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Neuropsychological considerations can arise in any forensic mental health assessment (FMHA), and all practitioners engaging in FMHA will therefore benefit from being able to recognize and respond to neuropsychological issues in their practice. The first section of this chapter focuses on relevance, including a discussion of how to recognize neuropsychological consideration in forensic referrals; a summary of the most relevant neuropsychological considerations of a clinical, practical, and legal nature within FMHA; and review of some of the most common brain-based disorders encountered in contemporary forensic practice. The second section focuses on competence, including an introduction to general and specialty competencies in neuropsychology, and a further discussion of selected practical concerns in the field. The chapter concludes with guidance on responding to neuropsychological considerations in forensic cases, and introduces a decision-making model to help forensic practitioners consider whether independent evaluation, consultation, or referral is the most effective response in these cases.

Amaranth, buckwheat, quinoa, and less known, canihua are the most important pseudocereals. Their high nutritional value is well recognized and they are increasingly used for the development of a wide range of starch-based foods, which has been fostered by intensified research data performed in recent years. In addition to health driven motivations, also environmental aspects like the ongoing climate change are an important stimulus to increase agricultural biodiversity again. As pseudocereals are botanically classified as dicotyledonous plants their chemical, physical and processing properties differ significantly from the monocotyledonous cereals. Most important factors that need to be addressed for processing is their smaller seed kernel size, their specific starch structure and granule architecture, their gluten-free protein, but also their dietary fibre and secondary plant metabolites composition. This review gives a condensed overview of the recent developments and gained knowledge with special attention to the technological and food processing aspects of these pseudocereals.

Endometrial cancer (EC) incidence and mortality continues to rise. Molecular profiling of EC promises improvement of risk assessment and treatment selection. However, we still lack robust and accurate models to predict those at risk of failing treatment. The objective of this pilot study is to create models with clinical and genomic data that will discriminate patients with EC at risk of disease recurrence. We performed a pilot, retrospective, case–control study evaluating patients with EC, endometrioid type: 7 with recurrence of disease (cases), and 55 without (controls). RNA was extracted from frozen specimens and sequenced (RNAseq). Genomic features from RNAseq included transcriptome expression, genomic, and structural variation. Feature selection for variable reduction was performed with univariate ANOVA with cross-validation. Selected variables, informative for EC recurrence, were introduced in multivariate lasso regression models. Validation of models was performed in machine-learning platforms (ML) and independent datasets (TCGA). The best performing prediction models (out of >170) contained the same lncRNA features (AUC of 0.9, and 95% CI: 0.75, 1.0). Models were validated with excellent performance in ML platforms and good performance in an independent dataset. Prediction models of EC recurrence containing lncRNA features have better performance than models with clinical data alone.

