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Context: Individuals with chronic ankle instability (CAI) demonstrate reduced spinal reflex modulation and corticospinal excitability of the soleus, which may contribute to decreased balance performance. Objective: To determine the effects of a single session of balance training on Spinal-reflexive excitability modulation and corticospinal excitability in those with CAI. Design: Randomized controlled trials. Setting: Research laboratory. Participants: Thirty participants with CAI were randomly assigned to the balance training (BAL) or control (CON) group. Main Outcome Measures: Modulation of soleus spinal-reflexive excitability was measured by calculating relative change in normalized Hoffmann reflexes (ratio of the H-reflex to the M-wave) from prone to single-leg standing. Corticospinal excitability was assessed during single-leg stance using transcranial magnetic stimulation, outcomes of which included active motor threshold (AMT), motor evoked potential, and cortical silent period (CSP). Balance performance was measured with center of pressure velocity in anterior to posterior and medial to lateral directions. Separate 2x2 repeated-measures analyses of variance were employed to determine the effect of group (BAL and CON) and time (baseline and posttraining) on each dependent variable. Results: There were significant group by time interactions in the modulation of soleus spinal-reflexive excitability (F1.27 = 4.763, P=-04); CSP at 100% AMT (F F1.27 = 4.727, P = .04); and CSP at 120% AMT (F F1.27 16.057, f < .01). A large effect size suggests increased modulation of spinal-reflexive excitability (d = 0.81 [0.03 to 1.54]) of the soleus in BAL compared with CON at posttest, while CSP at 100% (d = 0.95 [0.17 to 1.70]) and 120% AMT (d = 1.10 [0.29 to 1.84]) was reduced in BAL when compared with CON at posttest. Conclusion: After a single session of balance training, individuals with CAI initiated increases in spinal reflex modulation and corticospinal excitability of the soleus. Thus, individuals with CAI who undergo balance training exhibit positive neural adaptations that are linked to improvements in balance performance. [ABSTRACT FROM AUTHOR]

Graphogenic, or writing epilepsy, is a rare type of reflex epilepsy (RE) in which seizures are provoked by the act of writing. RE is a condition that affects between 4% and 7% of all patients diagnosed with epilepsy. In this case study, we provide a case report on a patient whose seizures were generated by the act of writing. We also present evidence that the cortical mechanisms by which writing-induced seizures occur are focal with possible secondary generalization. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine whether providing realistic auditory or somatosensory cues to spatial location would affect measures of vestibulo-ocular reflex gain in a rotary chair testing (RCT) context. Method: This was a fully within-subject design. Thirty young adults age 18-30 years (16 men, 14 women by self-identification) completed sinusoidal harmonic acceleration testing in a rotary chair under five different conditions, each at three rotational frequencies (0.01, 0.08, and 0.32 Hz). We recorded gain as the ratio of the amplitude of eye movement to chair movement using standard clinical procedures. The five conditions consisted of two without spatial information (silence, tasking via headphones) and three with either auditory (refrigerator sound, tasking via speaker) or somatosensory (fan) information. Two of the conditions also included mental tasking (tasking via headphones, tasking via speaker) and differed only in terms of the spatial localizability of the verbal instructions. We used linear mixed-effects modeling to compare pairs of conditions, specifically examining the effects of the availability of spatial cues in the environment. This study was preregistered on Open Science Framework (https://osf.io/2gqcf/). Results: Results showed significant effects of frequency in all conditions (p < .05), but the only pairs of conditions that were significantly different were those including tasking in one condition but not the other (e.g., tasking via headphones vs. silence). Post hoc equivalence testing showed that the lack of significance in the other comparisons could be confirmed as not meaningfully different. Conclusions: These findings suggest that the presence of externally localizable sensory information, whether auditory or somatosensory, does not affect measures of gain in RCT to any relevant degree. However, these findings also contribute to the increasing body of evidence suggesting that mental engagement ("tasking") does increase gain whether or not it is provided via localizable instructions. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to determine the normative vestibulo- ocular reflex gain output values of the computerized rotational head impulse test (crHIT) with stationary visual targets (earth bound) in healthy participants in each decade age band of life: 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, and 70+ years. Method: Seventy-seven community-dwelling participants (10-85 years of age) with normal lateral semicircular canal (SCC) functioning and no symptoms or history of vestibular dysfunction were recruited through convenience sampling and assessed with the crHIT using stationary targets. These participants were assessed using two standard protocols in a randomized order. Results: Results from 77 participants (Mage = 46 years; 43 women, 34 men) were analyzed. Pearson's correlation coefficient and simple linear regression indicated a statistically significant relationship between crHIT gain output and age (p >.05) for right gain, 1030°/s², and left gain, 1005°/s². Although a statistically significant relationship was found, the slope was minor, demonstrating that the clinical effect of age on crHIT gain output was insignificant. Furthermore, no statistically significant relationship exists between crHIT gain output and gender (p > .05). Age-dependent normative data were calculated using the 2.5th and 97.5th confidence interval (CI) percentile method. The responses of angular vestibulo-ocular reflex (aVOR) gain values for crHIT are expected to occur within the range for lower limit reference interval (RI) of 0.85-0.9 and upper limit RI of 1.11-1.18 for 1030°/s² and lower limit RI of 0.86-0.92 and upper limit RI of 1.13-1.16 for 1005°/s² .It can be expected that 90% CI of the population with normal lateral SCC function- ing will have aVOR gain values that fall within this range. Conclusion: Despite a statistically significant relationship that exists with aVOR gain output and age, the changes are minor, declining by 0.0088 units per 10 years, justifying the same normative data for all decade age bands. [ABSTRACT FROM AUTHOR]

Objectives: To investigate roles of brain carbon monoxide (CO), an endogenous gasotransmitter, in regulation of the rat micturition reflex. Methods: In urethane‐anesthetized (0.8 g/kg, ip) male rats, evaluation of urodynamic parameters was started 1 h before intracerebroventricular administration of CORM‐3 (CO donor) or ZnPP (non‐selective inhibitor of heme oxygenase, a CO producing enzyme) and continued for 2 h after the administration. We also investigated effects of centrally pretreated SR95531 (GABAA receptor antagonist) or SCH50911 (GABAB receptor antagonist) on the CORM‐3‐induced response. Results: CORM‐3 significantly prolonged intercontraction intervals (ICIs) without changing maximal voiding pressure (MVP), while ZnPP significantly shortened ICI and reduced single‐voided volume and bladder capacity without affecting MVP, post‐voided residual volume, or voiding efficiency. The ZnPP‐induced ICI shortening was reversed by CORM‐3. The CORM‐3‐induced ICI prolongation was significantly attenuated by centrally pretreated SR95531 or SCH50911, respectively. Conclusions: Brain CO can suppress the rat micturition reflex through brain γ‐aminobutyric acid (GABA) receptors. [ABSTRACT FROM AUTHOR]

