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Abstract Clinical and neuroanatomical correlates of daytime sleepiness in Parkinson’s disease (PD) remain inconsistent in the literature. Two studies were conducted here. The first evaluated the interrelation between non-motor and motor symptoms, using a principal component analysis, associated with daytime sleepiness in PD. The second identified the neuroanatomical substrates associated with daytime sleepiness in PD using magnetic resonance imaging (MRI). In the first study, 77 participants with PD completed an extensive clinical, cognitive testing and a polysomnographic recording. In the second study, 29 PD participants also underwent MRI acquisition of T1-weighted images. Vertex-based cortical and subcortical surface analysis, deformation-based morphometry, and voxel-based morphometry were performed to assess the association between daytime sleepiness severity and structural brain changes in participants. In both studies, the severity of daytime sleepiness and the presence of excessive daytime sleepiness (EDS; total score >10) were measured using the Epworth Sleepiness Scale. We found that individuals with EDS had a higher score on a component including higher dosage of dopamine receptor agonists, motor symptoms severity, shorter sleep latency, and greater sleep efficiency. Moreover, increased daytime sleepiness severity was associated with a larger surface area in the right insula, contracted surfaces in the right putamen and right lateral amygdala, and a larger surface in the right posterior amygdala. Hence, daytime sleepiness in PD was associated with dopaminergic receptor agonists dosage, motor impairment, and objective sleep measures. Moreover, neuroanatomical changes in cortical and subcortical regions related to vigilance, motor, and emotional states were associated with more severe daytime sleepiness.

Background. Cancer is the leading cause of disease-related death among children of more than 1 year of age. However, childhood cancer risk factors and etiology are yet to be fully understood. The goal of this study is to identify geographic variation among children and adolescents diagnosed with pediatric tumors between 2001 and 2018 in the province of Quebec. Methods. We analyzed pediatric patients less than 15 years of age from the Cancer in Young People in Canada (CYP-C) surveillance system who were diagnosed between 2001 and 2018 with cancer in the province of Quebec. The age-standardized age-adjusted incidence rates (AAIR) per 100,000 person years were calculated for all childhood cancers by cancer subgroups, Quebec Health regions, and age groups. Results. Overall, 3904 pediatric patients less than 15 years old were diagnosed with cancer in the province of Quebec in 2001–2018. The overall incidence rate (IR) in the province of Quebec was 16.14 (95%CL [15.56–16.73]) per 100,000 person years. For childhood cancers, regions that presented a higher AAIR were Chaudière-Appalaches and Capitale-Nationale with 18.2 and 17.5 per 100,000 person years, respectively. The incidence rates (IRs) in Chaudière-Appalaches (95% CI 1.0439–1.3532) and in Capitale-Nationale (95% CI 1.0124–1.2942) were statistically higher than the incidence in the province of Quebec (p = 0.0090 and p = 0.0310, respectively). When comparing the AAIR of the CNS tumor subgroup in Chaudière-Appalaches and in Capitale-Nationale, with the provincial average, we noticed a statistically higher incidence in Chaudière-Appalaches and a trend for Capitale-Nationale (p < 0.0001 and p = 0.0602, respectively). Conclusion. There is evidence of spatial clusters in Chaudière-Appalaches and Capitale-Nationale as areas for all childhood cancers. Further studies should be performed to investigate potential risk factors in these regions.