Hematopoietic stem cell transplantation (HSCT) is a curative therapy for many pediatric malignant and nonmalignant conditions. Gonadal insufficiency or infertility is present in almost all HSCT survivors who received a myeloablative conditioning (MAC) regimen. Reduced-intensity conditioning (RIC) regimens are being increasingly used in medically fragile patients or in patients with nonmalignant diagnoses to limit the toxicities associated with HSCT; however, the short-term and long-term gonadal toxicity of RIC regimens in pediatric and young adult survivors remains unknown. In this study, we compared the prevalence of gonadal insufficiency and infertility among pubertal and postpubertal pediatric and young adult survivors of HSCT who received a RIC regimen versus those who received a MAC regimen. Twenty-three females (RIC, n = 8; MAC, n = 15) and 35 males (RIC, n = 19; MAC, n = 16) were included in this single-center, retrospective cross-sectional study. Eligible patients were those with available laboratory results who were ≥1 year post-HSCT, age40 years, and pubertal or postpubertal as assessed by an endocrinologist. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH) levels were measured in females, and FSH, LH, total testosterone, and inhibin B (InhB) levels were measured in males. Twenty-one males (RIC, n = 11; MAC, n = 10) underwent semen analysis through a separate consent. Parametric and nonparametric analyses were undertaken to compare the RIC and MAC groups. Female patients who received RIC were less likely than those who received MAC to develop primary ovarian insufficiency, as demonstrated by elevated FSH (P = .02) and low estradiol (P = .01) or elevated LH (P = .09). Most females in the RIC (75%) and MAC (93%) groups had low AMH levels, indicating low or absent ovarian reserve, with no significant difference between the groups (P = .53). In males, there were no significant differences between the 2 groups in the prevalence of abnormal FSH, LH, testosterone, or InhB levels. Ten of 11 RIC males (91%) and 10 of 10 MAC males (100%) had azoospermia or oligospermia, at a median time to semen analysis from HSCT of 3.7 years (range, 1.3 to 12.2 years). RIC may pose less risk than MAC for primary ovarian insufficiency among female survivors of HSCT; however, both female and male recipients of either RIC or MAC regimens are at high risk for infertility. In the largest reported series of semen analyses of pediatric and young adult male recipients of RIC, azoospermia or oligospermia was found in nearly all (91%) RIC survivors. All patients undergoing HSCT should receive counseling about the high risk of gonadal toxicity, and efforts should be made to preserve fertility in patients undergoing either RIC or MAC.

This paper describes a computational investigation of multimode instability growth and multimaterial mixing induced by multiple shock waves in a high-energy-density (HED) environment, where pressures exceed 1 Mbar. The simulations are based on a series of experiments performed at the National Ignition Facility (NIF) and designed as an HED analogue of non-HED shock-tube studies of the Richtmyer–Meshkov instability and turbulent mixing. A three-dimensional computational modelling framework is presented. It treats many complications absent from canonical non-HED shock-tube flows, including distinct ion and free-electron internal energies, non-ideal equations of state, radiation transport and plasma-state mass diffusivities, viscosities and thermal conductivities. The simulations are tuned to the available NIF data, and traditional statistical quantities of turbulence are analysed. Integrated measures of turbulent kinetic energy and enstrophy both increase by over an order of magnitude due to reshock. Large contributions to enstrophy production during reshock are seen from both the baroclinic source and enstrophy–dilatation terms, highlighting the significance of fluid compressibility in the HED regime. Dimensional analysis reveals that Reynolds numbers and diffusive Peclet numbers in the HED flow are similar to those in a canonical non-HED analogue, but conductive Peclet numbers are much smaller in the HED flow due to efficient thermal conduction by free electrons. It is shown that the mechanism of electron thermal conduction significantly softens local spanwise gradients of both temperature and density, which causes a minor but non-negligible decrease in enstrophy production and small-scale mixing relative to a flow without this mechanism.

The hydrodynamic instability growth of a reshocked single-mode interface between high energy density fluids is studied. A laser-driven shock wave is used to drive an initially solid, sinusoidal interface between a dense plastic (1.43 g/cc) and a light foam ([Formula: see text] 0.110 g/cc). After the interface has grown to a nonlinear state where the amplitude is of order of the wavelength, it is reshocked. The reshock compresses the nonlinear perturbation, which then grows at about twice the rate. While the pre-reshock growth rate is sensitive to the initial amplitude and wavelength of the perturbation, the post-reshock growth rate is comparatively insensitive to the initial condition. Qualitatively, we observe that the perturbations are less coherent after reshock, consistent with the idea that having a reshock accelerates the transition to turbulence. We find that some memory of the initial condition remains, even after reshock at late time: it appears if the initial perturbations have large enough wavelengths, and the flow structure of size comparable to the initial wavelength persists through reshock. Our results agree with design simulations and are consistent with the phenomenology of reshock studies in conventional gaseous shock tubes.

