Bonding of Composite Cements Containing 10-MDP to Zirconia Ceramics Without Dedicated Ceramic Primer.

PURPOSE: To measure zirconia-to-zirconia microtensile bond strength (µTBS) using composite cements with and without primer. MATERIALS AND METHODS: Two Initial Zirconia UHT (GC) sticks (1.8x1.8x5.0 mm) were bonded using four cements with and without their respective manufacturer's primer/adhesive (G-CEM ONE [GOne] and G-Multi Primer, GC; Panavia V5 [Pv5]), and Panavia SA Cement Universal [PSAu], and Clearfil Ceramic Plus, Kuraray Noritake; RelyX Universal (RXu) and Scotchbond Universal Plus [SBUp], 3M Oral Care). Specimens were trimmed to an hour-glass shaped specimen whose isthmus is circular in cross-section. After 1-week water storage, the specimens were either tested immediately (1-week µTBS) or first subjected to 50,000 thermocycles (50kTC-aged µTBS). The fracture mode was categorized as either adhesive interfacial failure, cohesive failure in composite cement, or mixed failure, followed by SEM fracture analysis of selected specimens. Data were analyzed using linear mixed-effects statistics (α = 0.05; variables: composite cement, primer/adhesive application, aging). RESULTS: The statistical analysis revealed no significant differences with aging (p = 0.3662). No significant difference in µTBS with/without primer and aging was recorded for GOne and PSAu. A significantly higher µTBS was recorded for Pv5 and RXu when applied with their respective primer/adhesive. Comparing the four composite cements when they were applied in the manner that resulted in their best performance, a significant difference in 50kTC-aged µTBS was found for PSAu compared to Pv5 and RXu. A significant decrease in µTBS upon 50kTC aging was only recorded for RXu in combination with SBUp. CONCLUSION: Adequate bonding to zirconia requires the functional monomer 10-MDP either contained in the composite cement, in which case a separate 10-MDP primer is no longer needed, or in the separately applied primer/adhesive.

A new species of Mollinedia (Monimiaceae, Laurales) from the Quadrilátero Ferrífero, Brazil.

Monimiaceae comprises approximately 26 genera and 250 species, with a pantropical distribution, predominantly occurring in humid forests. In Brazil, it is represented by five genera and 47 species, most of which are found in the Atlantic Forest, particularly in dense ombrophilous forest. Nevertheless, studies on this family in other biomes and vegetation types in Brazil are still scarce. The Quadrilátero Ferrífero (QF), a region located in the state of Minas Gerais, exhibits high plant species richness and endemism. During collections and analysis of herbarium materials from this region, some specimens of Mollinedia caught our attention due to a combination of characteristics that do not match those of any described species within the genus. For this reason, we describe this new taxon and assess its risk of extinction. Additionally, we review the occurrences of Monimiaceae in the QF and provide maps of its geographical distribution. With the description of this new species, the region now hosts eight species of Monimiaceae, two from the genus Macropeplus and six from Mollinedia. The new species is the first endemic species of the Monimiaceae family to be described in the QF. Concerning the extinction risk assessment, the new species was assessed as critically endangered.

ResumoMonimiaceae abrange c. 26 gêneros e 250 espécies, tem distribuição pantropical e suas espécies ocorrem predominantemente em florestas úmidas. No Brasil está representada por cinco gêneros e 47 espécies, a maior parte das quais com ocorrência na Mata Atlântica, em floresta ombrófila densa. Estudos com a família em outros biomas e vegetações ainda são escassos no Brasil. O Quadrilátero Ferrífero (QF), região localizada no estado de Minas Gerais, possui alta riqueza e endemismo de plantas. Durante coletas e análise de materiais herborizados da região, alguns espécimes de Mollinedia nos chamaram a atenção devido a uma combinação de caracteres que não coincidem com nenhuma espécie descrita para o gênero. Este novo táxon é aqui descrito e tem seu risco de extinção avaliado, além disso, revisamos as ocorrências de Monimiaceae no QF, e fornecemos mapas de distribuição geográfica. Com a descrição desta nova espécie, a região apresenta agora oito espécies de Monimiaceae, duas do gênero Macropeplus e seis de Mollinedia. A nova espécie é a primeira da família endêmica do QF. Em relação à avaliação do risco de extinção, a nova espécie foi categorizada como Criticamente em Perigo.

