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Motor Pathway Analysis in HAM/TSP Using Magnetic Stimulation and F-waves
- Ronald E. Young, Owen C. Morgan, Allan Forster
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 25 / Issue 1 / February 1998
- Published online by Cambridge University Press:
- 18 September 2015, pp. 48-54
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Background:
Tropical Spastic Paraparesis/HTLV-I Associated Myelopathy (HAM/TSP) is a chronic, progressive myelopathy endemic to the Caribbean. In HAM/TSP, peripheral motor pathways have been assessed using electromyography and nerve conduction studies; central motor pathways have been assessed to a limited extent using electrocortical stimulation. We used magnetic cortical stimulation (a painless alternative to electrocortical stimulation) and F-wave analysis to study conduction in the central and peripheral motor pathways in 18 HTLV-I seropositive, Jamaican TSP patients (ages 29- 70 years; duration of symptoms 3-20 years) and 22 normal controls.
Methods:Magnetic cortical stimulation was effected using a 9 cm diameter undamped MES10 coil. F-waves and M-responses were elicited by electrical stimulation of the ulnar nerve at the wrist, and deep peroneal stimulation at the knee. Stimulation and recording of response latencies in abductor digitii minimi (ADM) and tibialis anterior (TA) were carried out using a Cadwell Excel system.
Results:With cortical stimulation, response latencies (TMCTs) to ADM and TA were prolonged in the patients relative to controls. F-wave and M-response latencies were unaffected, suggesting no peripheral pathology. Latency (CMCT) between cortex and lumbar cord was significantly prolonged; that between cortex and C7/T1, also, but less markedly (P < 0.0005). Amplitudes of cortically evoked responses were significantly reduced only in the lower limbs (TA). CMCT increased as the disease progressed from mild to moderate, thereafter remaining largely unchanged.
Conclusions:Meta-analysis of interlaboratory control data revealed no significant differences in TMCTs between our controls and others studied using similar techniques. The observations are consistent with pathology affecting mainly the thoracolumbar cord in HAM/TSP.
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- By Tod C. Aeby, Melanie D. Altizer, Ronan A. Bakker, Meghann E. Batten, Anita K. Blanchard, Brian Bond, Megan A. Brady, Saweda A. Bright, Ellen L. Brock, Amy Brown, Ashley Carroll, Jori S. Carter, Frances Casey, Weldon Chafe, David Chelmow, Jessica M. Ciaburri, Stephen A. Cohen, Adrianne M. Colton, PonJola Coney, Jennifer A. Cross, Julie Zemaitis DeCesare, Layson L. Denney, Megan L. Evans, Nicole S. Fanning, Tanaz R. Ferzandi, Katie P. Friday, Nancy D. Gaba, Rajiv B. Gala, Andrew Galffy, Adrienne L. Gentry, Edward J. Gill, Philippe Girerd, Meredith Gray, Amy Hempel, Audra Jolyn Hill, Chris J. Hong, Kathryn A. Houston, Patricia S. Huguelet, Warner K. Huh, Jordan Hylton, Christine R. Isaacs, Alison F. Jacoby, Isaiah M. Johnson, Nicole W. Karjane, Emily E. Landers, Susan M. Lanni, Eduardo Lara-Torre, Lee A. Learman, Nikola Alexander Letham, Rachel K. Love, Richard Scott Lucidi, Elisabeth McGaw, Kimberly Woods McMorrow, Christopher A. Manipula, Kirk J. Matthews, Michelle Meglin, Megan Metcalf, Sarah H. Milton, Gaby Moawad, Christopher Morosky, Lindsay H. Morrell, Elizabeth L. Munter, Erin L. Murata, Amanda B. Murchison, Nguyet A. Nguyen, Nan G. O’Connell, Tony Ogburn, K. Nathan Parthasarathy, Thomas C. Peng, Ashley Peterson, Sarah Peterson, John G. Pierce, Amber Price, Heidi J. Purcell, Ronald M. Ramus, Nicole Calloway Rankins, Fidelma B. Rigby, Amanda H. Ritter, Barbara L. Robinson, Danielle Roncari, Lisa Rubinsak, Jennifer Salcedo, Mary T. Sale, Peter F. Schnatz, John W. Seeds, Kathryn Shaia, Karen Shelton, Megan M. Shine, Haller J. Smith, Roger P. Smith, Nancy A. Sokkary, Reni A. Soon, Aparna Sridhar, Lilja Stefansson, Laurie S. Swaim, Chemen M. Tate, Hong-Thao Thieu, Meredith S. Thomas, L. Chesney Thompson, Tiffany Tonismae, Angela M. Tran, Breanna Walker, Alan G. Waxman, C. Nathan Webb, Valerie L. Williams, Sarah B. Wilson, Elizabeth M. Yoselevsky, Amy E. Young
- Edited by David Chelmow, Virginia Commonwealth University, Christine R. Isaacs, Virginia Commonwealth University, Ashley Carroll, Virginia Commonwealth University
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- Acute Care and Emergency Gynecology
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- 05 November 2014
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- 30 October 2014, pp ix-xiv
