International Classification of Diseases the 10th Revision (ICD-10) was implemented October 1, 2015, and there was little knowledge how the transition to ICD-10 would impact the revenue cycle for intraoperative neurophysiological monitoring medical practices in Oklahoma. This correlational quantitative study examined the changes in dependent variables of reimbursements due to the change from ICD-9 to ICD-10 for independent variables of intraoperative neurophysiological monitoring procedure codes. The reimbursements from 2014 were compared to reimbursements from 2016. Prices were adjusted for inflation to 2016 dollar values. Annual reimbursements decreased for all intraoperative neurophysiological monitoring procedures examined except the remote monitoring code. The intraoperative neurophysiological monitoring procedure with the greatest mean annual decreases in reimbursement was the lower somatosensory evoked potentials. The intraoperative neurophysiological monitoring procedures with the least annual reimbursement decreases were transcranial electrical motor potential monitoring and electromyography. The findings of the budget-impact analysis and cost-effectiveness analysis indicated that reimbursement for procedures has steadily decreased from 2014 to 2016, causing a negative effect on practices' revenue cycle management. The findings of this study could benefit intraoperative neurophysiological monitoring companies in Oklahoma by supporting adjustments essential for healthcare leaders to maintain a financially sustainable intraoperative neurophysiological monitoring medical practice.

This article presents an analysis of the pro active social behavior construct based on the sociallearning theory. Self efficacy is briefly reviewed and discussed in the context of Bandura' s conceptual work. Reference is made to cognitive variables such as values and beliefs, as fundamental principies in the development of the pro active social behavior. I examine che distinctions between fears of failure, success, and rejection as they relate to the process of self sabotage. Comments are made on the transformation of meaning and its benefits on fear extinction. Finally, I briefly describe the principies of the associative neurophysiological conditioning as a therapeutic program for the management of emocional states by the individual. / Este artículo presenta un análisis del Comportamiento Social Pro Activo utilizando como modelo la teoría del aprendizaje social. Se revisa el concepto de autoeficacia, originalmente propuesto por Bandura, y se hace referencia a variables de tipo cognitivo tales como los sistemas de valores y creencias. Se examinan las distinciones entre el temor al fracaso, al éxito, al rechazo, y su relación con el proceso de autosabotaje. Asimismo se discute la importancia de la transformación del significado y sus beneficios en la extinción del temor. Se presenta un modelo conceptual del control de los estados emocionales y sus implicancias en el proceso de la acción. Finalmente, se describen las premisas fundamentales del Condicionamiento Neurofisiológico Asociativo como un programa terapéutico que facilita el manejo de los estados emocionales de la persona.

The overall aim of this thesis is to increase our knowledge of the physical environment of office workers with special focus on electromagnetic fields and to address the question of whether electromagnetic fields can directly or indirectly contribute to symptoms or discomfort among video display terminal ( VDT) workers. Furthermore, we have measured light modulation from various commonly used light sources in laboratory conditions and, as a second step, used modulated light as stimulus for provocation of neurophysiological responses in persons with perceived “electrical hypersensitivity” (EHS).During the last 20 years work-related illness among office workers has received increased attention. Changes in the physical environment, the introduction of VDTs and other electrical equipment and changes in light conditions have been discussed in this context. The basis for this thesis is the interdisciplinary Office Illness Project in Northern Sweden. Using a questionnaire completed by 4,943 office workers, 150 VDT workers with or without facial skin symptoms were selected for a case referent study of the electromagnetic fields in offices.When the measurements in the offices were performed in 1989, the general level of the 50 Hz magnetic fields in the offices was rather low, but in 5% of the offices the flux density exceeded 0.5 pT. At this level VDT monitors were shown to display detectable instability (jitter). Furthermore, the ability of test subjects (healthy volunteers) to detect jitter was shown to depend on both the amplitude and frequency characteristics of this instability. The study indicates that the instability of computer monitors and thereby the instability of the visual image of the VDT screen might be an increasing problem since it is known that the harmonic content of the general magnetic field in offices is on the rise.VDT monitors contributed to the magnetic field level at VDT workplaces in both extremely low and very low frequency ranges. However, the dominant source of electric fields in rooms was ungrounded electrical