Context Increasing numbers of patients and caregivers are requesting transition to blenderized tube feeding. There is a lack of systematic reviews addressing the outcomes of blenderized tube feeding. Objective The aim was to evaluate the association of blenderized tube feeding on feeding tolerance in enterally fed pediatric patients. Data Sources A literature search for articles from 2012–2022 using PubMed, Medline, Embase, and CINAHL yielded 78 articles. Data Extraction A description and evaluation of the study's sample, purpose, and results were summarized for 9 studies using the Academy of Nutrition and Dietetics Evidence Analysis Library Worksheet. Data Analysis Nine studies were evaluated using the Evidence Analysis Library Quality Criteria checklist. Conclusions Studies demonstrated an improvement in vomiting (n = 7), gagging/retching and heartburn (n = 6), abdominal pain/upset and distension (n = 3), and diarrhea (n = 6) with blenderized tube feeding. The outcomes of blenderized tube feeding on gas (n = 5) and constipation (n = 9) are variable and remain unclear. Systematic Review Registration PROSPERO registration no. CRD42022369247. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionDiabetic Peripheral Neuropathy (DPN) impairs balance due to sensory loss, proprioceptive deficits, muscle weakness, altered gait, and delayed reflexes. Targeted aerobic and balance training seem promising to mitigate these issues. However, the exact content of a recommended training regime is yet to be determined.To delineate and synthesise balance training content and efficacy for people with DPN.The literature search was conducted on PubMed and Embase in accordance with the PRISMA-checklist. Last search was performed on April 29, 2024. Inclusion criteria were established using the PICO-framework. Methodological quality was assessed using the TESTEX Scale. Meta-analyses were exclusively applied to studies featuring a passive control group.A total of 2007 articles were identified. Twelve studies were included in the qualitative synthesis. Seven studies were included in the meta-analyses. Two studies were of high quality. Most studies reported the frequency, session time, duration, and setting of balance training, while none reported the intensity. The meta-analyses showed a standardized mean difference in favor of balance training compared to passive control for One-Legged Stance (openeyes) (0.89[0.5,1.28]), One-Legged Stance (closed eyes) (1.48[0.36, 2.60]), Postural sway (−0.71[−1.04, −0,37]), Timed Up and Go(−0.94[−1.78, −0.10]), and Berg Balance Scale (2.26[0.48, 4.05]), respectively.Studies are few and generally of low methodological quality. The content of balance training interventions is minimally described, especially concerning the applied intensity. However, balance training does seem to improve balance outcomes in people with DPN, but given the methodological limitations, interpretation must be cautious. [ABSTRACT FROM AUTHOR]

This paper explores the deliberate use of temporal ambiguities and discrepancies in Defoe’s The Fortunate Mistress to convey the disturbed retrospections of a guilt/shame-ridden narrator and the relationship between moral injury and temporal narrative techniques, highlighting the gendered nature of the fictional narrator’s moral injury. Drawing on Pederson’s model of moral injury in literature, which deals with perpetrator trauma, it argues that the narrator’s moral injury and its temporal reflexes in the narrative serve to reinforce the thematic and narratorial (re)iterations of female trauma and subsequent moral injury. Ultimately, this analysis provides compelling evidence of Defoe’s astute understanding of the psychology of shame, guilt, and narration, as well as his preference for psychological realism over traditional sequential narration, as he crafts stories that explore the human and psychological consequences of traumatic experiences. [ABSTRACT FROM AUTHOR]

The nociceptive withdrawal reflex (NWR) is a protective limb withdrawal response triggered by painful stimuli, used to assess spinal nociceptive excitability. Conventionally, the NWR is understood as having two reflex responses: a short-latency Aβ-mediated response, considered tactile, and a longer-latency Aδ-mediated response, considered nociceptive. However, nociceptors with conduction velocities similar to Aβ tactile afferents have been identified in human skin. In this study, we investigated the effect of a preferential conduction block of Aβ fibers on pain perception and NWR signaling evoked by intradermal electrical stimulation in healthy participants. We recorded a total of 198 NWR responses in the intact condition, and no dual reflex responses occurred within our latency bandwidth (50–150 ms). The current required to elicit the NWR was higher than the perceptual pain threshold, indicating that NWR did not occur before pain was felt. In the block condition, when the Aβ-mediated tuning fork sensation was lost while Aδ-mediated nonpainful cooling was still detectable (albeit reduced), we observed that the reflex was abolished. Further, short-latency electrical pain intensity at pre-block thresholds was greatly reduced, with any residual pain sensation having a longer latency. Although electrical pain was unaffected at suprathreshold current, the reflex could not be evoked despite a two-fold increase in the pre-block current and a five-fold increase in the pre-block pulse duration. These observations lend support to the possible involvement of Aβ-fiber inputs in pain and reflex signaling. [ABSTRACT FROM AUTHOR]

The proprioceptive sensory reflex (e.g. stretch reflex) plays an important role in perturbed arm stabilization. Neuroscience studies have widely identified the heteronymous spinal pathways in the human arm, which may contribute to stabilized movement. However, their interactions in living systems pose challenges for specific functional investigations through human experiments. Therefore, this paper concentrates on understanding the effects of two heteronymous pathways, specifically the transmission of monoarticular sensory feedback to innervate biarticular muscles, using the robot. We replicate specific reflex pathways on a 2-DoF musculoskeletal robot equipped with pneumatic artificial muscles. By adjusting the weights of pathways, which resemble human motor control, we evaluate our robot arm performance under the forearm and upper arm disturbances. The outcomes validate their effects on regulating biarticular muscle stimulation, resulting in more stable and coordinated end-effectory trajectories. These reflexive pathways provide insights into the mechanisms underlying human arm perturbations and stabilization. Additionally, the proposed bioinspired system with applicable reflex weights holds great potential in the adaptive response of musculoskeletal robots, guiding robotics researchers in controller design. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionTo present marginal reflex distance (MRD-1) outcomes based on intra-operative quantification of levator aponeurosis advancement.Forty-eight patients with unilateral aponeurotic ptosis underwent anterior levator aponeurosis advancement. Distance of advancement intra-operatively was compared with MRD-1 outcomes at the immediate postoperative sitting, approximately 1 week, and 1 month period. Surgical success was defined as a symmetric MRD-1 or an MRD-1 within 1 millimeter of the contralateral eyelid.Most MRD-1 exhibited the following trends: 1) initial decrease at about 1 week and increase at 1 month (n = 11), 2) initial increase at about 1 week with levelling at 1 month (n = 8), and 3) increasing through time (n = 7). Success rate significantly decreased through time (p = .0464). The change in proportion of successful and failed surgeries was insignificant. Surgical revision rate was 10.4%.Levator aponeurosis advancement distances do not correlate with MRD-1 outcomes linearly. MRD-1 exhibited stability over time with a satisfactory success rate at 1 month. [ABSTRACT FROM AUTHOR]

Background: Acute and complete unilateral vestibular deafferentation induces a significant change in ipsilateral vestibuloocular reflex gain, making the patient unable to stabilize gaze during active or passive head movements. This inability creates the illusion that the visual environment is moving, resulting in persistent visual discomfort during rapid angular or linear acceleration of the head. This is known as oscillopsia. Our objective was to understand if the spontaneous sensation of oscillopsias after complete unilateral vestibular deafferentation by vestibular neurotomy at 5 days (D5) and at 3 months (M3) is correlated with the loss of vestibuloocular reflex gain and dynamic visual acuity. Methods: Retrospective cohort study was conducted in an otolaryngology tertiary care center (2019-2022) on patients with complete unilateral vestibular loss by vestibular neurotomy. They were divided into 2 groups according to the presence (group G1) or absence (group G2) of a spontaneous complaint of oscillopsia assessed at M3. Severity of oscillopsias evaluated by Oscillopsia Severity Questionnaire. Vestibuloocular reflex gain based on video head impulse test (vHIT) and the dynamic visual acuity were measured for each group at D5 and M3. Categorical variables were compared using χ2 test and quantitative variables using the nonparametric Wilcoxon-Mann-Whitney test. Results: All patients have a complete vestibular deafferentation at D5 and M3. At D5 (G1 = 8 patients, G2 = 5 patients), there is no significant difference for ipsilateral and contralateral vestibuloocular reflex gains and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.68 ± 1.03 in G1 and 1.23 ± 1.03 in G2 (P <.05). At M3 (G1 = 9 patients, G2 = 6 patients), there is no significant difference between groups for epidemiologic and clinical data and for vestibuloocular reflex and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.10 ± 0.63 in G1 and 1.24 ± 0.28 in G2 (P <.05). Conclusions: The spontaneous disabling sensation of oscillopsia after complete unilateral vestibular loss is well assessed by the Oscillopsia Severity Questionnaire but cannot be explained by objective vestibular tests assessing vestibuloocular reflex gain (vHIT) or dynamic visual acuity loss at D5 or M3. Further studies are needed to measure the sensation of oscillopsia under real-life conditions and to identify the factors responsible for its persistence. Trial registration: Retrospectively registered. [ABSTRACT FROM AUTHOR]