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- By Michael F. Azari, Michael S. Beattie, Michael J. Bell, David M. Benglis, Anat Biegon, Jacqueline C. Bresnahan, A. Ross Bullock, D. James Cooper, Frances Corrigan, Kallol K. Dey, W. Dalton Dietrich, Volker Dietz, Per Enblad, Michael G. Fehlings, Julio C. Furlan, John C. Gensel, Gerald A. Grant, Gopalakrishna Gururaj, Ronald L. Hayes, Lars T. Hillered, John Houle, Jimmy W. Huh, Pavla Jendelová, Theresa A. Jones, Patrick M. Kochanek, Thomas Kossmann, Dorothy A. Kozlowski, Laura Krisa, Andrew Maas, Lawrence F. Marshall, Ankit I. Mehta, David K. Menon, Cristina Morganti-Kossmann, Marion Murray, Virginia F.J. Newcombe, Alistair D. Nichol, Linda Papa, Steven Petratos, Jennie Ponsford, Phillip G. Popovich, Gourikumar K. Prusty, Ramesh Raghupathi, Ricky Rasschaert, Peter L. Reilly, Nataliya Romanyuk, Bob Roozenbeek, Jeffrey V. Rosenfeld, Kathryn E. Saatman, Bridgette D. Semple, Esther Shohami, Eva Syková, Charles H. Tator, Brett Trimble, Robert Vink, Kevin K.W. Wang, Jefferson R. Wilson, Wise Young, Jenna M. Ziebell
- Edited by Cristina Morganti-Kossmann, Ramesh Raghupathi, Andrew Maas
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- Book:
- Traumatic Brain and Spinal Cord Injury
- Published online:
- 05 August 2012
- Print publication:
- 19 July 2012, pp ix-xii
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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- By Phillip L. Ackerman, Neil Anderson, Jens B. Asendorpf, R. Michael Bagby, Michael Harris Bond, Gregory J. Boyle, Andrea L. Briggs, Giles St J. Burch, Turhan Canli, David Canter, Gianvittorio Caprara, Charles S. Carver, Douglas F. Cellar, Gordon Claridge, Susan Cloninger, Elisabeth D. Conradt, Philip J. Corr, Sharon Dawe, Ian J. Deary, Boele De Raad, Edward L. Deci, Colin G. DeYoung, M. Brent Donnellan, Juris G. Draguns, Marko Elovainio, Aurelio José Figueredo, David C. Funder, Paul Gladden, Rapson Gomez, Samuel D. Gosling, Jeremy R. Gray, Robert D. Hare, B. Austin Harley, Edward Helmes, Robert Hogan, Lauri A. Jensen-Campbell, Daniel Nelson Jones, Mika Kivimäki, Jennifer M. Knack, James T. Lamiell, Natalie J. Loxton, Geoff MacDonald, Gerald Matthews, Robert R. McCrae, Mario Mikulincer, Stephanie N. Mullins-Sweatt, Marcus R. Munafò, Vickie Nam, Craig S. Newmann, Rainer Reisenzein, Madeline Rex-Lear, Richard W. Robins, Michael D. Robinson, Mary K. Rothbart, Richard M. Ryan, Gerard Saucier, Michael F. Scheier, Constantine Sedikides, Phillip R. Shaver, Brad E. Sheese, Yuichi Shoda, Ronald E. Smith, Alice F. Stuhlmacher, Rhonda Swickert, Avril Thorne, David D. Vachon, Geneva Vásquez, Michele Vecchione, Seth A. Wagerman, Fiona Warren, Hannelore Weber, Thomas A. Widiger, Pedro Sofio Abril Wolf, Donna Youngs, Moshe Zeidner
- Edited by Philip J. Corr, University of East Anglia, Gerald Matthews, University of Cincinnati
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- The Cambridge Handbook of Personality Psychology
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- 05 June 2012
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- 16 July 2009, pp xv-xvii
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- By Nicholas B. Allen, Joan Rosenbaum Asarnow, Jeanne Brooks-Gunn, Ronald E. Dahl, Joanne Davila, Laura M. DeRose, Lea R. Dougherty, Nancy Eisenberg, Erika E. Forbes, Wyndol Furman, Paul Gilbert, Julia A. Graber, Danielle M. Hessler, Erin C. Hunter, Chris Irons, Lynn Fainsilber Katz, Amanda Kesek, Daniel N. Klein, Annette M. La Greca, Rebecca S. Laptook, Reed W. Larson, Primrose Letcher, Peter M. Lewinsohn, Marc D. Lewis, Christine McDunn, James W. McKowen, Christopher S. Monk, Amanda Sheffield Morris, Thomas M. Olino, Tomáš Paus, Daniel S. Pine, Ann V. Sanson, John R. Seeley, Lisa B. Sheeber, Rebecca Siegel, Jennifer S. Silk, Diana Smart, Martha C. Tompson, Julie Vaughan, Brennan J. Young, Philip David Zelazo
- Edited by Nicholas B. Allen, University of Melbourne, Lisa B. Sheeber
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- Adolescent Emotional Development and the Emergence of Depressive Disorders
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- 14 September 2009
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- 20 November 2008, pp ix-xiv
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The Metallicity Distribution Function of the Halo of the Milky Way
- Timothy C. Beers, Norbert Christlieb, John E. Norris, Michael S. Bessell, Ronald Wilhelm, Carlos Allende Prieto, Brian Yanny, Constance Rockosi, Heidi Jo Newberg, Silvia Rossi, Young Sun Lee
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- Proceedings of the International Astronomical Union / Volume 1 / Issue S228 / May 2005
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- 23 December 2005, pp. 175-183
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- May 2005