equipment, not VDT screens.High electric fields in the extremely low frequency range in the offices were associated with skin symptoms among VDT workers. The causal nature of this association cannot be determined since it may depend on undetected factors related to exposure. No associations were found, however, for any of the VDT-related electromagnetic fields and skin symptoms.Commonly used fluorescent tubes in our office environment have a degree of modulation of the light (flicker) that varies widely from less than 1% (fluorescent tubes with high frequency gear) up to nearly 100%. When persons with perceived EHS were exposed to flickering light, a higher amplitude of brain cortex responses were found at all tested frequencies compared with control subjects. These findings are of considerable interest, but further studies are required in order to establish a possible relationship between flickering light and discomfort/symptoms in persons with perceived EHS. / digitalisering@umu

Title: Application of new trends beneath the neurophysiological patterns in sports training footballers. Objectives: The main objective of this work is the application of intervention programs based on the neurophysiological patterns of motion and determine their effectiveness. Methods: It is a methodical work, respecting the individual needs of soccer players in sports training. Players club FK Dukla Praha U16 were chosen on the basis of orthopedic disorders followed by a recommendation intervention programs into the training process. Results: We found that soccer players selected after the application of intervention programs in the training process achieved a significant improvement, especially on the muscles, on which the program was targeted . We have verified that the intervention programs in football practice could be applied. On the basis of subjective feelings footballers can say that the players perceive intervention largely as beneficial. Powered by TCPDF (www.tcpdf.org)

Les changements pubertaires peuvent être à l'origine de multiples expériences socio-émotionnelles positives et/ou négatives que les adolescents doiven gérer. Le processus de la régulation émotionnelle (RE) va être grandement sollicité au cours de cette période. La littérature montre que la RE est une fonction psychobiologique dont le développement peut être impacté par divers facteurs environnementaux de l'enfance. Parmi ces facteurs, l'expérienc de l'attachement avec la figure d'attachement y joue un rôle primordial. Cependant, la question cruciale concernant l'impact de l'attachement sur les mécanismes comportementaux et neurophysiologiques des stratégies de RE à l'adolescence reste sous-estimée et les publications à ce sujet sont encore rares. Dans ce contexte, notre étude vise à détem1iner les paramètres oculomoteurs et neurophysiologiques pour les utiliser comme marqueurs potentiel des stratégies de régulation des émotions en fonction du style d'attachement chez les adolescents. Toutefois, la RE est difficilement évaluable avec des outils ne sollicitant que les processus cognitifs conscients des adolescents. À ce titre, il nous a paru nécessaire d'utiliser un dispositif d'eye-tracking synchronisé avec un système de mesure physiologique permet de déterminer les paran1ètres oculomoteurs et neurophysiologiques lors d'exploration des ces images. Cette étude soutient l'hypothèse que l'attachement module des paramètres oculomoteurs et neurophysiologiques des stratégies de la RE Ces résultats pourraient inciter à une nouvelle ligne de recherche afin de proposer une solution thérapeutique dans le contexte de la dysrégulation émotionnelle. / Adolescence is a time of increasing vulnerability to intemalizing and extemalizing psychopathologies associated with poor emotion regulation, including depression, anxiety and antisocial behavior. Emotion regulation is the ability to recrui processes to influence emotion generation. It is therefore important to understand how emotion regulation develops at thi time and how this relates to ongoing development in adolescence. In recent years there has been increasing interest in how attachment styles modulate emotion regulation strategies. However, few researches have addressed this question directly in adolescence. The crucial question conceming the behavioral and neurophysiological mechanisms ofregulatior strategies emotions in adolescence remains underestimated. Employing a specific, an ecologically valid paradigm, the current study determines the oculomotor and neurophysiologie patterns as a potential marker of emotion regulation strategies i.e., comfort and proximity seeking as a function ofattachment style in healthy adolescents. The Attachment Scale Interview was used to detennine attachment style (i.e., secure, fearful, enmeshed and avoidant) in eighty-one healthy adolescents. A synchronized eye-tracking and physiologie measurement device was used to determine gaze and neurophysiologie parameters, respectively, on attachment-related pictures issue from The BASP-Ado. Our results show the existence of different profiles of emotional regulation in adolescence. These results could encourage a new line of research in order to offer a therapeutic solution in the context of emotional dysregulation.