We present a case of vertebral osteomyelitis in a previously healthy, adolescent Caucasian female athlete. After months of lower back pain, spinal imaging demonstrated phlegmon and suspected osteomyelitis of the L4 vertebral body. A bone biopsy was obtained, and microbiologic cultures yielded pure growth of Salmonella enterica subsp. enterica serovar Poona ( S . Poona), a member of the nontyphoid Salmonella group associated with food-borne gastroenteritis in the United States. This case represents the first reported association of S . Poona with osteomyelitis and is interesting in that the infection developed in a patient without traditional risk factors for invasive Salmonella disease (i.e. sickle cell disease). This case highlights the importance of keeping a broad differential diagnosis for lower back pain and emphasizes the value of obtaining specimens for microbiologic culture to aid in diagnosing non-traditional and potentially emerging bacterial pathogens.

Migraine is commonly reported among patients with temporomandibular disorders (TMDs), especially myogenic TMD. The pathophysiologic mechanisms related to the comorbidity of the two conditions remain elusive. In the present study, we combined masseter muscle tendon ligation (MMTL)-produced myogenic TMD with systemic injection of nitroglycerin (NTG)-induced migraine-like hypersensitivity in mice. Facial mechanical allodynia, functional allodynia, and light-aversive behavior were evaluated. Sumatriptan, an FDA-approved medication for migraine, was used to validate migraine-like hypersensitivity. Additionally, we examined the protein level of calcitonin gene-related peptide (CGRP) in the spinal trigeminal nucleus caudalis using immunohistochemistry. We observed that mice with MMTL pretreatment have a prolonged NTG-induced migraine-like hypersensitivity, and MMTL also enabled a non-sensitizing dose of NTG to trigger migraine-like hypersensitivity. Systemic injection of sumatriptan inhibited the MMTL-enhanced migraine-like hypersensitivity. MMTL pretreatment significantly upregulated the protein level of CGRP in the spinal trigeminal nucleus caudalis after NTG injection. Our results indicate that a pre-existing myogenic TMD can upregulate NTG-induced trigeminal CGRP and enhance migraine-like hypersensitivity.

Increased Intra-Subject Variability (ISV) is a candidate endophenotype of ADHD. ISV’s relationship with response speed is highly relevant for ADHD as patients are highly variable but typically no slower than controls. This brief report addresses the relationship between variability and speed by employing dimensional analyses for differentiated performance measures, with a particular focus on the ex-Gaussian measures, across relevant ADHD studies and in young healthy adults (N = 70). For both patients with ADHD and healthy adults, we found that reaction time standard deviation and mean reaction time were strongly correlated, thus failing to dissociate, but ex-Gaussian tau (τ) shared only little variance with Gaussian mu (μ), thus dissociating slow responses (τ) from response speed or—if given—slow responding (μ). Our results highlight the utility of employing the ex-Gaussian measures to disentangle ISV and speed, particularly for ADHD data as patients make more slow responses but are not overall slower than typical controls. © Copyright © 2020 Salunkhe, Feige, Saville, Stefanou, Linden, Bender, Berger, Smyrnis, Biscaldi and Klein.

Understanding gas–phase chemical kinetics is important for modeling hypersonic flows. This paper discusses quasiclassical trajectory analysis, in which gas–phase interactions are simulated using ab...

The diagnostic process of pain in the oral, facial, and head region is often perceived as more difficult due the numerous, extensively innervated structures located in this area. To successfully manage the patient with these pain presentations, it is critical for the clinician to spend ample time procuring a good medical and dental history. A systematic approach to the physical examination will ensure that sufficient data are acquired without overlooking potentially important contributing factors. The use of adjunctive laboratory tests and imaging studies should be based on the findings in the history and examination.

The following case report illustrates the value of neuropsychological expertise in disentangling the effects of brain injury and malingering when evaluating competency to stand trial (CST)....

