility in target E-field definition and faster computations compared to our previous method.

TMS-Induced Modulation of EEG Functional Connectivity Is Affected by the E-Field Orientation.

Coregistration of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) allows non-invasive probing of brain circuits: TMS induces brain activation due to the generation of a properly oriented focused electric field (E-field) using a coil placed on a selected position over the scalp, while EEG captures the effects of the stimulation on brain electrical activity. Moreover, the combination of these techniques allows the investigation of several brain properties, including brain functional connectivity. The choice of E-field parameters, such as intensity, orientation, and position, is crucial for eliciting cortex-specific effects.

Accuracy and precision of navigated transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) induces an electric field (E-field) in the cortex. To facilitate stimulation targeting, image-guided neuronavigation systems have been introduced. Such systems track the placement of the coil with respect to the head and visualize the estimated cortical stimulation location on an anatomical brain image in real time.

Faculty development participants' experiences of working with change in clinical settings.

Objectives: Many universities offer faculty development to support teachers in developing and improving clinical education in the health professions. Although research shows outcomes on individual levels after faculty development, little is known about its contribution to change within the organisation. To advance current faculty development and ensure that it can support wider educational change in healthcare organisations, a better understanding of educational change practices in these settings is needed.

Preoperative coagulation biomarkers associate with survival and pulmonary embolism after surgical treatment of non-spinal skeletal metastases.

Background: Thrombotic complications are synergistic and associated with orthopedic procedures, trauma, and malignancy. Because cancer enhances coagulation activity and vice versa, we assessed preoperative biomarkers for survival and complications after treatment of pathologic fractures in non-spinal skeletal metastases.

Patients/methods: Our study population comprised 113 actual or impending pathologic fractures in 100 patients admitted to two referral centers.

Surgical and patient-reported outcomes after total knee arthroplasty requiring soft tissue flap reconstruction - A 12-year experience from high-volume arthroplasty hospital.

Background: This study investigates the outcomes of complex knee joint reconstructions performed by an orthoplastic surgery team at a tertiary referral hospital.

Methods: Retrospective review of all the total knee arthroplasty (TKA)/revision TKA (rTKA) procedures with soft tissue flap reconstruction performed between 2008 and 2019 was conducted. Patients were stratified into two groups according to the urgency of surgery: scheduled non-complicated (SNC) and emergent complicated (EC).

Local brain-state dependency of effective connectivity: a pilot TMS-EEG study.

Spontaneous cortical oscillations have been shown to modulate cortical responses to transcranial magnetic stimulation (TMS). However, whether these oscillations influence cortical effective connectivity is largely unknown. We conducted a pilot study to set the basis for addressing how spontaneous oscillations affect cortical effective connectivity measured through TMS-evoked potentials (TEPs).

Wood-Based Cellulose-Rich Ultrafiltration Membranes: Alkaline Coagulation Bath Introduction and Investigation of Its Effect over Membranes' Performance.

In this study, wood-based cellulose-rich membranes were produced with a novel approach to casting procedure. Flat-sheet membranes were prepared from birch biomass pretreated with deep eutectic solvent and dissolved in ionic liquid-dimethylsulfoxide system via phase inversion method. Alkaline coagulation bath filled with sodium hydroxide solution was added to the process before a water coagulation bath and aimed to improve membranes' performance.

Unveiling ableism and disablism in assessment: a critical analysis of disabled students' experiences of assessment and assessment accommodations.

This study examines the underlying mechanisms of ableism and disablism in the assessment of student learning in higher education. Globally, higher education institutions rely strongly on assessment accommodations (e.g.

Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback.

Background: Transcranial magnetic stimulation (TMS) is widely used in brain research and treatment of various brain dysfunctions. However, the optimal way to target stimulation and administer TMS therapies, for example, where and in which electric field direction the stimuli should be given, is yet to be determined.

Objective: To develop an automated closed-loop system for adjusting TMS parameters (in this work, the stimulus orientation) online based on TMS-evoked brain activity measured with electroencephalography (EEG).

Quantifying arousal and awareness in altered states of consciousness using interpretable deep learning.