In this study, four anion transporter (AT) blockers, DIDS (4, 4′-diisothiocyanatostilbene-2, 2′-disulfonic acid), 9-AC (anthracene-9-carboxylic acid), NPPB (5-nitro-2-(3-phenylpropylamino) benzoic acid), and IAA-94 (indanyloxy acetic acid) were selected to evaluate ATs as potential target sites for insect and nematode control. All the AT blockers showed slowly developing toxicity against second-stage larvae of <i>Meloidogyne incognita</i> (Kofoid and White 1919) Chitwood 1949 and adults of <i>Caenorhabditis elegans</i> Maupas 1900 but not against third-stage larvae of <i>Heterorhabditis bacteriophora</i> Poinar 1975 even at 200 ppm. Symptoms of AT blocker toxicity observed in <i>C. elegans</i> adults were increased pharyngeal muscle contractions and decreased locomotion. Exposure of <i>C. elegans</i> as fourth-stage larvae to double-stranded RNA (dsRNA) of <i>ceclc-1</i> and <i>ceclc-2</i> (VGCC genes coding for CeClC-1 and CeClC-2, respectively) either alone or together for 24 h decreased their expression in F1 progeny in a time-dependent manner. Reduction in expression of <i>ceclc-2</i> alone or together with <i>ceclc-1</i> significantly increased pharyngeal contractions and decreased locomotion in significantly higher percentage of F1 progeny. The above findings suggested AT blockers nematicidal activity primarily comes from inhibition of CeClC-2 channels, while inhibition of CeClC-1 channels may enhance this activity. All the AT blockers showed slowly developing toxicity against adults of a susceptible strain (Oregon-R) of <i>Drosophila melanogaster</i> Meigen 1830, while DIDS, was equally toxic to dieldrin-resistant rdl flies. All AT blockers, except 9-AC, at 100 µM showed significant excitatory effect on desheathed central nervous system (CNS) of third-instar larvae of <i>Drosophila</i>, while DIDS showed a modest excitatory effect on ascending peripheral nerves. Feeding adult flies on 10% sugar solution mixed with 100 ppm of DIDS for 6 h decreased the midgut pH by 2 units approximately. All the AT blockers inhibited the growth of larvae (in weight), increased the developmental time, and decreased survival when <i>Ostrinia nubilalis</i> (Hübner 1796) second-instar larvae were fed for seven days. All the AT blockers decreased the midgut alkalinity and inhibited chloride ion transport from midgut lumen into epithelia in fifth-instar larvae when fed for 3 h on treated diet. Positive correlations observed among growth, midgut alkalinity, and midgut chloride transport in AT blocker-fed larvae suggested that inhibition of chloride/bicarbonate exchangers by AT blockers may have contributed to midgut alkalinity decrease affecting the digestion and resulting in observed lethal and sublethal effects. / Ph. D.