The first notosuchian crocodyliform from the Araçatuba Formation (Bauru Group, Paraná Basin), and diversification of sphagesaurians.

The mesoeucrocodylian record from the Bauru Group (Paraná Basin, Brazil) comes from three formations: Adamantina (Late Turonian-Early Maastrichtian), Presidente Prudente (Early Campanian-Early Maastrichtian) and Marília (Maastrichtian). These records are restricted to the Early Coniacian-Early Maastrichtian. Here, we report a new crocodyliform record from the Bauru Group, which was the first of the Araçatuba Formation, from a new locality of Coronel Goulart district, in Álvares Machado municipality. Coronelsuchus civali gen. nov. et sp. nov. comprises two related specimens - FFP PG 13 and FFP PG 14 recovered close to each other and on the same muddy sandstone level. We perform a phylogenetic analysis with 392 characters (five new added) and 88 taxa. Our analyses supported the new clades: Sphagesauria, Sphagesaurinae and Caipirasuchinae. Our phylogenetic results suggest C. civali as a basal Sphagesauria. Regarding the Crocodyliform Assemblage Zones (CAZ), the new species is correlated to the CAZ 1, together with small sphagesaurians, Caryonosuchus and itasuchids. The C. civali reveals an older appearing (pre-Turonian) and diversification of Sphagesauria. The specimens also expand the stratigraphic range for Notosuchia in the Bauru Group.

Seasonal Patterns of Host Plant Use in an Assemblage of Heliconiini Butterflies (Lepidoptera: Nymphalidae) in a Neotropical forest.

Insect-plant interactions involve physiological adaptations by insects to secondary metabolic compounds synthetized by host plants, which are considered essential for the determination of resources partitioning of these insects. Data on such phenomena are important to understand evolutionary and ecological processes. However, climatic factors also seem to play a key role in affecting these patterns. The present study aimed to investigate the influence of seasonal variation on patterns of host plant use (Passifloraceae) by Heliconiini butterflies (Nymphalidae: Heliconiinae) at a Neotropical site in Southeastern Brazil. A total of 12 species of Heliconiini were reported, with nine of them being resident and using five species of Passiflora (Passifloraceae) as larval host plants. Three host plant species accounted for 97% of the total use, and the use varied along the seasons highlighting the plasticity boundaries in Heliconiini and possible limiting factors.

Adhesive dentistry: Current concepts and clinical considerations.

OBJECTIVES: To address contemporary concepts in adhesive dental materials with emphasis on the evidence behind their clinical use. OVERVIEW: Adhesive dentistry has undergone major transformations within the last 20 years. New dental adhesives and composite resins have been launched with special focus on their user-friendliness by reducing the number of components and/or clinical steps. The latest examples are universal adhesives and universal composite resins. While clinicians prefer multipurpose materials with shorter application times, the simplification of clinical procedures does not always result in the best clinical outcomes. This review summarizes the current evidence on adhesive restorative materials with focus on universal adhesives and universal composite resins. CONCLUSIONS: (a) Although the clinical behavior of universal adhesives has exceeded expectations, dentists still need to etch enamel to achieve durable restorations; (b) there is no clinical evidence to back some of the popular adjunct techniques used with dental adhesives, including glutaraldehyde-based desensitizers and matrix metalloproteinase inhibitors; and (c) the color adaptation potential of new universal composite resins has simplified their clinical application by combining multiple shades without using different translucencies of the same shade. CLINICAL SIGNIFICANCE: New adhesive restorative materials are easier to use than their predecessors, while providing excellent clinical outcomes without compromising the esthetic quality of the restorations.

The volition, the mode of movement selection and the readiness potential.

