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Abstract: The neurophysiological influence of alcohol produces deficits of many cognitive functions, including executive and motor control processes. This study examined the acute effects of alcohol in the context of goal-directed visuomotor performance during functional magnetic resonance imaging (fMRI). Subjects consumed alcohol-laced gelatin during one scan session and non-alcoholic placebo gelatin in another. During each session, subjects performed a visuomotor target capture where they received continuous or terminal positional feedback information. Blood–oxygen level-dependent (BOLD) activity in the cerebellum was suppressed in the presence of alcohol, consistent with the known ethanol sensitivity of the cerebellum. A fronto-parietal network was identified as most affected by alcohol consumption, with differential patterns of BOLD contingent on visual feedback. Results indicate that alcohol selectively suppresses cognitive activity in frontal and posterior parietal brain regions that, in conjunction with cerebellar nuclei, are believed to contribute to the formation of internal cognitive models of motor representation and action. [Copyright &y& Elsevier]

[Display omitted] • Fabrication of ultrathin heterostructures of Al 2 O 3 /TiO 2 by atomic layer deposition. • Blue shift in optical bandgap indicates presence of quantizing effect. • Designing new materials with tunable refractive index and bandgap combinations. Atomically thin heterostructures and superlattices are promising candidates for various optoelectronic and photonic applications. Different combinations of Al 2 O 3 /TiO 2 composites are obtained by plasma enhanced atomic layer deposition (PEALD). Their growth, composition, dispersion relation, and optical bandgap are systematically studied by means of UV/VIS spectrophotometry, spectroscopic ellipsometry (SE), x-ray reflectometry (XRR), scanning transmission electron microscopy (STEM) and x-ray photoelectron spectroscopy (XPS). Besides, an effective medium approximation (EMA) approach is applied to model the heterostructures theoretically. The refractive index and the indirect bandgap of the heterostructures depend on the ratio of the two oxides, while the bandgap is very sensitive to the thicknesses of the barrier and quantum well layers. A large blue shift of the absorption edge from 400 nm to 320 nm is obtained by changing the TiO 2 (quantum well) thickness from ~2 nm to ~0.1 nm separated by ~2 nm of Al 2 O 3 (barrier) layers. PEALD unfolds the possibility of achieving optical quantizing effects within complex heterostructures enabling control of their structures down to atomic scale. It enables a path towards atomic scale processing of new 'artificial' materials with desired refractive indices and bandgap combinations by precise control of their compositions. [ABSTRACT FROM AUTHOR]

Objective: Flow diverting stents (FDS) are increasingly used for the treatment of intracranial aneurysms. While FDS can provide flow diversion of parent vessels, their high metal surface coverage can cause thromboembolism. Transcranial Doppler (TCD) emboli monitoring can be used to identify subclinical embolic phenomena after neurovascular procedures. Limited data exists regarding the use of TCDs for emboli monitoring in the periprocedural period after FDS placement. We evaluated the rate of positive TCDs microembolic signals and stroke after FDS deployment at our institution., Methods: We retrospectively evaluated 105 patients who underwent FDS treatment between 2012 and 2016 using the Pipeline stent (Medtronic, Minneapolis, MN, USA). Patients were pretreated with aspirin and clopidogrel. All patients were therapeutic on clopidogrel pre-operatively. TCD emboli monitoring was performed immediately after the procedure. Microembolic signals (mES) were classified as "positive" (<15 mES/hour) and "strongly positive" (>15 mES/hour). Clinical stroke rates were determined at 2-week and 6-month post-operatively., Results: A total of 132 intracranial aneurysms were treated in 105 patients. TCD emboli monitoring was "positive" in 11.4% (n=12) post-operatively and "strongly positive" in 4.8% (n=5). These positive cases were treated with heparin drips or modification of the antiplatelet regimen, and TCDs were repeated. Following medical management modifications, normalization of mES was achieved in 92% of cases. The overall stroke rates at 2-week and 6-months were 3.8% and 4.8%, respectively., Conclusions: TCD emboli monitoring may help early in the identification of thromboembolic events after flow diversion stenting. This allows for modification of medical therapy and, potentially, preventionf of escalation into post-operative strokes.