Purpose: Radiation therapy for early-stage breast cancer is typically delivered in a hypofractionated regimen to the whole breast followed by a tumor bed boost. This results in a treatment course of approximately 4 weeks. In this study, the tumor bed boost was delivered in a single fraction as part of a safety and feasibility study for FDA clearance of the device. Methods and Materials: Eligible women with early-stage breast cancer underwent lumpectomy followed by radiation therapy. Patients underwent breast immobilization using a system specific to the GammaPod followed by CT simulation, boost treatment planning, and boost treatment delivery all in a single treatment day. Patients then started whole-breast radiation therapy within 1 week of the boost treatment. Patients and treatments were assessed for safety and feasibility. Acute toxicities were recorded. Results: A single-fraction boost of 8 Gy was delivered to the tumor bed before a course of whole-breast radiation. The GammaPod treatment was successfully delivered to 14 of 17 enrolled patients. Acute toxicities from all radiation therapy, inclusive of the boost and whole-breast radiation, were limited to grade 1 events. Conclusions: The GammaPod device successfully delivered a single-fraction boost treatment to the tumor bed with no change in expected acute toxicities. The results of this study led to FDA clearance of the device through the Investigational Device Exemption process at the FDA. The GammaPod is in clinical use at 4e institutions nationally and internationally, with additional sites pending in 2023.

Les récentes avancées en matière de contrôle par courants de Foucault multi-éléments (eddy current array: ECA) ont considérablement élargi la gamme de composants et de structures qui peuvent être inspectés pour la détection de défauts de surface. L'un des grands avantages de cette technologie est sa capacité à s'adapter à divers matériaux et géométries. Passant des pipelines en acier carbone jusqu’aux soudures par friction-malaxage en aluminium, les courants de Foucault multi-éléments sont utilisés comme remplacement de la magnétoscopie et du ressuage dans un large éventail d'applications industrielles pour la détection de fissures et de discontinuités en surface ou proches de la surface. En transmettant et en recevant des signaux les uns avec les autres, les capteurs ECA permettent des performances de détection inégalées par les sondes traditionnelles à un seul élément. L'ECA est également beaucoup plus rapide, moins dépendant de l'opérateur et plus facile à automatiser. Un avantage moins connu des courants de Foucault est leur capacité à pénétrer les surfaces non ferromagnétiques et à être sensibles aux défauts sous la surface qui sont autrement invisibles par inspection visuelle. En contrôlant la taille et l'impédance des capteurs, la fréquence des courants et le modèle de multiplexage, il devient possible d'inspecter les deux côtés d'une paroi conductrice mince au cours d'une seule inspection. Cela s'avère particulièrement utile pour l'évaluation des tubes à parois minces contenant divers fluides, qui ne sont souvent accessibles que de l'extérieur. Cet article traite de l'inspection des tubes à paroi mince utilisés comme conduites d'alimentation et conduites hydrauliques dans les avions et les engins spatiaux. Ces conduites de petit diamètre sont souvent situées dans des zones à accès limité, où elles sont assemblées par soudage orbital automatisé. Même avec un processus de soudage hautement contrôlé, de petites fissures et porosités peuvent être présentes dans le joint et finir par se propager, entraînant des fuites de carburant et la potentielle défaillance des systèmes de propulsion. Un système ECA a été mis au point pour l’inspection circonférentielle rapide de ces soudures orbitales, ce qui permet de détecter les défauts en quelques secondes seulement. Cette solution représente un gain de temps considérable comme remplacement de la radiographie et du ressuage, qui sont actuellement les méthodes de choix pour cette inspection.

ABSTRACTBackground Preclinical and clinical evidence suggests that cannabis has potential analgesic properties. However, cannabinoid receptor expression and localization within spinal cord pain processing circuits remain to be characterized across sex and species.Aims We aimed to investigate the differential expression of the cannabinoid type 1 (CB1) receptor across dorsal horn laminae and cell populations in male and female adult rats and humans.Methods To investigate and quantify CB1 receptor expression in the spinal dorsal horn across species, we refined immunohistochemical procedures for successful rat and human fixed tissue staining and confocal imaging. Immunohistochemical results were complemented with analysis of CB1 gene (CNR1) expression within rodent and human dorsal horn using single-cell/nuclei RNA sequencing data sets.Results We found that CB1 was preferentially localized to the neuropil within the superficial dorsal horn of both rats and humans, with CB1 somatic staining across dorsal horn laminae. CB1 receptor immunoreactivity was significantly higher in the superficial dorsal horn compared to the deeper dorsal horn laminae for both rats and humans, which was conserved across sex. Interestingly, we found that CB1 immunoreactivity was not primarily localized to peptidergic afferents in rats and humans and that CNR1 (CB1) but not CNR2 (CB2) was robustly expressed in dorsal horn neuron subpopulations of both rodents and humans.Conclusions The conserved preferential expression of CB1 receptors in the superficial dorsal horn in male and female rodents and humans has significant implications for understanding the roles of this cannabinoid receptor in spinal mechanisms of nociception and analgesia.

