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Cerman J.,Neurologicka Klinika 2. LF UK a FN V Motole | Laczo J.,Neurologicka Klinika 2. LF UK a FN V Motole | Vyhnalek M.,Neurologicka Klinika 2. LF UK a FN V Motole | Vlcek K.,Oddeleni Neurofyziologie Pameti | And 3 more authors.
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2014

Impairment of multiple cognitive domains, including spatial navigation, leads to deterioration of self-sufficiency, a characteristic feature of patients with dementia. Spatial navigation is divided into three basic components that depend on different brain structures - navigation using a close orientation cue (cued), starting position of the body (egocentric) and distant orientation cue (allocentric). The aim of the study was to compare differences in impairment of these spatial navigation components in patients with the most common types of neurodegenerative dementias. In total, 78 patients with neurodegenerative dementias of various etiologies were divided into three groups: Alzheimer's disease (AD, n = 61), frontotemporal lobar degeneration (FTLD, n = 9) and dementia with Lewy bodies (DLB, n = 8). All subjects were examined in an experimental device called the Blue Velvet Arena that allows researchers to measure performance in each of the three navigation components. The results of the different tests were subsequently compared. In the cued navigation test, the FTLD group performed better than the AD (p = 0.03) and DLB (p = 0.006) groups. Furthermore, in the egocentric navigation test, the DLB group was outperformed by AD (p = 0.012) and FTLD (p = 0.012) groups. Finally, in the allocentric navigation test there were no differences among the groups (p = 0.069). Our results show that spatial navigation impairment may be least pronounced in FTLD patients and most pronounced in DLB patients. There are specific differences in spatial navigation impairment among patients with AD, FTLD and DLB that can be measured with the Blue Velvet Arena device.

Kuzilek J.,Czech Technical University | Kremen V.,Czech Technical University | Soucek F.,ICRC | Lhotska L.,Czech Technical University
PLoS ONE | Year: 2014

We have developed a method focusing on ECG signal de-noising using Independent component analysis (ICA). This approach combines JADE source separation and binary decision tree for identification and subsequent ECG noise removal. In order to to test the efficiency of this method comparison to standard filtering a wavelet- based de-noising method was used. Freely data available at Physionet medical data storage were evaluated. Evaluation criteria was root mean square error (RMSE) between original ECG and filtered data contaminated with artificial noise. Proposed algorithm achieved comparable result in terms of standard noises (power line interference, base line wander, EMG), but noticeably significantly better results were achieved when uncommon noise (electrode cable movement artefact) were compared. © 2014 Kuzilek et al.

Bartos R.,UJEP A Krajska Zdravotni A.s. | Malucelli A.,ICRC | Bartos P.,ICRC | Adamek D.,Krajska Zdravotni A.S | And 2 more authors.
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2015

In our short report, we show the relative nature of pyramidal tract representation using Diffusion Tensor Imaging in a patient with a precentral gyrus glioma and we discuss the factors that may affect tract reconstruction. We believe that, so far, inadequate attention has been paid in the published literature to the region of interest selection even though this is the key determinant of the imaging outcome.