Heterostructures increasingly attracted attention over the past several years to enable various optoelectronic and photonic applications. In this work, atomically thin interfaces of Ir/Al 2 O 3 heterostructures compatible with micro-optoelectronic technologies are reported. Their structural and optical properties were determined by spectroscopic and microscopic techniques (XRR, XPS, HRTEM, spectroscopic ellipsometry, and UV/vis/NIR spectrophotometry). The XRR and HRTEM analyses reveal a layer-by-layer growth mechanism of Ir in atomic scale heterostructures, which is different from the typical island-type growth of metals on dielectrics. Alongside, XPS investigations imply the formation of Ir-O-Al bonding at the interfaces for lower Ir concentrations, in contrast to the nanoparticle core-shell structure formation. Precisely tuning the ratio of the constituents ensures the control of the dispersion profile along with a transition from effective dielectric to metallic heterostructures. The Ir coating thickness was varied ranging from a few angstroms to films of about 7 nm in the heterostructures. The transition has been observed in the structures containing individual Ir coating thicknesses of about 2-4 nm. Following this, we show epsilon-near-zero metamaterials with tunable dielectric constants by precisely varying the composition of such heterostructures. Overall, a comprehensive study on structural and optical properties of the metal-dielectric interfaces of Ir/Al 2 O 3 heterostructures was addressed, indicating an extension of the material portfolio available for novel optical functionalities.

Ibrutinib is a potent Bruton tyrosine kinase inhibitor and is an effective and well-tolerated treatment for a variety of lymphoid diseases. However, its use is associated with an increased incidence of atrial fibrillation ranging from 4% to 16%. New onset atrial fibrillation in cancer patients is associated with a significantly higher risk of heart failure and thromboembolism, even after adjusting for known risk factors. Ibrutinib also inhibits platelet activation and decisions regarding anticoagulation must be carefully weighed against this increased risk of bleeding. It is well-known that the anti-arrhythmic and antithrombotic strategy for atrial fibrillation related to ibrutinib has its own characteristics. Physicians should be familiar with the special management considerations imposed by this drug. Indeed, the co-prescription of therapy in combination with ibrutinib must be carefully weighed in view of its numerous drug interactions. We review the potential mechanisms and incidence of ibrutinib-associated atrial fibrillation., Competing Interests: Déclaration de lien d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Tuning ion energies in plasma-enhanced atomic layer deposition (PEALD) processes enables fine control over the material properties of functional coatings. The growth, structural, mechanical, and optical properties of HfO 2 thin films are presented in detail toward photonic applications. The influence of the film thickness and bias value on the properties of HfO 2 thin films deposited at 100 °C using tetrakis(dimethylamino)hafnium (TDMAH) and oxygen plasma using substrate biasing is systematically analyzed. The HfO 2 films deposited without a substrate bias show an amorphous microstructure with a low density, low refractive index, high incorporation of residual hydroxyl (OH) content, and high residual tensile stress. The material properties of HfO 2 films significantly improved at a low bias voltage due to the interaction with oxygen ions accelerated to the film. Such HfO 2 films have a higher density, higher refractive index, and lower residual OH incorporation than films without bias. The mechanical stress becomes compressive depending on the bias values. Further increasing the ion energies by applying a larger substrate bias results in a decrease of the film density, refractive index, and a higher residual OH incorporation as well as crystalline inclusions. The comparable material properties of the HfO 2 films have been reported using tris(dimethylamino)cyclopentadienyl hafnium (TDMACpH) in a different apparatus, indicating that this approach can be transferred to various systems and is highly versatile. Finally, the substrate biasing technique has been introduced to deposit stress-compensated, crack- and delamination-free high-reflective (HR) mirrors at 355 and 532 nm wavelengths using HfO 2 and SiO 2 as high and low refractive index materials, respectively. Such mirrors could not be obtained without the substrate biasing during the deposition because of the high tensile stress of HfO 2 , leading to cracks in thick multilayer systems. An HR mirror for 532 nm wavelength shows a high reflectance of 99.93%, a residual transmittance of ∼530 ppm, and a low absorption of ∼11 ppm, as well as low scattering losses of ∼4 ppm, high laser-induced damage threshold, low mechanical stress, and high environmental stability.