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We report on the distribution of metallicities, [Fe/H], for very metal-poor stars in the halo of the Galaxy. Although the primary information on the nature of the Metallicity Distribution Function (MDF) is obtained from the two major recent surveys for metal-poor stars, the HK survey of Beers and collaborators, and the Hamburg/ESO Survey of Christlieb and collaborators, we also discuss the MDF derived from the publicly available database of stellar spectra and photometry contained in the third data release of the Sloan Digital Sky Survey (SDSS DR-3). Even though the SDSS was not originally planned as a stellar survey, significant numbers of stars have been observed to date – DR-3 contains spectroscopy for over 70,000 stars, at least half of which are suitable for abundance determinations. There are as many very metal-poor ([Fe/H] $< -2.0$) stars in DR-3 as have been obtained from all previous survey efforts combined. We also discuss prospects for significant expansion of the list of metal-poor stars to be obtained from the recently funded extension of the SDSS, which includes the project SEGUE: Sloan Extension for Galactic Understanding and Evolution.
Triage, Transportation, and Destination Decisions by Out-of-Hospital Emergency Care Providers
- Anthony J. Billittier IV, E. Brooke Lerner, Ronald M. Moscati, Gregory Young
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- Prehospital and Disaster Medicine / Volume 13 / Issue 2-4 / December 1998
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- 28 June 2012, pp. 22-27
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- December 1998
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Introduction:
The effectiveness of a tiered emergency medical services system often hinges upon the ability of initial care providers with little or no formal training to identify emergent patient needs and determine the best means to meet those needs.
Objectives:To determine if out-of-hospital emergency care providers consistently make appropriate triage, transportation, and destination decisions; and to determine if experience and training have an effect on these decisions.
Methods:A survey consisting of 14 patient-care scenarios was administered to certified and non-certified out-of-hospital emergency-care providers (n = 311) from 20 randomly selected EMS agencies. These agencies were part of EMS systems that utilize one, two, and three tiered responses by ambulance and fire-based commercial, municipal, and volunteer agencies. Participants were asked to select the most appropriate mode of transport and destination facility using the assumption that they had responded to each scenario in a basic life support ambulance. Answers included transporting the patient to various receiving facilities or requesting a more advanced-level unit to respond to the scene. Transport times to receiving facilities and estimated times of arrival for advanced-level units were provided with each choice. Eight emergency physicians unanimously had agreed upon the most appropriate answer for each scenario. A two-tailed t-test was used to compare the scores of the certified and non-certified groups; and Spearman's Correlation Coefficients were used to test the effects of experience and training.
Results:Non-certified providers (n = 108) had a mean score of 32.6% or 4.6 (SD = 1.84) correct answers; certified providers (n = 203) had a mean score of 41.1% or 5.76 (SD = 2.12) correct answers (p < 0.000001). Spearman's Correlation Coefficients were: 1) individual provider level - (0.3978); 2) agency provider level - (0.2741); 3) hours workea per week - (0.2505); 4) years in EMS - (- 0.0821); 5) commercial or volunteer provider - (0.2398); 6) agency call volume - (0.2012); 7) agency location - (0.0685), and 8) transporting versus non-transporting agency - (0.2523).
Conclusion:A need exists for further education of out-of-hospital emergency care providers with respect to triage, transportation, and destination decisions. Provider experience and level of certification do not appear to affect these critical patient-care decisions.
The Need for a Global Health Disaster Network
- Ingrid M. Libman, Ronald E. LaPorte, Shunichi Akazawa, Eugene Boostrom, Caryle Glosser, Eric Marler, Ernesto Pretto, Francois Sauer, Anthony Villasenor, Frank Young, Genro Ochi
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- Journal:
- Prehospital and Disaster Medicine / Volume 12 / Issue 1 / March 1997
- Published online by Cambridge University Press:
- 28 June 2012, pp. 11-12
- Print publication:
- March 1997
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When a disaster occurs, a major difficulty is knowing where to find accurate information, and how to help coordinate efforts to share accurate information in a quick and organized manner. The establishment of a global information network, that is in place before a disaster occurs, could link all the communication efforts for relief. We propose that a Global Health Unit for Disaster and Relief Coordination be set up as part of the Global Health Network, utilizing the Internet as its backbone. This Unit would establish the links for the disaster information mosaic.