IntroductionLearning from a case of a 13 year old patient with auditory hallucinations for 2 months, admitted to the hospital due to suicidal ideation. Her mother had been diagnosed with Lupus and OCD. Her mood had been low for several months, probable mild intellectual disability.ObjectivesLearn how to assess auditory hallucinations and possible new onset psychotic symptoms in teenagers. Learn about different levels of care involved. Discuss differential diagnosis and future directions and treatment.MethodsDescription of the case. Differential diagnosis: Obsessive compulsive disorder, Major depressive disorder with Psychotic features, schizophrenia spectrum disorder, epilepsy or other neurologic disease, autoimmune disease, post-traumatic stress disorder… Tests and consults conducted by Neurology team Psychopharmacology description.ResultsDifferential diagnosis: Obsessive compulsive disorder, Major depressive disorder with Psychotic features, schizophrenia spectrum disorder, epilepsy, autoimmune diseases like Lupus, post-traumatic stress disorder etc. Video EEG: normal. Brain MRI: normal Blood work unremarkable with positive ANA (titer 1:80). Work up, including lumbar puncture with autoimmune encephalitis and MS panels was negative. Psychopharmacology: Fluoxetine up to 40mg, and Aripiprazol up to 20mg without a good response. Possible sexual trauma was disclosed in a second hospitalization, months later.ConclusionsRecommendation of assessing new onset of psychotic symptoms in detail to get a good diagnosis. Psychotic symptoms in young teenagers may occur as part of different presentations and it is important to provide a good follow up of the patient in order to provide the most accurate treatment.Conflict of interestAlicia Koplowitz Foundation

3D terrain models are an important instrument in areas like geology, agriculture and reconnaissance. Using an automated UAS with a line-based LiDAR can create terrain models fast and easily even from large areas. But the resulting point cloud may contain holes and therefore be incomplete. This might happen due to occlusions, a missed flight route due to wind or simply as a result of changes in the ground height which would alter the swath of the LiDAR system. This paper proposes a method to detect holes in 3D point clouds generated during the flight and adjust the course in order to close them. First, a grid-based search for holes in the horizontal ground plane is performed. Then a check for vertical holes mainly created by buildings walls is done. Due to occlusions and steep LiDAR angles, closing the vertical gaps may be difficult or even impossible. Therefore, the current approach deals with holes in the ground plane and only marks the vertical holes in such a way that the operator can decide on further actions regarding them. The aim is to efficiently create point clouds which can be used for the generation of complete 3D terrain models.

Emergency physicians are well versed in cerebral herniation, pathology that typically results from increased intracranial pressure; however, paradoxical herniation is less common and requires opposing treatments. We describe a case of paradoxical herniation following lumbar puncture in a patient with previous hemicraniectomy. The symptomatology was similar to cerebral herniation from intracranial hypertension and included lethargy, bradycardia, headache, and compression of brain structures on non-contrast head computed tomography. However, contrary to treatment modalities for intracranial hypertension, our management strategy aimed to reverse intracerebral hypotension. Treatment for paradoxical herniation involved increasing intracranial pressure using fluid resuscitation and Trendelenburg positioning. In the intensive care unit our patient received an epidural blood patch and hydration with resolution of his symptoms.

This article provides an overview of validity assessment in persons with traumatic brain injury including evaluation caveats. Specific discussion is provided on post-concussive disorders, malingering, examination techniques to assess for validity, response bias, effort and non-organic/functional presentations. Examinee and examiner biases issues will also be explored. Discussion is also provided regarding judicial trends in limiting examiner scope of testing and/or testimony, and risk of liability when providing expert witness opinions on validity of examinee presentations. The hope is to encourage physiatrists to become more aware and skilled in validity assessment given its importance in differential diagnosis of impairment following traumatic brain injury.

Even when people perform tasks poorly, they often report unrealistically positive estimates of their own abilities in these situations. To better understand the origins of such overconfidence, we investigated whether it could be predicted by individual differences in working memory, attentional control, and self-reported trait impulsivity. Overconfidence was estimated by contrasting objective and subjective measures of situation awareness (the ability to perceive and understand task-relevant information in the environment), acquired during a challenging air traffic control simulation. We found no significant relationships between overconfidence and either working memory or attentional control. However, increased impulsivity significantly predicted greater overconfidence. In addition, overall levels of overconfidence were lower in our complex task than in previous studies that used less-complex lab-based tasks. Our results suggest that overconfidence may not be linked to high-level cognitive abilities, but that dynamic tasks with frequent opportunities for performance feedback may reduce misconceptions about personal performance.