A growing body of evidence suggests that the mode of movement selection is relevant for the readiness potential, namely, internal (or free) selection of movements is associated with increased readiness potential amplitudes compared to predetermined or externally guided selection. It is little acknowledged, however, that this finding may be ascribed to the different expression of volition (i.e., conscious experience of choice) rather than to the mode of movement selection per se. To probe this issue, we conducted two experiments: in Experiment 1, a mental task was employed to distract sixteen volunteers from the selection and performance of incidental movements, which consisted of pressing one of two buttons according to either free or externally guided modes of movement selection; in Experiment 2, another sixteen individuals performed the same motor task, however, they were encouraged to attend to their intention to act. As result, the increased readiness potential amplitude before freely selected movements was found exclusively in Experiment 2. More detailed analysis suggested that the attention to the initiation of movements was associated with greater readiness potential in its medial and late portion, while the attention to the movement selection, with more global increase of the component. The study suggests that much of the higher demands on motor preparatory activities ascribed to the internal selection of movements in previous studies actually depends on individual's attention and, thus, probably corresponds to volitional processes.

The roles of hybridization and habitat fragmentation in the evolution of Brazil's enigmatic longwing butterflies, Heliconius nattereri and H. hermathena.

BACKGROUND: Heliconius butterflies are widely distributed across the Neotropics and have evolved a stunning array of wing color patterns that mediate Müllerian mimicry and mating behavior. Their rapid radiation has been strongly influenced by hybridization, which has created new species and allowed sharing of color patterning alleles between mimetic species pairs. While these processes have frequently been observed in widespread species with contiguous distributions, many Heliconius species inhabit patchy or rare habitats that may strongly influence the origin and spread of species and color patterns. Here, we assess the effects of historical population fragmentation and unique biology on the origins, genetic health, and color pattern evolution of two rare and sparsely distributed Brazilian butterflies, Heliconius hermathena and Heliconius nattereri. RESULTS: We assembled genomes and re-sequenced whole genomes of eight H. nattereri and 71 H. hermathena individuals. These species harbor little genetic diversity, skewed site frequency spectra, and high deleterious mutation loads consistent with recent population bottlenecks. Heliconius hermathena consists of discrete, strongly isolated populations that likely arose from a single population that dispersed after the last glacial maximum. Despite having a unique color pattern combination that suggested a hybrid origin, we found no genome-wide evidence that H. hermathena is a hybrid species. However, H. hermathena mimicry evolved via introgression, from co-mimetic Heliconius erato, of a small genomic region upstream of the color patterning gene cortex. CONCLUSIONS: Heliconius hermathena and H. nattereri population fragmentation, potentially driven by historical climate change and recent deforestation, has significantly reduced the genetic health of these rare species. Our results contribute to a growing body of evidence that introgression of color patterning alleles between co-mimetic species appears to be a general feature of Heliconius evolution.

Rinomodelação ou rinoplastia não-cirúrgica: uma abordagem segura e reprodutível / Rhinomodelation or non-surgical rhinoplasty: a safe and reproducible approach

Introdução: A rinoplastia é uma cirurgia que muitas vezes apresenta resultados imprevisíveis, mesmo em mãos de cirurgiões experientes. Neste sentido, a rinomodelação com preenchedores é um procedimento não-cirúrgico para corrigir pequenas alterações externas nasais em casos específicos. Métodos: Os autores descrevem a técnica de aplicação de preenchedores (ácido hialurônico ou hidroxiapatita de cálcio) para modelação nasal. Foram incluídos todos os pacientes submetidos ao preenchimento nasal, entre 2009 e 2012. Foi avaliado o edema da ponta nasal, a dor e o grau de satisfação dos pacientes com o resultado. Resultados: Foram incluídos 39 pacientes no estudo. Com relação aos desfechos analisados com ácido hialurônico: 52% apresentaram edema leve; 74% tiveram dor leve; 15% se mostraram muito satisfeitos e 74% satisfeitos com o resultado. Com relação aos pacientes submetidos à rinomodelação com hidroxiapatita de cálcio: 67% apresentaram edema moderado; 50% dor moderada; 17% dor intensa e 84% se mostraram satisfeitos com o resultado. Conclusão: A rinomodelação com preenchedores reabsorvíveis é um procedimento simples, com resultados estéticos aceitáveis, sendo necessário um profundo conhecimento anatômico para diminuir o risco de complicações.