Introdução: No campo do tratamento cirúrgico de Gliomas, tem se observado um interesse crescente no uso de novas tecnologias de suporte como métodos auxiliares na obtenção do equilíbrio entre radicalidade cirúrgica e preservação da funcionalidade cerebral. Na maior parte dos estudos, a localização tumoral tem sido pouco considerada e a real eficácia das tecnologias de suporte ainda está pouco investigada nos gliomas insulares. Objetivos: avaliar a eficácia da fluorescência intraoperatória com 5-ALA, monitorização neurofisiológica, neuronavegação e tractografia no grau de ressecção tumoral (GRT), escores de funcionalidade, sobrevida global e sobrevida livre de progressão em uma coorte retrospectiva de gliomas insulares. Métodos: revisamos todos os casos de tumores insulares operados no Departamento de Neurocirurgia da Universidade de Tübingen - Alemanha, entre maio de 2008 e novembro de 2013. O grau de ressecção foi avaliado por volumetria. Foram utilizados os testes de Mann Whitney, Qui-quadrado e funções de Kaplan Meier para análise do efeito de cada tecnologia nos desfechos primários e secundários. Resultados: 28 casos - 18 homens (64%) e 10 mulheres (36%); idade média 52,5 anos (12 - 59) - foram inclusos para análise. Gliomas de alto grau corresponderam a 20 casos (71%), com 8 lesões de baixo grau (29%). As tecnologias mais utilizadas foram monitorização neurofisiológica (64%) e neuronavegação (68%). 5-ALA foi a única modalidade associada a taxas de ressecção > 90% (p = 0,05). O uso de tractografia determinou melhora no KPS (50% vs 5%, p = 0,02). Houve associação positiva entre o uso de neuronavegação e sobrevida global (23 vs. 27,4 meses, p = 0,03), mas o uso de 5-ALA se associou a piora na sobrevida global (34,8 vs 21,1 meses, p = 0,01) e sobrevida livre de progressão (24,4 vs. 11,8 meses, p = 0,01). Conclusões: Considerando os gliomas insulares, o presente trabalho demonstra pioneiramente que o uso de 5-ALA tem papel na obtenção de maiores taxas de ressecção, ainda que este achado possa estar associado a piora nas sobrevidas global e livre de progressão. Tractografia e neuronavegação parecem desempenhar papel importante no tratamento dos gliomas insulares, na medida em que determinaram melhor sobrevida global e funcionalidade, respectivamente. Estudos prospectivos com uma amostra mais proeminente e análise multivariada permitirão a avaliação do benefício real destas tecnologias de suporte no tratamento dos gliomas insulares / Introduction: In the field of Glioma surgery, there has been an increasing interest in the use of assistive technologies to overcome the difficulty of preserving brain function while improving surgical radicality. In most reports, tumor localization has seldom been considered a variable and the role of intraoperative adjuncts is yet to be determined for gliomas of the insula. Objectives: to evaluate the efficacy of fluorescence-guided resection with 5-ALA, intraoperative neurophysiological monitoring (IOM), neuronavigation, and tractography in the Extent of Resection (EOR), functionality scores, overall survival (OS) and progression-free survival (PFS) in a retrospective cohort of insular gliomas. Methods: we reviewed all cases of insular tumors operated on at the Department of Neurosurgery, University Hospital of Tübingen - Germany, between May 2008 and November 2013. EOR was determined by volumetric analysis. Mann Whitney, Chi-square and Kaplan Meier functions were used for assessment of each technology\'s effect on primary and secondary outcomes. Results: 28 cases (18 men (64%) and 10 women (36%); median age at diagnosis: 52.5 years, range 12 - 59) were considered eligible for analysis. High grade and low grade gliomas accounted for 20 (71%) and 8 (29%) cases, respectively. The most used technologies were IOM (64%) and Neuronavigation (68%). 5-ALA was the only technique associated with EOR > 90% (p = 0.05). Tractography determined improvement in the Karnofsky Performance Scale (50% vs 5% cases improved, p = 0.02). There was a positive association between the use of neuronavigation and overall survival (23 vs. 27.4 months, p = 0.03), but the use of 5-ALA was associated with shorter OS (34.8 vs. 21.1 months, p = 0.01) and PFS (24.4 vs. 11.8, p = 0.01). Conclusions: we demonstrate for the first time that for insular gliomas 5-ALA plays a role in achieving higher EOR, although this technology was associated with poor OS and PFS; Also tractography and neuronavigation can be of great importance in the treatment of insular gliomas as they determined better functionality and overall survival in this study, respectively. Prospective studies with a more prominent sample and proper multivariate analysis will help determine the real benefit of these adjuncts in the setting of insular gliomas