Texting while walking (TWW) is a dangerous behavior that can lead to injury and even death. While several studies have examined the relationship between smartphone use and stress, to our knowledge no studies have yet investigated the relationship between stress and TWW. The objective of the present study was to investigate this relationship by examining the effects of stress on TWW, the effects of TWW on subsequent stress, and the effect of stress on multitasking performance. A total of 80 participants completed two sequential tasks in a laboratory while they walked on a treadmill and responded to a biological motion stimulus imitating the movement of another pedestrian. In the unrestricted task, participants were given the choice to use their personal phones. In the controlled task, they carried a text conversation with a research assistant while they walked and responded to the stimulus. Stress was measured via questionnaire and saliva collection for measure of cortisol (a stress hormone) before and after each task. Results show that greater psychological stress and cortisol variations were associated with a greater number of phone uses during the unrestricted task. Greater phone use during the unrestricted task was associated with lower subsequent psychological stress in women and total time of phone use was correlated with subsequent cortisol levels. Stress measured before the controlled task had no effect on multitasking performance, but participants with moderate performance were those with the highest cortisol levels. Our results suggest that stress could be a precursor to TWW and that it could affect a pedestrian’s ability to stay safe when using their smartphone.

Background: The effectiveness of screening strategies targeting pregnancies at higher risk of congenital heart disease (CHD) is reduced by the low prevalence of severe CHD, the increase in CHD detection rates by second-trimester ultrasound (U/S), and the high proportion of severe CHD in low-risk pregnancies. We aimed to determine situations in which additional screening by fetal echocardiography (FE) would result in a significant increase in sensitivity and a sizable decrease in the false-negative rate of detection of severe CHD. Methods: We simulated the change in the numbers of detected severe CHD cases when FE is offered to women with a normal second-trimester U/S who have a higher risk of bearing a child with CHD, compared to U/S alone. The primary outcome was the increase in sensitivity. Secondary outcomes were the number needed to screen and the reduction in the rate of missed cases. Results: For an U/S sensitivity of 60%, the addition of FE in pregnancies at high risk of CHD (risk ratio 3.5; range: 2 to 5) increased sensitivity by 2.4 percentage points (1.1 to 7.9). The number needed to screen to detect one additional case of severe CHD was 436 (156 to 952). The rate of additional severe CHD cases detected by FE was 4 per 100,000 pregnancies (2 to 32). Conclusions: The addition of FE to U/S for severe CHD prenatal screening in pregnancies at high risk of CHD yielded marginal benefits in terms of increased sensitivity and decreased rates of false negatives, at the expense of significant resource utilization. Résumé: Contexte: L'efficacité des stratégies de dépistage ciblant les grossesses à haut risque de cardiopathie congénitale (CC) se trouve réduite par la faible prévalence des CC sévères, par l'augmentation des taux de détection des CC par l'échographie (E/G) du deuxième trimestre, et par la proportion élevée de CC sévères dans les grossesses à faible risque. Dans le cadre de la détection prénatale des CC sévères, nous avons cherché à identifier les situations pour lesquelles un dépistage supplémentaire par échocardiographie fœtale (EF) entraînerait une augmentation significative de la sensibilité et une diminution notable du taux de faux négatifs. Méthodes: Nous avons simulé le changement du nombre de cas de CC sévère détectées lorsque l'EF est proposée aux femmes dont l'E/G du deuxième trimestre est normal et qui présentent un risque plus élevé de porter un enfant atteint de CC, par rapport à l'examen du deuxième trimestre seul. L'issue primaire était l'augmentation de la sensibilité. Les issues secondaires étaient le nombre de dépistages nécessaires et la réduction du taux de cas manqués. Résultats: Pour une sensibilité de l'E/G de 60 %, l'ajout de l'EF pour les grossesses à haut risque de CC (rapport de risque de 3,5; intervalle: 2 à 5) a accru la sensibilité de 2,4 points de pourcentage (1,1 à 7,9). Le nombre de dépistages nécessaires pour détecter un cas supplémentaire de CC sévères était de 436 (156 à 952). La proportion de cas supplémentaires de CC sévères détectées par EF était de 4 pour 100 000 grossesses (2 à 32). Conclusions: L'ajout de l'EF à l'E/G pour le dépistage prénatal des CC sévères pour les grossesses à risque élevé de CC n'a apporté que des avantages marginaux en termes d'augmentation de la sensibilité et de diminution des taux de faux négatifs, cela au prix d'une utilisation importante des ressources.