News Article
Site: www.nature.com

As the world this week commemorates the armistice that ended the First World War in 1918, it is reprehensible that humanitarian rules forged in the suffering and bloodshed of battle are often being violated in contemporary conflicts. In the past month alone, two hospitals run by Médecins Sans Frontières (MSF; also known as Doctors Without Borders) were hit by air strikes. US warplanes destroyed one in Kunduz in Afghanistan — killing 13 MSF staff and 17 others — and another in Yemen was targeted, allegedly by Saudi-led coalition forces. These are not isolated incidents, but part of a string of violations of a fundamental part of international humanitarian law — that warring parties must consider the wounded and the medical staff who care for them as neutral, and protect them from harm. The public and the media must increase calls for political and diplomatic pressure to help to prevent such attacks. The scientific community, and in particular biomedical and clinical researchers and the professional bodies that represent them, must add their voices to this timely and important matter. The need for ground rules in conflicts has been recognized since antiquity, but today’s international humanitarian laws have their roots in the work of the nineteenth-century Swiss businessman, Henry Dunant. Horrified by the thousands of wounded left untreated and dying on the battlefield after the French and Sardinians crushed the Austrian army at Solferino in Italy in 1859, he proposed that states should allow, and protect, humanitarian volunteers to care for those who are wounded. In 1863, he helped to found what was to become the International Committee of the Red Cross (ICRC). Dunant’s efforts spurred 16 countries to agree the following year to the first internationally codified rules of war; the first Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field. As well as granting neutral status to medical staff, it obliged warring parties to care for wounded enemy prisoners. As the nature of warfare has changed, so the wording and scope of the Geneva Conventions have been regularly revised — for example in 1949 to better protect civilians. The principle of medical neutrality is more relevant today than ever, but it is under increasing threat. Syria, where conflict sparked in 2011, is by far the worst case. As of the end of September, 313 attacks on 227 medical facilities had been reported — 283 of them carried out by government forces, often using indiscriminate ‘barrel bombs’ dropped from helicopters. Over the same period, 679 medical staff have been killed, almost all by government forces, and scores of others have been arrested, imprisoned or tortured. The regime has also deployed chemical weapons. The health system has been all but destroyed in large parts of the country. During peaceful protests in Turkey in 2013 and 2014, the government used violence against clinics and medical staff, and health workers have been arrested and charged with assisting criminals simply for having treated wounded protestors. Similarly, during protests against the government in Bahrain in 2013, doctors and nurses were fired from civil-service posts, then arrested and jailed for the same motive as those in Turkey. Dozens of workers dispensing polio vaccinations have been assassinated in Pakistan and Nigeria. The ICRC has identified almost 2,000 incidents of violence against patients, health workers and medical facilities in 23 countries in 2012 and 2013 alone. These are estimates, but comprehensive monitoring of violations and data are both lacking. However, Susannah Sirkin, director of inter­national policy and partnerships for Physicians for Human Rights, based in New York City, points out that “we can safely say that the bombing of hospitals and deliberate killing of hundreds of medics, especially in Syria, is something more extreme and extensive than we have ever seen”. Among the explanations is a lack of awareness of the Geneva Conventions by protagonists — in what are increasingly not wars between nations, but smaller civil and sectarian wars, often involving non-state actors — but also a poor grasp by the media and public. People may have “become inured to the extraordinary level of targeting of civilians in many conflicts in the past few decades and simply shrug at the inclusion of medical facilities as regular targets”, adds Sirkin. What is worrying, she says, is that the overt targeting of humanitarian and health workers has become the “new normal”, despite it being illegal under international law — and having the effect of depriving entire populations of health care, and children of vital vaccinations. But above all, abuses happen because there is little accountability, with perpetrators operating with almost total impunity, despite their actions often clearly amounting to war crimes — or indeed crimes against humanity. The Geneva Conventions lack a body with teeth to ensure that the rules are respected, or to stop abuses when they are under way. They also lack mechanisms to investigate and prosecute abuses. Accountability has also suffered because many of those affected are voiceless. MSF, by contrast, has both political clout and moral authority, and, for example, is robustly and rightly pressing for an independent international fact-finding commission under the Geneva Conventions into the attacks on its facilities. Momentum to stop the attacks, led by campaigns from humanitarian groups, is building within civil society. Meanwhile, Ban Ki-moon, the secretary-general of the United Nations, and Peter Maurer, the president of the ICRC, last week issued a joint warning about the unprecedented level of violations of international humanitarian law in ongoing conflicts. As well as the armistice, this month marks 100 years since the decision to evacuate troops from the ill-fated 1915 Gallipoli campaign, in which medical staff working under atrocious battlefield conditions suffered extensive casualties. The world has been shocked into action to protect health workers before. It must be again.

Kadlecova A.,Kognitivni Centrum | Laczo J.,Kognitivni Centrum | Vyhnalek M.,Kognitivni Centrum | Sheardova K.,I. Neurologicka Klinika | And 4 more authors.
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2013

Objective: Neuropsychiatric disorders are frequent in mild cognitive impairment (MCI) as indicated by cross-sectional studies. Depression is the most frequent disorder in MCI patients and its presence increases the risk of conversion into Alzheimer's disease. Two systems are responsible for neuropsychiatric disorders: the limbic system and fronto-subcortical connections. The structures involved in these systems are also responsible for emotion processing. Aim: The aim of the study was to establish whether MCI patients have a deficit in emotion recognition and whether they have more severe depression than a control group and to assess the relationship between severity of depression and the ability to recognize emotions from facial expression. Patients and methods: The study included 34 MCI patients and 23 controls. All subjects underwent routine neuropsychological testing (focused on memory, attention and speed of processing, executive, visuospatial and language functions). Emotional agnosia was examined by Facial Emotion Recognition Test and depression was assessed by geriatric depression scale. Results: MCI group performed worse than controls on recognition of facial emotions (p < 0.05), and this group was also significantly more depressive than controls (p < 0.05). No significant correlation was found between severity of depression and total emotion recognition (r = 0.15, p = 0.28). Severity of depression correlated with inability to recognize happiness (p < 0.05, r = -0.32). Conclusion: The ability to recognize emotions from facial expression is impaired in MCI patients and severity of depression contributes to inability of MCI patients to recognize happiness.

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