Introdução: No campo do tratamento cirúrgico de Gliomas, tem se observado um interesse crescente no uso de novas tecnologias de suporte como métodos auxiliares na obtenção do equilíbrio entre radicalidade cirúrgica e preservação da funcionalidade cerebral. Na maior parte dos estudos, a localização tumoral tem sido pouco considerada e a real eficácia das tecnologias de suporte ainda está pouco investigada nos gliomas insulares. Objetivos: avaliar a eficácia da fluorescência intraoperatória com 5-ALA, monitorização neurofisiológica, neuronavegação e tractografia no grau de ressecção tumoral (GRT), escores de funcionalidade, sobrevida global e sobrevida livre de progressão em uma coorte retrospectiva de gliomas insulares. Métodos: revisamos todos os casos de tumores insulares operados no Departamento de Neurocirurgia da Universidade de Tübingen - Alemanha, entre maio de 2008 e novembro de 2013. O grau de ressecção foi avaliado por volumetria. Foram utilizados os testes de Mann Whitney, Qui-quadrado e funções de Kaplan Meier para análise do efeito de cada tecnologia nos desfechos primários e secundários. Resultados: 28 casos - 18 homens (64%) e 10 mulheres (36%); idade média 52,5 anos (12 - 59) - foram inclusos para análise. Gliomas de alto grau corresponderam a 20 casos (71%), com 8 lesões de baixo grau (29%). As tecnologias mais utilizadas foram monitorização neurofisiológica (64%) e neuronavegação (68%). 5-ALA foi a única modalidade associada a taxas de ressecção > 90% (p = 0,05). O uso de tractografia determinou melhora no KPS (50% vs 5%, p = 0,02). Houve associação positiva entre o uso de neuronavegação e sobrevida global (23 vs. 27,4 meses, p = 0,03), mas o uso de 5-ALA se associou a piora na sobrevida global (34,8 vs 21,1 meses, p = 0,01) e sobrevida livre de progressão (24,4 vs. 11,8 meses, p = 0,01). Conclusões: Considerando os gliomas insulares, o presente trabalho demonstra pioneiramente que o uso de 5-ALA tem papel na obtenção de maiores taxas de ressecção, ainda que este achado possa estar associado a piora nas sobrevidas global e livre de progressão. Tractografia e neuronavegação parecem desempenhar papel importante no tratamento dos gliomas insulares, na medida em que determinaram melhor sobrevida global e funcionalidade, respectivamente. Estudos prospectivos com uma amostra mais proeminente e análise multivariada permitirão a avaliação do benefício real destas tecnologias de suporte no tratamento dos gliomas insulares / Introduction: In the field of Glioma surgery, there has been an increasing interest in the use of assistive technologies to overcome the difficulty of preserving brain function while improving surgical radicality. In most reports, tumor localization has seldom been considered a variable and the role of intraoperative adjuncts is yet to be determined for gliomas of the insula. Objectives: to evaluate the efficacy of fluorescence-guided resection with 5-ALA, intraoperative neurophysiological monitoring (IOM), neuronavigation, and tractography in the Extent of Resection (EOR), functionality scores, overall survival (OS) and progression-free survival (PFS) in a retrospective cohort of insular gliomas. Methods: we reviewed all cases of insular tumors operated on at the Department of Neurosurgery, University Hospital of Tübingen - Germany, between May 2008 and November 2013. EOR was determined by volumetric analysis. Mann Whitney, Chi-square and Kaplan Meier functions were used for assessment of each technology\'s effect on primary and secondary outcomes. Results: 28 cases (18 men (64%) and 10 women (36%); median age at diagnosis: 52.5 years, range 12 - 59) were considered eligible for analysis. High grade and low grade gliomas accounted for 20 (71%) and 8 (29%) cases, respectively. The most used technologies were IOM (64%) and Neuronavigation (68%). 5-ALA was the only technique associated with EOR > 90% (p = 0.05). Tractography determined improvement in the Karnofsky Performance Scale (50% vs 5% cases improved, p = 0.02). There was a positive association between the use of neuronavigation and overall survival (23 vs. 27.4 months, p = 0.03), but the use of 5-ALA was associated with shorter OS (34.8 vs. 21.1 months, p = 0.01) and PFS (24.4 vs. 11.8, p = 0.01). Conclusions: we demonstrate for the first time that for insular gliomas 5-ALA plays a role in achieving higher EOR, although this technology was associated with poor OS and PFS; Also tractography and neuronavigation can be of great importance in the treatment of insular gliomas as they determined better functionality and overall survival in this study, respectively. Prospective studies with a more prominent sample and proper multivariate analysis will help determine the real benefit of these adjuncts in the setting of insular gliomas