Introduction: Rhinoplasty often leads to unpredictable results, even in the hands of experienced surgeons. However, in specific cases, rhinomodelation with fillers, a non-surgical procedure to correct minor nasal external changes, can be used. Methods: This study describes the application technique of fillers (hyaluronic acid or calcium hydroxyapatite) for nasal modeling. Patients undergoing nasal filling between 2009 and 2012 were included. Edema of the nasal tip, pain, and the degree of patient satisfaction with the outcome were assessed. Results: Thirty-nine patients were included in the study. Regarding the outcomes of rhinomodelation with hyaluronic acid, 52% patients presented with mild edema, 74% had mild pain, 15% were very satisfied, and 74% were satisfied with the result. For the outcomes of rhinomodelation with calcium hydroxyapatite, 67% patients presented with moderate edema, 50% had moderate pain; 17% had severe pain, and 84% were satisfied with the result. Conclusion: Rhinomodelation with resorbable fillers is a simple procedure with acceptable esthetic results. However, a deep anatomical knowledge is necessary to decrease the risk of complications.

A problemática da pobreza nos acolhimentos realizados nos serviços de acolhimento institucional para crianças e adolescentes e os desafios para a atuação do psicólogo / The problem of poverty in the shelter assistance carried out at the institutional welfare services for children and adolescents and the challenges to the psychologist’s deeds / La problemática de la pobreza en las acogidas realizadas en los servicios de acogimiento institucional para niños y adolescentes y los desafíos para la actuación del psicólogo

Este artigo analisa a relação da pobreza com os motivos de acolhimento de crianças e adolescentes registrados pelos Serviços de Acolhimento Institucional para Crianças e Adolescentes (SAICA). Para isso, foram analisados dados apresentados por duas pesquisas: O direito à convivência familiar e comunitária: os abrigos para crianças e adolescentes no Brasil, publicado em 2004, e Levantamento nacional de crianças e adolescentes em serviços de acolhimento institucional, publicado em 2013. A comparação dessas pesquisas mostra caminhos opostos: enquanto a primeira considera que a pobreza contribui para diversos motivos de acolhimento institucional, entre eles, a negligência familiar, na última, a pobreza não é significativamente considerada, principalmente nos casos de negligência e abandono. Assim, responsabiliza exclusivamente as famílias ao mesmo tempo em que atenua a função do Estado na produção da pobreza. Esse cenário traz desafios para o trabalho do psicólogo e reforça a importância de uma atuação implicada com aspectos sociais e políticos.

This study analyzes the relationship between poverty and the reasons for the reception of children and adolescents registered in the Institutional Reception Services for Children and Adolescents (SAICA - acronym in Portuguese). In order to do so, the data collected from two researches: O direito à convivência familiar e comunitária: os abrigos para crianças e adolescentes no Brasil – The right to Family and Community Interection: Child and Adolescent Shelters in Brazil published in 2004, and Levantamento nacional de crianças e adolescentes em serviços de acolhimento institucional – Data Registry of Children and adolescent in Institutional Sheltering Assistance - published in 2013, were analyzed. The comparison between these investigations shows opposite paths: while the first considers that poverty contributes to various reasons for institutional reception, among them, family negligence; in the latter, poverty is not significantly considered, mainly in cases of negligence and abandonment. Thus, the latter holds exclusive responsibility for families, while at the same time attenuating the role of the State in the production of poverty. This scenario brings challenges to the psychologists’ work and reinforces the importance of an action intermingled with social and political aspects.

Este artículo analiza la relación existente entre la pobreza y los motivos de acogida de niños y adolescentes registrados por los Servicios de Acogida Institucional para Niños y Adolescentes (SAICA). Para ello, se analizaron los datos presentados por dos investigaciones: O direito à convivência familiar e comunitária: os abrigos para crianças e adolescentes no Brasil, publicado en 2004, y Levantamento nacional de crianças e adolescentes em serviços de acolhimento institucional, publicado en 2013. La comparación de estas investigaciones muestra caminos opuestos: mientras la primera considera que la pobreza contribuye a diversos motivos de acogida institucional, entre ellos, la negligencia familiar; en la última, la pobreza no es significativamente considerada, principalmente en los casos de negligencia y abandono. Así, esta última responsabiliza exclusivamente a las familias, a la vez que atenúa la función del Estado en la producción de la pobreza. Este escenario trae desafíos para el trabajo del psicólogo y refuerza la importancia de una actuación implicada en aspectos sociales y políticos.