Introduction: Sex-specific patterns in respiratory conditions, such as asthma, COPD, cystic fibrosis, obstructive sleep apnea, and idiopathic pulmonary fibrosis, have been previously documented. Animal models of acute lung injury (ALI) have offered insights into sex differences, with male mice exhibiting distinct lung edema and vascular leakage compared to female mice. Our lab has provided evidence that the chemoreflex is sensitized in male rats during the recovery from bleomycin-induced ALI, but whether sex-based chemoreflex changes occur post-ALI is not known. To bridge this gap, the current study employed the bleomycin-induced ALI animal model to investigate sex-based differences in chemoreflex activation during the recovery from ALI. Methods: ALI was induced using a single intra-tracheal instillation of bleomycin (bleo, 2.5 mg/Kg) (day 1). Resting respiratory frequency (fR) was measured at 1-2 days pre-bleo, day 7 (D7) post-bleo, and 1 month (1 mth) post-bleo. The chemoreflex responses to hypoxia (10% O2, 0%CO2) and normoxic-hypercapnia (21%O2, 5%CO2) were measured before bleo administration (pre-bleo) and 1 mth post-bleo using whole-body plethysmography. The apnea-hypopnea Index (AHI), post-sigh apneas, and sighs were measured at each time point. Results: Therewere no significant differences in resting fR between male and female rats at the pre-bleo time point or in the increase in resting fR at D7 post-bleo. At 1mth post-bleo, the resting fR was partially restored in both sexes but the recovery towards normal ranges of resting fR was significantly lower in male rats. The AHI, post-sigh apneas, and sighs were not different between male and female rats pre-bleo and 1mth post-bleo. However, at D7 post-bleo, themale rats exhibited a higher AHI than female rats. Bothmale and female rats exhibited a sensitized chemoreflex in response to hypoxia and normoxic-hypercapnia with no significant differences between sexes. Conclusion: A sex difference in resting ventilatory parameters occurs post ALI with a prolonged increase in resting fR and larger AHI in male rats. On the other hand, we did not find any sex differences in the chemoreflex sensitization that occurs at 1 mth post-bleo. This work contributes to a better understanding of sex-based variations in lung disorders. [ABSTRACT FROM AUTHOR]

• Involvement of exogenous factors in the development of VVR remains unknown. • Meteorological conditions may play a role in blood donation-associated VVR onset. • Large diurnal temperature range may be a major risk factor. [ABSTRACT FROM AUTHOR]

Objective: Depth camera-based measurement has demonstrated efficacy in automated assessment of upper limb Fugl-Meyer Assessment for paralysis rehabilitation. However, there is a lack of adequately sized studies to provide clinical support. Thus, we developed an automated system utilizing depth camera and machine learning, and assessed its feasibility and validity in a clinical setting. Design: Validation and feasibility study of a measurement instrument based on single cross-sectional data. Setting: Rehabilitation unit in a general hospital Participants: Ninety-five patients with hemiparesis admitted for inpatient rehabilitation unit (2021–2023). Main measures: Scores for each item, excluding those related to reflexes, were computed utilizing machine learning models trained on participant videos and readouts from force test devices, while the remaining reflex scores were derived through regression algorithms. Concurrent criterion validity was evaluated using sensitivity, specificity, percent agreement and Cohen's Kappa coefficient for ordinal scores of individual items, as well as correlations and intraclass correlation coefficients for total scores. Video-based manual assessment was also conducted and compared to the automated tools. Result: The majority of patients completed the assessment without therapist intervention. The automated scoring models demonstrated superior validity compared to video-based manual assessment across most items. The total scores derived from the automated assessment exhibited a high coefficient of 0.960. However, the validity of force test items utilizing force sensing resistors was relatively low. Conclusion: The integration of depth camera technology and machine learning models for automated Fugl-Meyer Assessment demonstrated acceptable validity and feasibility, suggesting its potential as a valuable tool in rehabilitation assessment. [ABSTRACT FROM AUTHOR]

Introduction: Recognizing testicular torsion is extremely important in patients presenting to the emergency department (ED) with acute scrotal pain. Traditional manual detorsion techniques are frequently employed by emergency physicians but are not always successful. Delays in detorsion increase the risk of testicular infarction and infertility, and the need for orchiectomy. Novel techniques such as the testicular traction technique have been described as a potential solution for difficult-todetorse testicles. Case Report: Our case report describes a 20-year-old male with no significant past medical history who presented to a rural ED with acute, atraumatic testicular pain secondary to testicular torsion with an intact cremasteric reflex. After confirming the diagnosis using Doppler ultrasound, manual detorsion using the traditional “open book” technique was attempted and unsuccessful. The patient was subsequently successfully detorsed using the novel testicular traction technique. Conclusion: The testicular traction technique is a safe, rapid, and effective primary or adjunctive technique in manual testicular detorsion. Given the time-sensitive nature of testicular torsions, adjunctive techniques play a crucial role in managing challenging detorsions, particularly in resource-limited rural settings with limited access to urologic services. Although it is commonly thought that the cremasteric reflex is absent in testicular torsions, it may be present in rare circumstances, and its presence should not be an absolute in ruling out torsion. [ABSTRACT FROM AUTHOR]

The work in the technological sewing process is carried out on machine systems characterised by machine–hand work, where the worker and the machine work simultaneously. Such a work system requires a high level of responsibility in terms of quality, quantity, and the correct and timely execution of work, which requires workers to have fast and accurate reflexes, as well as exceptionally good psychomotor and visual skills. By applying the basic movements of the Methods-Time Measurement (MTM) system, the elaborated standard sets of hand sub-operations included in technological sewing operations, and the method of determining normal times for straight seams (RAV) and curved seams (ZAK), it is possible to determine the working method and time norm of individual technological sewing operations. The MTM Calculator software was developed to facilitate the determination of working methods and time norms on the basis of the MTM system. It can be used to quickly calculate the production time for a technological sewing operation. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment in the elderly may lead to potential increased sensitivity to anesthetic agents targeting receptors associated with cognition. This study aimed to explore the effect of cognitive status on propofol consumption during surgery in elderly patients. Methods: Sixty elderly patients scheduled for laparoscopic radical prostatectomy were allocated to either a cognitively normal [CogN, Montreal Cognitive Assessment (MoCA) score ≥26] or cognitively impaired (CogI, MoCA <26) group. Propofol was administered via target-controlled infusion to maintain a bispectral index (BIS) between 55-65 during surgery. Propofol consumption was recorded at three time points: T1 (abolished eyelash reflex), T2 (BIS = 50), T3 (extubation). BIS values at eyelash reflex abolition were also recorded. Postoperative MoCA, Visual Analogue Scale (VAS) scores, and remifentanil/sufentanil consumption were assessed. Results: BIS values before induction were similar between CogN and CogI groups. However, at eyelash reflex abolition, BIS was significantly higher in CogI than CogN (mean ± SD: 65.3 ± 7.2 vs. 61.1 ± 6.8, p = 0.031). Propofol requirement to reach BIS 50 was lower in CogI vs. CogN (1.24 ± 0.19 mg/kg vs. 1.46 ± 0.12 mg/kg, p = 0.003). Postoperative MoCA, VAS scores, and remifentanil/sufentanil consumption did not differ significantly between groups. Conclusion: Compared to cognitively intact elderly, those with cognitive impairment exhibited higher BIS at eyelash reflex abolition and required lower propofol doses to achieve the same BIS level, suggesting increased propofol sensitivity. Cognitive status may impact anesthetic medication requirements in the elderly. [ABSTRACT FROM AUTHOR]