Human aging is associated with structural and functional brain deteriorations and a corresponding cognitive decline. Exergaming (i.e., physically active video-gaming) has been supposed to attenuate age-related brain deteriorations and may even improve cognitive functions in healthy older adults. Effects of exergaming, however, vary largely across studies. Moreover, the underlying neurophysiological mechanisms by which exergaming may affect cognitive and brain function are still poorly understood. Therefore, we systematically reviewed the effects of exergame interventions on cognitive outcomes and neurophysiological correlates in healthy older adults (>60 years). After screening 2709 studies (Cochrane Library, PsycINFO, Pubmed, Scopus), we found 15 eligible studies, four of which comprised neurophysiological measures. Most studies reported within group improvements in exergamers and favorable interaction effects compared to passive controls. Fewer studies found superior effects of exergaming over physically active control groups and, if so, solely for executive functions. Regarding individual cognitive domains, results showed no consistence. Positive effects on neurophysiological outcomes were present in all respective studies. In summary, exergaming seems to be equally or slightly more effective than other physical interventions on cognitive functions in healthy older adults. Tailored interventions using well-considered exergames and intervention designs, however, may result in more distinct effects on cognitive functions.

Background: The use of intraoperative neurophysiological monitoring, including direct nerve stimulation (especially the facial nerve), acoustic evoked potentials (AEP) and somatosensory evoked potentials (SSEP), is a helpful tool in the microsurgery of vestibular schwannoma to prevent nerve injury. Patient characteristics and intraoperative and postoperative variables might also influence the postoperative facial nerve function. The study was performed to investigate these variables and the intraoperative neurophysiological monitoring values. Methods: Seventy-nine patients with vestibular schwannoma were included consecutively into this study. Intraoperative neurophysiological monitoring, including SSEP, AEP, and direct nerve stimulation for facial and trigeminal nerve electromyography, was performed utilizing digital data storage in all cases. The intensity (in volts) of the direct stimulation and the latency (in ms) for the orbicularis oculi and the orbicularis oris muscle and the amplitude (in mV) was measured. Univariate and multivariate statistical analyses concerning the different parameters was performed directly after the operation and in the subsequent follow-ups 3 and 6 months after the operation. Results: The mean intensity was 0.79 V (SD.29). The latency and amplitude for the oris muscle was 5.2ms (SD 2.07) and 0.68mV (SD.57), respectively. The mean latency for the occuli muscle was 5.58ms (SD 2.2) and the amplitude was 0.58mV (SD 1.04). The univariate and multivariate statistical analyses showed significance concerning the postoperative facial nerve function and the amplitude of the direct stimulation of the facial nerve in the orbicularis oris muscle (p = 0.03), so repeated direct nerve stimulation might show FN function deterioration. The mean diameter of the tumors was 24mm (range 10–57mm). Cross total resection and near total was achieved in 76 patients (96%) and subtotal in three patients (4%). The preoperative House–Brakeman score (HBS) 1 was constant in 65 (82%) cases. The mortality in our series was 0%; the overall morbidity was 10%. The HBS was not influenced concerning the extent of resection. The mean follow-up was 28 months (range 6 to 60 months). The limitations of the study might be a low number of patients and the retrospective character of the study. Conclusion: Intraoperative neurophysiological monitoring is crucial in vestibular schwannoma surgery. Repeated direct nerve stimulation and a detected decreased amplitude might show facial nerve function deterioration.