Disruption of volitional control in obsessive-compulsive disorder: Evidence from the Bereitschaftspotential.

In the context of controversies involving possible abnormalities in the volition and action control in obsessive-compulsive disorder (OCD), the current study examined electroencephalographic correlates of automatic and volitional brain processes involved in the genesis of spontaneous movements in individuals diagnosed with OCD. For this, the amplitudes of early and late Bereitschaftspotential (early BP and late BP) from 12 patients and 12 controls were obtained while they performed spontaneous button presses under different levels of volitional experience. In the first condition, participants were distracted from their motor actions by a mental task (automatic condition) and in the second condition they were instructed to attending to their own intention to move (willed condition). The results corroborate previous report that the attention to (and, presumably, the awareness of) intention to act accounts for the expression of significant portion of the late BP in healthy individuals. More relevantly, the increased late BP in willed condition in relation to automatic condition was not present in the OCD group. Neither groups nor conditions affected the early BP. In sum, the current findings suggest the existence of abnormalities in the brain activities associated with the establishment of volitional control in OCD patients.

Age and Disease have a Distinct Influence on Postural Balance of Patients with COPD.

The postural imbalance is an extra-pulmonary condition, associated with chronic obstructive pulmonary disease (COPD). COPD affects older individuals and it is unclear whether balance abnormalities can be described as pathophysiological mechanism or aging. The present study aimed to evaluate the influence of age or disease on postural balance of patients with COPD. Patients with COPD over 50 years old were compared with age- and sex-matched healthy adults, and with sex-matched younger healthy adults (n = 30 in each group). The Modified Sensory Organization Test (mSOT) was performed in four different conditions fixed or sway-referenced surface both either with full or no vision. It was analyzed the center of pressure (CoP) variables: amplitude, velocity, root-mean-square and load asymmetry. Three-way ANOVA and post hoc analysis were performed been represented of age (older or COPD compared with younger healthy adults) or disease influences (COPD compared with older healthy groups). Main results were as follows: The CoP excursion was faster, with higher amplitude and variability progressively from COPD vs. older healthy vs. younger healthy adults (p < 0.05) showing age and disease influences (p < 0.05). Age and disease influences were also observed in the sway-referenced surface in both vision conditions. Impairment in postural balance was found related to aging and disease in patients with COPD older than 50 years.

Dupuytren's disease: where do we stand?

Dupuytren's disease is a fibroproliferative disease that involves collagen deposition, leading to hand contractures that ultimately affect hand mobility and grip strength.It is a benign disorder but can cause high morbidity by limiting daily activities.Many factors have been proposed for its aetiology: namely genetics, smoking, alcohol intake and diabetes. However, there is still controversy as to the main aetiological cause of the disease.Treatment is not yet uniform around the world and still varies with the surgeon's experience and preference.In this review, the authors review the pathogenesis and treatment options for Dupuytren's disease in an attempt to summarize the current state of the art. Cite this article: EFORT Open Rev 2019;4:63-69. DOI: 10.1302/2058-5241.4.180021.

Comparison of macroscopic resorption time for a self-locking device and suture material in ovarian pedicle ligation in dogs.

A resorbable self-locking device (LigaTie) was developed to enable safe and easy surgical ligation of blood vessels. The aim of this study was to compare the long-term in vivo resorption of the device to a commercially available suture of equivalent material (Maxon) following ovarian pedicle ligation. After ovariohysterectomy follow-up ultrasound examinations were performed monthly on 21 dogs ligated with the device and 22 dogs ligated with the suture material until no hyperechoic remnants, acoustic shadowing or local tissue reactions were detected. In both groups, the ovarian pedicles gradually decreased in size. Ligation material was considered macroscopically resorbed when ultrasound showed no signs of the device or suture, ovarian pedicle or tissue reaction. Macroscopic resorption had occurred without signs of complications and was complete by four months for sutures and 5.5 months for the device. The results show that resorption time in vivo for the resorbable self-locking device is mildly longer than suture of the same material and that no complications of device resorption were detected, supporting that the resorbable self-locking device is safe for in vivo use.

