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The impact of motion on onboard MRI-guided pencil beam scanned proton therapy treatments
No full textPredictive value of synaptic plasticity for functional decline in patients with multiple sclerosis.
Get PDFBACKGROUND
Previous research suggested that quadripulse (QPS)-induced synaptic plasticity is associated with both cognitive and motor function in patients with multiple sclerosis (MS) and does not appear to be reduced compared to healthy controls (HCs).
OBJECTIVE
This study aimed to explore the relationship between the degree of QPS-induced plasticity and clinically significant decline in motor and cognitive functions over time. We hypothesized that MS patients experiencing functional decline would exhibit lower levels of baseline plasticity compared to those without decline.
METHODS
QPS-induced plasticity was evaluated in 80 MS patients (56 with relapsing-remitting MS and 24 with progressive MS), and 69 age-, sex-, and education-matched HCs. Cognitive and motor functions, as well as overall disability status were evaluated annually over a median follow-up period of 2 years. Clinically meaningful change thresholds were predefined for each outcome measure. Linear mixed-effects models, Cox proportional hazard models, logistic regression, and receiver-operating characteristic analysis were applied to analyse the relationship between baseline plasticity and clinical progression in the symbol digit modalities test, brief visuospatial memory test revised (BVMT-R), nine-hole peg test (NHPT), timed 25-foot walk test, and expanded disability status scale.
RESULTS
Overall, the patient cohort showed no clinically relevant change in any functional outcome over time. Variability in performance was observed across time points in both patients and HCs. MS patients who experienced clinically relevant decline in manual dexterity and/or visuospatial learning and memory had significantly lower levels of synaptic plasticity at baseline compared to those without such decline (NHPT: β = -0.25, p = 0.02; BVMT-R: β = -0.50, p = 0.005). Receiver-operating characteristic analysis underscored the predictive utility of baseline synaptic plasticity in discerning between patients experiencing functional decline and those maintaining stability only for visuospatial learning and memory (area under the curve = 0.85).
CONCLUSION
Our study suggests that QPS-induced plasticity could be linked to clinically relevant functional decline in patients with MS. However, to solidify these findings, longer follow-up periods are warranted, especially in cohorts with higher prevalences of functional decline. Additionally, the variability in cognitive performance in both patients with MS and HCs underscores the importance of conducting further research on reliable change based on neuropsychological tests
Impact of CT Selection on Dose Accumulation in Adaptive Radiotherapy for Head and Neck Patients
No full textNational intercomparison of radiosurgery treatment planning for multiple brain metastasis
No full textPolarized running training adapted to versus contrary to the menstrual cycle phases has similar effects on endurance performance and cardiovascular parameters.
Get PDFPURPOSE
This study compared the effects of polarized running training adapted to the menstrual cycle (MC) phases versus polarized training adapted contrary to the MC on endurance performance and cardiovascular parameters.
METHODS
Thirty-three naturally menstruating, moderately trained females (age: 26 ± 4 years; BMI: 22.3 ± 3.2 kg/m2; O2max/rel: 40.35 ± 4.61 ml/min/kg) were randomly assigned to a control (CON) and intervention (INT) group. Both groups participated in a load-matched eight-week running training intervention. In the INT, high-intensity sessions were aligned with the mid and late follicular phase, low-intensity sessions with the early and mid-luteal phase, and recovery with the late luteal and early follicular phase. In the CON, high-intensity sessions were matched to the late luteal and early follicular phase, and recovery to the mid and late follicular phase. Endurance performance and cardiovascular parameters were assessed at baseline and after the intervention.
RESULTS
Twenty-six females completed the intervention. A repeated measures ANOVA determined no time × group interaction effect for any parameter. A significant time effect was found for maximal oxygen uptake (F(1,12) = 18.753, p = 0.005, ηp2 = 0.630), the velocity at the ventilatory threshold one (F(1,12) = 10.704, p = 0.007, ηp2 = 0.493) and two (F(1,12) = 7.746, p = .018, ηp2 = .413).