The fabrication of highly reflective aluminum coatings is still an important part of current research due to their high intrinsic reflectivity in a broad spectral range. By using thin seed layers of Cu, CuO x , Cr, CrO x , Au, and Ag, the morphology of sputtered (unprotected) aluminum layers and, consequently, their reflectance can be influenced. In this long-term study, the reflectance behavior was measured continuously using spectrophotometry. Particular seed layer materials enhance the reflectance of aluminum coatings significantly and reduce their long-term degradation. Combining such seed layers with evaporation processes and suitable protective layers could further increase the reflectance of aluminum coatings.

The wafer-level integration of high aspect ratio silicon nanostructures is an essential part of the fabrication of nanodevices. Metal-assisted chemical etching (MACE) is a promising low-cost and high-volume technique for the generation of vertically aligned silicon nanowires. Noble metal nanoparticles were used to locally etch the silicon substrate. This work demonstrates a bottom-up self-assembly approach for noble metal nanoparticle formation and the subsequent silicon wet etching. The macroscopic wafer patterning has been done by using a poly(methyl methacrylate) masking layer. Different metals (Au, Pt, Pd, Cu, and Ir) were investigated to derive a set of technologies as platform for specific applications. Especially, the shape of the 3D structures and the resulting reflectance have been investigated. The Si nanostructures fabricated using Au nanoparticles show a perfect light absorption with a reflectance below 0.3%. The demonstrated technology can be integrated into common fabrication processes for microelectromechanical systems., (Copyright © 2020, Franz et al.; licensee Beilstein-Institut.)

Objective: Posterior circulation strokes account for over one quarter of all ischemic strokes. The frequency of vertebral artery origin stenosis (VAOS) in patients with vertebrobasilar insufficiency (VBI) has been estimated to be as high 26%-32%, and VAOS is the direct cause of posterior circulation strokes in 9% of patients. This association could have a significant genetic component. This study examines the feasibility of the internal thoracic artery (ITA) as a donor vessel for revascularization in patients with VAOS., Methods: Ten sides from 5 fresh-frozen white cadaveric necks derived from 3 women and 2 men were used in this study. The mean age of the cadavers at death was 77.2 years (range, 68-88 years). The subclavian artery, vertebral artery, and ITA were dissected. The length and diameter (proximal and distal) of the V1 segment and the length and diameter of the ITA were recorded. Finally, the ITA was transposed to the V1 segment of the vertebral artery (VA1)., Results: The mean length of the VA1 and its diameter at the proximal and distal parts were 35.51 and 3.69 mm, respectively. The mean length and diameter of the ITA were 26.53 and 3.27 mm, respectively. Rerouting the ITA to the VA1 was feasible without tension on all sides., Conclusions: This study indicates that the ITA is anatomically and hemodynamically an excellent option for bypass surgery in a VAOS scenario. We present convincing and reproducible data to aid neurosurgeons in choosing the procedure best suited to their patients., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: The authors report the diagnosis, management, and outcomes of 6 cases of spindle cell oncocytoma (SCO) in an effort to guide clinical diagnosis and management of these uncommon lesions., Methods: This study is a retrospective review of cases involving adult patients who underwent resection of pituitary lesions at the authors' institutions between January 2000 and October 2017. The authors identified patients with histopathological confirmation of SCO and collected clinical data, including preoperative, perioperative, and postoperative management, complications, and outcomes., Results: Six patients with SCO were identified. Clinical findings at initial presentation included visual disturbances, dizziness, and headache. All patients underwent resection. Four resections were initially performed by the transsphenoidal approach, and 2 resections were performed by craniotomy at an outside institution with subsequent transsphenoidal reoperations. Neither necrosis nor increased mitotic activity was seen in the tumor samples. All samples stained positive for S100 protein and thyroid transcription factor 1 and negative for glial fibrillary acidic protein and pituitary hormones. Five of the samples stained positive for epithelial membrane antigen. The average MIB-1 index was 8.3% (range 2-17). Postoperatively, 3 of the 6 patients received further treatment for progression of residual tumor or for recurrence, 2 have stable residual tumor, and 1 has had no recurrence after gross-total resection. Two patients developed postoperative complications of transient sixth cranial nerve palsy and diplopia. There were no other complications., Conclusions: SCO poses both a diagnostic and therapeutic challenge. These tumors are often initially misdiagnosed as nonfunctional pituitary adenomas because of their sellar location and nonspecific symptomatology. Postoperatively, SCO must also be distinguished from other neoplasms of the posterior pituitary gland through histopathological examination. Resection of SCO can be challenging, given its highly vascular and adherent nature. Long-term follow-up is critical, as the tumor is associated with higher recurrence and progression rates compared to other benign neoplasms of the sella.

