Patients’ Perceptions of Memory Functioning Before and After Surgical Intervention to Treat Medically Refractory Epilepsy.

Purpose:One risk associated with epilepsy surgery is memory loss, but perhaps more important is how patients perceive changes in their memories. This longitudinal study evaluated changes in memory self-reports and investigated how self-reports relate to changes on objective memory measures in temporal or extratemporal epilepsy patients who underwent surgery. Methods: Objective memory (Wechsler Memory Scale–Revised) and subjective memory self-reports (Memory Assessment Clinics Self-Rating Scale) were individually assessed for 136 patients ∼6 months before and 6 months after surgery. A measure of depressive affect (Beck Depression Inventory–2nd Edition) was used to control variance attributable to emotional distress. Results: Despite a lack of significant correlational relationships between objective and subjective memory for the entire sample, significant correlations between objective memory scores and self-reports did emerge for a subset of patients who evidenced memory decline. Differences also were found in the subjective memory ratings of temporal lobe versus extratemporal patients. Temporal lobe patients rated their memories more negatively than did extratemporal patients and were more likely to report significant improvements in their memory after surgery. Conclusions: In general, patients were not accurate when rating their memories compared to other adults. However, patients with significant declines in their memories were sensitive to actual changes in their memories over time relative to their own personal baselines

Geodetic Surveying for Rockfall Analyses

The evaluation of rockfall starts with a review of the relevant terminology in this field of study and continues with theoretical bases of collapse, reasons for their occurrence and mechanics of rockfalling. Modeling of rockfalling presents a special practical problem, so shortly described of mathematical modelling are presented and used for analysis of rockfalls. Technical measures for protection against falling rocks are described - mostly rockfall catch fences and their performance. The central part of the thesis is an overview of various measuring methods that are being used for the analysis of rockfalling. Important entering data for calculation of simulation of rockfalling is the longitudinal characteristic profiles of the ground, which are implemented in selected scale. We specially described the basic characteristics of measurement methods, namely measurement with compass and clinometer, classical terrestrial geodetic measurements, GNSS measurements and terrestrial laser scanning. We shortly introduced contactless acquisition of information with the help of helicopter or airplane and with use of XI

Attenuating the Paka River into Velenje Lake

V diplomskem delu je bila raziskana ideja zadrževanja Pake v Velenjskem jezeru pri visokovodnem valu s povratno dobo 100 let, saj bi v primeru takega dogodka Šoštanj ponovno trpel hudo gmotno škodo. Velenjsko jezero, ki se napaja iz hudourniških vodotokov gričevja Sopote in Lepene je eno večjih v Sloveniji, zato je bila v naši hipotezi pričakovana zadostna retenzijska sposobnost jezera. V primeru zadrževanja Pake v jezeru bi morali zadržati tudi Sopoto in Lepeno. Predpostavljeno je bilo, da se visokovodna valova Sopote in Lepene pojavita prej, zato bi čimvečji del teh valov odvedli še pred prihodom vala Pake. Za preverbo predpostavke sta bila v programu HEC-HMS 4.1 za povodji Sopote in Lepene, glede na ugotovljene podatke časovnega poteka stoletnih dnevnih padavin, topologije, pedologije ter rabe tal, izračunana hidrograma enote, ki sta podala podatke o času pojava konic pretoka, maksimalnem pretoku in volumnu. Hidrogram Pake je bil ob znanem stoletnem pretoku določen z analizo podatkov nihanja gladine ob večjih padavinskih dogodkih v zadnjih dveh letih in pol, odkar so vzpostavili samodejno merjenje na vodomerni postaji Velenje. Hidravlične razmere razbremenjevanja Pake v Velenjsko jezero v takšni meri, ki bi omogočila da se skozi Šoštanj spusti le tak pretok, ki bi ga bila struga zmožna prevajati, so bile izračunane v Excelu in nazorno predstavljene s pomočjo izrisanih grafikonov. Ugotovljeno je bilo, da se določeno količino visokega vala hudournikov lahko odvede še pred prihodom visokega vala Pake ter da je retenzijska zmožnost jezera dovoljšna za obravnavan ukrep. Možnost umestitve ukrepa v prostor je bila prikazana še z izdelavo idejne zasnove razbremenilnega objekta. Na koncu so se določile tudi smernice v morebitnih prihodnjih fazah študije.This diploma thesis explores the idea of impounding water from the Paka River in Lake Velenje in the event of a flood wave with a 100-year return period. If such an event were to take place, Šoštanj would once again be subject to substantial material damage. Lake Velenje, which feeds from torrential waters of the Sopota and Lepene hills, is one of the biggest lakes in Slovenia, so it was expected to have substantial capacity for water retention. If the Paka River were impounded in the lake, the Sopota and Lepena waters would have to be impounded as well. It was assumed that the flood waves from Sopota and Lepena would appear prior to the one from Paka, therefore some water from these waves would be drained before the arrival of the Paka wave. To test this assumption, the program HEC-HMS 4.1 was used to create hydrographs for Sopota and Lepena, which show information about peak flow times, maximum flow, and volume. The hydrographs were calculated using data about the timing of maximum daily precipitation with a 100-year return period that was researched and established within the thesis, as well as data on topology, pedology and soil use. The hydrograph for the Paka River was calculated through analysis of changes in water level during major precipitation events over the past two and a half years since automatic data collection was established at the Velenje gauging station. The hydraulic conditions for attenuating the Paka River into Velenje Lake at a scale that would only send as much water through Šoštanj as the existing stream banks can handle were calculated in Excel and visually presented using plotted graphs. It is established that a certain amount of the flood waves from torrential waters can be drained before the arrival of the flood wave from the Paka River and that, in this case, the retentive capacity of the lake is sufficient for the proposed measure. The possibility of implementing the proposed measure is further demonstrated by creating a conceptual design of the mitigating facility. Finally, guidelines are established for possible further phases of the study