Consciousness can be defined by two components: arousal (wakefulness) and awareness (subjective experience). However, neurophysiological consciousness metrics able to disentangle between these components have not been reported. Here, we propose an explainable consciousness indicator (ECI) using deep learning to disentangle the components of consciousness.

Immune response to a conserved enteroviral epitope of the major capsid VP1 protein is associated with lower risk of cardiovascular disease.

Background: Major cardiac events including myocardial infarction (MI) are associated with viral infections. However, how specific infections contribute to the cardiovascular insults has remained largely unclear.

Methods: We employed next generation phage display mimotope-variation analysis (MVA) to explore the link between antibody-based immune response and severe cardiovascular conditions.

TMS with fast and accurate electronic control: Measuring the orientation sensitivity of corticomotor pathways.

Background: Transcranial magnetic stimulation (TMS) coils allow only a slow, mechanical adjustment of the stimulating electric field (E-field) orientation in the cerebral tissue. Fast E-field control is needed to synchronize the stimulation with the ongoing brain activity. Also, empirical models that fully describe the relationship between evoked responses and the stimulus orientation and intensity are still missing.

Study Engagement and Burnout of the PhD Candidates in Medicine: A Person-Centered Approach.

This study focused on exploring individual variations in doctoral candidates' well-being, in terms of experienced research engagement and burnout by using a person-centered approach. In addition, the associations between well-being profiles and gender, country of origin, study status (full-time or part-time), research group status and drop-out intentions were explored. The participants were 692 PhD candidates in the field of medicine.

Multi-locus transcranial magnetic stimulation system for electronically targeted brain stimulation.

Background: Transcranial magnetic stimulation (TMS) allows non-invasive stimulation of the cortex. In multi-locus TMS (mTMS), the stimulating electric field (E-field) is controlled electronically without coil movement by adjusting currents in the coils of a transducer.

Objective: To develop an mTMS system that allows adjusting the location and orientation of the E-field maximum within a cortical region.

Distribution of perfluoroalkyl acids in fish species from the Baltic Sea and freshwaters in Finland.

Occurrence and distribution of perfluoroalkyl acids (PFAAs), a sub-category of per- and polyfluoroalkyl substances (PFASs), is widespread in the environment. Food, especially fish meat, is a major pathway via which humans are exposed to PFAAs. As fish is an integral part of Nordic diet, therefore, in this study, several fish species, caught in selected Baltic Sea basins and freshwater bodies of Finland, were analysed for PFAAs.

Trade-off between stimulation focality and the number of coils in multi-locus transcranial magnetic stimulation.

. Coils designed for transcranial magnetic stimulation (TMS) must incorporate trade-offs between the required electrical power or energy, focality and depth penetration of the induced electric field (E-field), coil size, and mechanical properties of the coil, as all of them cannot be optimally met at the same time. In multi-locus TMS (mTMS), a transducer consisting of several coils allows electronically targeted stimulation of the cortex without physically moving a coil.

Effect of stimulus orientation and intensity on short-interval intracortical inhibition (SICI) and facilitation (SICF): A multi-channel transcranial magnetic stimulation study.

Besides stimulus intensities and interstimulus intervals (ISI), the electric field (E-field) orientation is known to affect both short-interval intracortical inhibition (SICI) and facilitation (SICF) in paired-pulse transcranial magnetic stimulation (TMS). However, it has yet to be established how distinct orientations of the conditioning (CS) and test stimuli (TS) affect the SICI and SICF generation. With the use of a multi-channel TMS transducer that provides electronic control of the stimulus orientation and intensity, we aimed to investigate how changes in the CS and TS orientation affect the strength of SICI and SICF.

Primary total knee replacement for tibial plateau fractures in older patients: a systematic review of 197 patients.

Introduction: Tibial plateau fractures are typically treated with osteosynthesis. In older patients, osteosynthesis is associated with some complications, risk of post-traumatic osteoarthritis and long partial, or non-weight bearing during the recovery phase. To avoid these problems, primary total knee replacement (TKR) has become an increasingly common treatment option.