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Background and purpose: Primitive reflexes may reoccur in various neurodegenerative diseases. However, little is known about their structural and functional correlates in the human brain. Notably, the neural mechanisms underlying a positive palmomental reflex (PMR) are poorly understood. As recent studies link Alzheimer's disease (AD)‐related primitive reflexes to a dysfunction of the corticostriatal motor circuit (CMC), we conducted the present study to investigate functional and structural correlates of a positive PMR. We hypothesized an involvement of frontostriatal structures and an impairment of the CMC. Methods: Using whole‐brain resting‐state functional connectivity (FC), hypothesis and FC result‐based probabilistic tractography, and voxel‐based morphometry analyses, we compared two groups of AD patients with either positive (n = 12) or negative PMR (n = 12). Results: No significant differences in grey matter volume or structural connectivity (SC) could be observed between the PMR‐positive and PMR‐negative groups. In contrast, the PMR‐positive group showed a decreased seed‐to‐voxel FC between the bilateral supplementary motor area and parts of the right‐hemispherical caudate nucleus and thalamus and a decreased region of interest (ROI)‐to‐ROI FC between the left putamen and the left superior frontal gyrus. Conclusion: Data suggest that dysfunction of the CMC reflected by decreased FC underlies a positive PMR in patients with AD. The lack of significant grey matter or SC differences might reflect that changes in FC appear before changes in SC in the structures of the CMC and brain atrophy. [ABSTRACT FROM AUTHOR]

What is known and objective Drug-related problems ( DRPs) occur frequently in hospitalized patients. Patient discharge from the intensive care unit ( ICU) to a non- ICU ward is one of the most challenging and high-risk transitions of care due to the number of medications, and the complexity and acuity of the medical conditions that characterize this patient group. Pharmacists could play an important role in preventing DRPs. This study was undertaken to evaluate the impact on the number and severity of drug-related problems by assigning a clinical pharmacist to the transfer process from ICU to wards. Methods The study was a randomized controlled multicentre trial conducted at the Hospital Network of Antwerp between December 2010 and January 2012. The clinical pharmacist performed a medical review in both the intervention and control group. Recommendations for drug therapy changes were immediately communicated in the intervention group but were kept blinded in the control group. The primary outcome was expressed as the number of implemented recommendations for drug therapy changes. Differences between groups were calculated using mixed effects binary logistic regression. Results Drug-related problems were found in the medical records of 360 of the 600 participants (60%). A total of 743 recommendations could be made, 375 in the intervention group and 368 in the control group. 54·1% of these problems were adjusted on time in the intervention group vs. 12·8% in the control group. Of 743 recommendations, 24·8% were judged by the expert group as major, 13·1% as moderate, 53.4% as minor and 8·9% as having no clinical impact. The odds of implementing recommendations of drug therapy changes in the intervention group were 10 times the odds of implementing recommendations of drug therapy changes in the control group (odds ratio = 10·1; 95% CI [6·3-16·1]; P < 0·001), even after accounting for differences in types of DRP between the groups (odds ratio = 15·6; 95% CI [9·4-25·9]; P < 0·001). What is new and conclusion The integration of a clinical pharmacist at the transfer point from ICU to ward led to a significant reduction in DRPs. [ABSTRACT FROM AUTHOR]

Diabrotica virgifera virgifera Le Conte or western corn rootworm (WCR) is a major pest of cultivated maize, Zea mays L., introduced into Europe in 1992. Since then, the beetle spread through Central Europe, leading to a continuous pest population in 11 European countries. This article presents an economic assessment of different damage abatement strategies against this invasive species in the Hungarian maize sector. A bio-economic model, using Monte Carlo sampling, estimates the potential damage from WCR under no control and the value created by Bt maize, seed treatment, soil insecticides and cultural control. At the same time, potential market shares for the different damage abatement options under perfect information are deducted. The potential damages under a no control scenario are estimated at €176/ha for grain maize farmers on average, which points out the need for well-designed damage abatement strategies. For land-constrained farmers cultural control is a valuable damage abatement strategy, being the optimal choice in 69% of the cases. In monoculture Bt maize is the best option as it creates the highest value in 78% of the cases. However, as Bt maize active against WCR is not deregulated in the European Union, soil insecticides in 54% of the cases and seed treatment in 46% of the cases are the rational choices. As the value created by Bt maize is positive, not deregulating Bt maize in Hungary leads to benefits foregone ranging from €16/ha for land-constrained grain farmers to €49/ha in the case of silage maize under monoculture. Finally, the results of the sensitivity analysis can be used to develop a multi-criteria tool to aid farmers in applying the appropriate damage abatement strategy. This could decrease the dependency of farmers on scouting techniques and economic thresholds of WCR presence. [ABSTRACT FROM AUTHOR]