Evaluation of the Effect of Systolic Blood Pressure and Pulse Pressure on Cognitive Function: The Women's Health and Aging Study II

Evidence suggests that elevated systolic blood pressure (SBP) and pulse pressure (PP) in midlife is associated with increased risk for cognitive impairment later in life. There is mixed evidence regarding the effects of late life elevated SBP or PP on cognitive function, and limited information on the role of female gender.Effects of SBPand PPon cognitive abilities at baseline and over a 9-year period were evaluated in 337 non-demented community-dwelling female participants over age 70 in the Women's Health and Aging Study II using logistic and Cox proportional hazards regression analyses. Participants aged 76-80 years with SBP≥160 mmHg or PP≥84 mmHg showed increased incidence of impairment on Trail Making Test-Part B (TMT, Part B), a measure of executive function, over time when compared to the control group that included participants with normal and pre-hypertensive SBP (<120 and 120-139 mmHg) or participants with low PP (<68 mmHg) (HR = 5.05 [95%CI = 1.42, 18.04], [HR = 5.12 [95%CI = 1.11; 23.62], respectively). Participants aged 70-75 years with PP≥71 mmHg had at least a two-fold higher incidence of impairment on HVLT-I, a measure of verbal learning, over time when compared to participants with low PP (<68 mmHg) (HR = 2.44 [95%CI = 1.11, 5.39]).Our data suggest that elevated SBP or PP in older non-demented women increases risk for late-life cognitive impairment and that PP could be used when assessing the risk for impairment in cognitive abilities. These results warrant further, larger studies to evaluate possible effects of elevated blood pressure in normal cognitive aging

Characterizing a neurodegenerative syndrome: primary progressive apraxia of speech