Nonlinear optical Stokes ellipsometric (NOSE) microscopy was demonstrated for the analysis of collagen-rich biological tissues. NOSE is based on polarization-dependent second harmonic generation imaging. NOSE was used to access the molecular-level distribution of collagen fibril orientation relative to the local fiber axis at every position within the field of view. Fibril tilt-angle distribution was investigated by combining the NOSE measurements with ab initio calculations of the predicted molecular nonlinear optical response of a single collagen triple helix. The results were compared with results obtained previously by scanning electron microscopy, nuclear magnetic resonance imaging, and electron tomography. These results were enabled by first measuring the laboratory-frame Jones nonlinear susceptibility tensor, then extending to the local-frame tensor through pixel-by-pixel corrections based on local orientation., (Copyright © 2016. Published by Elsevier Inc.)

Fast beam-scanning non-linear optical microscopy, coupled with fast (8 MHz) polarization modulation and analytical modeling have enabled simultaneous nonlinear optical Stokes ellipsometry (NOSE) and linear Stokes ellipsometry imaging at video rate (15 Hz). NOSE enables recovery of the complex-valued Jones tensor that describes the polarization-dependent observables, in contrast to polarimetry, in which the polarization stated of the exciting beam is recorded. Each data acquisition consists of 30 images (10 for each detector, with three detectors operating in parallel), each of which corresponds to polarization-dependent results. Processing of this image set by linear fitting contracts down each set of 10 images to a set of 5 parameters for each detector in second harmonic generation (SHG) and three parameters for the transmittance of the fundamental laser beam. Using these parameters, it is possible to recover the Jones tensor elements of the sample at video rate. Video rate imaging is enabled by performing synchronous digitization (SD), in which a PCIe digital oscilloscope card is synchronized to the laser (the laser is the master clock.) Fast polarization modulation was achieved by modulating an electro-optic modulator synchronously with the laser and digitizer, with a simple sine-wave at 1/10th the period of the laser, producing a repeating pattern of 10 polarization states. This approach was validated using Z-cut quartz, and NOSE microscopy was performed for micro-crystals of naproxen.

Military explorations of the practical role of simulators have served as a driving force for much of the virtual reality technology that we have today. The evolution of 3-dimensional and virtual environments from the early flight simulators used during World War II to the sophisticated training simulators in the modern military followed a path that virtual surgical and neurosurgical devices have already begun to parallel. By understanding the evolution of military simulators as well as comparing and contrasting that evolution with current and future surgical simulators, it may be possible to expedite the development of appropriate devices and establish their validity as effective training tools. As such, this article presents a historical perspective examining the progression of neurosurgical simulators, the establishment of effective and appropriate curricula for using them, and the contributions that the military has made during the ongoing maturation of this exciting treatment and training modality., (Copyright © 2012. Published by Elsevier Inc.)