Rhythms are the most natural cue for temporal anticipation because many sounds in our living environment have rhythmic structures. Humans have cortical mechanisms that can predict the arrival of the next sound based on rhythm and periodicity. Herein, we showed that temporal anticipation, based on the regularity of sound sequences, modulates peripheral auditory responses via efferent innervation. The medial olivocochlear reflex (MOCR), a sound-activated efferent feedback mechanism that controls outer hair cell motility, was inferred noninvasively by measuring the suppression of otoacoustic emissions (OAE). First, OAE suppression was compared between conditions in which sound sequences preceding the MOCR elicitor were presented at regular (predictable condition) or irregular (unpredictable condition) intervals. We found that OAE suppression in the predictable condition was stronger than that in the unpredictable condition. This implies that the MOCR is strengthened by the regularity of preceding sound sequences. In addition, to examine how many regularly presented preceding sounds are required to enhance the MOCR, we compared OAE suppression within stimulus sequences with 0–3 preceding tones. The OAE suppression was strengthened only when there were at least three regular preceding tones. This suggests that the MOCR was not automatically enhanced by a single stimulus presented immediately before the MOCR elicitor, but rather that it was enhanced by the regularity of the preceding sound sequences. [ABSTRACT FROM AUTHOR]

Refractory chronic cough is a disabling disease with very limited therapeutic options. A better understanding of cough pathophysiology has led to the development of emerging drugs targeting cough receptors. Recent strides have illuminated novel therapeutic avenues, notably centred on modulating transient receptor potential (TRP) channels, purinergic receptors, and neurokinin receptors. By modulating these receptors, the goal is to intervene in the sensory pathways that trigger cough reflexes, thereby providing relief without compromising vital protective mechanisms. These innovative pharmacotherapies hold promise for improvement of refractory chronic cough by offering improved efficacy and potentially mitigating adverse effects associated with current recommended treatments. A deeper comprehension of their precise mechanisms of action and clinical viability is imperative for optimising therapeutic interventions and elevating patient care standards in respiratory health. This review delineates the evolving landscape of drug development in this domain, emphasising the significance of these advancements in reshaping the paradigm of cough management. [ABSTRACT FROM AUTHOR]

We previously showed that orexin neurons are activated by hypoxia and facilitate the peripheral chemoreflex (PCR)-mediated hypoxic ventilatory response (HVR), mostly by promoting the respiratory frequency response. Orexin neurons project to the nucleus of the solitary tract (nTS) and the paraventricular nucleus of the hypothalamus (PVN). The PVN contributes significantly to the PCR and contains nTS-projecting corticotropin-releasing hormone (CRH) neurons. We hypothesized that in male rats, orexin neurons contribute to the PCR by activating nTS-projecting CRH neurons. We used neuronal tract tracing and immunohistochemistry (IHC) to quantify the degree that hypoxia activates PVN-projecting orexin neurons. We coupled this with orexin receptor (OxR) blockade with suvorexant (Suvo, 20 mg/kg, i.p.) to assess the degree that orexin facilitates the hypoxia-induced activation of CRH neurons in the PVN, including those projecting to the nTS. In separate groups of rats, we measured the PCR following systemic orexin 1 receptor (Ox1R) blockade (SB-334867; 1 mg/kg) and specific Ox1R knockdown in PVN. OxR blockade with Suvo reduced the number of nTS and PVN neurons activated by hypoxia, including those CRH neurons projecting to nTS. Hypoxia increased the number of activated PVN-projecting orexin neurons but had no effect on the number of activated nTS-projecting orexin neurons. Global Ox1R blockade and partial Ox1R knockdown in the PVN significantly reduced the PCR. Ox1R knockdown also reduced the number of activated PVN neurons and the number of activated tyrosine hydroxylase neurons in the nTS. Our findings suggest orexin facilitates the PCR via nTS-projecting CRH neurons expressing Ox1R. [ABSTRACT FROM AUTHOR]

Dysphoric milk ejection reflex is a condition that causes an abrupt emotional downturn during the initial moments of milk ejection in a breastfeeding mother. Depression, anxiety, hopelessness, anger, irritability, homesickness, and stomach hollowness are all possible symptoms. The exact cause of D-MER remains unknown. However, it is proposed that it is caused by an alteration in oxytocin signaling response where secretion of oxytocin upregulates the stress response instead of its downregulation. Activation of the defensive response of the mother by oxytocin during breastfeeding, disruption in dopamine levels, and activation of vasopressin-regulated pathways are other probable causes. Due to a lack of awareness, this phenomenon is easily misdiagnosed as postpartum depression and aversion by many healthcare professionals. Its prevalence in various populations of the world remains unknown due to the lack of research studies conducted in these populations. While no medically approved therapeutic strategy is available, supportive techniques such as maintaining a healthy diet, mental distraction, relaxation methods, and increasing skin-to-skin contact can help alleviate dysphoria during breastfeeding. However, due to a lack of D-MER research, specific challenges exist regarding early withdrawal from breastfeeding and women's help-seeking attitude toward perinatal mental health. [ABSTRACT FROM AUTHOR]

Purpose: Syncope remains a common medical problem. Recently, the role of dedicated syncope units and implantable loop recorders has emerged in the investigation of unexplained syncope. This study aims to investigate the possibilities for a more rational and targeted use of various diagnostic tools. Methods: In this retrospective single-center study, 196 patients with unexplained syncope were included between March 2019 and February 2023. Various diagnostic tools were utilized during the investigation, according to clinical judgement. Patients were retrospectively allocated into Group A (including those who, among other tests, underwent loop recorder insertion) and Group B (including patients investigated without loop recorder implantation). Data were compared with Group C, including patients assessed prior to syncope unit establishment. Results: There was no difference between Group A (n = 133) and Group B (n = 63) in the diagnostic yield (74% vs. 76%, p = 0.22). There were significant differences between Groups A and B regarding age (67.3 ± 16.9 years vs. 48.3 ± 19.1 years, p < 0.001) and cause of syncope (cardiogenic in 69% of Group A, reflex syncope in 77% of Group B, p < 0.001). Electrocardiography-based diagnosis occurred in 55% and 19% of Groups A and B, respectively (p < 0.001). The time to diagnosis was 4.2 ± 2.7 months in Group A and 7.5 ± 5.6 months in Group B (p < 0.001). In Group C, the diagnostic yield was 57.9% and the electrocardiography-based diagnostic yield was 18.3%. Conclusions: A selective use of loop recorders according to clinical and electrocardiographic characteristics increases the effectiveness of the structured syncope unit approach and further preserves financial resources. [ABSTRACT FROM AUTHOR]

In the era after World War II, Francis (Frank) Forster (1912–2006) became a preeminent American neurologist and epileptologist, with international prominence in the study of reflex epilepsy. Forster's interest in reflex epilepsy began with a chance observation of the condition, in 1946, in a four-year-old girl. When medical measures failed to control her somatosensory-evoked seizures, Forster recommended surgery, and then facilitated transfer to Canadian neurosurgeon Wilder Penfield (1891–1976) at the Montreal Neurological Institute. Forster traveled to Montreal for the child's surgery. The surgery on February 27, 1948, proved to be curative for the child, and Forster's interactions with Penfield and epileptologist Herbert Jasper (1906–1999) made a lasting impression. This study reviews the medical and surgical history of this case, which strongly influenced Forster's career. [ABSTRACT FROM AUTHOR]