Apraxia of speech is a disorder of speech motor planning and/or programming that is distinguishable from aphasia and dysarthria. It most commonly results from vascular insults but can occur in degenerative diseases where it has typically been subsumed under aphasia, or it occurs in the context of more widespread neurodegeneration. The aim of this study was to determine whether apraxia of speech can present as an isolated sign of neurodegenerative disease. Between July 2010 and July 2011, 37 subjects with a neurodegenerative speech and language disorder were prospectively recruited and underwent detailed speech and language, neurological, neuropsychological and neuroimaging testing. The neuroimaging battery included 3.0 tesla volumetric head magnetic resonance imaging, [18F]-fluorodeoxyglucose and [11C] Pittsburg compound B positron emission tomography scanning. Twelve subjects were identified as having apraxia of speech without any signs of aphasia based on a comprehensive battery of language tests; hence, none met criteria for primary progressive aphasia. These subjects with primary progressive apraxia of speech included eight females and four males, with a mean age of onset of 73 years (range: 49–82). There were no specific additional shared patterns of neurological or neuropsychological impairment in the subjects with primary progressive apraxia of speech, but there was individual variability. Some subjects, for example, had mild features of behavioural change, executive dysfunction, limb apraxia or Parkinsonism. Voxel-based morphometry of grey matter revealed focal atrophy of superior lateral premotor cortex and supplementary motor area. Voxel-based morphometry of white matter showed volume loss in these same regions but with extension of loss involving the inferior premotor cortex and body of the corpus callosum. These same areas of white matter loss were observed with diffusion tensor imaging analysis, which also demonstrated reduced fractional anisotropy and increased mean diffusivity of the superior longitudinal fasciculus, particularly the premotor components. Statistical parametric mapping of the [18F]-fluorodeoxyglucose positron emission tomography scans revealed focal hypometabolism of superior lateral premotor cortex and supplementary motor area, although there was some variability across subjects noted with CortexID analysis. [11C]-Pittsburg compound B positron emission tomography binding was increased in only one of the 12 subjects, although it was unclear whether the increase was actually related to the primary progressive apraxia of speech. A syndrome characterized by progressive pure apraxia of speech clearly exists, with a neuroanatomic correlate of superior lateral premotor and supplementary motor atrophy, making this syndrome distinct from primary progressive aphasia

Chilean version of the INECO Frontal Screening (IFS-Ch) : psychometric properties and diagnostic accuracy

Objective: This study sought to analyze the psychometric properties and diagnostic accuracy of the Chilean version of the INECO Frontal Screening (IFS-Ch) in a sample of dementia patients and control. Methods: After adapting the instrument to the Chilean context and obtaining content validity evidence through expert consultation, the IFS-Ch was administered to 31 dementia patients and 30 control subjects together with other executive assessments (Frontal Assessment Battery [FAB], Modified version of the Wisconsin Card Sorting Test [MCST], phonemic verbal fluencies [letters A and P] and semantic verbal fluency [animals]) and global cognitive efficiency tests (Mini mental State Examination [MMSE] and Addenbrooke's Cognitive Examination-Revised [ACE-R]). Caregivers of dementia patients and proxies of control subjects were interviewed with instruments measuring dysexecutive symptoms (Dysexecutive Questionnaire [DEX]), dementia severity (Clinical Dementia Rating Scale [CDR]) and functional status in activities of daily living (Activities of Daily Living Scale [IADL] and Technology-Activities of Daily Living Questionnaire [T-ADLQ]). Convergent and discriminant validity, internal consistency reliability, cut-off points, sensitivity and specificity for the IFS-Ch were estimated. Results: Evidence of content validity was obtained. Evidence of convergent validity was also found showing significant correlations (p<0.05) between the IFS-Ch and the other instruments measuring: executive functions (FAB, r=0.935; categories achieved in the MCST, r=0.791; perseverative errors in the MCST, r= -0.617; animal verbal fluency, r=0.728; A verbal fluency, r=0.681; and P verbal fluency, r=0.783), dysexecutive symptoms in daily living (DEX, r= -0.494), dementia severity (CDR, r= -0.75) and functional status in activities of daily living (T-ADLQ, r= -0.745; IADL, r=0.717). Regarding reliability, a Cronbach's alpha coefficient of 0.905 was obtained. For diagnostic accuracy, a cut-off point of 18 points (sensitivity=0.903; specificity=0.867) and an area under curve of 0.951 were estimated to distinguish between patients with dementia and control subjects. Discussion: The IFS-Ch showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the measurement of executive functions in patients with dementia. The diagnostic accuracy of the IFS-Ch for detecting dementia patients was also considered acceptable