Feedback, fairness, and validity: effects of disclosing and reusing multiple-choice questions in medical schools.

Background: Disclosure of items used in multiple-choice-question (MCQ) exams may decrease student anxiety and improve transparency, feedback, and test-enhanced learning but potentially compromises the reliability and fairness of exams if items are eventually reused. Evidence regarding whether disclosure and reuse of test items change item psychometrics is scarce and inconclusive.

Methods: We retrospectively analysed difficulty and discrimination coefficients of 10,148 MCQ items used between fall 2017 and fall 2019 in a large European medical school in which items were disclosed from fall 2017 onwards.

Is time running out? The urgent need for appropriate global health curricula in Germany.

Recently, representatives of politics, health officials and academia in Germany have advocated a greater role for Germany in matters concerning global health. However, health professionals in Germany are rarely taught about global health topics and accordingly real expertise in this field is lacking. To advance knowledge and competencies at German universities and adequately equip health professionals to achieve Germany's political goals, global health curricula must be developed at medical schools and other institutions.

Excitability and recruitment patterns of spinal motoneurons in human sleep as assessed by F-wave recordings.

This study examines the excitability and recruitment of spinal motoneurons in human sleep. The main objective was to assess whether supraspinal inhibition affects the different subpopulations of the compound spinal motoneuron pool in the same way or rather in a selective fashion in the various sleep stages. To this end, we studied F-conduction velocities (FCV) and F-tacheodispersion alongside F-amplitudes and F-persistence in 22 healthy subjects in sleep stages N2, N3 (slow-wave sleep), REM and in wakefulness.

Is the synchronization between pallidal and muscle activity in primary dystonia due to peripheral afferance or a motor drive?

The pathophysiological mechanisms of primary dystonia have largely remained obscure. Yet there is one undeniable observation: lesioning or high-frequency stimulation of the internal segment of the globus pallidus (GP) ameliorates dystonic symptoms. The latter observation implicates abnormal pallidal activity in the genesis of primary dystonia.

Evaluation of carisbamate, a novel antiepileptic drug, in photosensitive patients: an exploratory, placebo-controlled study.

Purpose: Carisbamate, a novel neuromodulatory agent with antiepileptic properties, was evaluated in patients with photoparoxysmal responses to intermittent photic stimulation (IPS) in this multicenter, non-randomized, single-blind, placebo-controlled, proof-of-concept study.

Methods: Eighteen Caucasian patients (14 females, 4 males) with a mean age of 30 years (range: 16-51 years) underwent standardized IPS under three eye conditions (during eye closure, eyes closed and eyes open) at hourly intervals for up to 8h after receiving placebo (Day 1), carisbamate (Day 2) and placebo (Day 3). Carisbamate was given at single doses of 250-1000 mg.

A hypothesis for how non-REM sleep might promote seizures in partial epilepsies: a transcranial magnetic stimulation study.

Purpose: To investigate alterations of inhibitory and excitatory cortical circuits during non-rapid eye movement (NREM) sleep in drug-naive patients with partial epilepsies and sleep-bound seizures only.

Methods: A paired-pulse TMS paradigm was used to test intracortical inhibition (ICI) and facilitation (ICF) in the hemisphere of the epileptic focus in three untreated patients with nonlesional, nongenetic frontal lobe epilepsy in NREM2 (three patients), NREM3/4 (one patient), and wakefulness (three patients).

Results: All three patients exhibited a major decrease of ICI in NREM sleep as opposed to the physiological enhancement of ICI with the progression of NREM sleep.

BOLD correlates of EMG spectral density in cortical myoclonus: description of method and case report.

The recording of electrophysiological data during BOLD fMRI is highly challenging but provides the opportunity to develop a more thorough account of brain function than either modality alone. To develop new techniques in this area has often required the study of pathological electrophysiological measures because such measures can be unusually strong (e.g.

Patterns of EMG-EMG coherence in limb dystonia.

Dystonia of the limbs may be due to a wide range of aetiologies and may cause major functional limitation. We investigated whether the previously described pathological 4 to 7 Hz drive to muscles in cervical dystonia is present in patients with aetiologically different types of dystonia of the upper and lower limbs. To this end, we studied 12 symptomatic and 4 asymptomatic carriers of the DYT1 gene, 6 patients with symptomatic dystonia due to focal basal ganglia lesions, and 11 patients with fixed dystonia, a condition assumed to be mostly psychogenic in aetiology.

Coherence analysis in the myoclonus of corticobasal degeneration.

We investigated whether myoclonus in corticobasal degeneration (CBD) is cortical or subcortical in origin. Many authors have suggested that the myoclonus in CBD is a subtype of cortical myoclonus, despite the fact that back-averaging fails to detect a cortical correlate to spontaneous or action induced jerks and giant sensory evoked potentials are seldom found. Electroencephalographic-electromyographic (EEG-EMG) and EMG-EMG frequency analysis may be more sensitive to cortical drives when EMG bursts occur at a high frequency and at low amplitudes as in CBD.

Acoustic startle evokes bilaterally synchronous oscillatory EMG activity in the healthy human.

Despite animal evidence that the reticulospinal system is of major importance to movement, this motor pathway has remained relatively inaccessible to experimentation in the human. Consequently, little is known about its function in health and disease. Here, we use the acoustic startle response to demonstrate that one type of reticulospinal activity in the human is associated with a characteristic pattern of bilateral synchronization between motor units.