We measure the kinematic signature arising from the Milky Way (MW) disc moving with respect to the outer stellar halo, which is observed as a dipole signal in the kinematics of stellar halo tracers. We quantify how the reflex motion varies as a function of Galactocentric distance, finding that (i) the amplitude of the dipole signal increases as a function of radius, and (ii) the direction moves across the sky. We compare the reflex motion signal against a compilation of published models that follow the MW–LMC interaction. These models show a similar trend of increasing amplitude of the reflex motion as a function of distance, but they do not reproduce the direction of the disc motion with respect to the stellar halo well. We also report mean motions for the stellar halo as a function of distance, finding radial compression in the outer halo and non-zero prograde rotation at all radii. The observed compression signal is also present in MW–LMC models, but the rotation is not, which suggests that the latter is not induced by the LMC. We extensively validate our technique to measure reflex motion against idealized tests. We discuss prospects for directly constraining the mass and orbital history of the LMC through the impact on the motion of the MW stellar disc, and how the modelling of the reflex motion can be improved as more and better data become available. [ABSTRACT FROM AUTHOR]

Hypoxia is a pivotal factor in the pathophysiology of various clinical conditions, including obstructive sleep apnea, which has a strong association with cardiovascular diseases like hypertension, posing significant health risks. Although the precise mechanisms linking hypoxemia-associated clinical conditions with hypertension remains incompletely understood, compelling evidence suggests that hypoxia induces plasticity of the neurocirculatory control system. Despite variations in experimental designs and the severity, frequency, and duration of hypoxia exposure, evidence from animal and human models consistently demonstrates the robust effects of hypoxemia in triggering reflex-mediated sympathetic activation. Both acute and chronic hypoxia alters neurocirculatory regulation and, in some circumstances, leads to sympathetic outflow and elevated blood pressures that persist beyond the hypoxic stimulus. Dysregulation of autonomic control could lead to adverse cardiovascular outcomes and increase the risk of developing hypertension. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated that oral contraceptive (OC) users have enhanced cardiorespiratory responses to arm metaboreflex activation (i.e., postexercise circulatory occlusion, PECO) and attenuated pressor responses to leg passive movement (PM) compared to non‐OC users (NOC). We investigated the cardiorespiratory responses to arm or leg metaboreflex and mechanoreflex activation in 32 women (OC, n = 16; NOC, n = 16) performing four trials: 40% handgrip or 80% plantarflexion followed by PECO and arm or leg PM. OC and NOC increased mean arterial pressure (MAP) similarly during handgrip, plantarflexion and arm/leg PECO compared to baseline. Despite increased ventilation (VE) during exercise, none of the women exhibited higher VE during arm or leg PECO. OC and NOC similarly increased MAP and VE during arm or leg PM compared to baseline. Therefore, OC and NOC were similar across pressor and ventilatory responses to arm or leg metaboreflex and mechanoreflex activation. However, some differences due to OC may have been masked by disparities in muscle strength. Since women increase VE during exercise, we suggest that while women do not display a ventilatory response to metaboreflex activation (perhaps due to not reaching a theoretical metabolite threshold to stimulate VE), the mechanoreflex may drive VE during exercise in women. [ABSTRACT FROM AUTHOR]

Introduction: Research on healthy pregnant women's reflexes is almost unheard of, even if an estimation of reflexes is a conventional part of the physical examination of preeclamptic patients, and hyperreflexia is generally considered to be a warning sign of eclampsia. The aim of the present study was to investigate the possible impact of gestation on tendon reflexes and the Babinski response, as examined in a clinical bed‐side manner. Material and Methods: A prospective, single‐blind, cross‐sectional study. Three study groups comprised non‐pregnant (n = 20), 14–18 weeks (n = 16), and 34–38 weeks (n = 15) healthy pregnant women respectively. Two experienced neurologists examined separately each participant's patellar reflexes, Achilles reflexes, and Babinski response and rated them on two different scales, National Institute of Neurological Disorders and Stroke (NINDS) scale and Mayo Clinic Scale for Tendon Reflex Assessment. Inter‐observer estimations between the patient groups and the neurologists were made by mixed effect model methodology. Results: The patellar and Achilles reflexes´ strengths were rated similarly in all three groups (p > 0.05). The inter‐observer difference was non‐significant between the neurologists´ estimations (p > 0.05). The neurologists estimated the Babinski response in a few cases as neutral (0), otherwise down (normal). Conclusions: The patellar and Achilles reflex strengths are not affected in uncomplicated pregnancy. There is good concordance between neurologists´ estimations of tendon reflex strengths rated on the NINDS and Mayo scales. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate challenges in speech-in-noise (SiN) processing faced by school-age children with autism spectrum conditions (ASCs) and their impact on listening effort. Method: Participants, including 23 Mandarin-speaking children with ASCs and 19 age-matched neurotypical (NT) peers, underwent sentence recognition tests in both quiet and noisy conditions, with a speech-shaped steady-state noise masker presented at 0-dB signal-to-noise ratio in the noisy condition. Recognition accuracy rates and task-evoked pupil responses were compared to assess behavioral performance and listening effort during auditory tasks. Results: No main effect of group was found on accuracy rates. Instead, significant effects emerged for autistic trait scores, listening conditions, and their interaction, indicating that higher trait scores were associated with poorer performance in noise. Pupillometric data revealed significantly larger and earlier peak dilations, along with more varied pupillary dynamics in the ASC group relative to the NT group, especially under noisy conditions. Importantly, the ASC group’s peak dilation in quiet mirrored that of the NT group in noise. However, the ASC group consistently exhibited reduced mean dilations than the NT group. Conclusions: Pupillary responses suggest a different resource allocation pattern in ASCs: An initial sharper and larger dilation may signal an intense, narrowed resource allocation, likely linked to heightened arousal, engagement, and cognitive load, whereas a subsequent faster tail-off may indicate a greater decrease in resource availability and engagement, or a quicker release of arousal and cognitive load. The presence of noise further accentuates this pattern. This highlights the unique SiN processing challenges children with ASCs may face, underscoring the importance of a nuanced, individual-centric approach for interventions and support. [ABSTRACT FROM AUTHOR]