Sleep bruxism (SB) is a repetitive jaw muscle activity with clenching or grinding of the teeth during sleep. SB is characterized by what is known as rhythmic masticatory muscle activity (RMMA). RMMA is the laboratory polysomnographic finding that differentiates SB from other oromandibular movements seen during sleep. Most often RMMA episodes are associated with sleep arousal. Some patients will report similar complaints related to both SB and sleep disordered breathing (SDB). There are some reports that would suggest that SB is a result of SDB. It has has been postulated that SB is a compensatory mechanism to re establish muscle tone of the upper airway. While these disorders do in fact often present concomitantly, the relationship between the two is yet to be fully elucidated. This Critical Appraisal reviews 3 recent publications with the intent to better define what relationships may exists between SDB and SB. While the current evidence appears to support the notion that these are often concomitant disorders, it also makes clear that evidence to support the hypothesis that SDB is causative for SB is currently lacking.

Innovative pedagogies have significantly impacted health professions' education, dental education included. In this context, faculty, defined in this study as instructor in higher education, has been increasingly required to hone their instructional skills. The purpose of this exploratory study was to share the design, implementation and preliminary outcomes of two programmes to enhance dental faculty's instructional skills, the Teaching and Learning Seminar Series and the Course Director Orientation. Data sources included faculty and student surveys developed and administered by the researchers; data extracted from the learning management system; reports from the learning analytics tool; and classroom observations. Participants' satisfaction, self-reported learning, instructional behavioural change, and impact on student learning behaviours and institutional practice were assessed borrowing from Kirkpatrick's 4-level model of evaluation of professional development effectiveness. Initial findings showed that faculty in both programmes reported positive learning experiences. Participants reported that the programmes motivated them to improve instructional practice and improved their knowledge of instructional innovation. Some faculty reported implementation of new instructional strategies and tools, which helped create an active and interactive learning environment that was welcomed by their students. The study contributes to literature and best practice in health sciences faculty development in pedagogy and may guide other dental schools in designing professional development programmes.

Burning mouth syndrome (BMS) is a chronic disorder for which a definitive etiopathology is not known. The BMS patient often experiences a continuous burning pain in the mouth without any clinical signs. This confusing condition can create frustration for both patient and practitioner. Ultimately, it is important for the practitioner who treats head and face pain to become knowledgeable in the recognition of the many complexities and various presentations associated with BMS. In doing so, the practitioner can be better prepared to help patients cope with this confounding disorder and gain a better quality of life.

A 47-year-old man presented to the emergency department with fatigue and a rash. Two weeks prior to presentation, he had noticed a painful lesion in his left antecubital fossa (figure 1), which had gradually increased in size. Ten days later, he developed malaise, diffuse joint aches and a new rash (figure 2) over his torso, arms and legs. He had no palpitations, joint swelling or neurologic changes. Prior to the onset of his symptoms, he had vacationed in Wisconsin in early June—a Lyme-endemic region of the USA—and suspected that he may have had a tick bite to his left arm in the region adjacent to his initial rash. Physical exam was remarkable for a painful, indurated, erythematous plaque in the left antecubital fossa and multiple painless, erythematous patches with central clearing across his torso. He was afebrile, had no joint swelling or erythema and had no focal …

We report here a course of basic research into the potential suitability of a pseudo-icosahedral Cr aluminide as a material for high-temperature protective coatings. ${\mathrm{Cr}}_{55}{\mathrm{Al}}_{232\ensuremath{-}\ensuremath{\delta}}\phantom{\rule{4pt}{0ex}}\mathrm{[}\ensuremath{\delta}=2.70(6)]$ exhibits high hardness at room temperature as well as low thermal conductivity and excellent oxidation resistance at 973 K, with an oxidation rate comparable to those of softer, denser benchmark materials. The origin of these promising properties can be traced to competing long-range and short-range symmetries within the pseudo-icosahedral crystal structure, suggesting new criteria for future materials research.

