Transcranial direct current stimulation in neglect rehabilitation after stroke: a systematic review.

Hemispatial neglect is one of the most frequent attention disorders after stroke. The presence of neglect is associated with longer hospital stays, extended rehabilitation periods, and poorer functional recovery. Transcranial direct current stimulation (tDCS) is a new technique with promising results in neglect rehabilitation; therefore, the objective of this systematic review, performed following the PRISMA guidelines, is to evaluate the effectiveness of tDCS on neglect recovery after stroke. The search was done in MEDLINE (PubMed), Web of Science, Scopus, Cochrane Library, and BioMed Central databases. A total of 311 articles were found; only 11 met the inclusion criteria, including 152 post-stroke patients in total. Methodological quality and risk of bias were assessed for all the studies, and methodological characteristics of the studies, sample sizes, methods, main results, and other relevant data were extracted. tDCS intervention ranged from one to twenty sessions distributed in 1 day to 4 weeks, with intensity ranged from 1 to 2 mA. We found moderate evidence for the efficacy of tDCS in the rehabilitation of hemispatial neglect after a stroke, being more effective in combination with other interventions. Nonetheless, the limited number of studies and some studies' design characteristics makes it risky to draw categorical conclusions. Since scientific evidence is still scarce, further research is needed to determine the advantage of this treatment in acute, sub-acute and chronic stroke patients. Future studies should include larger samples, longer follow-ups, and broader neurophysiological assessments, with the final aim of establishing the appropriate use of tDCS as an adjuvant intervention in neurorehabilitation settings.

Patient satisfaction after the treatment of glabellar lines with Botulinum toxin type A (Speywood Unit): a multi-centre European observational study.

BACKGROUND: Whilst the efficacy and safety of glabella complex treatment with botulinum toxin type A (Speywood Unit) [BoNT-A (s.U)] has been comprehensively studied, there are very few trials on patient-reported outcomes and patient satisfaction associated with this treatment. OBJECTIVE: To assess the level of patient satisfaction 3 weeks and 4 months after the treatment of glabellar lines with BoNT-A (s.U). METHODS: This is a multi-centre, prospective, non-interventional observational study carried out in France, Germany, Spain and the United Kingdom. Subjects were eligible if the investigator had already decided to prescribe BoNT-A (s.U), according to the labelling. Subjects completed a questionnaire at both 3 weeks and 4 months after treatment. RESULTS: About 533 subjects completed at least one of the two questionnaires. About half of the subjects (47.9%) were naive to BoNT-A treatment of the glabella, while 50.6% had previously received another product. A high level of satisfaction was observed after the treatment, with 94.7% and 89.6% of subjects being satisfied or very satisfied with the aesthetic outcome at week 3 and month 4, respectively. Treatment was safe and well tolerated, as directly determined in the survey. Major reasons for satisfaction included the positive aesthetic outcome, a natural appearance, a rested look and comfort of injection. Most subjects felt the treatment brought them 'harmony', 'self-esteem/confidence' or 'youth'. Of the subjects who had previously been treated with another product, 51.2% considered the results obtained in the present study with BoNT-A (s.U) were better. CONCLUSION: Treatment of the glabellar lines with BoNT-A (s.U) led to a high level of patient satisfaction and a more positive self-perception up to 4 months after the treatment, regardless of whether the patients were naive or not to BoNT-A treatment.

Delayed capillary breakup of falling viscous jets.

Thin jets of viscous fluid like honey falling from capillary nozzles can attain lengths exceeding 10 m before breaking up into droplets via the Rayleigh-Plateau (surface tension) instability. Using a combination of laboratory experiments and WKB analysis of the growth of shape perturbations on a jet being stretched by gravity, we determine how the jet's intact length l(b) depends on the flow rate Q, the viscosity η, and the surface tension coefficient γ. In the asymptotic limit of a high-viscosity jet, l(b)∼(gQ(2)η(4)/γ(4))(1/3), where g is the gravitational acceleration. The agreement between theory and experiment is good, except for very long jets.

Inferring nonlinear mantle rheology from the shape of the Hawaiian swell.

The convective circulation generated within the Earth's mantle by buoyancy forces of thermal and compositional origin is intimately controlled by the rheology of the rocks that compose it. These can deform either by the diffusion of point defects (diffusion creep, with a linear relationship between strain rate and stress) or by the movement of intracrystalline dislocations (nonlinear dislocation creep). However, there is still no reliable map showing where in the mantle each of these mechanisms is dominant, and so it is important to identify regions where the operative mechanism can be inferred directly from surface geophysical observations. Here we identify a new observable quantity--the rate of downstream decay of the anomalous seafloor topography (swell) produced by a mantle plume--which depends only on the value of the exponent in the strain rate versus stress relationship that defines the difference between diffusion and dislocation creep. Comparison of the Hawaiian swell topography with the predictions of a simple fluid mechanical model shows that the swell shape is poorly explained by diffusion creep, and requires a dislocation creep rheology. The rheology predicted by the model is reasonably consistent with laboratory deformation data for both olivine and clinopyroxene, suggesting that the source of Hawaiian lavas could contain either or both of these components.

Buckling of liquid columns.