Simple Summary: Anesthesia in red-eared sliders is necessary both for surgical procedures and for imaging techniques. Propofol is a nonbarbiturate anesthetic agent used for induction in many species and should be administered intravenously. Jugular intravenous cannulas provide safe access with the least lymph contamination for anesthetic administration. In this study, red-eared sliders were anesthetized with 5 mg/kg and 10 mg/kg propofol administered in the jugular veins. Our results indicate that the 10 mg/kg dose is efficient for inducing anesthesia for short non-painful procedures, whereas the 5 mg/kg dose did not prove to be enough for anesthetic induction. This study compares the effects of two different doses of propofol administered intravenously (IV), in the jugular vein, to red-eared sliders (Trachemys scripta elegans). In this crossover study, 5 or 10 mg/kg propofol was administered to six Trachemys scripta elegans after cannulation of the jugular vein. Each turtle received each dose, G1 (5 mg/kg IV) and G2 (10 mg/kg IV), after a 7-day washout period. The parameters evaluated were heart rate, palpebral reflex, cloacal reflex, muscle relaxation, ease of handling, sensitivity to anterior and posterior pinch stimuli, and possibility of intubation. Additionally, respiratory rate was measured when possible, and the times from propofol administration to full recovery and from intubation to extubation were recorded. None of the turtles in G1 could be intubated, and this dose provided little relaxation and ease of handling, with a duration of effect until full recovery of 12.16 ± 8.32 (SD) min for this group. In G2, five out of the six turtles could be intubated, and the duration of effect was 32.33 ± 5.85 (SD) min. Heart rates were influenced by manipulation for catheter placement. There were statistically significant differences (p value ≤ 0.05) between the two groups in muscle relaxation degree, handling, cloacal reflex, and possibility of intubation. The 5 mg/kg propofol dose was not sufficient to induce anesthesia, even when administered in the jugular vein, in red-eared sliders. A dose of 10 mg/kg IV or higher should be used. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and intensity of grasp reflexes and to examine changes in these reflexes after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: We enrolled 147 patients with probable iNPH. A standard procedure was used to determine the presence of grasp reflexes, and the intensity of these reflexes was assessed using a four-category classification. Clinical rating scales and their correlation with grasp reflexes were also evaluated. Grasp reflexes were reassessed in 72 patients 1 year after surgery. Results: We found that approximately 50.3% of patients with iNPH exhibited a positive grasp reflex. Among these patients, 69% exhibited bilateral positivity, while the remaining patients showed unilateral positivity. Furthermore, the intensity of the grasp reflex was significantly correlated with the severity of gait and with cognitive, urinary, motor, and behavioural symptoms. Surgical interventions led to a reduction (41.7%) or maintenance (30.6%) of the reflex intensity in 72.3% of iNPH patients. The changes in reflex intensity showed significant positive correlations with changes in the number of steps of the Timed Up and Go test and Trail Making Test-A scores but not with changes in total scores on the iNPH Grading Scale. Conclusion: This retrospective study identified grasp reflexes as a highly prevalent phenomenon in patients with iNPH. These reflexes can assist in evaluating the severity of various symptoms, including cognitive, gait, urinary, motor and emotional symptoms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Per- and polyfluoroalkyl Substances (PFAS) are synthetic chemicals widely detected in humans and the environment. Exposure to perfluorooctanesulfonic acid (PFOS) or perfluorohexanesulfonic acid (PFHxS) was previously shown to cause dark-phase hyperactivity in larval zebrafish. OBJECTIVES: The objective of this study was to elucidate the mechanism by which PFOS or PFHxS exposure caused hyperactivity in larval zebrafish. METHODS: Swimming behavior was assessed in 5-d postfertilization (dpf) larvae following developmental (1-4 dpf) or acute (5 dpf) exposure to 0.43-7.86μM PFOS, 7.87-120μ M PFHxS, or 0.4% dimethyl sulfoxide (DMSO). After developmental exposure and chemical washout at 4 dpf, behavior was also assessed at 5-8 dpf. RNA sequencing was used to identify differences in global gene expression to perform transcriptomic benchmark concentration-response (BMCT) modeling, and predict upstream regulators in PFOS- or PFHxS-exposed larvae. CRISPR/Cas9-based gene editing was used to knockdown peroxisome proliferator-activated receptors (ppars) pparaa/ab, pparda/db, or pparg at day 0. Knockdown crispants were exposed to 7.86μM PFOS or 0.4% DMSO from 1-4 dpf and behavior was assessed at 5 dpf. Coexposure with the ppard antagonist GSK3787 and PFOS was also performed RESULTS: Transient dark-phase hyperactivity occurred following developmental or acute exposure to PFOS or PFHxS, relative to the DMSO control. In contrast, visual startle response (VSR) hyperactivity only occurred following developmental exposure and was irreversible up to 8 dpf. Similar global transcriptomic profiles, BMCT estimates, and enriched functions were observed in PFOS- and PFHxS-exposed larvae, and ppars were identified as putative upstream regulators. Knockdown of pparda/db, but not pparaa/ab or pparg, blunted PFOS-dependent VSR hyperactivity to control levels. This finding was confirmed via antagonism of ppard in PFOS-exposed larvae. DISCUSSION: This work identifies a novel adverse outcome pathway for VSR hyperactivity in larval zebrafish. We demonstrate that developmental, but not acute, exposure to PFOS triggered persistent VSR hyperactivity that required ppard function. [ABSTRACT FROM AUTHOR]

This paper describes content questions in Sm'algyax (or Coast Tsimshian, Maritime Tsimshianic) based on novel fieldwork. I outline the complex morphosyntactic reflexes of movement, or "extraction," including wh -movement, relativization, and focus. Despite behaving rigidly ergative in terms of number and person agreement, Sm'algyax exhibits a three-way distinction when extracting core arguments of the predicate: the extraction of an intransitive subject, a transitive subject, and a direct object are all marked uniquely. Extraction therefore reveals an underlying structural distinction between intransitive subjects and transitive objects that is not otherwise apparent in their in situ positions. We observe similar phenomena in the extraction of oblique arguments: a number of extraction configurations mark different types of adjunct and non-core argument extraction that are often marked identically in situ. Moving beyond local movement, I show that long-distance movement is possible and exhibits the same morphosyntactic marking found in local movement in each intermediate clause. [ABSTRACT FROM AUTHOR]

Importance: Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. Objective: To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. Design: Observational cohort longitudinal design using blinded video analysis. Participants: Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. Results: Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = −2.29, p <.05, r =.31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. Conclusions and Relevance: Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD. Infants who were later diagnosed with autism spectrum disorder (ASD) were found to have differences in early play behaviors compared to infants who were not later diagnosed with ASD. [ABSTRACT FROM AUTHOR]

Animal locomotion is the result of complex and multi-layered interactions between the nervous system, the musculo-skeletal system and the environment. Decoding the underlying mechanisms requires an integrative approach. Comparative experimental biology has allowed researchers to study the underlying components and some of their interactions across diverse animals. These studies have shown that locomotor neural circuits are distributed in the spinal cord, the midbrain and higher brain regions in vertebrates. The spinal cord plays a key role in locomotor control because it contains central pattern generators (CPGs) - systems of coupled neuronal oscillators that provide coordinated rhythmic control of muscle activation that can be viewed as feedforward controllers - and multiple reflex loops that provide feedback mechanisms. These circuits are activated and modulated by descending pathways from the brain. The relative contributions of CPGs, feedback loops and descending modulation, and how these vary between species and locomotor conditions, remain poorly understood. Robots and neuromechanical simulations can complement experimental approaches by testing specific hypotheses and performing what-if scenarios. This Review will give an overview of key knowledge gained from comparative vertebrate experiments, and insights obtained from neuromechanical simulations and robotic approaches. We suggest that the roles of CPGs, feedback loops and descending modulation vary among animals depending on body size, intrinsic mechanical stability, time required to reach locomotor maturity and speed effects. We also hypothesize that distal joints rely more on feedback control compared with proximal joints. Finally, we highlight important opportunities to address fundamental biological questions through continued collaboration between experimentalists and engineers.