In this paper, we present a graph based approach for performing the system calibration of a sensor suite containing a fixed mounted camera and an inertial navigation system. The aim of the presented work is to obtain accurate direct georeferencing of camera images collected with small unmanned aerial systems. Prerequisite for using the pose measurements from the inertial navigation system as exterior orientation for the camera is the knowledge of the static offsets between these devices. Furthermore, the intrinsic parameters of the camera obtained in a laboratory tend to deviate slightly from the values during flights. This induces an in-flight calibration of the intrinsic camera parameters in addition to the mounting offsets between the two devices. The optimization of these values can be done by introducing them as parameters into a bundle adjustment process. We show how to solve this by exploiting a graph optimization framework, which is designed for the least square optimization of general error functions.

The OPERA experiment, designed to perform the first observation of (Formula Presented) oscillations in appearance mode through the detection of the τ leptons produced in ντ charged current interactions, has collected data from 2008 to 2012. In the present paper, the procedure developed to detect τ 1~ from the neutrino interaction point, is described in detail and applied to the search for charmed hadrons, showing similar decay topologies as the τ lepton. In the analysed sample, 50 charm decay candidate events are observed while 54 ±4 are expected, proving that the detector performance and the analysis chain applied to neutrino events are well reproduced by the OPERA simulation and thus validating the methods for ντ appearance detection., 0, SCOPUS: ar.j, info:eu-repo/semantics/published

The OPERA experiment is designed to search for nu(mu) -> nu(tau) oscillations in appearance mode, i.e., through the direct observation of the tau lepton in nu(tau)- charged current interactions. The experiment has taken data for five years, since 2008, with the CERN Neutrino to Gran Sasso beam. Previously, two nu(tau) candidates with a tau decaying into hadrons were observed in a subsample of data of the 2008-2011 runs. Here we report the observation of a third nu(tau) candidate in the tau(-) -> mu(-) decay channel coming from the analysis of a subsample of the 2012 run. Taking into account the estimated background, the absence of nu(mu) -> nu(tau) oscillations is excluded at the 3.4 sigma level.

The OPERA experiment is searching for νμ ν τ oscillations in appearance mode, i.e. via the direct detection of \tau leptons in \nu -\tau charged-current interactions. The evidence of \nu -\mu \rightarrow \nu -\tau appearance has been previously reported with three \nu -\tau candidate events using a sub-sample of data from the 2008-2012 runs. We report here a fourth \nu -\tau candidate event, with the \tau decaying into a hadron, found after adding the 2012 run events without any muon in the final state to the data sample. Given the number of analyzed events and the low background, \nu -\mu \rightarrow \nu -\tau oscillations are established with a significance of 4.2\sigma., 0, SCOPUS: ar.j, info:eu-repo/semantics/published

We present global ground-state potential energy surfaces for the quintet and singlet spin states of the O

Among the most common pain-related temporomandibular disorders (TMDs) are disorders arising from muscular sources. Lacking a single etiology, treatment for TMD and myofascial pain (MP) is directed toward identifying and treating the source of the patient’s pain. Successful management of chronic TMD problems often requires a multidisciplinary approach utilizing a team of professionals working in conjunction with the individual patient. Evidence-based conservative treatment options to reduce the signs and symptoms of TMD, with special attention on MP, will be discussed in this chapter. These include patient education and biobehavioral strategies, therapeutic exercises, manual procedures, trigger point dry needling and therapeutic modalities offered by physical therapists, pharmacotherapy, and evidence-based oral appliances offered by dentists. In addition, the role of occlusion and occlusal oriented treatments will be discussed.