Motor skills emerge from learning feedforward commands as well as improvements in feedback control. These two components of learning were investigated in a compensatory visuomotor tracking task on a trial-by-trial basis. Between-trial learning was characterized with a state-space model to provide smoothed estimates of feedforward and feedback learning, separable from random fluctuations in motor performance and error. The resultant parameters were correlated with brain activity using magnetic resonance imaging. Learning related to the generation of a feedforward command correlated with activity in dorsal premotor cortex, inferior parietal lobule, supplementary motor area and cingulate motor area, supporting a role of these areas in retrieving and executing a predictive motor command. Modulation of feedback control was associated with activity in bilateral posterior superior parietal lobule as well as right ventral premotor cortex. Performance error correlated with activity in a widespread cortical and subcortical network including bilateral parietal, premotor and rostral anterior cingulate cortex as well as the cerebellar cortex. Finally, trial-by-trial changes of kinematics, as measured by mean absolute hand acceleration, correlated with activity in motor cortex and anterior cerebellum. The results demonstrate that incremental, learning-dependent changes can be modeled on a trial-by-trial basis and neural substrates for feedforward control of novel motor programs are localized to secondary motor areas.

Objective: This study was designed to determine the effects of twice daily tooth brushing with the Sonicare Elite (Elite) and the Oral-B P40 manual toothbrush (MTB) on plaque accumulation and plaque-induced gingival inflammation., Methods: One-hundred and eighty (180) subjects, with moderate gingival inflammation and a Silness and Löe Plaque Index (PI) of > or = 0.8 after refraining from oral hygiene for three to six hours, were randomly assigned to receive the Elite or MTB in this single-blinded, controlled clinical trial. At baseline and after two and four weeks of using the product at home twice daily for two minutes, efficacy was assessed with the PI and the Löe and Silness Gingival Index (GI) after brushing three to six hours prior to assessment The primary efficacy variable was reduction of baseline plaque scores over the four weeks for Elite compared to MTB. Secondary outcomes included a change in GI and number of bleeding sites. Safety was appraised using adverse event reports and soft tissue examinations., Results: One-hundred and sixty-eight subjects (81 Elite, 87 MTB) completed the study. The four-week study period resulted in significant reductions of PI and GI from baseline at weeks two and four for both brushes. Reduction in mean PI from baseline to week four for Elite was 0.84 (95% CI: 0.80, 0.88), and 0.72 (0.68, 0.76) for MTB, p < 0.0001. Reduction in mean GI from baseline to four weeks for Elite was 0.56 (0.53, 0.59), and 0.47 (0.45, 0.50) for MTB, p = 0.0001. Both treatment groups demonstrated a significant reduction in number of bleeding sites relative to baseline (p < 0.0001); however, a significant difference in percent reduction in favor of Elite relative to MTB was found at week four: 82.5% vs. 75.8% (p = 0.026). Both toothbrushes were safe on oral tissues., Conclusion: Elite was significantly more effective than MTB in the reduction of plaque after two and four weeks of product use, and significantly more effective in the reduction of gingivitis and bleeding sites than MTB after four weeks.

When individuals acquire new skills, initial performance is typically better and tasks are judged to be easier when the tasks are segregated and practiced by block, compared to when different tasks are randomly intermixed in practice. However, subsequent skill retention is better for a randomly practiced group, an effect known as contextual interference (CI). The present study examined the neural substrates of CI using functional magnetic resonance imaging (fMRI). Individuals learned a set of three 4-element sequences with the left hand according to a block or random practice schedule. Behavioral retest for skill retention confirmed the presence of a typical CI effect with the random group outperforming the block group. Using a go/no-go fMRI paradigm, sequence preparation during the premovement study period was separated from movement execution. Imaging data for the two groups were compared for the first 1/3 and final 1/3 of training trials. Toward the end of training, behavioral performance between the two groups was similar, although the random group would later display a performance advantage on retention testing. During study time, the random group showed greater activity in sensorimotor and premotor regions compared to the block group. These areas are associated with motor preparation, sequencing, and response selection. This pattern of recruitment is consistent with the hypothesis that CI benefits in a sequencing task are due to improved capacity to actively prepare motor responses.