BACKGROUND: The dysfunction of bladder function caused by spinal cord injury is a difficult point in clinical treatment and a hot spot in research. Repairing the injured spinal cord and remodeling the bladder micturition reflex pathway are the fundamental treatment methods. OBJECTIVE: To summarize the reconstruction of the bladder innervation pathway after spinal cord transection injury and its related influencing factors. METHODS: The relevant literature concerning the reconstruction of bladder micturition reflex, neurogenic bladder and urinary reflex and spinal cord repair was retrieved on CNKI, WanFang Data, PubMed and Web of Science. Chinese and English search terms were “neurogenic bladder; spinal cord injury; micturition reflex; spinal cord repair”. RESULTS AND CONCLUSION: In the process of reconstructing the bladder micturition reflex, there are many factors involved, including the repair and reconstruction of the injured spinal cord, the remodeling of micturition center, the changes of bladder tissue and substances and hormones in and out of the body. In this process, there are mainly the following problems: (1) As a complex process, there are many sites involved in the reconstruction of the micturition reflex, so the main sites of action can be selected for in-depth study, so as to break through the doubts existing in the reconstruction of the micturition reflex pathway. (2) The mechanism of the normal micturition reflex is complex. After spinal cord transection injury, whether the central nucleus mass controlling or participating in the micturition reflex is compensated and the corresponding compensatory mechanism needs to be further investigated. (3) Information communication between the center and the bladder is interrupted after spinal cord transection injury. Whether there is a direct information connection between the center and the bladder remains to be further investigated. (4) The relationship between reconstructing micturition reflex and body fluid after spinal cord transection injury needs further study. In the reconstruction of the bladder micturition reflex, the key treatment is to promote spinal cord repair, nerve reflex reconstruction, substance metabolism and bladder tissue structure adjustment through intervention. Chinese medicine and Western medicine have their methods. [ABSTRACT FROM AUTHOR]

Background: Late-life depression (LLD) is a prevalent neuropsychiatric disorder in the older population. While LLD exhibits high mortality rates, depressive symptoms in older adults are often masked by physical health conditions. In younger adults, depression is associated with deficits in pupil light reflex and eye blink rate, suggesting the potential use of these responses as biomarkers for LLD. Methods: We conducted a study using video-based eye-tracking to investigate pupil and blink responses in LLD patients (n = 25), older (OLD) healthy controls (n = 29), and younger (YOUNG) healthy controls (n = 25). The aim was to determine whether there were alterations in pupil and blink responses in LLD compared to both OLD and YOUNG groups. Results: LLD patients displayed significantly higher blink rates and dampened pupil constriction responses compared to OLD and YOUNG controls. While tonic pupil size in YOUNG differed from that of OLD, LLD patients did not exhibit a significant difference compared to OLD and YOUNG controls. GDS-15 scores in older adults correlated with light and darkness reflex response variability and blink rates. PHQ-15 scores showed a correlation with blink rates, while MoCA scores correlated with tonic pupil sizes. Conclusions: The findings demonstrate that LLD patients display altered pupil and blink behavior compared to OLD and YOUNG controls. These altered responses correlated differently with the severity of depressive, somatic, and cognitive symptoms, indicating their potential as objective biomarkers for LLD. [ABSTRACT FROM AUTHOR]

The hypoxic chemoreflex and the arterial baroreflex are implicated in the ventilatory response to exercise. It is well known that long-term exercise training increases parasympathetic and decreases sympathetic tone, both processes influenced by the arterial baroreflex and hypoxic chemoreflex function. Hypobaric hypoxia (i.e., high altitude [HA]) markedly reduces exercise capacity associated with autonomic reflexes. Indeed, a reduced exercise capacity has been found, paralleled by a baroreflex-related parasympathetic withdrawal and a pronounced chemoreflex potentiation. Additionally, it is well known that the baroreflex and chemoreflex interact, and during activation by hypoxia, the chemoreflex is predominant over the baroreflex. Thus, the baroreflex function impairment may likely facilitate the exercise deterioration through the reduction of parasympathetic tone following acute HA exposure, secondary to the chemoreflex activation. Therefore, the main goal of this review is to describe the main physiological mechanisms controlling baro- and chemoreflex function and their role in exercise capacity during HA exposure. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the efficacy of the potassium-titanyl-phosphate (KTP) laser and cold steel surgery in treating oropharyngeal papilloma. Methods: Between 2017 and 2020, we enrolled 242 patients with oropharyngeal papilloma who were treated with either the KTP laser (n = 160) or cold steel surgery (n = 82). Patient charts were reviewed for demographic data (age and gender), pathology, anatomical location of lesions, operative duration, pain rating, residual disease, and recurrence. Results: The oropharyngeal papillomas were successfully removed in all patients, except one with a significant pharyngeal reflex. There was no significant difference in the average time for lesion resection between KTP laser and cold steel group (18.11 ± 13.96 s vs 19.43 ± 16.91 s, P >.05). However, all patients who underwent cold steel surgery experienced bleeding during the operation and required postoperative observation (about 20 min), making the total procedure time longer than that of the KTP laser procedure, which did not cause any intraoperative bleeding or require postoperative observation. After KTP laser treatment, the pain rating was.49 ±.98, whereas after cold steel surgery, it was.74 ± 1.12 (P =.058). Twenty-five samples were sent for human papillomavirus (HPV) testing, and one tested positive for both HPV 6 and 11 strains, while another tested positive for HPV 16. No residual disease or recurrence was observed at the treatment sites after a long period of follow-up (M = 15.35 ± 10.79 mo; range = 6-39 mo). Conclusion: The KTP laser provided a better hemostasis effect and a good surgical field of vision during the operation, allowing the surgeon to complete the procedure in less time. No significant difference in terms of pain rating, incision recovery, and postoperative recurrence between the KTP laser treatment and cold steel surgery. [ABSTRACT FROM AUTHOR]

The authors present the life and art of Giuseppe Dagnini, a renowned Italian physician who was born in Bologna in 1866. He was the chief of the Maggiore Hospital in Bologna and authored valuable scientific works on the trigemino-cardiac reflex which is still applied in modern clinical practice. Dr. Dagnini firstly described the reflex in 1908 postulating that stimulation of one of the 3 branches of the trigeminal nerve triggers the afferent pathway in lowering heart rate. The authors also provide a modern outlook on the clinical implications of the TCR in neurosurgery, neuroanesthesia, and other medical specialties. [ABSTRACT FROM AUTHOR]

This paper brings evidence from Campidanese Sardinian and other languages to support and refine the author's earlier proposal that Proto-Austronesian *j was a palatal nasal whose modern reflexes arose through an episode of palatal glide fortition. It clarifies the evolution of *j in Formosan, responds to some criticisms, and details the circumstances leading to the loss of the nasal component after glide fortition. It concludes that where an alveolar or palatal nasal is in correspondence with [g], [ɟ], or [d], the default historical interpretation is of the nasal. [ABSTRACT FROM AUTHOR]

In many Oceanic languages, middle and reciprocal meanings are expressed by reflexes of Proto-Oceanic *paRi-, a polysemous and polyfunctional prefix with collective, associative, iterative, and reciprocal functions. Traditionally, reflexive constructions in Oceanic languages were marked differently from middles and reciprocals. Where reflexes of Proto-Oceanic *paRi- show a lower productivity or disappeared, Oceanic languages co-opted available morphemes and constructions to express the functions once performed by the prefix. In terms of polysemes, along with the middle/reciprocal one, which is rooted in the history of these constructions, two paths of extension developed over time: (i) from middle/reciprocal to reflexive (with reflexes of Proto-Oceanic *paRi-), and (ii) from reflexive to reciprocal, but different from middle (with innovated markers). The aim of this paper is twofold: (i) to provide a description of middles, reflexives, and reciprocals in Nalögo, a Reefs–Santa Cruz Oceanic language, and (ii) to contribute to the discussion on the typology and diachrony of such constructions within the Oceanic family. In particular, I show that Nalögo has two innovated markers, the reflexive =lëbu (maybe from Proto-Oceanic *[ta]bulo(s) 'turn round, turn back') and the reciprocal - welo. Furthermore, Nalögo displays a so-far unknown path of semantic extension within the Oceanic family: from reflexive to middle. While the reflexive–middle polysemy is widely attested in the languages of the world, it constitutes a typological rarity in Oceanic languages. [ABSTRACT FROM AUTHOR]