CONCLUSION
The training intervention improved endurance performance in both groups, with no further benefit observed from the MC-adapted polarized training in a group-based analysis. Replications with an extended intervention period, a larger sample size, and a more reliable MC determination are warranted
Lokale Energie-Transitions-Experimente als Beitrag zur Transformation hin zu einer klimaneutralen Gesellschaft. Pilotierung eines «Transition Management Prozesses» im Berner Oberland
Get PDFDie Schweiz hat sich mit der Ratifikation des Pariser Klimaabkommens und der Annahme des Klimagesetzes verpflichtet, klimaneutral zu werden. Um dieses Ziel zu erreichen, braucht es umfassende und weitreichende Veränderungen der vorherrschenden Systeme der Energieproduktion und des Energiekonsums. Diese lassen sich nicht allein mit den bisher ergriffenen Massnahmen und Instrumenten erreichen. Zudem müssen sie von der betroffenen Bevölkerung mitgetragen werden. Partizipative Gouvernanz-Ansätze, wie das in der Forschung zu Nachhaltigkeitstransformationen entstandene «Transition Management», stellen einen innovativen und vielversprechenden Ansatz dar, um alle relevanten Akteur:innen einzubeziehen und lokal angepasste, systemische Veränderungen Richtung Klimaneutralität anzustossen.
Der vorliegende Bericht dokumentiert die Umsetzung eines Transition Management Prozesses im östlichen Teil des Berner Oberlands in den Jahren 2020 bis 2024. Das Oberland-Ost ist als rurale und alpine Studienregion von besonderem Interesse. Einerseits ist die Region mit ihrer Abhängigkeit von (Winter)-Tourismus, Land- und Alpwirtschaft, besonders stark von den Folgen des Klimawandels betroffen. Gleichzeitig hatte die Region 2019 das strategische Entwicklungsziel gefasst, eine CO2-neutrale Tourismusregion zu werden, was dem Prozess politische Legitimität verlieh. Zudem bestand eine bereits etablierte Partnerschaft zwischen der Regionalkonferenz Oberland-Ost, der Wyss Academy for Nature und dem Amt für Umwelt und Energie (AUE) des Kantons Bern im Rahmen des Projekts «Klimaneutrale Region Oberland-Ost». Dies mit dem Ziel, die Region auf ihrem Weg Richtung Klimaneutralität zu unterstützen. Das in diesem Bericht dokumentierte Projekt ermöglichte den Einstieg in einen partizipativen regionalen Planungs- und Experimentierprozess, um gesellschaftlich getragene Schritte Richtung Klimaneutralität in die Wege zu leiten. Das Projekt wurde unter der Federführung des Zentrums für Nachhaltige Entwicklung und Umwelt (CDE) der Universität Bern, in Zusammenarbeit mit dem «Hub Bern» der Wyss Academy for Nature und dem Amt für Umwelt und Energie (AUE) des Kantons Bern ausgeführt, dies in enger Partnerschaft mit dem Präsidium und der Geschäftsstelle der Regionalkonferenz Oberland-Ost
Predictors of long-term memory and network connectivity 10 years after anterior temporal lobe resection.
Get PDFOBJECTIVE
Anterior temporal lobe resection (ATLR) effectively controls seizures in medically refractory temporal lobe epilepsy but risks significant episodic memory decline. Beyond 1 year postoperatively, the influence of preoperative clinical factors on episodic memory and long-term network plasticity remain underexplored. Ten years post-ATLR, we aimed to determine biomarkers of successful memory network reorganization and establish presurgical features' lasting impact on memory function.
METHODS
Twenty-five ATLR patients (12 left-sided) and 10 healthy controls underwent a memory-encoding functional magnetic resonance imaging paradigm alongside neuropsychometry 10 years postsurgery. Generalized psychophysiological interaction analyses modeled network functional connectivity of words/faces remembered, seeding from the medial temporal lobes (MTLs). Differences in successful memory connectivity were assessed between controls and left/right ATLR. Multivariate regressions and mixed-effect models probed preoperative phenotypes' effects on long-term memory outcomes.
RESULTS
Ten years post-ATLR, lower baseline functioning (verbal and performance intelligence quotient) and a focal memory impairment preoperatively predicted worse long-term memory outcomes. Poorer verbal memory was significantly associated with longer epilepsy duration and earlier onset age. Relative to controls, successful word and face encoding involved increased functional connectivity from both or remnant MTL seeds and contralesional parahippocampus/hippocampus after left/right ATLR. Irrespective of surgical laterality, successful memory encoding correlated with increased MTL-seeded connectivity to frontal (bilateral insula, right anterior cingulate), right parahippocampal, and bilateral fusiform gyri. Ten years postsurgery, better memory performance was correlated with contralateral frontal plasticity, which was disrupted with longer epilepsy duration.
SIGNIFICANCE
Our findings underscore the enduring nature of functional network reorganizations to provide long-term cognitive support. Ten years post-ATLR, successful memory formation featured stronger connections near resected areas and contralateral regions. Preoperative network disruption possibly influenced effectiveness of postoperative plasticity. These findings are crucial for enhancing long-term memory prediction and strategies for lasting memory rehabilitation
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