Background: Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability among men. This syndrome is frequently underdiagnosed in adults. The aim of this study was to develop and validate a French translation of the screening checklist "Fragiele-X screeningslijst." Method: The validation sample for the translated checklist included 22 pairs of men between the ages of 18 and 52, matched by age and degree of intellectual impairment. Results: The translated checklist achieved coefficients of 0.92 for internal consistency, 0.90 for test-retest reliability and 0.65 for inter-rater reliability. These psychometric properties are commensurate with those of the original checklist. Conclusion: Therefore, the translated checklist developed in this study can be considered a valid screening instrument for the detection of FXS in men with intellectual disabilities.

Using visual spectrographic examination of vowel nasalization to diagnose the syllabic affiliation of phonologically ambisyllabic nasal consonants (e.g., gamma), Durvasula and Huang [(2017). Lang. Sci. 62, 17–36] argued that anticipatory vowel nasalization in these words patterns with word-medial codas. Using nasometry, the current study finds that anticipatory nasalization before monomorphemic and multimorphemic (scammer) ambisyllabic nasals differ from word-medial coda (gamble) and word-final nasals (scam), but not from other intervocalic nasals. Additionally, vowel nasalization is sensitive to the manner of the preceding phoneme. These findings demonstrate that quantifying anticipatory nasalization using nasometry differs from visual spectrographic criteria. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods Our study population included participants in the Gastrointestinal Disease and Endoscopy Registry (GIDER), a colonoscopy-based longitudinal cohort at the Massachusetts General Hospital, who provided comprehensive information on dietary intake and lifestyle factors using validated questionnaires prior to colonoscopy. Information on presence and location of diverticula was obtained from the endoscopist at the end of each procedure. We used Poisson regression modeling to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs). Results Among 549 participants with a mean age of 61 years enrolled in GIDER, we confirmed diverticulosis in 245 (44.6%). The prevalence of diverticulosis appeared to decrease with higher consumption of fruit and vegetables (Ptrend = 0.007 for fruit and 0.008 for vegetables, respectively). Compared to participants with less than five servings of vegetables per week, the multivariable-adjusted PRs of diverticulosis were 0.84 (95% CI, 0.60–1.17) with five to seven servings per week and 0.62 (95% CI, 0.44–0.89) with greater than one serving per day. Similarly, compared to participants with less than five servings per week of fruit, the multivariable-adjusted PR of diverticulosis was 0.60 (95% CI, 0.41–0.87) with greater than one serving per day. These associations were not modified by age, BMI, smoking, or red meat intake (All Pinteraction > 0.055). Conclusion In a colonoscopy-based longitudinal cohort study, we show that higher consumption of fruit and vegetables is associated with lower risk of prevalent diverticulosis.