Photobiomodulation Improved the First Stages of Wound Healing Process After Abdominoplasty: An Experimental, Double-Blinded, Non-randomized Clinical Trial.

BACKGROUND: Photobiomodulation is widely studied for its potential benefits in the wound healing process. Numerous scientific studies have highlighted its effect on various phases of wound repair, but clinical validations are few. This comparative trial aims to evaluate the influence of photobiomodulation on the post-abdominoplasty healing process. METHODS: Seventeen Caucasian women (aged 18-55) who underwent an abdominoplasty were enrolled in this double-blinded, controlled clinical trial. The postoperative scars were divided into two areas; the right side of the scars was treated with ten sessions of photobiomodulation (consisting in three types of wavelengths). The other part of the scars was used as control and did not receive any additional treatment. Clinical assessments of both parts of the scars were scheduled at 1, 6 and 12 months postoperative. RESULTS: Within six months following surgery, significantly improved quality of the scars on the treated side compared with the untreated side was reported by patients and experienced professionals according to Vancouver Scar Scale, Patient and Observer Scar Assessment Scale (p < 0.05) and standardized photographs (p < 0.05). At 1 year of follow-up, patients observed no differences between the treated and untreated sides of the scars. This suggests that photobiomodulation appears to play an early role in the wound healing process, accelerating the first stages of cicatrization. CONCLUSION: This study statistically validates the positive impact of photobiomodulation treatment on the first stages of the postoperative healing process. Carried out on Caucasians participants only, this study should, however, be performed on a more heterogeneous population to definitively confirm these effects on an international population. CLINICAL TRIAL REGISTRY: Registro Brasileiro de ensaios clínicos: http://www.ensaiosclinicos.gov.br , Trial RBR-49PK78. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Breast Reduction: The Superolateral Dermoglandular Pedicle Revisited.

BACKGROUND: Breast hypertrophy, generally found in association with ptosis, is a common problem in postadolescent women. Beyond the psychological burden of excessively heavy, droopy breasts, physical symptoms compound the condition, with neck, shoulder and back pain. Reduction mammaplasty is one of the most common cosmetic operations, especially to improve patient's musculoskeletal symptoms, with proven benefits in patient satisfaction and self-esteem postoperatively. Multiple techniques exist for breast reduction, with no clear evidence of benefit of one over another. METHODS: We review the senior author's experience in using a superolateral pedicle for breast reduction in 726 patients over the past 40 years. Over the past 10 years, the technique has also been adapted for simultaneous augmentation-mastopexy, especially in post-bariatric surgery patients. Benefits include recruitment of lateral breast tissue to fill the upper pole and correct axillary fullness. The technique has the advantages of ease of execution and a low complication rate. RESULTS: Complete data were available for 397 patients. Resection weights varied from 380 to 1248 g, and mean sternal notch-nipple distance was 25.3 cm. Mean follow-up was 22 months. Complications were uncommon: four cases of partial nipple-areola complex loss, dehiscence in 14 patients, three hematomas and seven cases of superficial surgical site infection. Nipple sensitivity was decreased in eight patients, and three patients were unable to breastfeed following surgery. Revision surgery was requested by 14 patients. CONCLUSIONS: Breast reduction using the superolateral dermoglandular flap is easy to execute, versatile, safe and effective, preserving physiological functions, and is an excellent option when treating patients with medium-to-large breasts. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Coronary Sinus Stenosis With Right Coronary Artery to Coronary Sinus Fistula.