In this paper I will analyze the set of markers that have been associated with exclamative sentence-type and exclamations in Romance, like Catalan ma, mira, que , and si , Italian guarda and che , or Spanish mira, que, si , and vaya. The hypothesis I will defend is that the meaning encoded by each of these markers contribute to create an exclamation speech act. I will show that we must first distinguish mirative markers like ma, mira or guarda , which encode the surprise attitude of the speaker towards a proposition. A second class of elements are degree operators, like si , which create the necessary domain extension on which the attitude of the speaker is built. Finally, I will show that que / che is a marker of exclamative sentence-type. In the second part of the article I will show that these pragmatic differences have a transparent reflex in syntax: mirative markers occupy the Judge Phrase position in Krifka's Speech Act Layer, above ForceP and vocatives, so they may combine with different sentence-types, besides exclamatives. In ForceP we find degree operators (and exclamative wh -phrases) in its specifier, and the sentence-type marker que / che in its head. All in all, the paper aims at showing that a compositional approach to exclamativity can deal with the rich set of pragmatic and syntactic properties of exclamative markers in Romance. • Exclamativity and mirativity are two distinct pragmatic categories, with specialized markers. • Mirative markers are typically found with exclamative sentences, but they may appear with other sentence-types as well. • The set of pragmatic and syntactic properties of exclamative particles in Romance can be explained compositionally. • Data from exclamative markers support a rich syntax-pragmatics interface along the lines of the Cartographic Program. [ABSTRACT FROM AUTHOR]

• Latencies of cR1 have low intra-class variability. • Delayed cR1 onset and high cR1 activation thresholds are indicative of ELAR dysfunction. • Unsustained cR1, desynchronized cR1, and absence of cR2 signal an abnormal ELAR behavior. The laryngeal adductor reflex (LAR) is vital for airway protection and can be electrophysiologically obtained under intravenous general anesthesia (IGA). This makes the electrophysiologic LAR (eLAR) an important tool for monitoring of the vagus nerves and relevant brainstem circuitry during high-risk surgeries. We investigated the intra-class variability of normal and expected abnormal eLAR. Repeated measures of contralateral R1 (cR1) were performed under IGA in 58 patients. Data on presence/absence of cR2 and potential confounders were also collected. Review of neuroimaging, pathology and clinical exam, allowed classification into normal and expected abnormal eLAR groups. Using univariate and multivariate analysis we studied the variability of cR1 parameters and their differences between the two groups. In both groups, cR1 latencies had coefficients of variation of <2%. In the abnormal group, cR1 had longer latencies, required higher activation currents and was more frequently desynchronized and unsustained; cR2 was more frequently absent. cR1 latencies show high analytical precision for measurements. Delayed onset, difficult to elicit, desynchronized and unsustained cR1, and absence of cR2 signal an abnormal eLAR. Understanding the variability and behavior of normal and abnormal eLAR under IGA can aid in the interpretation of its changes during monitoring. [ABSTRACT FROM AUTHOR]

The cerebellum plays a critical role in the modulation of vestibular reflexes, dependent on input from proprioceptive afferents. The mechanism of this cerebellar control is not well understood. In a sample of 11 healthy human subjects, we investigated the effects of head orientation on ocular, cervical, postural and cerebellar short latency potentials evoked by impulsive stimuli applied at both mastoids and midline skull sites. Subjects were instructed to lean backwards with the head positioned straight ahead or held rotated in different degrees of yaw towards the right and left sides. Impulsive mastoid stimulation, a potent method of utricular stimulation, produced localised vestibular cerebellar evoked potentials (VsCEPs: P12-N17) which were strongly modulated by head orientation. The response was larger on the side opposite to the direction of head rotation and with stimulation on the side of rotation. In contrast, ocular VEMPs (oVEMPs: n10-p16) were present but showed little change with head posture, while cervical VEMPs (cVEMPs: p15-n23) were larger with the head held rotated away from the side of the recording. Postural effects with lateral vestibular stimulation were strongly modulated by head rotation, with more powerful effects occurring bilaterally with stimulation on the side of rotation. The duration of the postural EMG changes was similar to the post-excitation inhibition of the electrocerebellogram (ECeG), consistent with cerebellar participation. We conclude that head rotation selectively affects evoked vestibular reflexes towards different targets, consistent with their physiological roles. Changes in VsCEPs may contribute to the modulation of postural reflexes by the cerebellum. [ABSTRACT FROM AUTHOR]

In mammals, the ventral respiratory column (VRC) plays a pivotal role in integrating neurochemically diverse inputs from brainstem and forebrain regions to generate respiratory motor patterns. VRC microinjection of the neuropeptide galanin has been reported to dampen carbon dioxide (CO2)-mediated chemoreflex responses. Additionally, we previously demonstrated that galaninergic neurons in the retrotrapezoid nucleus (RTN) are implicated in the adaptive response to hypercapnic stimuli, suggesting a link between RTN neuroplasticity and increased neuronal drive to the VRC. VRC neurons express galanin receptor 1, suggesting potential regulatory action by galanin, however, the precise galaninergic chemoreceptor-VRC circuitry remains to be determined. This study aimed to identify sources of galaninergic input to the VRC that contribute to central respiratory chemoreception. We employed a combination of retrograde neuronal tracing, in situ hybridisation and immunohistochemistry to investigate VRC-projecting neurons that synthesise galanin mRNA. In an additional series of experiments, we used acute hypercapnia exposure (10% CO2, 1 h) and c-Fos immunohistochemistry to ascertain which galaninergic nuclei projecting to the VRC are activated. Our findings reveal that a total of 30 brain nuclei and 51 subnuclei project to the VRC, with 12 of these containing galaninergic neurons, including the RTN. Among these galaninergic populations, only a subset of the RTN neurons (approximately 55%) exhibited activation in response to acute hypercapnia. Our findings highlight that the RTN is the likely source of galaninergic transmission to the VRC in response to hypercapnic stimuli. [ABSTRACT FROM AUTHOR]

During quadrupedal locomotion, interactions between spinal and supraspinal circuits and somatosensory feedback coordinate forelimb and hindlimb movements. How this is achieved is not clear. To determine whether forelimb movements modulate hindlimb cutaneous reflexes involved in responding to an external perturbation, we stimulated the superficial peroneal nerve in six intact cats during quadrupedal locomotion and during hindlimb-only locomotion (with forelimbs standing on stationary platform) and in two cats with a low spinal transection (T12–T13) during hindlimb-only locomotion. We compared cutaneous reflexes evoked in six ipsilateral and four contralateral hindlimb muscles. Results showed similar occurrence and phase-dependent modulation of short-latency inhibitory and excitatory responses during quadrupedal and hindlimb-only locomotion in intact cats. However, the depth of modulation was reduced in the ipsilateral semitendinosus during hindlimb-only locomotion. Additionally, longer-latency responses occurred less frequently in extensor muscles bilaterally during hindlimb-only locomotion, whereas short-latency inhibitory and longer-latency excitatory responses occurred more frequently in the ipsilateral and contralateral sartorius anterior, respectively. After spinal transection, short-latency inhibitory and excitatory responses were similar to both intact conditions, whereas mid- or longer-latency excitatory responses were reduced or abolished. Our results in intact cats and the comparison with spinal-transected cats suggest that the absence of forelimb movements suppresses inputs from supraspinal structures and/or cervical cord that normally contribute to longer-latency reflex responses in hindlimb extensor muscles. NEW & NOTEWORTHY: During quadrupedal locomotion, the coordination of forelimb and hindlimb movements involves central circuits and somatosensory feedback. To demonstrate how forelimb movement affects hindlimb cutaneous reflexes during locomotion, we stimulated the superficial peroneal nerve in intact cats during quadrupedal and hindlimb-only locomotion as well as in spinal-transected cats during hindlimb-only locomotion. We show that forelimb movement influences the modulation of hindlimb cutaneous reflexes, particularly the occurrence of long-latency reflex responses. [ABSTRACT FROM AUTHOR]