Abstract Background Strength and coordination of lower muscle groups typically identified in healthy subjects are two prerequisites to performing functional activities. These physical qualities can be impaired following a neurological insult. A static dynamometer apparatus that measures lower limb joint moments during directional efforts at the foot was developed to recruit different patterns of muscular activity. The objectives of the present study were to 1) validate joint moments estimated by the apparatus, and 2) to characterize lower limb joint moments and muscular activity patterns of healthy subjects during progressive static efforts. Subjects were seated in a semi-reclined position with one foot attached to a force platform interfaced with a laboratory computer. Forces and moments exerted under the foot were computed using inverse dynamics, allowing for the estimation of lower limb joint moments. To achieve the study’s first objective, joint moments were validated by comparing moments of various magnitudes of force applied by turnbuckles on an instrumented leg equipped with strain gauges with those estimated by the apparatus. Concurrent validity and agreement were assessed using Pearson correlation coefficients and Bland and Altman analysis, respectively. For the second objective, joint moments and muscular activity were characterized for five healthy subjects while exerting progressive effort in eight sagittal directions. Lower limb joint moments were estimated during directional efforts using inverse dynamics. Muscular activity of eight muscles of the lower limb was recorded using surface electrodes and further analyzed using normalized root mean square data. Results The joint moments estimated with the instrumented leg were correlated (r > 0.999) with those measured by the dynamometer. Limits of agreement ranged between 8.5 and 19.2% of the average joint moment calculated by both devices. During progressive efforts on the apparatus, joint moments and patterns of muscular activity were specific to the direction of effort. Patterns of muscular activity in four directions were similar to activation patterns reported in the literature for specific portions of gait cycle. Conclusion This apparatus provides valid joint moments exerted at the lower limbs. It is suggested that this methodology be used to recruit muscular activity patterns impaired in neurological populations.

Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14–21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships.

Background: A cohort of 11 patients with an intellectual disability and a psychiatric diagnosis present severe behavioural disorders in psychiatric hospital of Quebec in 2009. Control-measure use for this clientele has now been reduced. How do management personnel, families and care teams explain the changes? What clinical interventions did management and care providers implement that contributed to the reduction? Method: A retrospective case study was conducted. Five focus groups were held with people involved in their care, and the patient files were examined. Results: The factors contributing to this change were the cohesion of the care providers, the involvement of the families and the efforts to determine the function of the behaviour. Implications: This study may inspire other care teams to try new approaches in dealing with patients with severe behavioural disorders. Also, the model of factors and interventions supporting a reduction in seclusion and restraint measures may inspire future studies.

Abstract Background The long-term natural history of microscopic colitis (MC) (collagenous colitis (CC), lymphocytic colitis (LC)), traditionally considered relapsing but non-progressive diseases, is poorly defined. Whether persistent histologic inflammation in such diseases is associated with an increased risk of colorectal neoplasia (CRN) or extracolonic cancers has not been robustly established. Methods This retrospective cohort included diagnosed with MC at a referral center. Rates of CRN and extracolonic cancer were compared to patients undergoing screening colonoscopy (n = 306) and to the United States population using data from the Surveillance, Epidemiology, and End-Results (SEER) program. Standardized incidence ratios (SIR) and 95% confidence intervals were calculated and multivariable regression models used to identify the effect of MC diagnosis and severity on cancer risk. Results Our study included 221 patients with microscopic colitis (112 CC, 109 LC) among whom 77% were women. Compared to the colonoscopy control population, MC was associated with similar odds of tubular adenoma (Odds ratio (OR) 1.07, 95% CI 0.69–1.66) or villous adenoma (OR 1.26, 95% CI 0.17–9.42). Compared to patients with a single episode of MC, those with 2 or more episodes had similar risk of colon cancer (OR 0.83, 95% CI 0.20–3.39) or tubular adenoma (OR 1.49 95% CI 0.83–2.67). We also identified no statistical increase in the rates of cancer in the MC population compared to US-SEER data. Conclusion Microscopic colitis was not associated with increased risk of CRN and extracolonic cancers when compared to controls undergoing colonoscopy or the US SEER population.