Coronary artery fistula is a rare congenital cardiac anomaly. We report a 34-year-old woman who presented with a recurrent large pericardial effusion during pregnancy. She was found to have a right coronary artery to coronary sinus fistula. The coronary sinus was severely dilated due to coronary sinus ostial stenosis. Primary surgical closure of coronary artery fistula was performed with resection of coronary sinus ostial stenosis.

Young and older adults adapt automatic postural responses equivalently to repetitive perturbations but are unable to use predictive cueing to optimize recovery of balance stability.

Processing of contextual cues has been proposed to modulate the generation of automatic postural responses to unanticipated balance perturbations. In this investigation, we compared young and older individuals in responses to sudden rotations of the support base inducing either planti- or dorsiflexion of the ankles. Assessment was made in conditions resulting from the combination of visual directional cueing of the forthcoming platform rotation, and block versus random sequences of platform rotation directions. Results showed that, for both rotation directions, the block sequence led to reduced magnitude of activation of distal agonist muscles and direction-specific modulation of ground reaction forces to recover body balance. Visual directional cueing, conversely, failed to modulate either muscular responses or forces applied to the support base through the feet for balance recovery. Effects were similar between ages, suggesting that aging does not increase the influence of cognition on the generation of automatic postural responses, and that adaptation to repeated postural perturbations over trials is preserved in healthy older individuals.

The effect of conscious intention to act on the Bereitschaftspotential.

The current study investigated the effect of conscious intention to act on the Bereitschaftspotential. Situations in which the awareness of acting is minimally expressed were generated by asking 16 participants to press a button after performing a mental imagery task based on animal pictures (automatic condition). The affective responses induced by the pictures were controlled by selecting the animals according to different valences, threatening and neutral. The Bereitschaftspotential associated with the button presses was compared to the observed when similar movements were performed under the basic instructions of the self-paced movement paradigm (willed condition). Enhanced Bereitschaftspotential amplitudes were observed in the willed condition with respect to the automatic condition. This effect was manifested as a negative slope at medial frontocentral sites during the last 500 ms before movement onset. The valence of the pictures did not affect the motor preparatory potentials. The results suggest that significant part of the NS' subcomponent of the readiness potential is associated with the attention to-and, presumably, awareness of-intention to move, possibly reflecting cortical activation from supplementary motor areas. Secondarily, our findings supports that the feeling of threat does not influence the Bereitschaftspotential associated with automatic movements. Regarding methodological issues, the behavioural model of spontaneous voluntary movements proposed in automatic condition can benefit investigations on purely motor (or non-cognitive) subcomponents of the Bereitschaftspotential.

Obsessive-Compulsive Disorder.

PURPOSE OF REVIEW: This article reviews current knowledge regarding diagnosis, pathophysiology, and treatment trends in obsessive-compulsive disorder (OCD), a severe, underrecognized, and chronic condition frequently encountered in neurologic practice. RECENT FINDINGS: With a lifetime prevalence estimated at 2.5%, OCD is a common condition that can also present comorbidly with neurologic disease. The core symptoms of OCD are obsessions and compulsions. Obsessions are intrusive repetitive thoughts, urges, images, or impulses that trigger anxiety and that the individual is not able to suppress. Compulsions are repetitive behaviors or mental acts occurring in response to an obsession with the intention of reducing the distress caused by obsessions. Neuroimaging, neuropsychological, and pharmacologic studies suggest that the expression of OCD symptoms is associated with dysfunction in a cortico-striato-thalamo-cortical circuit. Evidence-based treatments for OCD comprise pharmacotherapy and cognitive-behavioral therapy. Selective serotonin reuptake inhibitors (SSRIs) are the first-line drugs recommended for OCD, but significant differences exist in their use for OCD compared to their use for other mood and anxiety conditions, including the need for higher dosage, longer trials necessitated by a longer lag for therapeutic response, and typically lower response rates. Cognitive-behavioral therapy, based on the principles of exposure and response prevention, shows results superior to pharmacologic treatments with lower relapse rates on long-term follow-up and thus should be considered in the treatment plan of every patient with OCD. SUMMARY: OCD and obsessive-compulsive symptoms are frequently encountered in the neurologic clinic setting and require a high index of suspicion to effectively screen for them and an illness-specific therapeutic approach.