Under appropriate conditions, a column of viscous liquid falling onto a rigid surface undergoes a buckling instability. Here we show experimentally and theoretically that liquid buckling exhibits a hitherto unsuspected complexity involving three different modes-viscous, gravitational, and inertial-depending on how the viscous forces that resist bending of the column are balanced. We also find that the nonlinear evolution of the buckling exhibits a surprising multistability with three distinct states: steady stagnation flow, "liquid rope coiling," and a new state in which the column simultaneously folds periodically and rotates about a vertical axis. The transitions among these states are subcritical, leading to a complex phase diagram in which different combinations of states coexist in different regions of the parameter space.

Coiling of elastic ropes.

A rope falling onto a solid surface typically forms a series of regular coils. Here, we study this phenomenon using laboratory experiments (with cotton threads and softened spaghetti) and an asymptotic "slender-rope" numerical model. The excellent agreement between the two with no adjustable parameters allows us to determine a complete phase diagram for elastic coiling comprising three basic regimes involving different force balances (elastic, gravitational, and inertial) together with resonant "whirling string" and "whirling shaft" eigenmodes in the inertial regime.

Liquid rope coiling on a solid surface.

We present an experimental study of the coiling instability of a liquid "rope" falling on a solid surface. Coiling can occur in three different regimes--viscous, gravitational, or inertial--depending on the fluid viscosity and density, the fall height, and the flow rate. The competition among the different forces causes the coiling frequency first to decrease and subsequently to increase with increasing height. We also observe an oscillation between two coiling states in the gravitational-to-inertial transitional range, reflecting the multivaluedness of the dependence of coiling frequency on fall height. The data can be rescaled in a universal way, and agree very well with numerically predicted coiling frequencies.

[TESE-ICSI in the treatment of secretory azoospermia secondary to cryptorchism. Report of a clinical case]. / TESE-ICSI nel trattamento della azoospermia secretoria secondaria a criptorchidismo. Descrizione di un caso clinico.

The pathogenic role of cryptorchism in male infertility is still controversial. To report a case of a 34-year-old patient consulted for primary infertility with a history of 2 years associated with prepubertal bilateral orchidopexy for cryptorchidism. The fertility studies demonstrated azoospermia and normal sperm volume. Testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) were performed with success. Cryptorchism can cause primary obstructive infertility. Testicular sperm aspiration (TESA) is an alternative when spermatogenesis is preserved. In this patient TESE-ICSI was performed with success.

[Response to intracavernous administration of 3 different drugs in the same group of patients with erectile dysfunction]. / Respuesta a la administración intracavernosa de tres fármacos diferentes en el mismo grupo de pacientes con disfunción eréctil.

OBJECTIVE: To compare the subjective and objective penile rigidity in the same group of patients with erectile dysfunction after intracavernous injection of different vasoactive drugs. METHODS: 91 impotent males were randomly assigned to three groups of intracavernous injection: A: 20 micrograms PGE1 B: 30 mg papaverine hydrochloride + 1 mg phentolamine (bimix), and C: 10 micrograms PGE1 + 15 mg papaverine hydrochloride + 0.5 mg phentolamine (trimix). Each patient was scheduled to receive the three modalities of intracavernous injection randomly with an interval of 7-10 days between injections. Penile rigidity equal to or more than 60% was considered positive. Subjective and objective penile rigidity were evaluated with callipers by the same observer. RESULTS: 82 patients completed the study and 9 dropped out after prolonged erection with one of the ICI modalities. Rigidity after treatment with C (66 +/- 15%) was significantly superior to that of B (59 +/- 15%, p = 0.0001) and A (60 +/- 13%, p = 0.0115). No differences were observed between A and B (p = 0.4644). Analysis of only the positive response showed significant differences between A and C, but not between C and B (p = 0.3323). Differences were not found between the response to PGE1 (A) and bimix (B) (p = 0.1275). The order of application of the drug had no effect on response (p = 0.026). CONCLUSIONS: A higher percentage of positive response in patients with erectile dysfunction was achieved with the trimix modality. Choice of more potent ICI regimens can improve the diagnostic and/or therapeutic efficacy in males that do not respond to PGE1 alone.

Cavernositis following intracavernous injection of vasoactive drugs.

Intracavernous injection is one of the most common treatments of erectile dysfunction. Infectious complications are rare, but hazardous. We report the case of a 44-year-old to stress the importance of patient supervision and drug prescription.

Cartesian optics and the mastery of nature.

Descartes's Dioptrics is more than a mere technical treatise on optics; it is an essay in the "practical philosophy" that he claimed could render us "masters and possessors of nature." Descartes's practical intent is indicated first by the instrumentalist character of his derivation of the sine law of refraction, which is based on a heuristic and readily mathematizable model that requires no consideration of light's "true nature." Descartes's subsequent discussion of human vision is an extended critique of nature's workmanship that grounds the possibility of improving vision by artificial means. I suggest that this critique is the source of Descartes's doctrine that the purpose of sensory perception is to preserve the mind-body composite, not to provide knowledge of the essential nature of things. Accordingly, the ultimate goal of the Dioptrics is to "master" human vision by raising it from a mere means of self-preservation to an instrument of scientific knowledge.